RFP 24-2616TM Addendum 1 with cmk answers 2.pdf

ADDENDUM NO 1

DATE: March 13, 2024 ITB: RFP 24-2616TM On-Site Employee Wellness Center DATE ISSUED: February 20, 2024 BID DUE: March 21, 2024TM (Changed) SUBJECT: To extend the closing date and provide responses to questions received.

Ladies/Gentlemen:

Addendum No. is being issued to extend the closing date and provide responses to questions received.

The closing date for RFP 24-2616TM On-Site Wellness Center has been extended to:

March 21, 2024 at 11:00 a.m.

Questions Received

1. Question: When does the contract with the current vendor expire?

Answer: The contract will end June 30, 2024.

2. Question: Is the City of Hampton Schools interested in mental health services?

a. If yes, would you like for us to price that as a buy up offering or just explain capabilities associated?

Answer: HCS currently offers mental health services, and they would like to continue those services. Please provide pricing and explain the capabilities.

3. Question: Would the HCS be open to alternative staffing models? If so, where shall we include that pricing?

Answer: HCS will consider other models. Please outline how an alternative model will affect pricing.

4. Question: What is the utilization % of the health center appointments today?

Answer: Following is a chart representing visits over the most recent 13-month period. Please note that June is typically the busiest month because employees are trying to meet the requirements to earn wellness rates under the group medical plan. HCS would like to increase participation at the employee health & wellness center throughout the year.

5. Question: What is the current penetration % of employees that use the health center / call it their medical home?

Answer: The following chart represents the number of unique patients by month for the most recent 13-month period.

6. Question: Does City of Hampton Schools have a preference as to financial model–cost + or fixed fee?

Answer: Please provide a quote on a per participant per year basis. You can then determine the total cost by using 3,697 eligible participants (2,645 employees, 192 spouses, and 860 children age 6 and over). Feel free to list out services, especially optional services.

7. Question: Is the current vendor sending $0 claims to the carrier for tracking purposes?

Answer: Yes

8. Question: How does HCS define success associated with the health center?

Answer: This can be measured through a combination of staffing, utilization, and employee satisfaction. The schools would like to see improved utilization in preventive care, along with a decrease in emergency room and urgent care visits.

9. Question: What is driving the City of Hampton Schools to initiate a RFP?

Answer: Our current contract is ending.

10. Question: What reports does the City of Hampton Schools receive today associated with their health center?

a. Are there additional reports the School District would like to receive?

Answer: Monthly utilization reports from the incumbent show

• Number of visits by months and by unique patients

• Types of visits

• Whether the patient is an employee, spouse or child

• In person versus virtual

• Top written prescriptions

• Referrals made

• Chronic disease summary

• Diagnosis summary

• Personal health assessment completions

There are no particular additional reports that HCS would like at this time. However, they would like to see offeror’s reporting capabilities.

11. Question: Is there interest in being able to run labs onsite vs sending labs out?

Answer: Please provide a quote for onsite lab services if your firm thinks it would be beneficial and cost effective to have these services in the health and wellness center.

12. Question: How long are the health center appointment times? 15 min blocks? 20 min blocks? longer?

Answer: The length of the appointment depends on the type of visit. Appointments are typically 15 to 60 minutes depending on appointment type. However, more time is generally allocated for a first visit.

13. Question: Are performance guarantees currently in place?

Answer: None are currently in place, but HCS would welcome/preferred performance guarantees.

14. Question: What engagement tactics are in place today with the current vendor today?

Answer: Most recently, wellness center staff members have visited most of the schools during staff meetings to talk about the services offered.

15. Question: Does City of Hampton Schools feel enough is being done by their current vendor to engage members / drive utilization?

Answer: The Schools would like to increase utilization of the health & wellness center.

16. Question: What is the HCS’s current utilization of onsite coaching / dietician services?

Answer: Following is a breakdown of the types of visits for the most recent three months.

Physical therapy benefits were only recently added.

12/2023 1/2024 2/2024 Physical Therapy 1 4 Occupational Health 25 19 24 Lab, Injection, Other 39 53 25 Health Coaching 41 52 54 Health Care Provider Visit 97 158 198

17. Question: What is the HCS’s current utilization of onsite PT services?

Answer: Please refer to the previous answer.

