THE STATE OF OREGON

OREGON HEALTH AUTHORITY

DEPARTMENT OF HUMAN SERVICES

Addendum #3 to OregonBuys Bid Number S-10000-00013757/Request for Proposals (RFP) 6124

AGENCY WITH CHOICE SERVICES

Addendum Date: August 7, 2025

Point of Contacts (POCs) Stephanie Morgan & Geoffrey Nowak E-mail: stephanie.b.morgan@odhsoha.oregon.gov; geoffrey.nowak@odhsoha.oregon.gov

RFP 6124/S-10000-00013757 is hereby amended as follows:

1. The Opening Date & Time (Proposals Due) date and time listed on the Cover Page of this RFP is hereby amended as follows. Language to be added is bold/underlined; language to be deleted is struck-through.

Opening Date & Time (Proposals Due): 9AM 2PM PST, August 25 29, 2025

2. Section 1.1, “Introduction” is hereby amended and attached herein as Attachment A to this

Addendum #3, “Section 1.1, Introduction”. Language to be added is bold/underlined; language to be deleted is struck-through.

3. Section 1.2, “Schedule”, is hereby amended as follows. Language to be added is bold/underlined;

language to be deleted is struck-through.

SCHEDULE

The table below represents a tentative and approximate schedule of events. All times in this RFP are listed in Pacific Time and days/timeframes are listed in calendar days. All dates listed are subject to change.

Event Date & Time (if applicable) Pre-Proposal Conference 10:30AM, July 30, 2025 Price-Related Questions / Requests for Clarification Due (additional Q&A period is for any price-related questions only)

5PM, July 31 9AM, August 8, 2025

Answers to Questions / Requests for Clarification Issued (approx.) 11AM, August 5 12PM, August 11, 2025

RFP Protest Period Ends 7 calendar days prior to RFP Opening

Opening (Proposals Due) See RFP Cover Page 9AM PST, August 29, 2025

Public Opening of Proposal(s) (approx.) 25-Aug- 1-Sept-25 Issuance of Notice of Intent to Award (approx.) 8 15-Sep-25 mailto:stephanie.b.morgan@odhsoha.oregon.gov mailto:geoffrey.nowak@odhsoha.oregon.gov

Addendum #3 re: RFP 6124 – Agency with Choice Services OregonBuys Bid # S-10000-000013757

Issuance of Notice of Intent to Award Protest Period Ends

7 calendar days after Notice of Intent to Award

4. Section 2.5.1t is hereby amended as follows. Language to be added is bold/underlined; language to be deleted is struck-through.

Contractor shall maintain an office location within the State of Oregon. Contractor shall display its State-issued Agency with Choice-issued license in public view near the front of its Oregon place of business at all times.

5. Section 2.5.1r is amended to add the following:

The Contractor shall conduct an initial assessment within ten (10) days of receiving the Person- Centered-Service Plan for each Individual. The initial assessment shall include a review of the Person-Centered Service Plan with the Individual and/or Authorized Representative to discuss and understand the Individual’s service needs and preferences.

For more information see Attachment B to the RFP, OAR Chapter 411 Div 39 under 411-039- 0170, delivery of services for ODHS. The OHA AWC rules will be similar to ODHS rules. The OHA OAR Chapter 309 Div 045 rules will be located at this link in August at:

https://www.oregon.gov/oha/hsd/pages/mental-health-rules.aspx

6. Amend Section 2.5.2d as follows. Language to be added is bold/underlined; language to be deleted is struck-through.

Develop separate policies and procedures for ODHS and OHA for contacting the applicable Agency with Choice Administrator or Administrator’s designee during all available hours during which services are provided to Individuals. A Contractor staff person working under this Contract must be available 24/7 to receive incoming calls.

7. Amend Section 3.2.1, “General Requirements” as follows. Language to be added is bold/underlined; language to be deleted is struck-through.

Proposers must maintain an office location within the State of Oregon. Proposers must identify and provide the physical address of its place of business located in the State of Oregon. Proposers which do not currently maintain a place of business within the State of Oregon must identify a proposed location for which it plans to secure within 60 days following award of the Contract and must open such location before serving any Individual.

