RFP Document.pdf

STATE OF SOUTH DAKOTA

RURAL HEALTH TRANSFORMATION

DEPARTMENT OF HEALTH

600 EAST CAPITOL AVENUE

PIERRE, SD 57501

Rural Strong Grants: Strengthening Access to Care in Rural Communities A Rural Health Transformation Grant Opportunity

PROPOSALS ARE DUE NO LATER THAN MAY 22nd, 2026, at 5PM CT

RFP #: 26-09RHT-001 State POC: Kirsten Blachford EMAIL: Kirsten.Blachford@state.sd.us

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FIRM NAME: AUTHORIZED SIGNATURE:

ADDRESS: TYPE OR PRINT NAME:

CITY/STATE: TELEPHONE NO:

ZIP (9 DIGIT): FAX NO:

E-MAIL:

PRIMARY CONTACT INFORMATION

CONTACT NAME: TELEPHONE NO:

FAX NO: E-MAIL:

1.0 GENERAL INFORMATION

1.1 PURPOSE OF REQUEST FOR PROPOSAL (RFP)

The Rural Health Transformation initiative is a statewide effort focused on strengthening rural healthcare systems and improving access to quality care across South Dakota. Through strategic investments, innovative care models, and cross-agency collaboration, Rural Health Transformation is designed to build a more resilient, connected, and sustainable rural health system for communities across the state.

These grants are intended to strengthen access to care in rural communities. These are subrecipient provider grants funded through the Rural Health Transformation Project supported by the Centers for Medicare & Medicaid Services (CMS) and are in support of the following initiatives described in the Rural Health Transformation Program project narrative.

Medicaid Rural Health Access and Quality Grants Medicaid Primary Accountable Care Transformation Regional Maternal and Infant Health Hubs

Funding Available The grant opportunity will make multiple awards with a total funding pool for awards of up to $31,750,000 for budget period one. Please note future budget periods funding amounts are to be determined and have not been awarded to the State by CMS. It is anticipated funding levels may be similar in budget periods 2 and 3, before tapering down in budget periods 4 and 5. The award amount per applicant is expected to vary based on the proposed project.

Eligible Providers The South Dakota Department of Social Services, Division of Medical Services (Medicaid) and Department of Health, are requesting proposals from hospitals, federally qualified health centers, rural health clinics, Indian Health Services/Tribal 638 clinics, clinics enrolled as physician groups, behavioral health clinics, and dental clinics for Rural Strong Grants. Applicants must be enrolled with Medicaid. Only business entities are eligible to apply. Individual providers are not eligible for grant awards.

Allowable Uses of Funds Grant funds may only be used for the following purposes:

Operational and Strategic Planning: Assessing health and service needs of their communities and conducting strategic planning. Results of this may inform other allowable grant activities including development of strategic partnerships, service line expansion, and development of regional resources.

Strategic Partnerships: Planning and developing mutually beneficial strategic partnerships including partnerships and affiliations with regional health systems, which would include referral and coordination of specialty provider services in-person or virtually. Funding for shared infrastructure including patient referral systems, telehealth platforms, population health tools, billing services, and affiliation development assistance.

Service Line Expansion: Technical assistance for providers to expand existing specialty service lines in their community or develop new viable and necessary service lines to be able to deliver services in the local community. Funding may be used for minor renovations or alterations if they are clearly linked to the program goals and approved by CMS in advance.

Preference may be given to providers addressing access to maternal healthcare services.

Regional Resources/Hub and Spoke Models: Funding for the development of shared rural regional resources such as creation or rural regional hubs for services that leverage economies of scale. Results of this action may include regionals hubs and spoke models for specialized care not widely available in rural parts of the state such as hub and spoke models for maternal healthcare. Funding can be used to develop telehealth and data infrastructure, provide training and technical assistance to hub and spoke staff, and pilot, refine, and scale hub operations. Preference may be given to providers addressing access to maternal healthcare services.

Care Coordination Infrastructure/Readiness for Value-Based Care: Funding for developing and supporting care coordination infrastructure including case management staff, tools for case management/population health, and/or case management specific technology upgrades. This funding can be used for participation in Medicaid Primary Accountable Care Transformation and/or regional maternal hub and spoke models. Although proposals are not required to request care coordination infrastructure funding, proposals for regional maternal hub and spoke models must outline how care coordination will be achieved. Funding may also be used for specific barriers primary care may have to enter value-based payment space, with special consideration given to clinics not connected to larger health systems and shared resources.

For more information regarding the Rural Health Transformation program please refer to this website:

ruralhealthtransformation.sd.gov.

1.2 ISSUING OFFICE AND RFP REFERENCE NUMBER

The Division of Medical Services is the issuing office for this document and all subsequent addenda relating to it, on behalf of the State of South Dakota, Department of Social Services. The reference number for the transaction is RFP #26-09RHT-001. This number must be referred to on all proposals, correspondence, and documentation relating to the RFP.

