RFP 13201 Packet.pdf

REQUEST FOR PROPOSALS (RFP) 13201

DEPARTMENT OF BEHAVIORAL HEALTH SERVICES

MEDI-CAL BILLING CONSULTANT SERVICES

July 8, 2026

A. KEY INFORMATION

1. The County of San Diego is seeking proposals from firms interested in providing Medi-Cal Billing Consultant Services

(“Offerors”).

2. The contract term is anticipated to be an initial (base) period of one (1) year with four (4) one-year options. Anticipated contract maximum amount for the five (5) year contract is $4,250,000 to $5,000,000.

3. The County has posted this solicitation on its official BuyNet website at https://sdbuynet.sandiegocounty.gov/. In order to see all information related to this RFP, to submit Questions, and to receive notifications of updates, Offerors must select “Participate in RFx” for this solicitation in BuyNet.

4. The Contracting Officer for this solicitation is Tiana Row, Procurement Contracting Officer, tiana.row@sdcounty.ca.gov.

5. Schedule: This timeline is subject to change at any time, at the County’s sole discretion. The County will issue an addendum for changes to the Pre-Proposal Conference date, Questions due date, or Proposal due date.

Event Description Date and Time (San Diego Time) Pre-Proposal Conference July 14, 2026, at 10:00 a.m.

Questions due July 22, 2026, prior to 5:00 p.m.

Proposals due August 19, 2026, prior to 3:00 p.m.

6. Pre-Proposal Conference. The County will hold a pre-proposal conference by Video/Teleconference using the Microsoft Teams platform on the Date and Time listed in the Schedule. To participate, join the virtual conference at https://events.gcc.teams.microsoft.com/event/16e1b96a-21ce-4ae2-9222-43ca2464977d@4563af13-c029-41b3-b74c-965e8eec8f96. The County will provide an overview of the RFP process and may provide a program/technical overview and other information. Attendance at the pre-proposal conference is encouraged but not mandatory.

7. Questions:

7.1. Offerors should submit all Questions, including requests for clarification related to definition or interpretation of this RFP, in writing by the Date and Time specified in the Schedule. Questions should be submitted via BuyNet, by sending a message to the Contracting Officer through the “Discussions” functionality.

7.2. Non-Offerors should direct inquiries regarding this solicitation to the Contracting Officer.

8. Table of Contents:

A. Key Information B. RFP Instructions and Rules C. Evaluation Criteria D. Submittal Items E. Required Forms F. Statement of Work G. Payment Schedule H. Draft Agreement

MAGGIE RAMSBERGER

INTERIM DIRECTOR

DEPARTMENT OF PURCHASING AND CONTRACTING

5560 OVERLAND AVENUE, SUITE 270, SAN DIEGO, CALIFORNIA 92123-1204

Phone (858) 505-6367 Fax (858) 715-6452

BRENDA MILLER

ASSISTANT DIRECTOR

https://sdbuynet.sandiegocounty.gov/ mailto:tiana.row@sdcounty.ca.gov https://events.gcc.teams.microsoft.com/event/16e1b96a-21ce-4ae2-9222-43ca2464977d@4563af13-c029-41b3-b74c-965e8eec8f96 https://events.gcc.teams.microsoft.com/event/16e1b96a-21ce-4ae2-9222-43ca2464977d@4563af13-c029-41b3-b74c-965e8eec8f96

COUNTY OF SAN DIEGO – REQUEST FOR PROPOSALS (RFP 13201)

MEDI-CAL BILLING CONSULTANT SERVICES

B. RFP INSTRUCTIONS AND RULES

1. INSTRUCTIONS FOR SUBMITTING A PROPOSAL

1.1. It is the Offeror’s responsibility to submit a proposal based on the most current RFP, addenda thereto, responses to Questions, any other information posted on BuyNet, and any diligence material made available by the County. Offerors are advised to regularly check BuyNet for information. The County has no obligation to contact Offerors directly with any such RFP-related information.

1.1.1. In order to see all information related to this RFP, to submit Questions, and to receive notifications of updates, Offerors must select “Participate in RFx” for this solicitation in BuyNet.

1.2. Forms required to be submitted with Offerors response to this RFP are included in this RFP or posted on the County’s web site at https://www.sandiegocounty.gov/content/sdc/purchasing/purchasing-forms.html.

1.2.1. Posted forms may be updated from time to time. Unless otherwise specified, offerors may submit the version of a form in place as of the date of the posting of this RFP or any later version.

1.3. Offerors are advised to allow for sufficient time to obtain all necessary documents and forms, resolve any technical difficulties obtaining or completing documents or forms, and, if necessary, obtain documents and forms by an alternate method. If you are unable to download documents or forms, you may request a hard copy or technical assistance from Purchasing and Contracting’s front desk or contact clerical support at (858) 505-6367.

1.4. Offeror must submit a complete original proposal in accordance with the format provided in this solicitation to the County of San Diego, Department of Purchasing and Contracting, through electronic upload to BuyNet before the Date and Time listed in Schedule.

1.4.1. If Offeror is unable to submit via BuyNet for any reason, Offeror may submit by providing the Purchasing and Contracting front desk with either (i) electronic files on CD/DVD or, (ii) a printed proposal. Offeror must prominently mark such submissions with the RFP number on the outside of the packaging. Please use this method only if unable to submit through BuyNet.

