RFP CFP Hospital and Healthcare Services - FINAL.docx

STATE OF MICHIGAN

Department of Health and Human Services

Hospital and Healthcare Services Request for Proposal No: 491 190000000546

Solicitation Manager Name: Debra Frazzitta Direct Phone: 810.966.2029 Email: frazzittad@michigan.gov

This is a Request for Proposal (RFP) for:

Hospital and Healthcare Services for the Center for Forensic Psychiatry

RFP Timeline

*A bidder’s proposal received at 1:59:01 p.m. Eastern is late and subject to disqualification.

This RFP is subject to change. Check www.michigan.gov/SIGMAVSS for current information.

PROPOSAL INSTRUCTIONS

1. PROPOSAL PREPARATION. The State recommends reading all RFP materials prior to preparing a proposal, particularly these Proposal Instructions and the Vendor Questions Worksheet. Bidders must follow these Proposal Instructions and provide a complete response to the items indicated in the table below. References and links to websites or external sources may not be used in lieu of providing the information requested in the RFP within the proposal. Include the bidder’s company name in the header of all documents submitted with your proposal.

RFP Structure and Documentation

2. CONTACT INFORMATION FOR THE STATE. The sole point of contact for the State concerning this RFP is listed on the Cover Page. Contacting any other State personnel, agent, consultant, or representative about this RFP may result in bidder disqualification.

3. QUESTIONS. Bidder questions about this RFP must be emailed to the Solicitation Manager no later than the time and date specified on the Cover Page. In the interest of transparency, only written questions sent by email are accepted. Answers to questions will be posted on www.michigan.gov/SIGMAVSS. Submit questions using the format below; a Microsoft Excel format or similar is suggested.

4. MODIFICATIONS. The State may modify this RFP at any time. Modifications will be posted on www.michigan.gov/SIGMAVSS . This is the only method by which the RFP may be modified.

5. RESERVED.

6. DELIVERY OF PROPOSAL.

Electronic – The bidder must submit its proposal, all attachments, and any modifications or withdrawals electronically through www.michigan.gov/SIGMAVSS. The price proposal should be saved separately from all other proposal documents. The bidder should submit all documents in a modifiable (native) format (examples include, but are not limited to: Microsoft Word or Excel and Google Docs or Sheets). In addition to submitting documents in a modifiable format, the bidder may also submit copies of documents in PDF. Bidder’s failure to submit a proposal as required may result in disqualification. The proposal and attachments must be fully uploaded and submitted prior to the proposal deadline. Do not wait until the last minute to submit a proposal, as the SIGMA VSS system requires the creation of an account and entry of certain information, in addition to uploading and submitting the materials. The SIGMA VSS system will not allow a proposal to be submitted after the proposal deadline identified in the Cover Page, even if a portion of the proposal has been uploaded.

Questions on how to submit information or how to navigate in the SIGMA VSS system can be answered by calling (517) 373-4111 or (888) 734-9749.

7. MANDATORY MINIMUM REQUIREMENTS.

To avoid disqualification, the bidder must provide documentation to support the following:

· It is required that the local healthcare providers are accredited by The Joint Commission (TJC) and Center for Medicare and Medicaid Services (CMS), and physicians providing direct healthcare services to CFP patients be privileged by the healthcare provider.

Only proposals meeting the mandatory minimum requirements will be considered for evaluation.

8. EVALUATION PROCESS. If all mandatory minimum requirements are met, the State will evaluate each proposal based on the following factors:

Proposals receiving 80 or more technical evaluation points will have pricing evaluated and considered for award.

The State may utilize all bidder information, without regard to a proposal’s technical score, to determine fair market value for goods or services sought. The State is not obligated to accept the lowest price proposal. If applicable, the State’s evaluation will include consideration of a bidder’s qualified disabled veteran (QDV) status under MCL 18.1261(8). Additional information on the QDV preference is available at: http://michigan.gov/micontractconnect/0,https://www.michigan.gov/dtmb/0,5552,7-358-82550_85746_48677-412612--,00.html,7-225-48677-123519--,00.html.

The State strongly encourages strict adherence to the Contract Terms. The State reserves the right to deem a bid non-responsive for failure to accept the Contract Terms. Nevertheless, the bidder may submit proposed changes to the Contract Terms in track changes (i.e., visible edits) with an explanation of the bidder’s need for each proposed change. Failure to include track changes with an explanation of the bidder’s need for the proposed change constitutes the bidder’s acceptance of the Contract Terms. General statements, such as that the bidder reserves the right to negotiate the terms and conditions, may be considered non-responsive.