18. Question: Is HCS interested in pricing for an after hours urgent care service offering?

Answer: Please show pricing as a separate item. However, there may not be a need for that service.

19. Question: Injury treatment for sprains and contusions is referenced in the RFP. Are those services specific to treatment of workers compensation injuries?

a. If so, Is full case management of workers compensation injuries being handled by the health center or are those services being referred out?

Answer: Workers’ compensation injuries are not handled through the onsite health & wellness center. At this time, there is no intention to include workers’ compensation medicine in the health and wellness center’s scope of services.

20. Question: Does the onsite PT also address workers comp / occ PT related needs?

b. If so, are they part of the HCS’s w/c panel?

Answer: Workers’ compensation injuries are not handled through the onsite health & wellness center. At this time, there is no intention to include workers’ compensation medicine in the health and wellness center’s scope of services.

21. Question: With allergy shots (given an allergist is not on staff), are those being administered once the patient has received their 1st vial dose (to ensure less chance of reaction)?

Answer: Health and Wellness Staff can administer allergy shots.

22. Question: Who manages HCS’s pharmacy?

Answer: On-Site Rx manages HCS's pharmacy. Those services are not part of this RFP.

23. Question: Does HCS own the existing space in which the Onsite Health & Wellness Center is currently located (2238 Todds Lane)?

Answer: Yes

24. Questions: On pages 11 and 13 of the RFP documents, HCS indicates that “Attachment A” is a pricing sheet. However, “Attachment A” within the proposal is “Offerors and Representations” (beginning pg. 24). The Pricing Sheet was not attached.

a. Can HCS please advise on where to find (or provide) the pricing attachment in the Bid page?

b. If we have questions after we receive the Pricing template, upon review, can Bidder’s ask questions if needed?

Answer:

A: Sections II.E.1.b. and II.G.1.4. of the RFP erroneously refer to a Pricing Sheet (Attachment A). Attachment A is actually the Offeror Representation and Acknowledgement. Please use your firm’s own template to provide a quote on a per participant per year basis. You can then determine the total cost by using 3,697 eligible participants (2,645 employees, 192 spouses, and 860 children age 6 and over). Feel free to list out services, especially optional services.

B: n/a

25. Question: Does HCS currently charge a visit fee for employees, spouses and dependents who are on the HDHP to utilize the onsite wellness center?

Answer: Yes, $15 per visit.

26. Question: Why has HCS chosen to put out this RFP?

Answer: Our current contract is ending.

27. Question: Can HCS please provide the schedules (including days of the week and hours) each staff member currently works? Would HCS like to make any changes in regards to the current staffing model or schedule?

Answer: The onsite health & wellness center is open 6 days a week. All employees except the health coach and physical therapist work full-time schedules. Employees rotate the Friday and Saturday hours. The health coach and physical therapist each work 20 hours in a week.

28. Question: What is currently working well at the onsite wellness center?

Answer: Employees enjoy the convenience of the health and wellness center. The center is intended to drive engagement with a healthcare provider and the center accomplishes this goal. The health center is a one-stop shop. Patients can be seen for preventive needs as well as for acute care. The staff can act as the employee’s primary care provider.

29. Question: Is there anything that HCS would like the onsite program to improve?

Answer: Staffing has been an issue. It has been difficult to maintain a consistent staff and to provide temporary staffing when necessary. HCS would like to further increase utilization of the center.

30. Question: Does HCS currently have access to any other clinics or near-sites provided by the existing vendor?

Answer: No.

31. Question: Can you please confirm the name of the vendor that currently manages the Onsite Health & Wellness Center? The RFP documents state that administration of the health center services is performed by CareATC, but the website indicates that HCS is in partnership with Marathon Health Answer: The current vendor is CareATC.

32. Question: Can HCS provide the most current two-years of Health & Wellness clinic utilization (visits per days, visit types, diagnoses, chronic health conditions, etc.)?

Answer: Please refer to previous answers for the most recent utilization.