1.4.2. When submitting via BuyNet, Offerors are advised to allow for sufficient time to submit by an alternate method in the event of technical difficulties.

1.4.3. For proposals submitted electronically through BuyNet, the time on the BuyNet server shall be considered the official time for the purpose of determining timely submittal.

1.4.4. For proposals submitted at the Purchasing and Contracting front desk, the time stamp at the front desk shall be considered the official time for the purpose of determining timely submittal.

1.4.5. In the event of multiple submittals of an original proposal by an Offeror, the County will only consider the most recent submittal submitted before the due date and time. The County will not review or consider previous submittals, whether submitted at the front desk or through BuyNet.

Offerors are strongly encouraged to submit only one original proposal and to withdraw or replace any previous submittals in the event they update their proposal. Proposals may be found non-conforming if the County is unable to determine which proposal is the most recent, timely submittal.

1.5. A proposal that is untimely or otherwise not submitted in conformance with 1.4 above will not be considered for award unless: it is received before award is made; the County determines that it is in its best interest to accept the proposal; and

1.5.1. It is determined by the County that the late receipt was due solely to mishandling by the County, or

1.5.2. No timely and conforming proposal was submitted.

1.6. Proposals may not be modified after the due date, except for modifications resulting from the Contracting Officer’s request for a revised proposal, Best and Final Offer (BAFO), or an addendum to the proposal.

https://www.sandiegocounty.gov/content/sdc/purchasing/purchasing-forms.html

1.7. Proposals may be withdrawn by written notice signed by a duly authorized representative of Offeror if received prior to Notice of Intent to Award. After Notice of Intent to Award, all proposals constitute firm offers, subject to negotiation, that will remain open and cannot be revoked, withdrawn, or modified for a period of six (6) months.

1.7.1. All proposals become the property of the County upon submission. An Offeror may request the return of its proposal upon withdrawal, which return the County may grant or deny in its sole discretion.

1.8. By submitting a proposal, Offeror agrees to these RFP Instructions and Rules and all other terms of this

RFP.

2. QUESTIONS

2.1. Offerors shall direct requests for explanation regarding the RFP or related documents to the Contracting

Officer in writing as a question (“Question”). Submit Questions by sending a message to the Contracting Officer through the “Discussions” functionality in BuyNet.

2.2. The County may choose not to respond to Questions received after the date and time stated Schedule.

Offeror is responsible for ensuring that Questions are received by the County.

3. PROPOSAL FORMAT

3.1. Submit electronic proposals as files in .pdf format, except where specified otherwise. For pages other than signature pages, converted and searchable formats are preferred.

3.2. Proposals shall be formatted to print on 8-1/2” x 11” page size, with no less than ½” margins and eleven

(11) point font and to be suitable for black and white reproduction with no loss of information.

3.3. All proposals shall be signed with a handwritten signature by an authorized officer or employee of the Offeror.

3.3.1. Electronic or digital signatures will not be accepted.

3.3.2. Pages requiring signatures must be scanned from an original handwritten signature. If Offerors are unable to submit a .pdf with scanned signatures, Offerors may optionally submit clear pictures of signature pages containing original handwritten signatures.

4. PROPOSAL ORGANIZATION

4.1. Your proposal must be organized in accordance with the Submittal Items in this RFP.

4.1.1. Content shall be organized to correspond to the applicable exhibit and question or item within each exhibit.

4.1.2. Offerors shall separate each exhibit into one or more files, clearly named as to the exhibit and order.

4.1.3. Pages shall be consecutively numbered within each exhibit at the bottom or top margin of each page.

4.1.4. Cost/Price information:

4.1.4.1. All cost and pricing information must be contained within Cost/Price exhibit and be inclusive of all proposed compensation. No price data is to be included in the Program/Technical or other exhibits.

4.2. Confidential/Proprietary information:

4.2.1. The County is a public agency subject to the California Public Records Act, Government Code § 7920.000, et seq. Some or all of the documents submitted in response to this RFP may be subject to disclosure, and the County intends to publish any resulting contracts to its public website.

4.2.2. It is Offeror's responsibility to identify and separate into a "CONFIDENTIAL/PROPRIETARY” exhibit and to provide a signed Nondisclosure Indemnification Agreement for:

4.2.2.1. all confidential information that should be protected from disclosure, including PI (Personal Information), PII (Personally Identifiable Information), or PHI (Protected Health Information), and

4.2.2.2. any proprietary or other information Offeror determines is exempt from disclosure under the California Public Records Act and wishes to protect from disclosure.

4.2.3. The “CONFIDENTIAL/PROPRIETARY” exhibit must be clearly labeled with all pages marked as “CONFIDENTIAL/PROPRIETARY”

4.2.4. Refence material in the “CONFIDENTIAL/PROPRIETARY” exhibit where it is needed to respond to a Submittal Item (for example “See response 1 contained within the “CONFIDENTIAL/PROPRIETARY” exhibit” for staff Social Security numbers”).

4.2.5. If the County determines that a submission improperly designates information as confidential or proprietary, the County may, at its sole discretion: (i) deem the information releasable; (ii) declare the submission non-conforming/non-responsive; (iii) remove such information, or (iv) take any other appropriate action. (Note: pricing and terms and conditions are generally not considered confidential under the California Public Records Act).

5. PROPOSAL EVALUATION

5.1. Evaluations shall be based on the criteria contained in the Evaluation Criteria and Submittal Items to determine the proposals(s) that provide the best value to the County.