8. Section 3.4, “Price Proposal” is hereby superseded and replaced entirely as set forth in Attachment B to this Addendum #3, “Section 3.4, Price Proposal”, incorporated by this reference.

9. Section 4.10.3, Table 2., “Technical Evaluation Criteria, Points, and Scoring” is hereby superseded and replaced entirely as set forth in Attachment C to this Addendum #3, “Section 4.10.3, Table 2., Technical Evaluation Criteria, Points, and Scoring”, incorporated by this

10. Section 4.10.4, “Price Evaluation” is hereby superseded and replaced entirely as set forth in Attachment D to this Addendum #3, “Section 4.10.4, Price Evaluation”, incorporated by this

11. Amend Section 4.11, “Ranking of Proposers” as follows. Language to be added is

RANKING OF PROPOSERS

The POCs will average the scores for each Technical Proposal in a given round of competition (calculated by totaling the technical points awarded by each Evaluation Committee member and dividing by the number of members).

After any applicable preference has been applied, the POCs will determine the rank of each Proposal, with the Proposal(s) with the highest rank to be those with the highest technical score coupled with pricing that is the best value and most advantageous to the State.

After any applicable preference has been applied, the SPC will determine the rank of each Proposal, with the highest score receiving the highest rank, and successive rank order determined by the next highest score.

The State may, in the State’s sole discretion, determine an apparent successful Proposer with no additional rounds of competition. If additional rounds are conducted, the State will rank advancing Proposers at the conclusion of each subsequent round and may determine an apparent successful Proposer at any time during the solicitation process.

12. Section 5.4, “Contract Negotiation” is hereby amended and attached herein as Attachment E to this Addendum #4, “Section 5.4, Contract Negotiation”. Language to be added is

13. See below “Attachment F – Addendum 3 Questions and Answers”, for the State’s responses to questions received against this RFP.

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Attachment A – Section 1.1, Introduction

INTRODUCTION

In the 2024 legislative session, the Oregon State Legislature appropriated funding under House Bill (HB) 4129 to the Oregon Department of Human Services (ODHS) and the Oregon Health Authority (OHA). The House Bill was signed into law by Governor Tina Kotek on March 27, 2024, with an effective date of January 1, 2026. The law mandates the establishment of the Agency with Choice (AwC) program (“Program”), a new self-directed service delivery model for older adults, individuals with physical disabilities, and individuals with behavioral health conditions (“Individuals”) to co-employ Direct Support Workers (DSW). This allows Individuals to direct their own care services while a Contractor provides the administrative functions of an employer and supports Individuals in managing care services provided in their own home. This self-directed service delivery model is designed to empower Individuals receiving care and provide flexible employment options to Direct Support Workers in the performance of caring for Individuals.

The State of Oregon, acting by and through the Oregon Department of Human Services and the Oregon Health Authority (hereinafter collectively referred to as the “State”), are issuing this Request for Proposal (RFP) under the provisions of ORS 279B.060 for qualified Contractor(s) to provide “Agency with Choice” services.

The initial term of the Contract is anticipated to be two (2) years with options to renew up to a cumulative maximum of five (5) years.

The Work required under this RFP, Section 2.5, Scope of Work (SOW)/Specifications, is inclusive and representative of both the OHA population to be served (“OHA Population”) and the ODHS population (“ODHS Population”) to be served (collectively the “Entire Population”). See Section 2.4 below for additional details on current approximate Population volumes.

The State may award a maximum of four (4) Contracts resulting from this RFP. Pursuant to HB 4129, Contract awards may only be executed with a maximum two (2) successful Proposers. The State, in its sole discretion, may award the Entire Population to one successful Proposer; or may award the Entire Population to multiple successful Proposers; or may award less than the Entire Population to multiple successful Proposers. The State will use its discretion in determining the number of awards to be made and the distribution of Contracts to serve the ODHS Population and/or the OHA Populations based on what is most advantageous to the State. Potential contract award outcomes possible under this RFP include but are not limited to the following:

a. The State may award the Entire Population to one (1) single successful Proposer; or

b. The State may award the Entire Population to two (2) successful Proposers; or

c. The State may bifurcate the OHA & ODHS Populations and award two (2) contracts to two (2) successful Proposers, whereby one successful Proposer will be awarded the OHA Population, and the other successful Proposer will be awarded the ODHS Population; or

d. The State may award four (4) Contracts to two (2) successful Proposers, whereby the same two successful Proposers will each hold a Contract to serve the OHA Population and a contract to serve the ODHS Population.

e. The State may award three (3) Contracts to two (2) successful Proposers, whereby one (1) successful Proposer will serve the ODHS Population and the OHA Population under two (2) separate Contracts; and a second successful Proposer will serve either the OHA or ODHS Population.