The State may conduct an on-site visit to tour and inspect the bidder’s facilities; require an oral presentation of the bidder's proposal; conduct interviews, research, reference checks, and background checks; and request additional price concessions at any point during the evaluation process.

9. NOTICE OF DEFICIENCY. The State reserves the right to issue a Notice of Deficiency to bidders if the State determines after the proposal deadline that a portion of the RFP was deficient, unclear, or ambiguous. Failure to respond to a Notice of Deficiency timely may be cause for disqualification.

10. CLARIFICATION REQUEST. The State reserves the right to issue a Clarification Request to a bidder to clarify its proposal if the State determines the proposal is not clear. Failure to respond to a Clarification Request timely may be cause for disqualification.

11. RESERVATIONS. The State reserves the right to:

a. Disqualify a bidder for failure to follow these instructions.

b. Discontinue the RFP process at any time for any or no reason. The issuance of an RFP, your preparation and submission of a proposal, and the State’s subsequent receipt and evaluation of your proposal does not commit the State to award a contract to you or anyone, even if all the requirements in the RFP are met.

c. Consider late proposals if: (i) no other proposals are received; (ii) no complete proposals are received; (iii) the State received complete proposals, but the proposals did not meet mandatory minimum requirements or technical criteria; or (iv) the award process fails to result in an award.

d. Consider an otherwise disqualified proposal, if no other proposals are received.

e. Disqualify a proposal based on: (i) information provided by the bidder in response to this RFP; (2) the bidder’s failure to complete registration on www.michigan.gov/SIGMAVSS ; or (3) if it is determined that a bidder purposely or willfully submitted false or misleading information in response to the RFP.

f. Consider prior performance with the State in making its award decision.

g. Consider overall economic impact to the State when evaluating proposal pricing and in the final award recommendation. This includes but is not limited to: considering principal place of performance, number of Michigan citizens employed or potentially employed, dollars paid to Michigan residents, Michigan capital investments, job creation, tax revenue implications, and economically disadvantaged businesses.

h. Consider total-cost-of-ownership factors (e.g., transition and training costs) when evaluating proposal pricing and in the final award recommendation.

i. Refuse to award a contract to any bidder that has failed to pay State taxes or has outstanding debt with the State.

j. Enter into negotiations with one or more bidders on price, terms, technical requirements, or other deliverables.

k. Award multiple, optional-use contracts, or award by Contract Activity.

l. Evaluate the proposal outside the scope identified in Section 8, Evaluation Process, if the State receives only one proposal.

12. AWARD RECOMMENDATION. The contract will be awarded to the responsive and responsible bidder who offers the best value to the State, as determined by the State. Best value will be determined by the bidder meeting the minimum point threshold and offering the best combination of the factors stated in Section 8, Evaluation Process, and price, as demonstrated by the proposal. The State will post a Notice of Recommendation for Award on www.michigan.gov/SIGMAVSS .

13. DEBRIEF MEETING AND BID PROTEST. MDHHS will post a Notice of Recommendation for Award, which will provide instructions on how to request a debrief meeting.

Bidders who wish to initiate a protest of the award must submit the protest in writing no later than 3:00 p.m. on the fifth business day after the notice of recommendation for award is published on the SIGMA VSS website. MDHHS reserves the right to adjust this timing and will publish any change on the SIGMA VSS system.

Submit protests via email to MDHHS-BGP@michigan.gov. Include “Protest” in the email subject line. All protests must include the bid number.

Additional information about the protest process is available at www.michigan.gov/micontractconnect under the “Programs and Policies” link.

14. STATE ADMINISTRATIVE BOARD. Contracts in excess of $500,000 require approval by the State Administrative Board. The State Administrative Board’s decision is final; however, its approval does not constitute a contract. The award process is not complete until the awarded contractor receives a contract fully executed by all parties.

