RFP Document.pdf

Dated 10/16/23

STATE OF SOUTH DAKOTA

Rural Health Transformation

Office of Rural Health and Emergency Services 600 East Capitol Avenue

Pierre, SD 57501

Building a Sustainable Rural Healthcare Workforce: Recruitment and Retention

PROPOSALS ARE DUE NO LATER THAN 5PM CT 09/04/2026

RFP #: 26-09RHT-024 State POC: Josie Petersen EMAIL: Josie.Petersen@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.

The purpose of this RFP is to solicit proposals from qualified healthcare organizations, facilities, and other eligible entities to participate in and support strategies to recruit, deploy, and retain a sustainable rural healthcare workforce across rural and underserved and frontier communities in South Dakota. Through this RFP, the State intends to fund and partner with multiple entities to implement coordinated, outcomes-driven workforce solutions that address critical staffing needs, improve workforce stability, and expand access to care in rural areas.

Rural healthcare systems across the state face persistent and compounding workforce challenges, including provider shortages, high turnover rates, maldistribution of licensed professionals, and increasing reliance on temporary or contract staffing. These challenges limit access to care, strain existing providers, and threaten the long-term viability of rural healthcare delivery systems.

This initiative is intended to directly address these challenges by establishing a coordinated, scalable, and outcomes-driven workforce model that:

Accelerates recruitment of qualified healthcare professionals into rural and frontier communities through targeted incentives and streamlined placement strategies Improves retention and workforce stability by supporting providers throughout their service commitment, reducing turnover, and strengthening long-term rural practice viability Optimizes workforce distribution by aligning staffing resources with areas of highest need, ensuring equitable access to care across geographies Reduces reliance on temporary staffing models (e.g., locum tenens) by building a more stable, permanent workforce base Enhances provider experience in rural settings through structured support, engagement, and administrative simplification Establishes a sustainable workforce infrastructure that can be maintained beyond the initial funding period

Proposals should align with the broader goals of the Rural Health Transformation Project to develop the rural workforce, improve access to care, and create sustainable healthcare systems across the state which can be found online at ruralhealthtransformation.sd.gov and consideration of the Strategic Analysis of South Dakota’s Rural Healthcare Programs, 2024, including the Data Analysis Summary, Infographic Summary, and Final Recommendations Report which can be found at https://doh.sd.gov/healthcare-professionals/rural-health/

1.2 ISSUING OFFICE AND RFP REFERENCE NUMBER

The Division of Healthcare Access, Office of Rural Health and Emergency 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 Health. The reference number for the transaction is RFP #26-09RHT-024.

1.3 SCHEDULE OF ACTIVITIES (SUBJECT TO CHANGE)

RFP Publication 07/22/2026 Offeror Questions Due 08/04/2026 Responses to Offeror Questions 08/14/2026 Proposal Submission 09/04/2026, at 5PM CT Anticipated Award Decision/Contract Negotiation 09/30/2026

1.4 SUBMITTING YOUR PROPOSAL

All proposals must be completed and received via email to Josie.Petersen@state.sd.us by the date and time indicated in the Schedule of Activities.

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

All proposals must be signed, in ink or an electronic signature by an officer of the responder, legally authorized to bind the responder to the proposal. Proposals that are not properly signed may be rejected.

Please place the following in the subject line of your email: Proposal for RFP #26-09RHT-024.

No proposal shall be accepted from, or no contract or purchase order shall be 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.

1.5 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.

1.6 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.

1.7 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.

1.8 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.

1.9 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.

1.10 OFFEROR INQUIRIES

Offerors may email inquiries concerning this RFP to obtain clarification of requirements. No inquiries will be accepted after the date indicated in the Schedule of Activities. Inquiries must be emailed to Josie Petersen at Josie.Petersen@state.sd.us with subject line RFP #26-09RHT-024.

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.

1.11 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.

1.12 LENGTH OF CONTRACT

The anticipated contract period is October 1, 2026 – July 31, 2027, with the option to renew for three (3) additional years in one (1) year increments. The renewal will not be automatic.

1.13 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.

1.14 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 __TBD__ and end on __TBD__, 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 $_TBD_. 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 affected 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 _Josie Petersen_ on behalf of the State, and by __TBD__, 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 Stevens Amendment Language

2.20.1 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 $_TBD__ 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 South Dakota Department of Health, Division of Healthcare Access, Office of Rural Health and Emergency Services is requesting proposals from qualified organizations to support the implementation of Building a Sustainable Rural Healthcare Workforce Initiative under the Rural Health Transformation Project administered by the South Dakota Department of Health. This RFP is specific to recruit, deploy, and retain a sustainable rural healthcare workforce.