33. Question: Will the onsite health clinic clinician be permitted to e-prescribe to HCS’s pharmacy that is located in the same building?

Answer: Yes.

34. Question: I was wondering: is there a specific pricing template that you would like us to use for this appendix, or is the instruction merely that when submitting, we label our pricing document as Appendix A?

Answer: Please use your firm’s own template to provide a quote on a per participant per year basis. You can then determine the total cost by using 3,697 eligible participants (2,645 employees, 192 spouses, and 860 children age 6 and over). Feel free to list out services, especially optional services.

35. Question: I’m hoping to get some clarity on the below section of RFP 24-2616TM for the Employee Health center that asks for pricing in Appendix A. This is not included in the RFP documents. Any assistance would be appreciated.

Answer: Please refer to the answer for question 24.

36. Question: Can you please explain the rationale for issuing this RFP after one year under your current vendor?

Answer: Our contract is expiring

37. Question: Could you please send Attachment A (pricing), which seems to be missing from the RFP.

Answer: Please refer to the answer for question 24.

38. Question: What important characteristics (demographic or otherwise) should we consider in developing a solution for your organization?

Answer: The vast majority of HCS employees are teachers with limited time away from the classroom. Therefore, maintaining the existing schedule is important. Additionally, when employees with a CDL license are scheduled for random testing, it is necessary for staff to be available for that testing between the hours of 9:00 and 11:30. Virtual appointments are important as well.

39. Question What is your annual budget for your health center program?

Answer: This information is not available.

40. Question: For Occupational Health Services, please indicate if you are wanting to add:

Service Add Yes/No 2022 visit volume 2023 visit volume Service Add Yes/No 2022 visit volume 2023 visit volume Answer: Occupational Health services are currently provided for new hires. Services depend on the employment position. There are approximately 170 CDL-licensed employees. Of those employees, 85 must undergo random drug screens and 43 are subject to breath alcohol tests throughout the year. Annual physicals are offered for CDL employees.

Service Add Y/N 2022 Visit Volume

2023 Visit Volume

Urine Drug Collections

Y 85 85

Breath Alcohol Collections

Y 43 43

DOT Physicals

Y 170 170

Immunizations for safety/work purposes

N

Lab evaluation for annual surveillance (i.e. – lead monitoring)

Pre-employment physical exams

Y for CDL 40 40

OSHA-mandated hearing tests Y for CDL 40 40

Respiratory surveillance testing (Annual OSHA questionnaires/spirometry/exam)

Respirator Fit testing (specify qualitative or quantitative)

Return to work exams (for non-work related conditions)

Possibly for

CDL

Fit for duty exams (exam when an employee is underperforming

Work Related Injury Care N

Work Related Injury Case Management N

PT for Work Injury Management/Rehab N

PT for work conditioning/Strengthening N

PT for Other Purposes? (please List) Y at employee’s request

PT services were only recently added

Other Services? (Please list)

41. Question: Who owns the equipment and furniture? Can you provide an inventory list?

Answer: An inventory list is not available currently. Hampton City Schools owns the office furniture and office equipment, along with the majority of the medical equipment and furniture. Pricing for equipment can be outlined in your proposal separately.

42. Question: Please provide recent health center reports that detail Rx prescribed and diagnosis types.

Answer: There were 1,845 prescriptions written by clinic staff from March 2023 through February 2024. The top 10 prescriptions written for July 2022 through June 2023 were:

43. Question: Can you provide claims trend reporting that identifies the claims spend of the users of the health centers vs. non-users of the health center?

Answer: That information is not available.

44. Question: Please provide a census file with demographic information— full home address (at a minimum at least zip codes) for your entire employee population and spouses/dependents that are on the health plan. If possible please also include ages and gender.

Answer: A census file is not being released with this RFP. Most employees live in the Hampton, Virginia area. The average age of employees is 49, and the average age of eligible members is

42. 78% of the employees are female.

45. Question: Is an HSA plan design offered? What percentage of employees are enrolled in it?

Answer: 22%

46. Question: What is your PMPM medical spend now? PMPM for primary care now?

Answer: The information in not available.