5.2. The County shall have the discretion, but not the obligation, to construe any submission as non-conforming and ineligible for consideration if it does not conform to the requirements of this Request for Proposals.

The County shall also have the discretion to waive any irregularities or deviations from the requirements of this Request for Proposals in any submission.

5.3. Small-Local Business preference: In accordance with Section 405 of the San Diego County Code of Administrative Ordinances, when evaluating competing proposals, the County will give a fifteen percent (15%) price preference to offerors that meet the definition of a Small-Local Business set forth in Board Policy B-53 and that have completed the Small-Local Business Self-Certification Form.

The price preference will be applied to the proposed price portion of the evaluation only. Fifteen percent (15%) or one hundred and fifty-thousand dollars ($150,000), whichever is less (“Price Adjustment”), shall be subtracted from any Small-Local Business’s proposed price being evaluated for award (“Adjusted Price”). A Small-Local Business’s Adjusted Price shall be the basis for evaluating the proposal’s price.

Contract award will be made to the proposer(s) providing the best value to the County after consideration of the price preference and will be made at the unadjusted price. For example, a Small-Local Business submitting a proposal for $100,000 would be evaluated as if the proposed price was $85,000. If, based on the Adjusted Price, the Small-Local Business is evaluated to be the best value, the Small-Local Business would be awarded a contract at the unadjusted price of $100,000.

5.4. Small-Local Business Subcontractor Utilization: Offeror’s failure to submit an acceptable Small-Local Business Subcontractor Utilization Plan at time of submittal may result in the County rejecting Offeror’s proposal. Notwithstanding the foregoing, County, at its sole discretion, may elect to allow an Offeror to supplement, correct deficiencies in, or provide additional information or documentation to support its Small-Local Business Subcontractor Utilization Plan.

5.5. During evaluation, County may appropriately consider the sustainability and social, human health, environmental, and economic impact of Offeror’s proposed products and approach to providing goods and services, in accordance with Board Policy B-67. Therefore, Offerors are encouraged to include relevant information in their proposals.

5.6. During evaluation, the County may appropriately evaluate the cultural competency of Offeror and Offeror’s proposed approach to providing goods and services. Therefore, Offerors are encouraged to include relevant information in their proposals.

5.7. When evaluating an Offeror’s cost or pricing, the County may also consider the effect of the proposal on the overall total cost to the County.

5.8. In evaluating an Offeror’s ability to satisfy the requirements of this RFP and any resulting contract, the County may also consider any parent, subsidiary, or related legal entity of Offeror, including, without limitation, a legal entity that Offeror acquired or merged with or will use as a guarantor in providing services to the County.

6. EVALUATION AND SELECTION PROCESS

6.1. Proposals received, including any additions, revisions, and clarifications, will be evaluated by a Source

Selection Committee (SSC) appointed by a Source Selection Authority(s) (SSA). The County may evaluate information known to the County, in addition to the information provided in response to the RFP.

6.2. The County reserves the right to request clarification and/or additional information (“Clarification”) from Offerors. The Contracting Officer will determine the appropriate means of requesting and obtaining Clarification, which may include telephonic communication, email, letter, presentation, oral interview, or an addendum or revision to the proposal. The County may invite Offerors to make presentations to, or participate in interviews with, the County at a date, time, and location determined by the County.

Notwithstanding the foregoing, the County is not obligated to seek Clarification, therefore Offerors are advised to submit complete and accurate information in their proposals.

6.3. At any point in the evaluation process, the County may determine that a proposal is unacceptable in any area or that a proposal is no longer in the competitive range, and no longer consider it for award. In such cases, the Contracting Officer will attempt to notify the Offeror.

6.4. At any point in the evaluation process, the County may hold discussions with one or more Offerors in the competitive range. Discussions may include requests for revised proposals, Best and Final Offers (BAFOs), or addenda to the proposal that may contain additional selection factors.

6.5. The SSC may recommend to the SSA that award be made to one or more Offerors. After receipt and approval of the SSA’s decision, the County will post a Notice of Intent to Award (NOI).

6.6. Upon posting of the NOI, the County will enter into contract finalization negotiations with the selected Offeror(s) and, upon successful completion, award a contract(s).

6.7. The County may rescind or modify the NOI at any time due to unsuccessful negotiations or if the County otherwise determines that it is in its best interest to do so.

6.8. Reserved.

6.9. The actual timing and sequence of events resulting from this RFP shall ultimately be determined by the County, in its sole discretion. The County may, at any time cancel this RFP, reject all proposals, restart evaluations, modify or replace the membership of the SSC, or correct any deficiencies in the procurement process or evaluation.

7. DEBRIEF AND REVIEW OF CONTRACT FILES

7.1. After an Offeror has been notified by the Contracting Officer that that Offeror’s proposal is no longer being considered for award, the Offeror may request a debriefing from the Contracting Officer. For debriefings held prior to contract execution, the Offeror will be limited to a review of the information pertaining to the County’s evaluation of their own proposal, in accordance with Section 9.4 of these RFP Instructions and Rules. After contract execution, debriefings may include review of other proposals, the Source Selection Committee Report, and other releasable documents.

8. PROTEST PROCEDURE

8.1. Board Policy A-97 sets forth the procedures for the filing and resolution of protests related to this RFP.

Board Policy A-97 is available from the Clerk of the Board, 1600 Pacific Highway, San Diego, CA 92101, or on the County’s website at https://www.sandiegocounty.gov/content/sdc/cob/ocd.html .