15. GENERAL CONDITIONS. The State will not be liable for any costs, expenses, or damages incurred by a bidder participating in this solicitation. The bidder agrees that its proposal will be considered an offer to do business with the State in accordance with its proposal, including the Contract Terms, and that its proposal will be irrevocable and binding for a period of 180 calendar days from date of submission. If a contract is awarded to the bidder, the State may, at its option, incorporate any part of the bidder’s proposal into a contract. This RFP is not an offer to enter into a contract. This RFP may not provide a complete statement of the State’s environment, or contain all matters upon which agreement must be reached. Other than verified trade secrets, proposals submitted via www.michigan.gov/SIGMAVSS are the State’s property.

16. CONFIDENTIAL TREATMENT FORM AND THE FREEDOM OF INFORMATION ACT. All portions of the bidder’s proposal and resulting contract are subject to disclosure as required under Michigan’s Freedom of Information Act (FOIA), MCL 15.231, et seq. However, some information may be exempt from disclosure. Under MCL 18.1261(13)(b), records containing “a trade secret as defined under section 2 of the uniform trade secrets act, 1998 PA 448, MCL 445.1902,” are exempt from disclosure under FOIA. In addition, “financial or proprietary information” submitted with a bidder’s proposal is exempt from disclosure under FOIA. A bidder’s failure to comply with this Section is grounds for rejecting a bidder’s proposal as non-responsive. As a part of its proposal, each bidder must follow the procedure below.

a. SUBMIT A COMPLETED “CONFIDENTIAL TREATMENT FORM” (CT FORM) WITH YOUR BID. Completion and submission of the CT Form is required regardless of whether the bidder seeks confidential treatment of information. Failure to submit a completed CT Form may be cause for disqualification from the solicitation process.

i. Complete and sign Section 1 of the CT Form if the bidder does NOT request confidential treatment of information contained in its proposal; or

ii. Complete and sign Section 2 of the CT Form if the bidder requests confidential treatment of certain information. Bidder must also submit a “Public Copy” of the proposal with the trade secret, financial, and proprietary information redacted and clearly labeled as the “Public Copy.”

b. FOIA REQUESTS. If a FOIA request is made for a bidder’s proposal, the Public Copy may be distributed to the public along with the bidder’s CT Form. The CT Form is a public document and serves as an explanation for the redactions to the Public Copy. Do not put any trade secret, financial, or proprietary information in the CT Form. Do not redact the CT Form itself.

c. NO ADVICE. The State will not advise a bidder as to the nature or content of documents entitled to protection from disclosure under FOIA or other laws, as to the interpretation of such laws, or as to the definition of trade secret or financial or proprietary information. Nothing contained in this provision will modify or amend requirements and obligations imposed on the State by FOIA or other applicable law.

d. FAILURE TO REQUEST CONFIDENTIAL TREATMENT. Failure to request material be treated as confidential as specified herein relieves the State, its agencies, and personnel from any responsibility for maintaining material in confidence.

e. Bids containing a request to maintain an entire proposal as confidential may be rejected as non-responsive. Bidders may not request confidential treatment with respect to resumes, pricing, and marketing materials. The State reserves the right to determine whether material designated as exempt by a bidder falls under MCL 18.1261 or other applicable FOIA exemptions. If a FOIA request is made for materials that the bidder has identified as trade secret, financial, or proprietary information, the State has the final authority to determine whether the materials are exempt from disclosure under FOIA.

f. Bidder forever releases the State, its departments, subdivisions, officers, and employees from all claims, rights, actions, demands, damages, liabilities, expenses and fees, which arise out of or relate to the disclosure of all or a portion of bidder’s proposal submitted under this RFP. Bidder must defend, indemnify and hold the State, its departments, subdivisions, officers, and employees harmless, without limitation, from and against all actions, claims, losses, liabilities, damages, costs, attorney fees, and expenses (including those required to establish the right to indemnification), arising out of or relating to any FOIA request, including potential litigation and appeals, related to the portion of bidder’s proposal submitted under this RFP that bidder has identified as a trade secret, or financial or proprietary information. The State will notify bidder in writing if indemnification is sought. The State is entitled to: (i) regular updates on proceeding status; (ii) participate in the defense of the proceeding; (iii) employ its own counsel; and to (iv) retain control of the defense, or any portion thereof, if the State deems necessary. Bidder will not, without the State’s written consent (not to be unreasonably withheld), settle, compromise, or consent to the entry of any judgment in or otherwise seek to terminate any claim, action, or proceeding. If a State employee, official, or law is involved or challenged, the State may control the defense of that portion of the claim. Any litigation activity on behalf of the State, or any of its subdivisions under this Section, must be coordinated with the Department of Attorney General. An attorney designated to represent the State may not do so until approved by the Michigan Attorney General and appointed as a Special Assistant Attorney General.