47. Question: Please provide a year-end health plan report showing utilization and unit cost performance.

Answer: Please refer to questions 4 and 5 for utilization. Unit cost performance is not available.

48. Question: Are there any prevalent conditions or problem areas, that are of specific concern, within the employee population? If so, what programs and efforts have been offered to help?

Answer: Diabetes management and prevention programs have been offered through the wellness center as that is a prevalent condition in the HCS population.

49. Question: Have there been any changes to your wellness program in the past year?

Answer: The wellness incentive has increased from $750 to $1000. HCS continuously considers changes that might be appropriate.

50. Question . Do you currently provide (or will you consider) incentives/disincentives to employees for participating in health care intervention services, wellness, onsite clinic, etc.?

What are the current (or contemplated) rewards/incentives/disincentives for the future plan years?

Answer: Employee cost shares (copayments) are less when using the wellness center. HCS is open to other ideas to incentivize employees to use the center.

51. Question: If Health Risk Assessments (HRA’s) are completed, is a personal health record generated for the employee as a result?

Answer: Yes

52. Question: What healthcare services listed below are currently provided or desired onsite?

Service/Event Yes/No Current vendor Current volume (if applicable)

Service Y/N Current Vendor Current Volume (if applicable)

Time Period Service is Delivered

Mass biometric screenings

Done by individual appointments at the wellness center

Throughout the year, but June tends to be the busiest month (end of incentive year).

Flu Shots Offered through pharmacy.

HRA’s Employees can complete health risk assessment through wellness center’s portal.

Health Coaching Programs

Done by individual appointments at the wellness center.

Disease Management Programs

Diabetes management programs are offered.

53. Question: Is the current staff fully in place? Which staff members would the district like to keep? How long has the current providers been providing care at this location?

Answer: There are currently positions that are staffed by temporary employees. Staffing will be decided once vendor is awarded. Most other positions have been filled within the past year.

54. Question: Are there any specific needs for hiring additional positions?

Answer: We are open to alternative staffing and those decisions will be decided once a vendor is awarded.

55. Question: Is there provider oversight included in your current staffing model? If so, how much is allocated from an FTE perspective?

Answer: There is a physician oversight model currently in place. This is included in the administrative fees.

56. Question: Is the district looking for any alternative staffing models, or only price the current model?

Answer: HCS will consider other models.

57. Question: What vendors or groups is the district expecting integration with?

Answer: The wellness center partners with the onsite pharmacy and HCS’s Sentara health plan.

58. Question: Is CareATC providing HRA’s or is it another vendor?

Answer: They are available through CareATC’s portal.

59. Question: Will you send a sample of your eligibility file?

Answer: No. A census is not being released with this RFP.

60. Question: Are copays being collected in the health center now, if so what is the amount?

Answer: $15 copays are required from employees who do not participate in HCS’s healthcare plan and from members of the high deductible health plan. The wellness center coordinates those payments.

61. Question: Provide pertinent financial data that demonstrates your organization’s ability to successfully perform this contract. Include a copy of the most recent annual report and financial statements for each quarter since the last annual report to date. Please provide your most recent ratings (include the date of the rating) by each of the following: ***There is nothing listed below, are you able to clarify please? ***

Answer: Please report your corporate credit ratings, such as Standard & Poor’s, Moody’s and

Fitch.

62. Question: What other type of minor surgical procedures is the clinic looking for?

Answer: Anything that is typically performed by a nurse practitioner.

63. Question: Is there DOT physicals expected to be completed and is there an estimated volume?

Answer: Please refer to the answer to question 40.

64. Question: What has been the historical amount of patient encounters yearly?

Answer: Please refer to the answers to questions 4 and 5.

Bidders must take due notice and be governed accordingly. This addendum must be acknowledged as indicated in the Request for Proposal or your Bid may not be considered.

All other terms and conditions must remain the same.

For the City of Hampton

Tammy Martin

Tammy Martin, CPPB, Senior Buyer 1 Franklin Street Hampton, VA 23669 Phone: 757-727-2205 Email: tmartin@hampton.gov mailto:tmartin@hampton.gov