8.2. All protests must be filed in accordance with Board Policy A-97, which requires, among other things, that a protest must be filed timely, be submitted in writing to the Contracting Officer identified in the solicitation package, and be based on a protestable action and established grounds for protest.

9. COUNTY COMMITMENT

9.1. This RFP does not commit the County to award a contract, nor does it commit the County to pay any of

Offeror’s costs incurred in the preparation or submission of the proposal. Further, no reimbursable cost may be incurred in anticipation of a contract award.

9.2. Neither Offeror nor any of its representatives shall have any claims whatsoever against the County or any of its respective officials, agents, or employees arising out of or relating to this RFP or these procedures (other than those arising under a definitive contract with Offeror in accordance with the terms thereof).

9.3. The County reserves the right to separately procure the same or similar goods or services.

9.4. The County may withhold all information regarding this procurement until after negotiations are complete, including, but not limited to: the number of proposals received; the identity of Offeror(s); the content of proposals; the County’s evaluation and results thereof; and, the identity of the members of the SSC.

Information releasable after the conclusion of negotiations is subject to the disclosure requirements and withholding exemptions of the California Public Records Act.

9.5. Pursuant to County Charter §§ 703.10 and 916, award of a contract resulting from this RFP may be subject to the County’s requirement to determine that the services can be provided more economically and efficiently by an independent contractor than by persons employed in the Classified Service

9.6. In the event that an Offeror is involved in a merger, acquisition, or other change in control, the County reserves the right to award a contract to a resulting entity.

10. DILIGENCE AND DUTY TO INQUIRE

10.1. Should an Offeror find discrepancies in or omissions from, or be in doubt as to the meaning of, the RFP or related documents, Offeror shall have a duty to submit a Question to the County.

10.2. Offerors are expected to perform reasonable due diligence with regard to this RFP and the work required, including, but not limited to, information that is publicly or otherwise reasonably available and, if applicable, information that can be obtained during a site visit (including verification of measurements, conditions, and other attributes). Neither the selected Offeror(s), nor any Offerors, shall be entitled to any price adjustment or other relief based upon information that was discovered or should have been discovered through due diligence.

10.3. The County makes no representation or warranty, express or implied, as to the accuracy or completeness of any diligence material or other information provided by the County or any of its agents, representatives, contractors or consultants. Such information may reflect good faith assumptions, estimates, or projections, which may or may not prove to be correct.

10.4. Offeror should not rely upon oral statements made or explanations given by the County, including any oral responses to Questions or other inquiries. No prior, current, or post award communication(s) with any officer, agent, or employee of the County shall affect or modify any terms or requirements of this RFP, except as explicitly provided for in this RFP.

11. OFFEROR COMMUNICATIONS

11.1. All communications from the Offeror (including its employees, agents, and representatives) to the County or its officers and employees (including consultants working on or assisting with this procurement), related https://www.sandiegocounty.gov/content/sdc/cob/ocd.html to this RFP or the Offeror’s proposal, must be directed in writing exclusively to the Contracting Officer, unless otherwise authorized in writing by the Contracting Officer. Offerors shall not communicate with or attempt to contact any other County personnel about this solicitation, except as otherwise allowed for in this RFP or by law. Any improper contact may, at the County’s sole discretion, cause the Offeror to be removed from consideration for contract award.

11.2. If Offeror issues any public announcement, or otherwise engages in communication that, in the County’s sole determination, compromises the integrity of this RFP process or attempts to restrain competition, Offeror may be removed from consideration for award.

11.3. Audio and/or video recording of pre-proposal conferences, presentations, discussions, negotiations, debriefings, or other communications with the County regarding this RFP are prohibited, unless specifically authorized in writing by the Contracting Officer.

12. SOLICITING EMPLOYEES

12.1. Until contract award, Offerors shall not, directly or indirectly, solicit any employee of the County to leave the County’s employ in order to accept employment with the Offeror, its affiliates, actual or prospective contractors, or any person acting in concert with the Offeror without prior written approval of the County’s Contracting Officer. This paragraph does not prevent the employment by an Offeror of a County employee who has initiated contact with the Offeror.

13. PROHIBITED CONTRACTS AND SUBCONTRACTS

13.1. In accordance with Section 67 of the San Diego County Administrative Code, the County shall not contract with, and shall reject any bid or proposal submitted by the person or entities specified below, unless the Board of Supervisors finds that special circumstances exist which justify the approval of such contract:

13.1.1. Persons employed by the County or of public agencies for which the Board of Supervisors is the governing body;

13.1.2. Profit making firms or businesses in which employees described in subsection 13.1.1 serve as officers, principals, partners or major shareholders;

13.1.3. Persons who, within the immediately preceding twelve (12) months, came within the provisions of subsection 13.1.1, and who (1) were employed in positions of substantial responsibility in the area of service to be performed by the contract, or (2) participated in any way in developing the contract or its service specifications; and

13.1.4. Profit making firms or businesses in which the former employees described in subsection 13.1.3 serve as officers, principals, partners or major shareholders.

13.2. Per Board Policy A-79, a successful Offeror that is a non-profit corporation shall not subcontract any work under the agreement with a related for-profit subcontractor where an interlocking directorate, management, or ownership relationship exists, unless specifically authorized by the Board of Supervisors.