The selected contractors will be responsible for supporting strategies to recruit, deploy, and retain a sustainable rural healthcare workforce across rural and underserved and frontier communities in South Dakota. Through this RFP, the State intends to fund and partner with multiple entities to implement coordinated, outcomes-driven workforce solutions that address critical staffing needs, improve workforce stability, and expand access to care in rural areas.

Proposals should include components addressing the following:

3.1 Workforce Recruitment & Hiring Implementation

Applicants will implement targeted recruitment strategies to fill high-priority workforce gaps, including:

Identification of critical staffing needs by role and service line (e.g., primary care, behavioral health, nursing, dental, allied health)

Development of localized recruitment plans tailored to community needs Implementation of incentive packages, which may include, but is not limited to:

Signing bonuses Relocation assistance Rural service incentives such as rental assistance or housing subsidies Preceptor or mentorship stipends Childcare support Wellness, Resilience, and Burnout Prevention

Execution of hiring processes, including candidate sourcing, interviewing, and onboarding Participation in statewide or regional recruitment coordination efforts, as applicable

3.2 Workforce Retention and Stability Strategies

Applicants will implement evidence-based retention strategies to improve workforce stability, including:

Development of retention plans for newly recruited and existing staff

Implementation of provider support strategies (e.g., mentorship, peer support, onboarding programs)

Efforts to reduce burnout and turnover (e.g., scheduling models, team-based care approaches)

Use of financial and non-financial retention incentives tied to service duration

Tracking and reporting on retention outcomes

3.3 Workforce Deployment and Access Optimization

Applicants will optimize how workforce resources are deployed to improve access to care, including:

Aligning staffing models to patient demand and community health needs

Expanding or modifying care delivery models (e.g., team-based care, cross-training staff)

Leveraging flexible staffing approaches across sites within a system or region

Reducing reliance on temporary staffing (e.g., contract or locum tenens providers)

3.4 Partnerships and Regional Collaboration

Applicants are encouraged to collaborate with regional partners to maximize impact, including:

Coordination with other healthcare providers and systems Engagement with tribal health organizations, where applicable Participation in regional workforce-sharing or coverage models Alignment with statewide workforce initiatives and reporting requirements

Collaborative or multi-organization proposals are strongly encouraged where they improve efficiency or expand geographic reach.

3.5 Program Management and Administration

Applicants will be responsible for managing awarded funds and program activities, including:

Development of a clear implementation plan with timelines and milestones Administration of workforce incentives and documentation of service commitments (if applicable) Financial management and compliance with state and federal requirements Designation of a program lead or coordinator Participation in state-led convenings, and technical assistance Reporting activities

3.6 Data Collection, Reporting, and Continuous Improvement

Applicants will collect and report data to demonstrate program impact and support continuous improvement, including:

Baseline and ongoing workforce metrics (e.g., vacancies, time-to-fill, turnover rates) Tracking of recruitment outcomes and placements Monitoring retention and service duration of funded positions

Reporting on use of funds and return on investment Participation in statewide evaluation efforts Impact stories, testimonials, photos, quotes, etc.

Reporting on five-year service commitments or as otherwise required by CMS. Additional reporting requirements may be implemented based upon updated federal guidance. The CMS Rural Health Transformation Service Commitment Fact Sheet can be found at https://www.cms.gov/priorities/rural-health-transformation-rht-program/overview or the direct link is https://www.cms.gov/files/document/5-year-service-commitment-fact-sheet.pdf.

3.7 Sustainability Plan

Applicants will describe how workforce gains will be sustained beyond the funding period, including:

Long-term staffing models and financial planning Strategies to maintain filled positions after incentives end Integration of successful practices into ongoing operations Establishing policies, procedures and service commitment agreements to manage incentives, including a five-year service commitment agreement with participating staff and a process for monitoring compliance. The CMS Rural Health Transformation Service Commitment Fact Sheet can be found at https://www.cms.gov/priorities/rural-health-transformation-rht-program/overview or the direct link is https://www.cms.gov/files/document/5-year-service-commitment-fact-sheet.pdf.