CONFIDENTIAL TREATMENT FORM (CT FORM)

INSTRUCTIONS. Complete either Section 1 or Section 2 of this CT Form and sign where indicated. This CT Form must be signed by the individual who signed the bidder’s proposal. A completed CT Form must be submitted with your proposal, regardless of whether your proposal contains confidential information. Failure to submit a completed CT Form with your bid is grounds for rejecting the proposal as non-responsive. See Section 16 of the Proposal Instructions for additional information.

Section 1. Confidential Treatment Is Not Requested

This section must be completed, signed, and submitted with the proposal if bidder does not request confidential treatment of any material contained in the proposal.

By signing below, the bidder affirms that confidential treatment of material contained in the proposal is not requested.

[Printed Name] [Title] [Company]

Section 2. Confidential Treatment Is Requested

The section must be completed, signed, and submitted with the proposal if bidder requests confidential treatment of any material contained in the proposal. Submission of a completed CT Form is required to request confidential treatment.

Provide the information in the table below. Bidder may add rows or additional pages using the same format shown in the table. Bidder must specifically identify the information to be protected as confidential and state the reasons why protection is necessary. The CT Form will not be considered fully complete unless, for each confidentiality request, the bidder: (1) identifies whether the material is a trade secret (TS), financial information (FI), or proprietary information (PI); (2) explains the specific legal grounds that support treatment of the material as TS, FI, or PI; and (3) provides the contact information for the person at bidder’s organization authorized to respond to inquiries by the State concerning the material. Bidders must not simply cite to an applicable act or case name; rather, bidders must provide a complete justification as to how the material falls within the scope of an applicable act or relevant case law.

CONFIDENTIAL TREATMENT FORM (CT FORM)

By signing below, the bidder affirms that confidential treatment of material contained in its proposal is requested and has attached to this form a redacted “Public Copy” of the bidder’s proposal.

[Printed Name] [Title] [Company]

VENDOR QUESTIONS WORKSHEET

Provide a detailed response to each question. “You” and “company” refers to the bidder.

1. Contact Information

Bidder’s sole contact person during the RFP process. Include name, title, address, email, and phone number.

Person authorized to receive and sign a resulting contract. Include name, title, address, email, and phone number.

2. Company Background Information

Legal business name and address. Include business entity designation, e.g., sole proprietor, Inc., LLC, or LLP.

What state was the company formed in?

Phone number

Website address

Number of years in business and number of employees

Legal business name and address of parent company, if any

Has there been a recent change in organizational structure (e.g., management team) or control (e.g., merger or acquisition) of your company? If the answer is yes: (a) explain why the change occurred and (b) how this change has affected your company.

Discuss your company’s history. Has growth been organic, through mergers and acquisitions, or both?

Has bidder ever been debarred, suspended, or disqualified from bidding or contracting with any entity, including the State of Michigan? If yes, provide the date, the entity, and details about the situation.

Has your company been a party to litigation against the State of Michigan? If the answer is yes, then state the date of initial filing, case name and court number, and jurisdiction.

Within the last 5 years, has your company or any of its related business entities defaulted on a contract or had a contract terminated for cause? If yes, provide the date, contracting entity, type of contract, and details about the termination or default.

State your gross annual sales for the last 5 years.

If receiving a contract under this RFP will increase your gross revenue by more than 25% from last year’s sales, explain how the company will scale-up to manage this increase.

Describe partnerships and strategic relationships you think will bring significant value to the State.

State the physical address of the place of business that would have primary responsibility for this account if bidder is awarded a contract under this RFP.

3. Qualified Disabled Veteran

To demonstrate qualification as a qualified disabled veteran, you must provide:

(a) Proof of service and conditions of discharge (DD214 or equivalent);

(b) Proof of service-connected disability (DD214 if the disability was documented at discharge or Veterans Administration Rating Decision Letter or equivalent if the disability was documented after discharge); and

(c) Legal documents setting forth the ownership of the business entity.

In lieu of the documentation identified above, you may provide proof of certification by the National Veterans Business Development Council.

