RFP Event 390 Administrative Document.docx

STATE OF IDAHO

DIVISION OF PURCHASING

FOR THE

Idaho Department of Corrections

REQUEST FOR PROPOSAL

Substance Use Disorder RFP Event 390 IDOC Data Sensitivity Classification - L3 Restricted

IDOC Data Sensitivity Classification - L3 Restricted

TABLE OF CONTENTS

IDOC Data Sensitivity Classification - L3 Restricted

RFP ADMINISTRATIVE INFORMATION

RFP Title:

Substance Use Disorder

RFP Project Description:

Provide the management of substance use disorder (SUD) treatment and recovery support services for the Idaho Department of Correction

RFP Lead:

Thayne Pearson, Purchasing Officer Idaho Division of Purchasing 650 W. State St. Room 100 Thayne.Pearson@adm.idaho.gov 208-332-1605

Submit electronically via IPRO:

Electronic Submission:

Pre-Proposal Conference Date/Time:

Pre-Proposal Conference Location:

Wednesday April 24, 2024, at Mountain Time

Virtual via Microsoft Teams

Deadline to Receive Questions:

Monday April 29, 2024, at 9:30am p.m. Mountain Time

RFP Closing Date:

See IPRO Header Document

Public Opening Date:

10:30 a.m. Mountain Time, the following business day after closing

Initial Term of Contract and Renewals:

Two (2) years. Upon mutual, written agreement, the Contract may be renewed, extended, or amended in one (1) year terms. The anticipated total Contract term is seven (7) years.

THE ADMINISTRATIVE FEE DETAILED IN PARAGRAPH 5 OF THE STATE’S STANDARD CONTRACT TERMS AND CONDITIONS WILL NOT APPLY TO THE CONTRACT(S) THAT RESULT FROM THIS SOLICITATION.

OVERVIEW

1.1. Purpose

The Division of Purchasing (DOP), on behalf of the Idaho Department of Corrections (IDOC), is seeking qualified offered from vendors who can provide the management of substance use disorder (SUD) treatment and recovery support services for the Idaho Department of Correction.

1.2. Definitions

· SUD – Substance Use Disorder

· WITS – Web Infrastructure Treatment Service (Owned/operated by Federal Executive Institute (FEI)

· RSS – Recovery Support Services

· EHR -Electronic Health Record

1.3. Background Information

Historically (10 + years) the Substance Use Disorder contract has been a joint effort between state agencies (IDOC, DHW, ISC, and DJC). This contract has been held by BPA Health and has provided clients of IDOC with a substance use disorder treatment network. BPA became familiar with IDOC processes and helped screen clients for engagement in court ordered substance treatment. They also help with utilization of an Electronic Health Record system which includes itemized billing between subcontractor and state agencies. They manage the network of subcontractors, work with state agencies when ethical violations occurred, and recoupment of improper payments as needed.

1.4. Resulting Contract

If the State awards a contract from this Solicitation, it will do so by issuing a Service Contract document from the State’s eProcurement system, IPRO, which will be an acceptance of the successful offer. The Contract will be comprised of that contract document; this RFP, including any incorporated documents; the successful Proposal, including any clarifications requested by the state of Idaho (State); and an artifact formalizing any requirements agreed upon through contract discussions or negotiations, if applicable.

The following documents are incorporated into this RFP as if set out in their entirety, whether or not they are attached in IPRO:

· Solicitation Instructions for Vendor

· Standard Contract Terms and Conditions

If not attached in IPRO, the documents may be found on the “Information for Vendors” page of DOP’s website, www.purchasing.idaho.gov. If multiple versions of any of these documents are available on the website, the version in effect on the day the RFP was issued shall apply.

2.

QUESTIONS

2.1. Restrictions on Communications

From the issue date of this RFP, until a contract is awarded, or the RFP is cancelled, vendors are prohibited from communications regarding this RFP with the IDOC staff, evaluation committee members, or other associated individuals, except the Division of Purchasing.