3.8 Stakeholder Engagement and Collaboration

Collaborate with key partners, including but not limited to healthcare systems, public health entities, tribal organizations, and community-based organizations

Facilitate regular stakeholder meetings, advisory groups, or learning collaboratives Promote alignment across statewide workforce and education initiatives

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 Provide the following information related to at least three previous and current service/contracts, performed by the offeror’s organization, which are similar to the requirements of this RFP.

a. Record of past performance, including price and cost data from pervious projects, quality of work, ability to meet schedules, cost control, and contract administration;

b. Familiarity with project locale and population; and

c. Ability and proven history in handling special project constraints;

5.0 PROPOSAL RESPONSE FORMAT

5.1 Disclosure of other RHT Funding (2 pages or less single-spaced)

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

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

5.2 An electronic copy shall be submitted.

5.2.1 The offeror should provide a proposal via email in Microsoft Word or PDF electronic format by the due date.

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

5.2.3 RFP cannot exceed 50 pages.

5.3 All proposals must be organized in the following order:

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

5.3.2 Executive Summary. The one- or two-page executive summary should briefly describe the offeror's proposal. This summary should highlight the major features of the proposal.

It must indicate any requirements that cannot be met by the offeror. The reader should be able to determine the essence of the proposal by reading the executive summary.

Proprietary information requests should be identified in this section.

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

5.3.3.1 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. This should demonstrate the offeror's understanding of the desired overall performance expectations. Include the overarching goals of your proposed project and the workforce groups who will benefit (e.g., nursing staff, radiology technician, occupational therapist, behavioral health, etc.). Goals should describe the change your organization seeks to achieve. Identify any similar projects being implemented and their funding sources. Explain how your proposed project will enhance, rather than duplicate, existing efforts, including how you plan to coordinate with partners to prevent duplication. Rural Health Transformation funds cannot be used to duplicate or replace existing funding, known as supplanting, but may be used to expand or enhance an existing project.

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

5.3.3.3 A clear description of any options or alternatives proposed.

5.3.4 Cost Proposal. Cost will be evaluated independently from the technical proposal.

Offerors may submit multiple cost proposals. All costs related to the provision of the required services must be included in each cost proposal offered.

See section 7.0 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 Specialized expertise, capabilities, and technical competence as demonstrated by the proposed approach and methodology to meet the project requirements;

6.1.2 Resources available to perform the work, including any specialized services, within the specified time limits for the project;

6.1.3 Record of past performance, including price and cost data from previous projects, quality of work, ability to meet schedules, cost control, and contract administration;

6.1.4 Availability to the project locale;

6.1.5 Familiarity with the project locale;

6.1.6 Proposed project management techniques; and

6.1.7 Ability and proven history in handling special project constraints.

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 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 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.

7.0 COST PROPOSAL

The cost proposal must be submitted in a separate document clearly labeled “Cost Proposal”. Please include this as a separate document in the email submission. The proposal can be in an alternate format but should include the elements detailed below.

The cost proposal will be evaluated independently from the technical proposal. Contractors may submit multiple cost proposals. All costs related to the provision of the required services must be included in each cost proposal offered.

Budget Allocation: Provide a general recommendation and explanation for allocating the budget into the sections detailed on the chart below. The budget is based on costs for 10 months, the timeframe for the first contract. Please indicate anticipated future cost increases and budget through July 31, 2027, as a part of the cost proposal.

The cost proposal must describe the following elements for which the Contractor will expect reimbursement:

A. Personnel Costs include both salary and fringe benefits for the individual(s) dedicating time to this service. Also include the percent of time the individual is dedicating to providing services. All of these details must be included in the description and cost proposal.

B. Travel/Training of Personnel should include total cost per trip. All of these details must be included in the description column below. The State will pay all travel expenses based on state per diem rates. Per Diem expense rates are established by the State of SD Board of Finance. All travel must be approved in advance by the State.

C. Other:

Supplies (office supplies, postage, printing, no permanent equipment) Contractual/Operating (phone, rent for office space, etc.)

Administration (administrative fees/indirect costs at flat rate or percentage)

The contractor must submit a statement in the Proposal that attests the contractor’s willingness and ability to perform the work described in this RFP for the price being offered.