Enter the names of documents submitted with your proposal to demonstrate status as a qualified disabled veteran.

4. Participation in RFP Development or Evaluation

Did your company, an employee, agent, or representative of your company, or any affiliated entity participate in developing any component of this solicitation? For purposes of this question, business concerns, organizations, or individuals are affiliates of each other if, directly or indirectly: (1) either one controls or has power to control the other or (2) a third party controls or has the power to control both. Indicia of control include, but are not limited to, interlocking management or ownership, identity of interests among family members, shared facilities or equipment, and common use of employees.

If you entered “YES”, you are not eligible for contract award or to work as a subcontractor for the awarded vendor.

5. State of Michigan Experience and Prior Experience

Does your company have experience working with the State of Michigan? If so, please provide a list (including the contract number) of the contracts you hold or have held with the State for the last 10 years.

Describe at least 3 relevant experiences from the last 5 years supporting your ability to successfully manage a contract of similar size and scope for the work described in this RFP.

Experience 1

Company name Contact name Contact role at time of project Contact phone Contact email

City State Zip

1. Project name and description of the scope of the project

2. What role did your company play?

3. How is this project experience relevant to the subject of this RFP?

Dollar value

Start and end date (mm/yy – mm/yy)

Status (completed, live, other – specify phase)

Results obtained

Experience 2

Company name

Contact role at time of project

City

1. Project name and description of the scope of the project

Dollar value

Start and end date (mm/yy – mm/yy)

Status (completed, live, other – specify phase)

Results obtained

Experience 3

Company name

Contact role at time of project

City

1. Project name and description of the scope of the project

Dollar value

Start and end date (mm/yy – mm/yy)

Status (completed, live, other – specify phase)

Results obtained

6. Standard Contract Terms

Bidder must affirm agreement with the attached Contract Terms. If not in agreement, written exceptions in accordance with Section 8 Evaluation Process must be provided with Bidder’s proposal.

7. Other

Request for Proposal No. 491 190000000546 MDHHS Center for Forensic Psychiatry – Hospital and Healthcare Services

SCHEDULE A

STATEMENT OF WORK

CONTRACT ACTIVITIES

This schedule identifies the anticipated requirements of any Contract resulting from this RFP. The term “Contractor” in this document refers to a bidder responding to this RFP.

The Contractor must respond to each requirement or question and explain how it will fulfill each requirement. Attach any supplemental information and appropriately reference within your response.

BACKGROUND

The Center for Forensic Psychiatry (CFP) is a 240-bed facility and is the statewide provider of essential mental health services for forensic patients in Michigan. CFP operates in accordance with the standards set forth by the Michigan Department of Health and Human Services (MDHHS) and is accredited by The Joint Commission (TJC) and the Center for Medicare and Medicaid Services (CMS). Patients are either Not Guilty by Reason of Insanity (NGRI) or Incompetent to Stand Trial (IST). There is an occasional admission on some other basis such as an order to treat on behalf of one of the Probate Courts or Community Health Organizations. These represent a very small part of the population served.

The medical staff at CFP primarily consists of Forensic Psychiatrists with a limited number of internal medical physicians. CFP has minimal provisions to provide direct medical services by the facility, including limited staffing, space and equipment. Most treatment for medical issues is provided by local health care organizations.

SCOPE

This is a Request for Proposal (RFP) for Hospital and Healthcare Services for the CFP.

The purpose of this RFP is to acquire essential hospital and healthcare services from a qualified medical entity which will supplement services provided by the CFP facility. This agreement will provide administrative oversight with centralized billing which will ensure orderly, efficient, and cost-effective health services to CFP patients. CFP requires that contractual agreements be established between the Contractor and the local health care organizations to promote and maintain quality healthcare while fulfilling the mission, goals, and objectives of the CFP.

1.0 General Requirements

1. Hospital and Healthcare Services Hospital and healthcare services needed by CFP include a combination of external inpatient/outpatient facility services, emergency services, group or individual physician services, and other ancillary healthcare services such as laboratory or radiology services.

The CFP internal medical physicians will perform medical assessments of the patients and make treatment recommendations. Treatment services must be arranged by the Contractor, including the scheduling of the appointments. The Contractor must establish relationships with local healthcare organizations and physicians with cost incentives at sites within a 15-mile radius of CFP. It is required that the local healthcare providers and physicians be privileged and accredited by the TJC and CMS. Services may be obtained from providers outside of the 15-mile radius if approved by CFP.