Proposers shall submit one (1) Technical Proposal describing how it will serve the entire Population. Proposers are required to submit a separate one Price Proposal for each of the that will be the same for both of the two (2) Populations.

Proposers please note that the Oregon Administrative Rules related to this RFP have not yet been finalized. For purposes of responding to this RFP, Proposers are directed to use the draft Oregon Administrative Rules for ODHS for Chapter 411, Division 039 in Attachment B, and the temporary rules for OHA in OAR Chapter 309, Division 045 found at https://www.oregon.gov/oha/hsd/pages/mental-health-rules.aspx.

Additionally, and as a requirement of this RFP, Proposers must submit an auditor’s certified financial statement and other verifiable documentary evidence of fiscal solvency to demonstrate the Proposer has sufficient existing capital to operate the Program for 90 days post award of a Contract.

Contractors must comply with all applicable Federal and State laws and Medicaid requirements.

Applicable laws include federal Fair Labor Standards Act and Oregon Employment Law.

Additional details on the Scope of the goods or services or both are included in the Scope of Work/Specifications section.

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Attachment B, Section 3.4, Price Proposal

3.4. PRICE PROPOSAL

3.4.1 Submit a proposed fully loaded Medicaid reimbursable hourly rate for DSWs that will be used to support and invoice for both ADL and IADL services.

3.4.2 Administrative fee included in the proposed hourly rate may not exceed 15%. This administrative cost cap is fixed and will remain in effect for the duration of the Contract, unless otherwise amended. The 15% Administrative fee cap includes:

a. Wages paid to the Administrator and any other staff providing Work under the Contract award;

b. Any costs associated with EVV implementation; and

c. The cost for EVV information exchange with the State’s contacted data aggregator.

3.4.3 The hourly rate paid to DSWs must meet or exceed the current rate paid to ODHS Homecare Workers under the existing collective bargaining agreement, which is currently $20.00 per hour. This required rate will increase once a new collective bargaining agreement is ratified.

3.4.4 At a minimum, 85% of the total hourly rate must be used directly towards the total compensation for DSW who furnish services. Total compensation includes the following:

(1) Wages;

(2) Benefits;

(3) Health insurance;

(4) Retirement plans;

(5) Life and disability insurance;

(6) Paid time off; and

(7) Other benefits.

3.4.5 Mileage will be reimbursed by Contractor at the current ODHS and OHA approved mileage rate per mile for authorized travel incurred during service delivery, which is currently $0.70/mile and is subject to change. Mileage reimbursement is not authorized for travel by the DSW between the homes of the DSWs and the Individuals served or travel between the homes of multiple Individuals served.

3.4.6 Initial assessment fee is allocated 3 hours to be billed at the Proposers hourly rate for DSWs.

3.4.7 Proposal must include a breakdown of all cost/price components included in the DSW’s hourly to include the administrative fee (which shall not exceed 15% of the overall unite rate) for each year of the anticipated 5-year Contract term based on the projected estimated Population served.

3.4.8 Proposers must submit one Price Proposals that is the same for both State Agency Populations.

3.4.9 When submitting the Price Proposal attachment in OregonBuys, Proposers must remove the “Y” under the “No Bid” column and enter a price (entering a price of $1 is acceptable as this price will not be evaluated). The price figure entered into OregonBuys in the Items tab will not be evaluated. Rather, the Price Proposal attachment(s) the Proposer attaches in OregonBuys is the price that will be evaluated.