13.3. Offeror certifies that if awarded a contract under this RFP, such contract will be in compliance with Sections 13.1 and 13.2 above. Offeror shall promptly notify the County of any change in circumstance affecting these provisions.

14. CALIFORNIA REVENUE & TAXATION CODE § 18662

14.1. In compliance with California Revenue and Taxation Code § 18662, if Offeror is a non-resident of

California (out-of-state invoices) that receives California source income and has not completed Franchise Tax Board Form 590, there may be a backup withholding on all payments. Fifteen (15) business days prior to the first payment from the County, new suppliers, or suppliers with expired forms or forms with incorrect information, must submit new forms to the County (forms are available from the Franchise Tax Board website listed below).

14.2. Under certain circumstances, Offerors may be eligible for reduced or waived nonresident withholding. If Offeror has already received a waiver or a reduced withholding response from the State of California and the response remains valid, Offeror should submit the response to the County in lieu of the forms. Failure to submit the required forms will result in withholding of payments. Offerors should access the Franchise Tax Board websites, listed below, for tax forms and relevant information regarding non-resident withholding, including waivers or reductions. The County will not give Offerors any tax advice. It is recommended that Offerors speak with their tax advisers and/or the State of California for guidance.

Franchise Tax Board Websites:

https://www.ftb.ca.gov https://www.ftb.ca.gov/forms/search/

14.3. If selected for award, the Offeror must submit applicable forms to the Auditor & Controller via fax, at

(858) 694-2060, or mail originals to: County of San Diego, 5530 Overland Avenue, Suite 410, San Diego, CA 92123. The P.O. Number or Contract Number (if available) and “California Revenue and Taxation Code § 18662” must appear on fax cover sheet and/or the outside of the mailing envelope.

15. W-9 FORM

15.1. If selected for award, the Offeror must complete and submit a W-9 form if a current form is not on file with the County.

(Remainder of this page left blank) https://www.ftb.ca.gov/ https://www.ftb.ca.gov/forms/search/

C. EVALUATION CRITERIA

Proposal Evaluation Criteria

The evaluation criteria listed below are in descending order of importance by paragraph, not subparagraph, and will be considered in the evaluation of the Offeror’s written and oral proposals accordingly. Proposals should give clear, concise information in sufficient detail to allow an evaluation based on these criteria.

Criteria Key factors include, but not limited to:

Program Approach • Offeror’s acceptance of the Statement of Work (SOW).

• Offeror’s proposed methodology and approach demonstrate the ability to effectively meet the requirements, goals, and outcome objectives as listed in the SOW and any added value.

• Offeror provides a clear plan to conduct optimization of Medi-Cal billing consulting services and maximize reimbursement opportunities

• Offeror’s coder approved training, technical assistance, and materials that demonstrate sustainability through the ability to train, manage, and disseminate the required data and documentation

• Offeror’s implementation plan is feasible and operationally efficient, including milestones and dates, and presents the ability to support the program’s goals and objectives.

Organizational Capability, Experience, and Qualifications

• Offeror’s proposal demonstrates relevant experience and knowledge in providing same or similar services outlined in the SOW.

• Offeror’s organizational framework, including the Offeror’s management, proposed staffing, resources, and experience with relevant data systems are designed to support the achievement of the program’s goals and objectives.

• Offeror’s proposal demonstrates experience collaborating with providers, small and local businesses, and community partners in San Diego County, if applicable, and how these collaborations promote equity and inclusion in the communities served.

• Subcontracting, if proposed, offers substantial and meaningful impact or added value to the proposed approach.

• Offeror shall submit a Small-Local Business Utilization Plan, in accordance with Board Policy B-53, demonstrating meaningful impact through subcontractors and either 3% participation by small, local businesses, a good faith effort to meet this goal, or a valid exemption.

Organizational Stability and Risk

• Offeror’s fiscal stability, contract compliance, litigation, record of quality performance and any risk to the County.

Cost • Offeror’s proposal provides reasonable, stable, comprehensive and predictable pricing that limits pricing risk or variance to the County.

• Price reasonableness to support the program.

Acceptance of County’s Terms and Conditions and Insurance

• The acceptance or non-acceptance of the terms and conditions, including insurance, and the extent to which any exceptions increase risk to the County.

D. SUBMITTAL ITEMS

Proposals should give clear, concise information in sufficient detail and in the order presented below to allow for a comprehensive evaluation. The County shall have the discretion, but not the obligation, to construe any submission as non-conforming and ineligible for consideration if it does not conform to the Submittal Requirements described by these Submittal Items. The County shall also have the discretion to waive any irregularities or variances from these Submittal Items in any submission and/or seek Clarification.

Although the Submittal Requirements below may be organized by Evaluation Criteria, the headings are only for purposes of organization and clarity. The County may evaluate the information provided under any section of the Submittal Requirements for each Evaluation Criterion (e.g., when evaluating the offeror’s Technical Approach, the County is not limited to reviewing the information submitted in response to the Technical Approach section and may, for example, also rely on information submitted in response to the Offeror's Experience, Qualifications, Capacity, Competency, etc.).

Offeror’s response to these Submittal Items shall be no more than forty (40) pages, excluding disclosures, financials, sample reports, etc.