2.2. Pre-Proposal Conference

A non-mandatory pre-proposal conference will be held at the location and time as indicated in Section 1, page 1 of this RFP. This will be your opportunity to ask questions, in person, with the IDOC staff. All parties interested are invited to participate either by attending the conference or by an established call-in number. Those choosing to participate must pre-register to receive phone conferencing and meeting details by submitting the completed Attachment 1 - Pre-Proposal Conference Registration Form via email to the RFP Lead. Parties interested are asked to register by Friday April 26, 2024. Any oral answers given by the State during the pre-proposal conference are unofficial and will not be binding on the State. Conference attendance is at the participant’s own expense.

2.3. Questions

2.3.1. This solicitation is issued via the State’s e-Procurement system, IPRO (IPRO Powered by LUMA). The RFP Lead is the only contact for this Solicitation. All correspondence must be in writing. In the event that it becomes necessary to revise any part of this RFP, amendments will be posted at IPRO. It is the responsibility of parties interested in this RFP to monitor IPRO for any updates or amendments. Any oral interpretations or clarifications of this RFP must not be relied upon. All changes to this RFP will be in writing and must be posted to IPRO to be valid.

2.3.2. Questions or other correspondence must be submitted in writing to the RFP Lead (see contact information in the RFP Administrative Information, page 1). QUESTIONS MUST BE RECEIVED BY 11:59:59 P.M. MOUNTAIN TIME ON THE DATE LISTED IN THE RFP ADMINISTRATIVE INFORMATION.

2.3.3. Written questions must be submitted using Attachment 2 - Offeror Questions. Official answers to all written questions will be posted on IPRO as an amendment to this RFP.

2.4. Vendor Proposed Modifications and Exceptions to Requirements, Terms, and Conditions

2.4.1. Vendors must submit any proposed modifications to the requirements, terms, or conditions of the RFP on Attachment 2 - Offeror Questions prior to the deadline to submit questions. Questions regarding these requirements must contain the following:

· The rationale for the specific requirement being unacceptable to the party submitting the question (define the deficiency).

· Recommended verbiage for the State’s consideration that is consistent in content, context, and form with the State’s requirement that is being questioned.

· Explanation of how the State’s acceptance of the recommended verbiage is fair and equitable to both the State and to the party submitting the question.

2.4.2. In the event that a Proposal contains modifications or exceptions to any Solicitation requirements, terms, or conditions which are not addressed during the question and answer period, they must be identified and submitted on Attachment 3 - Modification and Exception Form and must contain the same information outlined in Section 2.3.1, above. The State will not consider any modifications or exceptions that are not identified specifically on Attachment 3.

2.4.3. The State has sole discretion to determine if the modifications or exceptions submitted by an Offeror would result in a material change or otherwise threaten the integrity of the procurement process. See Appendix A - Idaho Terms and Conditions Background and Limitations. Pursuant to IDAPA 38.05.01.084.e, the State may only negotiate non-material modifications or exceptions. Modifications or exceptions which the State determines to be material, or which otherwise threaten the integrity of the procurement process, will not be accepted or negotiated. In the event that the Offeror has conditioned its Proposal on the State’s acceptance or negotiation of its proposed modifications or exceptions, and the modifications or exceptions are deemed material, the Offeror will be given the opportunity to retract the proposed modifications or exceptions from its Proposal. Failure to do so will result in the Offeror’s Proposal being found non-responsive, after which it will receive no further consideration.

2.4.4. Non-material modifications or exceptions may be discussed with the apparent successful Offeror, at the discretion of the State; however, the State shall have the right to reject any and all such modifications and/or exceptions, or to call an end to such discussions, and to instruct the Offeror to amend its Proposal and remove the modifications and/or exceptions. Failure to do so may result in the State finding the Proposal non-responsive.

2.4.5. Except as otherwise provided within the Solicitation, the State will not consider modifications or exceptions to the requirements, terms, or conditions which are proposed after the RFP Closing Date

INSTRUCTIONS FOR SUBMISSION OF PROPOSAL

3.

3.1. General Instructions

3.1.1. Proposals must be submitted electronically. Except as otherwise addressed in this solicitation, all submission materials must be submitted at the same time. If multiple submissions are received, only the latest timely submission will be considered.