1.3 LETTER OF INTENT

All interested offerors are requested to submit a non-binding Letter of Intent to respond to this RFP. While preferred, a Letter of Intent is not mandatory to submit a proposal.

Be sure to reference the RFP number in your letter.

The Letter of Intent may be submitted to Kirsten Blachford via email at Kirsten.Blachford@state.sd.us no later than April 16th, 2026. Please place the following in the subject line of your email: “Letter of Intent for

RFP26-09RHT-001.

1.4 SCHEDULE OF ACTIVITIES (SUBJECT TO CHANGE)

RFP Publication 04/02/2026 Letter of Intent to Respond Due 04/16/2026 Offeror Questions Due Responses to Offeror Questions

04/23/2026 05/07/2026

Request for SFTP folder Proposal Submission

05/21/2026 05/22/2026

State Request for Additional Information/Clarification TBD Anticipated Award Decision/Contract Negotiation On or before 06/22/2026

1.5 SUBMITTING YOUR PROPOSAL

All proposals must be completed and received in the SFTP by the date and time indicated in the Schedule of Activities.

Proposals received after the deadline will be late and ineligible for consideration.

Proposals must be submitted as PDFs via Secured File Transfer Protocol (SFTP). Offerors must request an SFTP folder no later than the date indicated in the Schedule of Activities by emailing Kirsten Blachford at Kirsten.Blachford@state.sd.us.

The subject line should read “RFP# 26-09RHT-001 SFTP Request”. The email should contain the name and the email of the person who will be responsible for uploading the document(s).

Please note, offeror will need to work with their own technical support staff to set up an SFTP compatible software on offeror’s end. While the State of South Dakota can answer questions, State of South Dakota is not responsible for the software required.

All proposals may be signed in ink or digitally by an officer of the offeror legally authorized to bind the offeror to the proposal and sealed in the form intended by the respondent. Proposals that are not properly signed may be rejected.

No proposal may be accepted from, or any contract or purchase order awarded to any person, firm or corporation that is in arrears upon any obligations to the State of South Dakota, or that otherwise may be deemed irresponsible or unreliable by the State of South Dakota.

1.6 CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY

EXCLUSION – LOWER TIER COVERED TRANSACTIONS

By signing and submitting this proposal, the offeror certifies that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation, by any Federal department or agency, from transactions involving the use of Federal funds.

Where the offeror is unable to certify to any of the statements in this certification, the bidder shall attach an explanation to their offer.

1.7 NON-DISCRIMINATION STATEMENT

The State of South Dakota requires that all contractors, vendors, and suppliers doing business with any State agency, department, or institution, provide a statement of non-discrimination. By signing and submitting their proposal, the offeror certifies they do not discriminate in their employment practices with regard to race, color, creed, religion, age, sex, ancestry, national origin or disability.

1.8 CERTIFICATION RELATING TO PROHIBITED ENTITY

For contractors, vendors, suppliers, or subcontractors who enter into a contract with the State of South Dakota by submitting a response to this solicitation or agreeing to contract with the State, the bidder or offeror certifies and agrees that the following information is correct:

The bidder or offeror, in preparing its response or offer or in considering proposals submitted from qualified, potential vendors, suppliers, and subcontractors, or in the solicitation, selection, or commercial treatment of any vendor, supplier, or subcontractor, is not an entity, regardless of its principal place of business, that is ultimately owned or controlled, directly or indirectly, by a foreign national, a foreign parent entity, or foreign government from China, Iran, North Korea, Russia, Cuba, or Venezuela, as defined by SDCL 5-18A. It is understood and agreed that, if this certification is false, such false certification will constitute grounds for the State to reject the bid or response submitted by the bidder or offeror on this project and terminate any contract awarded based on the bid or response. The successful bidder or offeror further agrees to provide immediate written notice to the contracting executive branch agency if during the term of the contract it no longer complies with this certification and agrees such noncompliance may be grounds for contract termination.

1.9 RESTRICTION OF BOYCOTT OF ISRAEL

For contractors, vendors, suppliers, or subcontractors with five (5) or more employees who enter into a contract with the State of South Dakota that involves the expenditure of one hundred thousand dollars ($100,000) or more, by submitting a response to this solicitation or agreeing to contract with the State, the bidder or offeror certifies and agrees that the following information is correct:

The bidder or offeror, in preparing its response or offer or in considering proposals submitted from qualified, potential vendors, suppliers, and subcontractors, or in the solicitation, selection, or commercial treatment of any vendor, supplier, or subcontractor, has not refused to transact business activities, has not terminated business activities, and has not taken other similar actions intended to limit its commercial relations, related to the subject matter of the bid or offer, with a person or entity on the basis of Israeli national origin, or residence or incorporation in Israel or its territories, with the specific intent to accomplish a boycott or divestment of Israel in a discriminatory manner. It is understood and agreed that, if this certification is false, such false certification will constitute grounds for the State to reject the bid or response submitted by the bidder or offeror on this project and terminate any contract awarded based on the bid or response. The successful bidder or offeror further agrees to provide immediate written notice to the contracting executive branch agency if during the term of the contract it no longer complies with this certification and agrees such noncompliance may be grounds for contract termination.