It is anticipated that the medical services needed will include but not be limited to the following:

Please acknowledge your firm’s understanding and acceptance of this requirement. Describe a plan to achieve this requirement and attach any related certifications.

Bidder Response:

In the event of an emergency evacuation at CFP, the Contractor must make arrangements for all patients that require medical attention to be admitted to hospitals within a 30-mile radius of CFP.

Please acknowledge your firm’s understanding and acceptance of this requirement, describe plan to achieve this requirement and the evacuation plan.

2. Patient Care Management

2.1. Referral and Scheduling

The CFP Clinical Nurse will refer patients to the Contractor. The Contractor must schedule appointments within five calendar days of receipt of a referral from CFP, or as otherwise agreed upon. Outpatient examinations will typically be scheduled during normal working hours Monday through Friday. There may be occasions when outpatient services would be required on holidays or weekends. The CFP maintains the right to cancel patient appointments at any time. Procedures for referral and scheduling will be determined by CFP prior to service delivery.

Please acknowledge your firm’s understanding and acceptance of this requirement. Describe a plan to achieve this requirement.

2.2. Admissions

The Contractor will implement a system for direct admission whereby emergency room and associated physician costs would not be incurred. The Contractor will only process admissions through the emergency room when there is an emergency that requires the use of special care units (e.g., intensive care, cardiac care, and emergency room care). Inpatient admissions must require private room accommodations with available space for up to two CFP security staff per patient.

There must be an open line of communication between physicians at the local healthcare facility and CFP to ensure that only those services ordered by CFP are provided, unless required for intervention in a life-threatening emergency. In the event of a life-threatening emergency, the Contractor must contact the CFP Clinical Nurse within a 24-hour period.

The Contractor must conduct an insurance preauthorization and/or consultative review of the patient through on-line electronic communication methods prior to admitting a patient for inpatient services, scheduling outpatient surgery, or ordering a session for outpatient services, with the exception of emergency admissions.

Please acknowledge your firm’s understanding and acceptance of this requirement. Describe a plan to achieve this requirement.

2.3. Case Management

The Contractor must provide medically necessary healthcare consistent with community standards, while maintaining the standards of the TJC and CMS. The Contractor must develop a method for managing the provision of the patients’ health care. The Contractor must monitor the utilization of the services and assess medical necessity and appropriateness. Contractor must ensure monitoring of accounting and financial data to assure appropriate verification, account designation, and timely payment of invoices.

Please acknowledge your firm’s understanding and acceptance of this requirement. Describe your method for managing the provision of services.

Contractor must report all issues which interfere with the provision of services that could result in imminent threats to the CFP patients. Contractors must describe a process for reporting issues as part of the bid response. The process must include, at a minimum, the responsible party (CEO or designee), contact information, and how issues will be identified, reported and escalated.

Please acknowledge your firm’s understanding and acceptance of this requirement. Describe your process for managing and reporting issues.

Contractor must conduct risk assessments and develop a risk management process. Risk management generally involves (1) identification of the risk, (2) assigning a level of priority based on the probability of occurrence and impact to the project, (3) definition of mitigation strategies, and (4) monitoring of risk and mitigation strategy. Risk assessment review should be conducted on a regular basis. Contractor must propose a standard risk management process for managing this contract as part of bid response.

CFP will have access to the CEO or designee 24 hours a day, 7 days a week for any issues or concerns. In the event the CFP has not received a resolution within 10 business days that meets their expectation, they will be able to directly contact the CEO or designee.

Please acknowledge your firm’s understanding and acceptance of this requirement. Describe your standard risk process for managing and reporting issues.

2.4. Discharge Planning

At the time of a patient’s discharge, whether for inpatient, outpatient, or emergency services, the Contractor must provide the CFP with documented discharge instructions, completed by the attending physician, which includes any prescriptions. The Contractor must monitor the patients’ length of stay and ensure patients are discharged from medical facilities at the appropriate time. The Contractor must submit all medical reports to CFP by fax and/or US Postal Service as soon as available and in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.

Regardless of the type of service provided, all patient evaluations and treatment must be documented and signed by the attending physician. Upon request, authorized CFP staff will have access to and must be provided copies of all patient medical records. Patient medical records will be subject to review by the CFP for validation of payment and verification of services rendered. Any request for copies of a patient’s medical records by the patient or a third party must be directed to the CFP Clinical Nurse for processing.