1) EXHIBIT 1 - REQUIRED FORMS

1.1. Submit a completed and signed Offeror’s Cover Page (PC600) form

• Required for all Offerors

• located at:

https://www.sandiegocounty.gov/content/dam/sdc/purchasing/docs/PC600_dpc_Offerors_Cover_Page.pdf

1.2. Submit a completed and signed Representations and Certifications form (PC601)

• Required for all Offerors

• located at:

https://www.sandiegocounty.gov/content/dam/sdc/purchasing/docs/PC601_dpc_Reps_and_Certs.pdf

1.3. Submit a completed and signed Small-Local Business Self-Certification Form (PC610)

• Required if claiming Small-Local Business Preference; All other Offerors are encouraged to complete this form to support County data collection.

• located at:

https://www.sandiegocounty.gov/content/dam/sdc/purchasing/docs/PC610_dpc_Small_Local_Self_Cert.pdf

• Submit a completed Small-Local Business Subcontractor Utilization Plan (PC611) In accordance with Board Policy B-53, Offeror must submit a Small-Local Business Utilization Plan demonstrating that Offeror: (i) will either meet or exceed a 3% Small-Local Business Subcontractor Participation Requirement based on the total pricing/payment schedule of Offeror's submittal or show a good faith effort to do so, or (ii) is exempt from the Small-Local Business Subcontractor Participation Requirements.

• located at:

https://www.sandiegocounty.gov/content/dam/sdc/purchasing/docs/PC611_dpc_SLB_Sub_Utilization.pdf

1.4. Submit a completed and signed Nondisclosure Indemnification Agreement (PC620) (if applicable).

• Required if submitting Confidential/Proprietary Information (see RFP Instructions and Rules section 4.2)

• located at:

https://www.sandiegocounty.gov/content/dam/sdc/purchasing/docs/PC620_dpc_Nondisclosure_Indemnity.pdf https://www.sandiegocounty.gov/content/dam/sdc/purchasing/docs/PC600_dpc_Offerors_Cover_Page.pdf https://www.sandiegocounty.gov/content/dam/sdc/purchasing/docs/PC601_dpc_Reps_and_Certs.pdf https://www.sandiegocounty.gov/content/dam/sdc/purchasing/docs/PC610_dpc_Small_Local_Self_Cert.pdf https://www.sandiegocounty.gov/content/dam/sdc/purchasing/docs/PC611_dpc_SLB_Sub_Utilization.pdf https://www.sandiegocounty.gov/content/dam/sdc/purchasing/docs/PC620_dpc_Nondisclosure_Indemnity.pdf

2) EXHIBIT 2 - PROGRAM/TECHNICAL EXHIBIT

SECTION 2A: PROGRAM APPROACH

2.1 Confirm (YES/NO) that Offeror has read, understands, and accepts the Statement of Work as referenced in Exhibit A Payment Schedule. Offeror understands that by marking YES, Offeror may not introduce negotiations to Exhibit A upon award.

YES ☐ NO ☐

2.1.1 If Offeror has exceptions to any requirements, provide a marked up redline version of the SOW that provides applicable alternative language along with supporting explanation to support any alternative standards/language being proposed. Failure to specifically reject a proposed requirement(s) will be deemed an acceptance of such requirement. By accepting, Offeror may not introduce negotiations to Exhibit A requirements upon award.

2.2 Describe how the Offeror’s program design will meet the requirements of Section 6, Specific Requirements for Deliverables/Specifications/Service Delivery, of Exhibit A and achieve the outcomes as described in Section 3, Goals and Deliverables/Outcomes, of Exhibit A. Description should include the following:

2.2.1 How Offeror will optimize Medi-Cal billing processes, procedures, accuracy, and compliance.

2.2.2 How Offeror will achieve the objectives listed.

2.2.3 Project work plan outline.

2.2.4 Describe the Offeror’s proposed coder approved training, technical assistance, and materials that demonstrate sustainability through the ability to train, manage, and disseminate the required data and documentation.

2.3 Provide a plan for program implementation. Include a Gantt chart (or a similar type of chart), with start dates and completion dates for all the actions leading up to a fully functioning program. The chart should show actions required, strategies employed, responsibilities (persons, organizations, agencies), dependencies (actions which must be completed before subsequent actions may be initiated or completed), and milestones (significant actions and dates in the implementation). Timeline shall extend through completion of deliverables.

2.3.1 Describe how recruitment efforts will fill program positions including addressing and minimizing challenges hiring bicultural/bilingual staff, and timelines to fill each position in the program.

Description should include, but is not limited to:

2.3.1.1 Contractor shall provide a Human Resource Plan that includes how Contractor shall recruit, hire, and retain bilingual and culturally diverse staff, and shall provide an updated Human Resource Plan when any substantive changes have been made.

2.3.1.2 Contractor shall identify a process to determine bilingual proficiency of staff at a minimum in the threshold languages for the County as described in the OPOH.

2.3.1.3 Contractor shall describe their organization’s approach of methods to achieve culturally responsive, diverse, and community based behavioral health and primary care services in performing the SOW. Provide sufficient detail that demonstrates how these approaches will effectively and efficiently meet the requirements, goals, and proposed process outcomes.