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Attachment C, Price Evaluation, Section 4.10.4

4.10.4 PRICE EVALUATION (20 Points Maximum Possible)

a. Each Price Proposal will be evaluated and scored subjectively as follows:

(1) For completeness based upon the traceability of the estimates used in the proposal to the performance of the requirements as addressed in the solicitation. 5 Points Maximum

(2) To determine if the estimated elements are realistic for the Work to be performed, reflect a clear understanding of the SOW requirements, and are consistent with the various elements of the Proposer’s Technical Proposal.

Inconsistencies could raise concerns regarding the Proposer’s understanding of the requirements and its ability to perform the Work for the proposed cost/price. 5 Points Maximum

(3) To examine if profit or fees are reasonable in light of any associated risks.

5 Points Maximum

(4) To determine if proposed prices are fair and reasonable under current market conditions. 5 Points Maximum

b. Cost/price evaluation may use any or all of several bases of comparison including the independent government estimate, current or recent prices for the same or substantially the same services purchased in comparable quantities under similar terms and conditions, comparisons with other Proposers’ proposals, market prices of commercial products sold to the public, and GSA contract pricing or discounted GSA pricing.

c. Pricing is subject to negotiation.

d. Evaluated price will be based on the Price Proposal attachment that is uploaded as a separate attachment in OregonBuys. If submitting two Price Proposals, those two Proposals should be submitted as one single attachment in OregonBuys.

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Attachment D, Price Evaluation, Section 4.10.4

Section 4.10.3, Table 2., “Technical Evaluation Criteria, Points, and Scoring” The State will evaluate Technical Proposals based on the criterion set forth below in this Table 2.

Evaluation Criteria

Maximum Points Possible/and

Maximum Weighted Score

Organization and Staffing - 20 Maximum Points Degree to which Proposer's resumes of Key Personnel demonstrate Proposer’s ability to provide the services as outlined in this RFP and demonstrates how each candidate meets or exceeds the qualifications identified, demonstrates relevant past performance and aligns with the Work requirements.

Proposed staffing and organizational structure and processes per this RFP Section 3.3.2 seems feasible and realistic for the Work to be performed.

Feasibility and advantages of the Proposer's approach to orientation, and training including proposed training plan and curriculum. 3

Feasibility and advantages of proposed solution that addresses how disputes between DSWs and Individuals will be handled. The State will assess the feasibility and advantages of proposed incident reporting system.

Feasibility on assisting Individuals and developing a plan to recruit and retain DSWs, coordinate DSW schedules based on the Individuals preferences, and choices, and ensure back up plan is in place.

Implementation Plan and Technical Approach - 20 Maximum Points

Feasibility and advantages to proposed approach to act as a co-employers of the DSWs with the Individual, providing Individuals with AwC services and supports aligned with the Individual’s needs, preferences, and are self-directed.

Feasibility and advantages of Proposer’s methods to prepare, implement, maintain, and comply with policies and procedures. 4

Feasibility and approach to Proposer's Emergency and Continuity of Operation Plan. 4

Proposer's responses to Section 3.3.3 of this RFP demonstrate creativity, innovation, organization, planning, and clearly articulates “how” the Section 2.5 Statement of Work requirements will be performed. Degree to which Proposer’s technical solution to implementation of this project and to carrying-out the Work seems feasible, realistic and advantageous to the State.

ODHS and OHA will assess the feasibility and advantages of Proposer's approach to implement an Advisory Board and Proposer's description of and methods to be used to collaborate with Individuals in designing and implementing Agency with Choice services under this RFP.

Access to Services/Equity - 20 Maximum Points

Proposer’s capacity to deliver services statewide while maintaining compliance with regulations. The State will assess how effectively Proposers address the needs of rural and underserved areas, including accessibility, resource allocation, and outreach efforts. The State will consider how the location of the Proposer’s primary place of business or its regional offices support timely, culturally responsive, and geographically feasible service delivery to both ODHS and OHA Individuals.

Advantages to Proposer's approach to providing equitable and non-discriminatory services to all Individuals, regardless of race, color, religion, national origin, age, sex, sexual orientation, gender identity, disability, or any other protected status under state and federal law.

Past Performance - 15 Maximum Points

ODHS and OHA will assess Past Performance with a focus on information demonstrating quality and relevancy of the performance.