1.10 MODIFICATION OR WITHDRAWAL OF PROPOSALS

Proposals may be modified or withdrawn by the offeror prior to the established due date and time.

No oral, telephonic, telegraphic or facsimile responses or modifications to informal, formal bids, or Request for Proposals will be considered.

1.11 OFFEROR INQUIRIES

Offerors may email inquiries concerning this RFP to obtain clarification of requirements. No inquiries will be accepted after the date and time indicated in the Schedule of Activities. Inquiries must be emailed to Kirsten Blachford at Kirsten.Blachford@state.sd.us with the subject line “RFP #26-09RHT-001”.

The State will respond to offeror’s inquiries (if required) via e-mail. In addition, all inquiries and the State’s response will be posted on the state’s e-procurement system. Offerors may not rely on any other statements, either of a written or oral nature, that alter any specification or other term or condition of this RFP. Offerors will be notified in the same manner as indicated above regarding any modifications to this

RFP.

1.12 PROPRIETARY INFORMATION

The proposal of the successful offeror(s) becomes public information. Proprietary information can be protected under limited circumstances such as client lists and non-public financial statements. An entire proposal may not be marked as proprietary. Offerors must clearly identify in the Executive Summary and mark in the body of the proposal any specific proprietary information they are requesting to be protected.

The Executive Summary must contain specific justification explaining why the information is to be protected. Proposals may be reviewed and evaluated by any person at the discretion of the State. All materials submitted become the property of the State of South Dakota and may be returned only at the State's option.

1.13 LENGTH OF CONTRACT

The contract resulting from this RFP will be issued for a period starting on or around May 8, 2026, and ending September 30, 2027. Contracts may include options for up to four one-year renewals.

1.14 GOVERNING LAW

Venue for any and all legal action regarding or arising out of the transaction covered herein shall be solely in the State of South Dakota. The laws of South Dakota shall govern this transaction.

1.15 DISCUSSIONS WITH OFFERORS (ORAL PRESENTATION/NEGOTIATIONS)

An oral presentation by an offeror to clarify a proposal may be required at the sole discretion of the State.

However, the State may award a contract based on the initial proposals received without discussion with the Offeror. If oral presentations are required, they will be scheduled after the submission of proposals.

Oral presentations will be made at the offeror’s expense.

This process is a Request for Proposal/Competitive Negotiation process. Each Proposal shall be evaluated, and each respondent shall be available for negotiation meetings at the State’s request. The State reserves the right to negotiate on any and/or all components of every proposal submitted. From the time the proposals are submitted until the formal award of a contract, each proposal is considered a working document and as such, will be kept confidential. The negotiation discussions will also be held as confidential until such time as the award is completed.

2.0 STANDARD CONTRACT TERMS AND CONDITIONS

Any contract or agreement resulting from this RFP will include the State’s standard terms and conditions as listed below, along with any additional terms and conditions as negotiated by the parties:

2.1 The Contractor will perform those services described in the Scope of Work, attached hereto as Section 3 of the RFP and by this reference incorporated herein.

2.2 The Contractor’s services under this Agreement shall commence on ___ and end on ___, unless sooner terminated pursuant to the terms hereof.

2.3 The Contractor will not use State equipment, supplies or facilities. The Contractor will provide the State with its Employer Identification Number, Federal Tax Identification Number or Social Security Number upon execution of this Agreement.

2.4 The State will make payment for services upon satisfactory completion of the services. The TOTAL

CONTRACT AMOUNT is an amount not to exceed $___. The State will not pay Contractor's expenses as a separate item. Payment will be made pursuant to itemized invoices submitted with a signed state voucher.

Payment will be made consistent with SDCL ch. 5-26.

2.5 The Contractor agrees to indemnify and hold the State of South Dakota, its officers, agents and employees, harmless from and against any and all actions, suits, damages, liability or other proceedings that may arise as the result of performing services hereunder. This section does not require the Contractor to be responsible for or defend against claims or damages arising solely from errors or omissions of the State, its officers, agents or employees.

2.6 The Contractor, at all times during the term of this Agreement, shall obtain and maintain in force insurance coverage of the types and with the limits as follows:

A. Commercial General Liability Insurance:

The Contractor shall maintain occurrence based commercial general liability insurance or equivalent form with a limit of not less than $1,000,000.00 for each occurrence. If such insurance contains a general aggregate limit it shall apply separately to this Agreement or be no less than two times the occurrence limit.

B. Professional Liability Insurance or Miscellaneous Professional Liability Insurance:

The Contractor agrees to procure and maintain professional liability insurance or miscellaneous professional liability insurance with a limit not less than $1,000,000.00.

C. Business Automobile Liability Insurance:

The Contractor shall maintain business automobile liability insurance or equivalent form with a limit of not less than $1,000,000.00 for each accident. Such insurance shall include coverage for owned, hired and non-owned vehicles.