A. STAFFING

Name Role & Duties Total Hours on Project Hourly Rate Total

Total:

B. TRAVEL AND EXPENDITURE TABLE

Name Method of Travel Cost per trip Number of Trips Total Cost

Total:

Name Lodging Cost per night

Number of Nights

Lodging Cost

Per diem

Number of Days

Per diem Cost

Total Cost

Totals:

NOTE: The State asks that vendors accept state per diem. Lodging and per diem rates can be found at https://sdsos.gov/about-the-office/board-of-finance/bof-docs/Travel%20Reimbursement%20FY2026.pdf

C. OTHER COSTS

Show any other costs such as software, hardware, ongoing costs, etc. with additional detail breakdown.

Project Period (Year 1)

Hardware

Software

Maintenance

License Fees

Training

Other…

Totals

Exhibit A: Quick Answers

1. Who can apply?

Any licensed healthcare facility, dental clinic, or healthcare clinic, etc. providing healthcare services to rural South Dakota citizens.

2. How much money can be applied for?

Up to $6 million in total is available for this RFP in year one. It is anticipated that multiple awards will be made that will total $6 million to be spent over year 1.

3. Do applicants have to be in a rural area?

Applicants 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 healthcare workforce, keep healthcare in local rural communities and expands access to healthcare in rural communities. Geography definitions and classifications can be found in the Strategic Analysis of South Dakota’s Rural Healthcare Programs, 2024. The Data Analysis Summary and Final Recommendations Report can be found at https://doh.sd.gov/healthcare-professionals/rural-health/

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?

Proposals may include funding for technology. Proposals should not be duplicative of the Digital Health Modernization and Technology Grant opportunity. Information about Rural Health Transformation funding opportunities can be seen in the RHT Funding Forecast on the DOH website at ruralhealthtransformation.sd.gov or the direct link is https://doh.sd.gov/media/yeajycsi/rht-funding-forecast.pdf

6. 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. Proposals may include minor renovations or alterations, but the projects will require additional approval by CMS.

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

Selected contractors will be responsible for submitting monthly and annual reports to monitor progress, impact, accomplishments, successes, and challenges. Information will be used to comply with CMS requirements to file quarterly and annual progress reports.

8. What is the five-year rural service commitment?

Per federal guidance, financial incentives are tied to a minimum five-year service commitment. As part of the application review, the South Dakota Department of Health will determine whether any additional applicant-proposed strategies are subject to the federal five-year service commitment requirement and will notify the applicant accordingly.

9. What are some examples and requirements of the five-year rural service commitment?

Additional information can be found in the CMS Rural Health Transformation Service Commitment Fact Sheet found on their website at https://www.cms.gov/priorities/rural-health-transformation-rht-program/overview or the direct link is https://www.cms.gov/files/document/5-year-service-commitment-fact-sheet.pdf

10. Are there additional helpful tips for creating a proposal?

Number your strategies, activities or proposals in order of priority.

Provide detail for each strategy, service, task or activity. Examples include:

o Retention Bonuses: Provide details including how bonus amounts will be determined (e.g., by role, tenure or performance), the types of bonuses offered (e.g., milestone based, performance based) and outline the criteria and process used to select eligible recipients. Clarify whether the bonuses are tied to a five-year service commitment.

o Child Care Support: Explain what childcare support will be offered and how it will be implemented (e.g., childcare provided at no cost or reduced cost to nursing staff, use of vouchers or stipends, minor renovations or equipment purchases for on-site childcare).

Describe how enhanced child care supports will be implemented.

o License Renewal Fees: Identify which license types (e.g., RN, LPN, CNA) will be covered, who is eligible and how the fee coverage process will work. Additionally, explain how covering license renewal fees is expected to support staff retention and contribute to reducing vacancy rates.

Financial incentives must be tied to a minimum five-year service commitment. On a prorated basis, the employer (grantee) is required to return the corresponding funds to the state for any participant who fails to complete their five-year service commitment, within 90 days of the default.

11. What are some unallowable and limited costs?

Pre-award costs.

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

Providers currently participating in a state loan repayment program that includes a service commitment are not eligible for financial retention incentives under this funding opportunity.

Contracted or locum tenens providers are not eligible for retention incentives or projects, as these efforts are intended to focus on developing a long-term provider base.

Services, equipment or supports that are the legal responsibility of another party under federal, state, tribal or civil rights law.

Supplanting existing state, local, tribal or private funding of infrastructure or services (ex. staff salaries).

The cost of independent research and development.

Funds related to any activity designed to influence the enactment of legislation, appropriations, regulation, administrative action or executive order.

Financial assistance to households for installation and monthly broadband internet costs.

Replacing payment(s) for clinical services that could be reimbursed by insurance.