Relevant work would be work that involves/involved work that is similar in nature, effort, and complexity to that of what this solicitation requires.

Electronic Verification System Demonstration - 5 Maximum Points

Proposed EVV demonstration demonstrates compliance with this RFP requirements, SOW requirements, and demonstrates feasibility for the Work to be performed and degree to which the EVV system will be advantageous to carrying out the work of this RFP.

Maximum Score Possible for Price 20

Total 100

Attachment E – Section 5.4, Contract Negotiation

5.4 CONTRACT NEGOTIATION

5.4.1 Negotiation

After selection of a successful Proposer(s), the State may enter into Contract negotiations with the successful Proposer(s). By submitting a Proposal, Proposer agrees to comply with the requirements of the RFP, including the terms and conditions of the Sample Contract (Attachment C), with the exception of those terms listed below for negotiation.

Proposer shall review the attached Sample Contract and note exceptions. Proposer must submit those exceptions to the State during the Questions / Requests for Clarification period set forth in Section 1.2.

If the State agrees to make any requested changes to the Sample Contract, the State will issue an Amendment to notify Proposers of such changes. Unless the State issues an Amendment modifying any of the terms and conditions, the State intends to enter into a Contract with the successful Proposer(s) substantially in the form set forth in Sample Contract (Attachment C).

Following the selection of the apparent successful Proposer(s), the State may agree to negotiate changes to the negotiable provisions of the Sample Contract listed below. However, the State is not required to make any changes and many provisions cannot be changed. Proposer is cautioned that the State of Oregon believes modifications to the standard provisions constitute increased risk and increased cost to the State.

Any subsequent negotiated changes are subject to prior approval of the Oregon Department of Justice.

The State is willing to negotiate all items, except those listed below:

• Choice of law

• Choice of venue

• Constitutional requirements

• Requirements of applicable federal and State law

• Insurance Requirements

In the event that the parties have not reached mutually agreeable terms within 30 calendar days, the State may terminate Negotiations and commence Negotiations with the next highest ranking Proposer(s).

Attachment F – Addendum 3 Questions and Answers

1. Question: Who is the state of OR currently utilizing as a provider for these services?

Answer: Agency with Choice is a new program. As such, there is no incumbent provider of these services for OHA & ODHS. Individuals receiving in-home services who choose to self-direct their services receive the services through the Consumer Employer Program.

2. Question: Does DHS and OHA have an expectation of what % of the population will choose the

Agency with Choice Options across the two populations?

Answer: The State does not have an expectation as to the percentage of either population that will enroll in the Program. Approximately, 54% of the APD Medicaid consumers receive in-home services.

3. Question: If Oregon contracts with multiple FMS vendors, will the state equally split the participants amongst each vendor, or will the participant have the option to choose?

Answer: Successful Proposer(s)/Contractor(s) will be submitting claims as a traditional Medicaid billing provider, not as a Financial Management Services (FMS) vendor.

In the event multiple awards are made to two different successful Proposers/Contractors, the Individual will be able to choose from either Contractor.

4. Question: Does the vendor need to have a physical office currently? Or can it be assumed a physical office can be leased at a later date if awarded?

Answer: See Section 1 above of this Addendum #3.

5. Question: Does the office have to be open to the public?

Answer: Yes.

6. Question: Please clarify what "all available hours" entails. During what specific hours must the

AwC administrator or designee be available?

Answer:

The Contractor’s Administrator or designee must be available during all hours which services are being provided to Individuals under this Contract. See also Section 3 on page 2 of this Addendum #3.

For more information on Administrator Qualifications and Requirements please refer to Attachment OAR Chapter 411 Div 39 of the RFP under 411-039-0100 for ODHS. The OHA AWC rules will be similar to ODHS. The OHA OAR Chapter 309 Div 045 rules will be located at this link in August at: https://www.oregon.gov/oha/hsd/pages/mental-health-rules.aspx

7. Question: RFP indicates the contract effective date is 1/1/2026. What is the expected go-live date for services?

Answer: Per Section 3.3.3a of this RFP, Proposer must submit an Implementation Plan that includes a schedule and milestones for implementation of the Program. Proposer’s Implementation Plan should set forth the schedule for all activities it plans to conduct under this RFP and potential Contract award.