D. Worker’s Compensation Insurance:

The Contractor shall procure and maintain workers’ compensation and employers’ liability insurance as required by South Dakota law.

Before beginning work under this Agreement, Contractor shall furnish the State with properly executed Certificates of Insurance which shall clearly evidence all insurance required in this Agreement. In the event a substantial change in insurance, issuance of a new policy, cancellation or nonrenewal of the policy, the Contractor agrees to provide immediate notice to the State and provide a new certificate of insurance showing continuous coverage in the amounts required. Contractor shall furnish copies of insurance policies if requested by the State.

2.7 While performing services hereunder, the Contractor is an independent contractor and not an officer, agent, or employee of the State of South Dakota.

2.8 Contractor agrees to report to the State any event encountered in the course of performance of this

Agreement which results in injury to the person or property of third parties, or which may otherwise subject Contractor or the State to liability. Contractor shall report any such event to the State immediately upon discovery.

Contractor's obligation under this section shall only be to report the occurrence of any event to the State and to make any other report provided for by their duties or applicable law. Contractor's obligation to report shall not require disclosure of any information subject to privilege or confidentiality under law (e.g., attorney-client communications). Reporting to the State under this section shall not excuse or satisfy any obligation of Contractor to report any event to law enforcement or other entities under the requirements of any applicable law.

2.9 This Agreement may be terminated by either party hereto upon thirty (30) days written notice. In the event the Contractor breaches any of the terms or conditions hereof, this Agreement may be terminated by the State at any time with or without notice. If termination for such a default is effected by the State, any payments due to Contractor at the time of termination may be adjusted to cover any additional costs to the State because of Contractor's default. Upon termination the State may take over the work and may award another party an agreement to complete the work under this Agreement. If after the State terminates for a default by Contractor it is determined that Contractor was not at fault, then the Contractor shall be paid for eligible services rendered and expenses incurred up to the date of termination.

2.10 This Agreement depends upon the continued availability of appropriated funds and expenditure authority from the Legislature for this purpose. If for any reason the Legislature fails to appropriate funds or grant expenditure authority, or funds become unavailable by operation of law or federal funds reductions, this Agreement will be terminated by the State. Termination for any of these reasons is not a default by the State nor does it give rise to a claim against the State.

2.11 This Agreement may not be assigned without the express prior written consent of the State. This Agreement may not be amended except in writing, which writing shall be expressly identified as a part hereof, and be signed by an authorized representative of each of the parties hereto.

2.12 This Agreement shall be governed by and construed in accordance with the laws of the State of South

Dakota. Any lawsuit pertaining to or affecting this Agreement shall be venued in Circuit Court, Sixth Judicial Circuit, Hughes County, South Dakota.

2.13 The Contractor will comply with all federal, state and local laws, regulations, ordinances, guidelines, permits and requirements applicable to providing services pursuant to this Agreement, and will be solely responsible for obtaining current information on such requirements.

2.14 The Contractor may not use subcontractors to perform the services described herein without the express prior written consent of the State. The Contractor will include provisions in its subcontracts requiring its subcontractors to comply with the applicable provisions of this Agreement, to indemnify the State, and to provide insurance coverage for the benefit of the State in a manner consistent with this Agreement. The Contractor will cause its subcontractors, agents, and employees to comply, with applicable federal, state and local laws, regulations, ordinances, guidelines, permits and requirements and will adopt such review and inspection procedures as are necessary to assure such compliance.

2.15 Contractor hereby acknowledges and agrees that all reports, plans, specifications, technical data, miscellaneous drawings, software system programs and documentation, procedures, or files, operating instructions and procedures, source code(s) and documentation, including those necessary to upgrade and maintain the software program, and all information contained therein provided to the State by the Contractor in connection with its performance of services under this Agreement shall belong to and is the property of the State and will not be used in any way by the Contractor without the written consent of the State. Papers, reports, forms, software programs, source code(s) and other material which are a part of the work under this Agreement will not be copyrighted without written approval of the State.

2.16 The Contractor certifies that neither Contractor nor its principals are presently debarred, suspended, proposed for debarment or suspension, or declared ineligible from participating in transactions by the federal government or any state or local government department or agency. Contractor further agrees that it will immediately notify the State if during the term of this Agreement Contractor or its principals become subject to debarment, suspension or ineligibility from participating in transactions by the federal government, or by any state or local government department or agency.

2.17 Any notice or other communication required under this Agreement shall be in writing and sent to the address set forth above. Notices shall be given by and to ___ on behalf of the State, and by ___, on behalf of the Contractor, or such authorized designees as either party may from time to time designate in writing. Notices or communications to or between the parties shall be deemed to have been delivered when mailed by first class mail, provided that notice of default or termination shall be sent by registered or certified mail, or, if personally delivered, when received by such party.

2.18 In the event that any court of competent jurisdiction shall hold any provision of this Agreement unenforceable or invalid, such holding shall not invalidate or render unenforceable any other provision hereof.