Please acknowledge your firm’s understanding and acceptance of this requirement and describe a plan to achieve these requirements.

3. Reporting Requirements All reports must be submitted electronically within ten days of the end of the reporting time period requirement. All reports must be in accordance with HIPAA standards.

3.1. The Contractor must provide a monthly report that details the number of patient referrals and the type of procedures performed separated by place of service (e.g. inpatient, outpatient or emergency).

3.2. The Contractor must provide a detailed quarterly report that includes the following information:

3.3. The Contractor must provide an annual report for each health care provider site that details the following:

Please acknowledge your firm’s understanding and acceptance of this requirement and provide a sample of each report.

4.0 Staffing

4.1. Contractor Representative

The Contractor must appoint an Account Manager specifically assigned to State of Michigan accounts, that will respond to State inquiries regarding the Contract Activities, answering questions related to ordering and delivery, etc. (the “Contractor Representative”). The Contractor must notify the Contract Administrator at least 14 calendar days before removing or assigning a new Contractor Representative.

Bidder’s Contractor Representative:

4.2. Customer Service Toll-Free Number

The Contractor must specify its toll-free number for the State to make contact with the Contractor Representative. The Contractor Representative must be available for calls during the hours of 7 a.m. to 5 p.m. EST.

Bidder’s Toll-Free Number:

4.3. Work Hours

The Contractor must provide Contract Activities during the State’s normal working hours Monday – Friday, 7:00 a.m. to 5:00 p.m. EST, and possible night and weekend hours in case of medical emergencies of the patients.

Please acknowledge your firm’s understanding and acceptance of this requirement.

4.4. Key Personnel

The Contractor must appoint a minimum of one individual, and one alternative as a back-up, who will be directly responsible for the day-to-day operations of the Contract (“Key Personnel”). Key Personnel must be specifically assigned to the State account, be knowledgeable on the contractual requirements, and respond to State inquires within 48 hours.

The Contractor must identify the Key Personnel, indicate where they will be physically located, describe the functions they will perform, and provide current chronological résumés.

The Contractor may not remove or assign Key Personnel without the prior written consent of the State. Prior consent is not required for reassignment for reasons beyond the Contractor’s control, including illness, disability, death, leave of absence, personal emergency circumstances, resignation, or termination for cause. The State may request a resume and conduct an interview before approving a change. The State may require a 30-calendar day training period for replacement personnel.

Please acknowledge your firm’s understanding and acceptance of this requirement and provide the name of the Key Personnel and their back up, where they will be physically located, and describe the functions they will perform.

4.5. Organizational Chart

The Contractor must provide an overall organizational chart that details staff members, by name and title, and subcontractors.

Bidder’s Organizational Chart:

4.6. Disclosure of Subcontractors

If the Contractor intends to utilize subcontractors, the subcontractor must be Medicaid-enrolled, and the Contractor must disclose the following:

A. The legal business name, address, telephone number, a description of subcontractor’s organization and the services it will provide, and information concerning subcontractor’s ability to provide the Contract Activities.

B. The relationship of the subcontractor to the Contractor.

C. Whether the Contractor has a previous working experience with the subcontractor. If yes, provide the details of that previous relationship. If no, provide the details on how the working relationship will be established.

D. A complete description of the Contract Activities that will be performed or provided by the subcontractor including the provision of services for patients and care management.

Bidder’s Response:

5. Meetings The Contractor must attend a Kick-off meeting as close as possible to the effective date of this Contract as determined by the CFP. The State may request other meetings, as it deems appropriate.

6.0 Pricing

6.1. Price Term

Pricing is firm for the entire length of the Contract.

7. Ordering

7.1. Authorizing Document

The appropriate authorizing document for the Contract will be a Master Agreement and Delivery Order release.

8. Invoice and Payment

8.1. Invoice Requirements

All invoices submitted to the State must include: (a) date of service, (b) delivery order number, (c) patient name/ID number, (d) date of birth (e) description of the procedure performed, (f) provider billed amount (g) amount billed to the State.