8. Question: Is SOC2 / Type2 required?

Answer: No.

9. Question: Pertaining to participant enrollment, will we use our Intake system to enroll, or data import?

Answer: At the request of the individual for Agency with Choice Services, the individual’s Case Manager (ODHS) or Service Coordinator (OHA) enrolls the individual and authorizes services through the Agency with Choice. The Case Manager or Service Coordinator provides the Individual’s Person-Centered Service Plan to the Contractor, which includes the approved Task List.

10. Question: Are there any paper-based enrollment and payroll processes? If yes, what percentage of processes are paper based?

Answer: Enrollment occurs at the State level. The Proposer must propose its processes for payroll actions. There are no requirements for paper-based processes under this RFP/Contract.

11. Question: Is overtime allowed?

Answer: The Contractor shall follow labor, state and federal law and rules. The Contractor will need to determine if overtime is allowed. The state will not be responsible for increased costs.

12. Question: Is sick time applicable to this contract?

Answer: The Contractor shall follow labor, state, and federal law and rules. In the proposed rates, the Contractor should specify this as a benefit if they intend to provide sick leave and or paid time off.

13. Question: What is the average number of workers per participant? Do the departments have data on how many DSWs work for more than one individual?

Answer: This data is not yet available because this is an entirely new Program. This information will, however, vary per Individual. On average, in the current self-directed program, an Individual has one in-home care worker and an in-home worker has 1-2 Individuals in the consumer-employer programs. Under the Contract, a DSW may provide services to more than one Individual and the Individual may have more than one DSW.

14. Question: How can the contractor train DSWs on the individual’s specific needs? How would contractor have knowledge about those needs?

Answer: Upon the Contractor receiving an Individual’s Person-Centered Service Plan, the

Contractor will conduct an initial assessment with the Individual and/or the Authorized Representative to further understand each Individual's needs. Specific needs might entail support required from the Individual, such as assistance with avoiding certain food allergies in meal preparation. As a co-employer, the Individual will help train the DSW on specific preferences.

See Attachment B to the RFP, OAR Chapter 411 Div 39 of the RFP for ODHS. The OHA AWC rules will be similar to ODHS rules. The OHA OAR Chapter 309 Div 045 rules will be located at this link in August at: https://www.oregon.gov/oha/hsd/pages/mental-health-rules.aspx

15. Question: When must the Program Administrator’s employment begin? Must the person be employed as of submission or is it sufficient to have him, her or them only identified at time of submission?

Answer: Administrator must be employed and in place at the time services for Individuals begin.

16. Question: What does the initial assessment consist of? Do the individuals performing the assessments need to be licensed or credentialed? Which parties are included in the assessment of need?

Answer: The initial assessment shall include a review of the Person-Centered Service Plan with the Individual and/or Authorized Representative to discuss and understand the Individual’s service needs and preferences. The person performing the assessment is not required to be licensed or credentialed. The participants in the initial assessment must minimally include the Individual or authorized representative and the Agency with Choice staff member who conducts assessments.

The goal of the assessment is to ensure the Contractor understands the service needs of the Individual and allow the development of plan to meet those needs.

17. Question: Does the participant’s eligibility ever change retroactively?

Answer: No.

18. Question: How often is eligibility reviewed and redetermined?

Answer: Eligibility for services is reviewed and redetermined at least annually as part of the Individual's Person-Centered Service Plan. However, eligibility may also be re-evaluated sooner if there is a significant change in the Individual's condition or if requested by the Individual.

For more information, see Attachment B to the RFP, OAR Chapter 411, Div 39 under 411-039- 0170 for ODHS. The OHA AWC rules will be similar to ODHS rules. The OHA OAR Chapter 309 Div 045 rules will be located at this link in August at:

19. Question: Who is the current data aggregation provider?

Answer: The current ODHS/OHA data aggregator is Acumen Fiscal Agent, LLC.

20. Question: Does the program allow for exemptions from EVV?

Answer: EVV is a federal requirement and the only exemptions are those allowed in CFR.