2.19 All other prior discussions, communications and representations concerning the subject matter of this

Agreement are superseded by the terms of this Agreement, and except as specifically provided herein, this Agreement constitutes the entire agreement with respect to the subject matter hereof.

2.20 This contract is supported by the Centers for Medicare & Medicaid Services (CMS) of the U.S.

Department of Health and Human Services (HHS) as part of a financial assistance award totaling $___ with 100 percent funded by CMS/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CMS/HHS, or the U.S. Government.

3.0 SCOPE OF WORK

The purpose of this Request for Proposal (RFP) is to obtain proposals from Medicaid enrolled hospitals, federally qualified health centers, rural health clinics, Indian Health Services/Tribal 638 clinics, clinics enrolled as physician groups, behavioral health clinics, and dental clinics to strengthen and sustain essential services in South Dakota’s rural communities. The grants will help ensure continued access and expand access to important health care services, which will ultimately result in improved outcomes for rural South Dakotans. Additional guidance regarding allowable use of funds is provided in Exhibit A and Exhibit B. A grant template guide is provided in Exhibit C and a Budget Template is provided in Exhibit D.

3.1 Project goals and overview (3 pages, single-spaced or less): Projects should have a clearly articulated vision that leverages an identified allowable use of funds to strengthen rural providers, keep healthcare in local rural communities, expand access to healthcare in rural communities, and ultimately improves health outcomes. Provide the following information:

3.1.1 Identify which of the allowable uses of fund this proposal is for: A) Operational and Strategic Planning, B) Strategic Partnerships, C) Service Line Expansion, D) Regional Resources/Hub and Spoke Models, E) Care Coordination Readiness for Value Based Care. Applicants may identify multiple allowable uses of funds.

3.1.2 An overview of the proposed project.

3.1.3 Project goals that are specific, measurable, achievable, relevant, and time bound.

3.2 Impact statement (2 pages, single-spaced or less): Proposals should include an identified need and clearly demonstrate how the proposal addresses the need. Proposal must have positive and transformative impact on rural healthcare in South Dakota. Proposals should be beneficial for the Medicaid population, but may also benefit the general patient population. Provide the following information.

3.2.1 Identify the estimated number of patients that will be impacted by the proposal, including the number of Medicaid recipients.

3.2.2 The anticipated impact of the proposal, how it will be transformative, how it will benefit Medicaid recipients, and the specific health outcomes that it will improve.

3.2.3 The need being addressed, data that supports addressing the need, and an explanation regarding how the proposal addresses the need.

3.3 Organizational and community profile (2 pages, single-spaced or less): Proposals should strengthen rural providers and primarily benefit rural communities and residents. Provide the following information:

3.3.1 An overview of your organization including physical locations where the organization is located and services areas.

3.3.2 An overview of the community including the demographics of the community that this proposal is for, anticipated changes in demographics over the next 10 years, and how the proposal aligns with both current and future demographics.

3.4 Project management plan (2 pages, single-spaced or less): Organizations should have a plan that demonstrates the ability to manage and implement the proposal timely and successfully. Provide the following information:

3.4.1 An overview of your organization’s project management structure for the proposal including the project director responsible for oversight and implementation and key staff members and their titles.

3.4.2 A brief biography or resume for key resources. This item is exempt from the page limit and may be provided as an exhibit or appendix.

3.5 Implementation plan (2 pages, single-spaced or less): Implementation plans should reflect the organization ability to make timely progress and utilize the funding within the allotted timeline. Provide the following information:

3.5.1 An implementation timeline with key project milestones including estimated percentage of funding utilized by key project milestones.

3.6 Sustainability plan (2 pages, single-spaced or less): Proposals should be sustainable and be able to continue with minimal disruption when grant funding ends. Provide the following information:

3.6.1 Describe how the proposal will be sustainable and how the organization anticipates the proposal will be funded or self-sustainable after grant funding ends.

3.7 Reporting and evaluation plan (2 pages, single-spaced or less): It is anticipated that awardees will be required to submit a quarterly progress report and an annual report, which will help inform required reporting to CMS. Provide the following information

3.7.1 Specific evaluation measures that will be utilized to measure success.

3.7.2 A plan for collecting and evaluating data that will be reported to the State and inform reporting to

CMS.

3.8 Budget and Budget Narrative (4 pages, single-spaced or less): Applicants should submit a budget and budget narrative that identifies and clearly explains the proposed budget. Budgets should be clear, reasonable, and demonstrate an efficient and effective use of grant funding. Awards may be less than the offeror’s budget, depending on the number of quality responses received.

The Budget periods and State spending deadlines for funds are as follows:

Budget Period Begin Date End Date Deadline for Spending Budget Period 1 Award Date October 30, 2026 September 30, 2027 Budget Period 2 October 31, 2026 October 30, 2027 September 30, 2028 Budget Period 3 October 31, 2027 October 30, 2028 September 30, 2029 Budget Period 4 October 31, 2028 October 30, 2029 September 30, 2030 Budget Period 5 October 31, 2029 October 30, 2030 September 30, 2031

Provide the following information:

3.8.1 A detailed proposed budget and budget narrative for the project. Budgets should be completed using the Budget Template provided in Exhibit D.