SECTION 2B: ORGANIZATIONAL CAPABILITY, EXPERIENCE AND QUALIFICATIONS

2.4 Offeror's Resume. (The information requested in this section is in regard to the experience of the Offeror’s organization in providing the proposed service listed in this solicitation, and NOT the experience of the proposed staff). Offeror is to provide a resume of Offeror's experience within the last five (5) years in developing and implementing the same or similar services described in Exhibit A. If Offeror does not have experience providing the same or similar services, describe Offeror’s relevant experience that demonstrates the ability to perform these services. Include the following information for up to five (5) contracts that are most recent and relevant to the services in this solicitation, beginning with the most recent, and ending with the oldest of those selected:

2.4.1 Dates of operation for each program; the facility name, address, phone number, email address, director and contact person(s); agency for which the program(s) operated; target population; a brief description of the services provided; and annual and total contract values.

2.4.1.1 Provide a summary and documentation of the agreement performance and the Offeror’s compliance for the last three (3) agreement years.

2.4.1.2 List all findings and/or corrective actions related to the following: In-Depth Invoice

Reviews, Medical Records Reviews, Corrective Action Notices, or similarly related reviews and/or notices of Agency-issued non-compliance; also list why the corrective actions were issued, their required timelines/deadlines, how they were resolved, and if they were resolved within the required timeline/deadline.

2.4.1.3 Provide the history of all programs on a required Corrective Action, or Contract Risk Report, or similarly related history on correction actions or risk reports, over the past three (3) years including the program name, reason for corrective action, and corrective action timeline.

2.4.1.4 Provide a detailed listing of any breach or noncompliance, failure, or refusals to complete an agreement; information on early termination and details of any and all liquidated damages assessed by any entity during the last three (3) years.

2.5 Staffing Chart: Provide a legible staffing chart that describes the Offeror's proposed program and identifies program staff positions and reporting responsibility. Offeror may combine both the organization and identifies all program staff positions (by name and title, if known) and reporting responsibility. Include all proposed volunteer and other non-paid positions, if applicable. Clearly identify positions designated as bilingual.

2.6 Consultants/Subcontractors or Memorandum of Agreement Linkages: If consultants/subcontractors are to be used to meet specific requirements of the Statement of Work under a Memorandum of Agreement (including volunteer services), provide a list of those consultants/subcontractors with the following information. Consultants/subcontractors include vendors such as nursing registries, equipment, part-time labor, physicians, psychiatrists, etc. Do not include copies of subcontract agreements or Memorandum of Agreements.

2.6.1 Fully identify the consultant(s)/subcontractor(s), if known at the time of proposal submission, and describe, in accordance with the appropriate experience requirements specified above, the name and address and experience of each consultant/subcontractor.

2.6.2 Describe the specific program requirements to be met by the subcontractor(s), minimum requirements anticipated hours and cost per fiscal year. Include Statement of Work references as applicable.

2.6.3 Specify the type of contract or agreement and whether or not the consultant/subcontractor has committed to the contract or agreement.

2.6.4 If the consultant(s)/subcontractor(s) are unknown at the time of proposal submission, explain how they will be solicited and selected and provide a draft schedule for soliciting, selecting and subcontracting.

2.6.5 If Offeror does not propose to use subcontractor(s)/partnership(s), state as such in the response.

2.7 Job Descriptions: Provide a one (1) page job description for every staff category in the Program, including all administrative, support, and direct service staff positions by position title, including the specific positions identified in Exhibit A. Identify primary duties/responsibilities, range of authority and minimum requirements for employment skills (including linguistic and cultural skills), education, experience, licenses and certifications, etc. If position is not a full-time position, identify the portion of a full-time position, such as 0.75, 0.50, etc. Include hourly and annual salary range and benefits. Include all volunteer and other non-paid positions.

2.8 Staff Training: Provide separate initial and annual training plans for all proposed services and staff. Include type of training, course descriptions, number of hours per course, numbers and types of staff who will attend each training, and timeframes (i.e., when they will occur).

2.9 Describe Offeror’s experience utilizing an electronic database record system(s). In your response, include the name of the system and years of experience.

SECTION 2C: ORGANIZATIONAL STABILITY AND RISK

2.10 Financial Information:

2.10.1 Submit documentation demonstrating fiscal solvency and how Offeror will maintain solvency throughout the contract term. Briefly outline the internal fiscal management process the organization will use to monitor and ensure that County funding and other revenues are adequate to meet program costs.

2.10.2 Submit, as applicable, the most current un-audited financial statements, to include the Statement of Financial Position (Balance Sheet) and the Statement of Activities (Income Statement).

2.10.3 Submit, as applicable, the following information for the last three (3) fiscal years. Annual audit report to include:

2.10.3.1 Audited financial statements with the applicable notes.

2.10.3.2 Independent Auditor’s Report on Compliance and Internal Control over Financial Reporting based on an Audit of the Financial Statements in Accordance with Government Accounting Standards.

2.10.3.3 Independent Auditor’s Statement of Findings and Questioned costs.

2.10.3.4 Management Letter (if applicable).

2.10.4 If Offeror does not have audited financial statements, submit un-audited financial statements for the last three (3) Fiscal Years, to include the Statement of Financial Position (Balance Sheet) and the Statement of Activities (Income Statement).

2.10.5 Offeror may submit in place of the requested audited or un-audited financial statements for the last three (3) Fiscal Years, as listed above, copies of letters issued by Agency Contract Support verifying receipt of audited or unaudited financial statements for the last three (3) fiscal years.