You may find more information on Attachment B to the RFP, OAR Chapter 411, Div 39 under 411-039-0040 for ODHS. The OHA AWC rules will be similar to ODHS rules. The OHA OAR

21. Question: Are any specific elements required with regard to the video demonstration in terms of

(1) technical and accessibility elements such as login credentials, sound, or closed captioning, and

(2) specific perspectives to be shown regarding elements such as consumer use, direct care worker duties, provider reporting, or data integration?

Answer: Per Section 4.10.3 of this RFP, the EVV demonstration should demonstrate compliance with this RFP requirements, SOW requirements, and demonstrate feasibility for the Work to be performed and degree to which the EVV system will be advantageous to carrying out the work of this RFP. Proposer should conduct a demonstration that demonstrates an EVV solution that is advantageous to carrying out the Work.

22. Question: For billing, who is the payer entity (Gainwell)?

Answer: The State of Oregon is the payer for payments made by Medicaid Management Information System (MMIS).

23. Question: Are budgets based on dollars or time units?

Answer: There's no budget for an Individual; only maximum service hours per pay period per their Person-Centered Service Plan as defined in Oregon Administrative Rule Chapter 411, Division 30. This can vary for each Individual and population being served. Data shows that the in-home care workers for ODHS providing services are estimated to work an average of 90 hours per month. In-home care workers for OHA providing these services are estimated to work an average of 45 hours per month.

The Contractor must submit claims in 15-minute unit increments into the Medicaid Management Information System (MMIS) for services rendered.

24. Question: What type of billing is required? 837 or invoicing?

Answer: MMIS accepts electronic data interchange billings in 837 formats from authorized submitters and supports a secure provider web portal that allows online billing.

25. Question: How often is the frequency of payroll? Weekly? Biweekly?

Answer: The frequency of payroll for the Contractor’s staff is determined by the Contractor.

26. Question: How quickly does the FMS vendor get reimbursed by Oregon?

Answer: Approved claim submissions are paid on a weekly basis.

27. Question: Will Oregon forward fund payroll or does the FMS vendor pay payroll and submit billing for reimbursement?

Answer: The State will not make advanced payments on this Contract. Pursuant to Attachment C to this RFP, “Sample Contracts”, Section 3, Subsection c., OHA/ODHS “will only pay for completed Work.”

The Contractor(s) submits bills to the State for reimbursement in 15-minute unit increments, up to the authorized amount of units and for service units that were actually delivered. The Contractor will submit for payment on a weekly basis, after the services are delivered. The payments are made through MMIS, and may be billed in the 837 format through an authorized entity or through the online provider web portal.

28. Question: If a participant does not spend all of their budget in a single month, can they “rollover” funds to a subsequent month? If so, how long/how much may a participant roll over funds until such funds are considered non-usable or are to be forfeited?

Answer: The Agency with Choice does not provide a monthly budget for each Individual. Each Individual is assigned hours of available services approved by either a Case Manager or Service Coordinator per their Person-Centered Service Plan. There are no rollover hours since hours are capped every 14 days. If all hours are not used within the 14-day period, they are forfeited.

29. Question: What is the expected total monthly payroll for this program?

Answer: Since this is an entirely new program, we do not have that data yet. It will depend how many Individuals enroll in the Program.

30. Question: What is the duration of each individual budget?

Answer: There is no Individual budget. The Individual’s plan is based on service hours not on a budget. The Case Manager or the Service Coordinator develops a Person-Centered Service Plan which includes the total authorized hours of service for a two-week period. Typically, Individuals receive a re-assessment annually. The Person-Centered Service Plan specifies the length of eligibility which can vary if there was a reassessment or if an Individual becomes ineligible to receive in-home care services.

31. Question: What is the anticipated volume of participants by program by month for the duration of the contract? What is the total average monthly spending for all participants?

Answer: The State does not have an anticipated volume of Individuals expected to enroll in the Program. The total average spending will be based on the number of Individuals who enroll in the Program, and the hours of authorized services provided by the Contractor, which is unknown at this time since this is a new program.

32. Question: Is workers compensation to be included in our admin cost, or is this reimbursable?

Answer: No, workers compensation will not be included in the administrative fee. It will be included in the total compensation including benefits for DSWs. You can find more information on

3.4 of the RFP page 24.