The Contractor is responsible for medical bill filing to patient’s third-party funding sources, e.g. insurance companies. The third-party reimbursement shall be considered payment in full unless the third-party fund source requires a co-pay, in which case MDHHS can be billed for the amount of the co-pay. No supplemental billing is allowed. The State will require proof of submission to the patient’s insurance providers and must attach the respective form to the individual patient’s invoice.

The Contractor guarantees that any claims made to MDHHS under this contract shall not be financed by any source other than MDHHS under the terms of this contract. If funding is received through any other source, the Contractor agrees to deduct from the amount billed to MDHHS the greater of either the fee amounts, or the actual costs of the services provided.

Please acknowledge your firm’s understanding and acceptance of this requirement and describe a plan to achieve these requirements.

8.2. Payment Methods

The State will make payment for Contract Activities via EFT.

9. Liquidated Damages Late or improper completion of the Contract Activities will cause loss and damage to the State and it would be impracticable and extremely difficult to fix the actual damage sustained by the State. Therefore, if there is late or improper completion of the Contract Activities the State is entitled to collect liquidated damages in the amount of $5,000 and an additional $100 per day for each day Contractor fails to remedy the late or improper completion of the Work.

Bidder must enter company name here

Version 2 (10/2018) 2

STATE OF MICHIGAN

Request For Proposal No. 491 190000000546 Hospital and Healthcare Services for Center for Forensic Psychiatry

SCHEDULE B

PRICING

1. The Contractor must propose a pricing schedule for the proposed Contract Activities. The pricing schedule must include rates for direct services as well as one hourly rate for all administrative functions. The Contractor must define all administrative functions that will be included in the hourly rate. The pricing schedule should be submitted in a modifiable format (e.g.. Microsoft Word or Excel); however, you may also submit an additional pricing schedule in a non-modifiable format (e.g., PDF). Failure to complete the pricing schedule as requested may result in disqualification of your proposal.

2. Price proposals must include all costs, including but not limited to, any one-time or set-up charges, fees, and potential costs that Contractor may charge the State (e.g., shipping and handling, per piece pricing, and palletizing).

3. The Contractor is encouraged to offer quick payment terms. The number of days must not include processing time for payment to be received by the Contractor's financial institution.

Quick payment terms: ________ % discount off invoice if paid within ________ days after receipt of invoice.

4. By submitting its proposal, the Contractor certifies that the prices were arrived at independently, and without consultation, communication, or agreement with any other Contractor.

Enter company name here.

Version 2 (10/2018) 2

STANDARD CONTRACT TERMS

It is anticipated that this Contract will be effective for the period April 1, 2019 through March 31, 2022.

This Contract may be renewed for up to 2 additional 1-year periods. Renewal is at the sole discretion of the State and will automatically extend the Term of this Contract. The State will document its exercise of renewal options via Contract Change Notice.

The parties agree as follows:

1. Duties of Contractor. Contractor must perform the services and provide the deliverables described in Schedule A – Statement of Work (the “Contract Activities”). An obligation to provide delivery of any commodity is considered a service and is a Contract Activity.

Contractor must furnish all labor, equipment, materials, and supplies necessary for the performance of the Contract Activities, and meet operational standards, unless otherwise specified in Schedule A.

Contractor must: (a) perform the Contract Activities in a timely, professional, safe, and workmanlike manner consistent with standards in the trade, profession, or industry; (b) meet or exceed the performance and operational standards, and specifications of the Contract; (c) provide all Contract Activities in good quality, with no material defects; (d) not interfere with the State’s operations; (e) obtain and maintain all necessary licenses, permits or other authorizations necessary for the performance of the Contract; (f) cooperate with the State, including the State’s quality assurance personnel, and any third party to achieve the objectives of the Contract; (g) return to the State any State-furnished equipment or other resources in the same condition as when provided when no longer required for the Contract; (h) not make any media releases without prior written authorization from the State; (i) assign to the State any claims resulting from state or federal antitrust violations to the extent that those violations concern materials or services supplied by third parties toward fulfillment of the Contract; (j) comply with all State physical and IT security policies and standards which will be made available upon request; and (k) provide the State priority in performance of the Contract except as mandated by federal disaster response requirements. Any breach under this paragraph is considered a material breach.

Contractor must also be clearly identifiable while on State property by wearing identification issued by the State, and clearly identify themselves whenever making contact with the State.

2. Notices. All notices and other communications required or permitted under this Contract must be in writing and will be considered given and…