2.11 Systems/Accounting Information:

2.11.1 Accounting System. Offeror shall have use of an accounting system for segregating, supporting, controlling and accounting of all funds, property, expenses, revenues, and assets for each County of San Diego agreement distinct from other provider activities. Offeror shall have the ability to provide assurance that the system is in accordance with generally accepted accounting principles and federal Office of Management and Budget (OMB) Circulars, located within the applicable Code of Federal Regulations. The Offeror shall describe how the proposed system will be used for this program.

Accounting systems are subject to the County’s review and approval prior to the agreement award.

No cost reimbursement agreement will be awarded to any Offeror who does not have an acceptable accounting system.

2.11.2 Describe Offeror’s accounting system and its protocols to be utilized to meet the appropriate and applicable accounting and invoicing requirements.

2.11.3 Provide documentation that Offeror has sufficient reserves to maintain the program for sixty (60) days. Documentation may include cash and/or credit reserves.

2.12 Litigation:

2.12.1 Provide a description of any litigation and the resolution, if resolved, in the past five (5) years related to Offeror’s performance. Provide a brief explanation of the reasons for the actions, their status, how they were resolved, and if there were any penalties, fines, or other actions taken. If there are none, state as such in the response.

2.12.2 Description should include the status of any lawsuits and pending litigation of Offeror and principals thereof, and a description of any litigation active in the past five (5) years related to Offeror’s past performance under contracts similar to the one proposed in this RFP.

2.12.3 Provide a copy of a letter from Offeror’s attorney and/or in-house legal counsel concerning the status of lawsuits and pending litigation for the most recent fiscal year.

2.12.4 Explain if the Offeror, or any of its officers, are presently the subject of any investigations, accusations, or charges by any federal, State, or local law enforcement agencies; or licensing/certification body as certified in Paragraph 4 of the Representations and Certifications form in this packet.

2.13 Provide a minimum of three (3) business references for the Offeror’s most relevant similar projects or programs within the past five (5) years. County staff will verify the information provided. Each reference should be summarized in no more than one (1) page and should include the following:

2.13.1 Reference organization's name, purpose, address, phone number, and email address.

2.13.2 Reference contact person’s name, title, phone number, and email address. The referenced contact person must be familiar with the Offeror and the Offeror's relevant experience and performance.

2.13.3 Brief statement of the person’s or organization’s relationship to the Offeror, and the period of the relationship.

2.13.4 A summary narrative of the applicable work provided; fee and contract term for the work; if the program’s service was completed within the original contract fee and term (explain reasons for any fee increase and delays); problems encountered and resolutions; contract objectives and results.

Explain how the experience gained could be beneficially applied to this project.

2.13.5 If previous work was not similar, list three (3) references who can attest to Offeror’s competency and how experience gained could be applied to this project.

2.13.6 If an Offeror lists a County of San Diego Contracting Officer’s Representative (COR) or Health and Human Service Agency (HHSA) staff member as a reference, the Source Selection Committee (SSC) shall rely upon compliance and performance history provided by Agency Contract Support (ACS).

3) EXHIBIT 3 - COST/PRICE EXHIBIT

3.1. Contractor shall be compensated on a Fixed Price basis. Contractor shall submit a completed Exhibit C - Payment Schedule (attached separately in BuyNet) that includes deliverables that are aligned with each of the proposed Outcomes and Measures. For each item on the schedule, include at a minimum the deliverable, estimated quantity, unit price, and extended price. The Payment Schedule shall include the initial term and all option years. The total payment amounts to the Contractor shall not exceed the established contract maximum for all services performed under this contract. If awarded, Offeror’s program cost proposal shall be used as the basis of the contract’s Payment Schedule. Offeror’s proposal should include justification for each deliverable and how the estimated quantity was determined.

3.2. Offeror shall complete and submit a Payment Schedule, listed under Section G of the RFP.

4) EXHIBIT 4 – ACCEPTANCE OF TERMS AND CONDITIONS

4.1 Confirm acceptance “YES/NO” of the County of San Diego’s Draft Agreement (including insurance requirements):

YES ☐ NO ☐

4.1.1 If “NO,” provide a detailed list of exceptions to the Draft Agreement, the nature of its concern, and what terms the Offeror is willing to accept.

Note: The Offeror will be deemed to have accepted any terms and conditions of the Draft Agreement to which it does not take exception to in its response to this RFP. The County may, as part of its evaluation process, conclude that exceptions are so numerous and/or material as to make Offeror’s response to the solicitation unacceptable.

5) EXHIBIT 5 – CONFIDENTIAL PROPRIETARY

5.1 Include any Confidential/Proprietary Information in this exhibit, in accordance with RFP Instructions and Rules section 4.2

E. REQUIRED FORMS

(RESERVED)

F. STATEMENT OF WORK

1. Scope of Work/Purpose:

1.1. Contractor shall provide the County of San Diego (County) Behavioral Health Services (BHS) and the contracted network of service providers with comprehensive Medi-Cal billing consulting services to optimize the County’s specialty Mental Health and Substance Use Disorder (SUD) Medi-Cal billing system and maximize reimbursement opportunities. This includes, but is not limited to:

1.1.1. Development of standardized best-practices, training materials, tools, technical assistance, and documented policies and procedures to support maximization and accuracy of Medi-Cal behavioral health billing. Update these materials as needed, at least quarterly, to align with changes in State and Federal regulations.

1.1.2. Development of recommended strategies to optimize billing of various payor sources to ensure maximum reimbursement within County-operated and contracted programs.

1.1.3. Provide ad hoc support related to billing improvement

1.1.4. Implement an…