33. Question: Are background checks to be included in the administrative rate, or is this reimbursable?

Answer: Yes, background are to be included in the administrative fee.

34. Question: Can the departments clarify the EVV reimbursement at $5.50? Is the contractor accounting for cost in the administrative rate, or offsetting the cost with the $5.50?

Answer: Yes, the contractor is accounting for EVV costs in the administrative fee.

35. Question: Does the $42.12 fully loaded rate include compensation to the contractor for overtime premium payments or will there be a separate way to reimburse the Contract for that?

Answer: Yes, overtime premium pays are included in the fully loaded rate. There will be on additional compensation to the Contractor for Overtime payments to DSWs. See Sections 8-10 on pages 2-3 on this Addendum #3.

36. Question: This section says that the Contractor must reimburse DSWs for mileage. Will contractor be reimbursed for this cost, or does it come out of the $42.12 fully loaded hourly rate?

Answer: Yes, the Contractor will be reimbursed for this cost. Mileage is prior authorized by the case manager or service coordinator. See Section 3.4.1d of the RFP or Attachment B to the RFP, OAR Chapter 411 Div 39 under 411-039-0040 for ODHS. The OHA AWC rules will be similar to ODHS. The OHA OAR Chapter 309 Div 045 rules will be located at this link in August at:

https://www.oregon.gov/oha/hsd/pages/mental-health-rules.aspx. See Sections 8-10 on pages 2-3 on this Addendum #3.

37. Question: Will the contractor be required to conduct background checks for DSWs before they can begin work? If so, what are the criteria for pass/fail?

Answer: Yes, Contractor staff must have an adjudicated background check prior to conducting Work on the Contract.

For more information, please refer to Attachment B to the RFP, OAR Chapter 411, Div 39 under 411-039-0070, for ODHS. Details of the BCU Background Checks, including reviewed criteria for pass/fail, can be found in Chapter 407, Division 7 at https://secure.sos.state.or.us/oard/displayDivisionRules.action?selectedDivision=1626

38. Question: In general, are there any penalties for non-compliance with the contract terms?

Answer: Information on civil penalties are found on the RFP Attachment B, OAR Chapter 411, Division 39, for ODHS on 411-039-0240. The OHA AWC rules will be similar to ODHS rules.

The OHA OAR Chapter 309 Div 045 rules will be located at this link in August at:

39. Question: How are the terms “Incident” and “Critical Incident” defined?

Answer: “Incident” is not defined in the Oregon Administrative Rules. It signifies an unexpected event that affects or has the potential to affect the health, safety, or welfare of an

Individual but does not meet the threshold for being classified as a “Critical Incident.”

“Critical Incident” means an event that creates a risk of harm to the health or welfare of an individual receiving care and services and may endanger or negatively impact the mental or physical well-being of an Individual. Critical Incidents include:

(a) Abuse as defined in OAR chapter 411, division 020;

(b) Fiscal Improprieties as defined in OAR 411-031-0020;

(c) A medication error resulting in:

(A) A telephone call to or a consultation with a poison control center or emergency department;

(B) Receiving medical care through urgent care, emergency room or hospital; or

(C) Death

ODHS Definition terms can be found in the attachment B to the RFP, OAR Chapter 411, Div 39 under 411-039-0010. The OHA AWC rules will be similar to ODHS rules. The OHA OAR

40. Question: What steps or activities will the departments take to raise access to information and awareness about the option beyond their one-time annual re-assessment?

Answer: OHA and ODHS educate providers, staff, and partners about the Agency with Choice Program through trainings, webinars, educational materials, and both internal and external facing websites. Prior to launch of services being provided to Individuals under this Contract, the ODHS & OHA will run a media campaign for the public on Agency with Choice and will provide a mailing to all individual’s receiving In-home services.

41. Question: If Proposer believes any of its Proposal is exempt from disclosure under Oregon public records law, should the redacted version be delivered as an entirely separate submission, or should the redacted version be submitted as an additional attachment (marked as confidential) within the same submission?

Answer: The redacted Proposal shall be submitted with Attachment E, not as a separate submission.

END