3.8.2 To demonstrate a scalable option, applicants may provide one alternative budget/budget narrative to reflect a higher or lower level of funding than their main budget proposal at their discretion. If submitting an alternative budget, clearly label the budget as “Alternative Budget Proposal.”

3.8.3 If not awarded the full requested amount, please specify if you have other resources available to capitalize the proposal and the extent of the resources.

Applicants may be asked to submit a revised budget during the evaluation or contracting phase.

4.0 PROPOSAL REQUIREMENTS AND COMPANY QUALIFICATIONS

4.1 The offeror is cautioned that it is the offeror's sole responsibility to submit information related to the evaluation categories and that the State of South Dakota is under no obligation to solicit such information if it is not included with the proposal. The offeror's failure to submit such information may cause an adverse impact on the evaluation of the proposal.

4.2 Offeror's Contacts: Offerors and their agents (including subcontractors, employees, consultants, or anyone else acting on their behalf) must direct all of their questions or comments regarding the RFP, the evaluation, etc. to the buyer of record indicated on the first page of this RFP. Offerors and their agents may not contact any state employee other than the buyer of record regarding any of these matters during the solicitation and evaluation process. Inappropriate contacts are grounds for suspension and/or exclusion from specific procurements. Offerors and their agents who have questions regarding this matter should contact the buyer of record.

4.3 The offeror may be required to submit a copy of their most recent independently audited financial statements.

4.4 If an offerors proposal is not accepted by the State, the proposal will not be reviewed/evaluated. Examples include: Proposal was not received on time. Proposal was not signed. Electronic file was not provided.

5.0 PROPOSAL RESPONSE FORMAT

5.1 Proposals must follow all identified page limits.

5.2 Disclosure of other RHT Funding (2 pages or less single-spaced) – PDF

5.2.1 Disclose any other RHT funding applied for with the state of South Dakota and any potential duplication between this application and other funding.

5.2.2 Disclose any other RHT funding applied for with another state and any potential duplication between this application and other funding.

5.3 Only a PDF copy shall be submitted via SFTP folder.

5.3.1 The proposal should be page numbered and have an index and/or a table of contents referencing the appropriate page number.

5.4 All proposals must be organized and tabbed with labels for the following headings:

5.4.1 RFP Form. The State’s Request for Proposal form (1st page of RFP) completed and signed.

5.4.2 Detailed Response. This section should constitute the major portion of the proposal and must contain at least the following information:

5.4.2.1 A complete narrative of the offeror's assessment of the work to be performed, the offeror’s ability and approach, and the resources necessary to fulfill the requirements as outlined in Section 3. This should demonstrate the offeror's understanding of the desired overall performance expectations.

5.4.2.2 A specific point-by-point response, in the order listed in Section 3, to each requirement in the RFP. The response should identify each requirement being addressed as enumerated in the RFP.

5.4.3 Cost Proposal. This section will be evaluated independently from the technical proposal. All costs related to the provision of the required services must be included in each cost proposal offered. See section 3.8 for more information related to the cost proposal.

6.0 PROPOSAL EVALUATION AND AWARD PROCESS

6.1 After determining that a proposal satisfies the mandatory requirements stated in the Request for Proposal, the evaluator(s) shall use subjective judgment in conducting a comparative assessment of the proposal by considering each of the following criteria:

6.1.1 Demonstrates significant, measurable health impacts (improved access, improved health outcomes, earlier care intervention, etc.) for rural South Dakotans;

6.1.2 Describes a compelling healthcare need affecting rural South Dakotans and has a clear plan for addressing this need;

6.1.3 Is transformative for healthcare in rural South Dakota and considers the long-term needs of the community served;

6.1.4 Demonstrates the availability or plan to secure necessary partners or resources to perform the work within the specified time limits for the project;

6.1.5 Describes a project structure and project management approach that will meet project implementation requirements;

6.1.6 Presents a detailed and logical implementation plan that reflects the organization’s readiness to initiate promptly and maintain progress;

6.1.7 Is sustainable when grant funding ends or includes the ability for the proposal to be self-sustaining;

6.1.8 Identifies specific, relevant evaluation measures that can be used in regular progress and comprehensive evaluative reports.

6.1.9 Proposed budget is clear, economical, efficient, and reasonable.

Preference may be given to projects addressing access to maternal healthcare services, as well as projects addressing care coordination infrastructure and/or readiness for value-based care.

6.2 Experience and reliability of the offeror's organization are considered subjectively in the evaluation process.

Therefore, the offeror is advised to submit any information which documents successful and reliable experience in past performances, especially those performances related to the requirements of this RFP.

6.3 The qualifications of the personnel proposed by the offeror to perform the requirements of this RFP, whether from the offeror's organization or from a proposed subcontractor, will be subjectively evaluated. Therefore, the offeror should submit detailed information related to the experience and qualifications, including education and training, of proposed personnel.

6.4 The State reserves the right to reject any or all proposals, waive technicalities, and make award(s) as deemed to be in the best interest of the State of South Dakota.

6.5 Award: The requesting agency and the highest ranked offeror(s) shall mutually discuss and refine the scope of services for the project and shall negotiate terms, including compensation and performance schedule.

6.5.1 If the agency and the highest ranked offeror(s) are unable for any reason to negotiate a contract at a compensation level that is reasonable and fair to the agency, the agency shall, either orally or in writing, terminate negotiations with the contractor. The agency may then negotiate with the next highest ranked contractor.

6.5.2 The negotiation process may continue through successive offerors, according to agency ranking, until an agreement is reached or the agency terminates the contracting process.

6.5.3 Only the response of the vendor(s) awarded work becomes public. Responses to work orders for vendors not selected and the evaluation criteria and scoring for all proposals are not public.

Vendors may submit a redacted copy with the full proposal as stated in Section 1.12 Proprietary Information. SDCL 1-27-1.5 and See SDCL 1-27-1.5 and 1-27-1.6.

7.0 COST PROPOSAL

Please note that funding for this RFP is subject to spending approval of Rural Health Transformation grant funds by the SD Legislature.

Budgets should be completed using the Budget Template provided in Exhibit D.

Refer to section 3.8 for information that must be provided.

Exhibit A: Use of Funds and Limitations Proposed fund use cannot include unallowable costs as outlined in the CMS Notice of Award. This includes, but is not limited to:

Pre-award costs.

Meeting matching requirements for any other federal funds or local entities.

Services, equipment, or supports that are the legal responsibility of another party under federal, State, or tribal law, such as vocational rehabilitation or education services.

Services, equipment, or supports that are the legal responsibility of another party under any civil rights law, such as modifying a workplace or providing accommodations that are obligations under law.

Goods or services not allocable to the project Supplanting existing State, local, tribal, or private funding of infrastructure or services, such as staff salaries.

Construction or building expansion, purchasing or significant retrofitting of buildings, cosmetic upgrades, or any other cost that materially increases the value of the capital or useful life as a direct cost.

The cost of independent research and development, including their proportionate share of indirect costs. See 2

CFR 300.477.

Purchase of covered telecommunications and video surveillance equipment (See 2 CFR 200.216) as well as financial assistance to households for installation and monthly broadband internet cost.

Meals, unless in limited circumstances such as:

o Subjects and patients under study.

o Where specifically approved as part of the project or program activity, such as in programs providing children’s services.

o As part of a per diem or subsistence allowance provided in conjunction with allowable travel.

Activities prohibited under 2 CFR 200.450 and the HHS Grants Policy Statement, including but not limited to:

o Payments related to any activity designed to influence the enactment of legislation, appropriations, regulation, administrative action, or executive order proposed or pending before the Congress or any State government, State legislature, local legislature or legislative body, including but not limited to paying the salary or expenses of any grant Recipient or agent acting for such Recipient for such activity.

o Lobbying, but Recipients can lobby at their own expense if they can segregate federal funds from other financial resources used for lobbying.

Construction. Funds may not be used for new construction. Funds also may not be used for the following:

o To supplant funding for in process or planned construction projects or directing funding towards new construction builds.

o Construction or building expansion, purchasing or significant retrofitting of buildings, cosmetic upgrades, or any other cost that materially increases the value of the capital or useful life as a direct cost.

Minor Renovations or Alterations. Funds may be used for minor renovations or alterations if they are clearly linked to program goals and receive CMS prior approval.

Duplicate payments. Funds may not be used to replace payment for clinical services that could be reimbursed by insurance. Funds also may not be used for payments to clinical services if they duplicate billable services and/or attempt to change the payment amounts of existing fee schedules.

None of the funding shall be used by the Recipient for an expenditure that is attributable to an intergovernmental transfer, certified public expenditure, or any other expenditure to finance the non-Federal share of expenditures required under any provision of law.

SSA 2105(c), paragraphs (1), (7), and (9) apply as funding limitations. These limitations are related to general limitations, limitations on payment for abortions, and citizenship documentation requirements for payments made with respect to an individual.

Exhibit B: Quick Answers

1. Is this grant limited to enrolled Medicaid providers?

Yes, grant applicants must be Medicaid enrolled with Medicaid. Enrolled providers may contract with or partner with other entities that are not Medicaid providers.

2. Do applicants have to be located in a rural area?

Providers located in urban areas may apply but must explain in the application how the proposal benefits rural South Dakotans. Funding is targeted at initiatives that strengthen rural providers, keep healthcare in local rural communities, and expands access to healthcare in rural communities.

3. For hospitals, is funding limited to critical access hospitals.

No, other hospitals may apply. Funding is targeted to initiatives that build a more resilient, connected, and sustainable rural health system.

4. Is funding for future budget periods guaranteed?

No, CMS has only awarded funding for the first budget period. Funding for subsequent budget periods is subject to change.

5. Can funding be used for technology?

Proposal may include funding for technology. Proposals should not be duplicative of the Digital Health Modernization and Technology Grant opportunity and to the extent technology can be funded through that opportunity it is recommended that providers apply for that opportunity.

6. Can funding be used for expansion of services that are targeted at chronic diseases?

Proposals may include expansion of services that address a need related to chronic disease. For initiatives primarily focused on chronic diseases it is recommended that providers apply for the Strengthening Chronic Disease Management grant opportunity that will be made available.

7. Can funding be used for new construction or major remodeling?

No, per CMS funding cannot be used for new construction or building expansion. Minor renovation or alterations related to program goals may be allowable. Providers may propose projects that include minor renovations or alterations, but the projects will require additional approval by CMS.

8. Can funding be used to pay for a clinician's salary?

Per CMS guidance RHT Program funds may not be used for clinician salaries or wage support for facilities that subject clinicians to noncompete contractual limitations. Funds may go towards clinician salaries and wage supports if the clinician is not subject to a non-compete agreement and the salary/wage support is being funded as part of an approved initiative. Any proposed use of funds for clinician salaries should be clearly linked to program goals and the sustainability plan should explain how the provider will support the clinician salary when grant funds end. In addition, the applicant should provide confirmation in the application that the clinician is not subject to a non-compete agreement.

9. Can funding be used to pay for clinical support staff such as case managers?

Proposals for funding for clinical support staff that align with program goals may be considered. The sustainability plan should explain how the provider will support the clinician salary when grant funds end.

10. Can funding be used for expansion of transportation services to medical appointments?

Yes, it is anticipated that this is an allowable activity. Proposals to use funding to purchase vehicles may require additional approval by CMS.

11. Will additional funding be released to support the case management activities for the Medicaid Primary Accountable Care Transformation model?

This grant funding is included in this opportunity. Additional rounds of funding to support implementation of this model may be made available in the future.

12. Can funds be used to purchase radiography equipment, laboratory equipment or other medical equipment?

Proposals can include funding for this type of equipment. Providers should explain how the equipment will support access to care and financial sustainability.

13. What are the reporting requirements associated with accepting grant funding?

The State will require reporting from awardees to monitor progress, impact, and help inform reporting required to CMS. CMS requires the State to file quarterly and annual progress reports. It is anticipated that awardees will be required to report to the State on a similar frequency.

Exhibit C: Rural Strong Grants Template Guide Applicants are encouraged to use this guide to help complete the application.

RFP Form (Section 5.2)

Complete the State’s Request for Proposal form (1st page of RFP) and sign it.

Disclosure of RHT Funding (Section 5.4) Disclose any other RHT funding applied for with the state of South Dakota and any potential duplication between this application and other funding.

Disclose any other RHT funding applied for with another state and any potential duplication between this application and other funding.

Project Goals and Overview (Section 3.1) Page Limit: 3 pages, single-spaced or less Identify one or more allowable uses of funding that aligns with your proposal (see Section 1.1 for further description of the categories):

o A) Operational and Strategic Planning o B) Strategic Partnerships o C) Service Line Expansion o D) Regional Resources/Hub and Spoke Models, o E) Care Coordination Readiness for Value Based Care.

Provide an overview of the proposed project.

Provide project goals in the SMART (specific, measurable, achievable, relevant, and time bound) format.

Impact Statement (Section 3.2) Page Limit: 2 pages, single-spaced or less Provide the estimated number of patients that will be impacted by the proposal, including the number of

Medicaid recipients.

Provide the anticipated impact of the proposal, how it will be transformative, how it will benefit Medicaid recipients, and the specific health outcomes that it will improve.

Provide the need being addressed, data that supports addressing the need, and an explanation regarding how the proposal addresses the need.

Organizational and Community Profile (See section 3.3) Page Limit: 2 pages, single-spaced or less Provide an overview of your organization including physical locations where the organization is located and service areas.

Provide an overview of the community including the demographics of the community that this proposal is for, anticipated changes in demographics over the next 10 years, and how the proposal aligns with both current and future demographics.

Project Management Plan (Section 3.4)

Provide an overview of your organization’s project management structure for the proposal including the project director responsible for oversight and implementation and key staff members and their titles.

Provide a brief biography or resume for key resources. This item is exempt from the page limit and may be provided as an exhibit or appendix.

Implementation Plan (Section 3.5)

Provide an implementation timeline with key project milestones including estimated percentage of funding utilized by key project milestones.

Sustainability Plan (Section 3.6)

Describe how the proposal will be sustainable and how the organization anticipates the proposal will be funded or self-sustainable after grant funding ends.

Reporting and evaluation plan (Section 3.7)

Provide specific evaluation measures that will be utilized to measure success.

Provide a plan for collecting and evaluating data that will be reported to the State and inform reporting to CMS.

Budget and Budget Narrative (Section 3.8)

Page Limit: 4 pages, single-spaced or less Provide a detailed proposed budget and budget narrative for the project.