3.1.2. Alternate proposals are not allowed.

3.1.3. All electronic files must be in Microsoft Word or Excel format; the only exception is financials, brochures, or other information only available in an alternate format.

3.1.4. It is mandatory to submit your Proposal electronically via IPRO, all Offerors participating in this Solicitation must establish an account in the IPRO system, as it is necessary in order to process and/or award the resulting Contract(s). Establishing an account is free and only takes a few minutes.

3.2. Trade Secrets

Paragraph 28 of the Solicitation Instructions to Vendors describes trade secrets to “include a formula, pattern, compilation, program, computer program, device, method, technique or process that derives economic value, actual or potential, from not being generally known to, and not being readily ascertainable by proper means by other persons and is subject to the efforts that are reasonable under the circumstances to maintain its secrecy.” In addition to marking each page of the document with a trade secret notation (as applicable; and as provided in Paragraph 28 of the Solicitation Instructions to Vendors), Offerors must also:

3.2.1. Identify with particularity the precise text, illustration, or other information contained within each page marked “trade secret” (it is not sufficient to simply mark the entire page). The specific information you deem “trade secret” within each noted page must be highlighted, italicized, identified by asterisks, contained within a text border, or otherwise clearly delineated from other text/information and specifically identified as a “trade secret.”

3.2.2. Provide a separate document entitled “List of Redacted Trade Secret Information” which provides a succinct list of all trade secret information noted in your Proposal; listed in the order it appears in your submittal documents, identified by Page #, Section #/Paragraph #, Title of Section/Paragraph, specific portions of text/illustrations; or in a manner otherwise sufficient to allow the State’s procurement personnel to determine the precise text/material subject to the notation. Additionally, this list must identify with each notation the specific basis for your position that the material be treated as exempt from disclosure and how the exempting the material complies with the Public Records Law.

3.2.3. Submit a redacted copy of the Proposal with all trade secret information removed or blacked out. The redacted copy must be submitted electronically, with the word “redacted” in the file name, whether the Proposal is submitted manually or electronically.

3.3. Electronic Submission

3.3.1. Electronically submitted Proposals must be submitted through IPRO, at IPRO Powered by LUMA When submitting through IPRO, enter your Cost in IPRO as “$1,” and UPLOAD YOUR TECHNICAL PROPOSAL, SEPARATE COST PROPOSAL, AND ALL OTHER REQUIRED SUBMITTAL ITEMS. Remember to submit an additional redacted version of the proposal if you have identified trade secrets.

3.3.2. Vendors are strongly encouraged to begin the process of submitting the response far enough in advance of the End Time to allow for resolution of technical difficulties. Be advised that the state is not responsible for a Vendor’s failure to timely submit a responsive submission due to any technical or technological difficulties. See IDAPA 38.05.01.61.02.

3.3.3. Submitting via IPRO, be advised that the Offeror for Proposal evaluation and award purposes is the entity profile under which the Proposal is submitted in IPRO, which must be the same legal entity presented in the uploaded response materials. If the entity identified on the state supplied Signature Page differs from the entity under which you submit your Proposal in IPRO, the information provided on the Signature Page prevails.

3.3.4. Offerors are further advised to upload response materials with descriptive file names, organized and consolidated in a manner which allows evaluators to efficiently navigate the Offeror’s response; as the State will print uploaded documents for evaluation in the manner received via IPRO.

PROPOSAL FORMAT

1.

2.

3.

4.

These instructions describe the format to be used when submitting a Proposal. The format is designed to ensure a complete submission of information necessary for an equitable analysis and evaluation of submitted Proposals. There is no intent to limit the content of Proposals.

4.1. Table of Contents

Include a table of contents in the Technical Proposal identifying the contents of each section, including page numbers of major Sections.

4.2. Format

Proposals shall follow the numerical order of this RFP beginning with Section 6 and continuing through the end of the applicable RFP Attachments, including all mandatory submission items detailed in Section 6 and identified throughout the RFP. Proposal sections and subsections must be identified with the corresponding numbers and headings used in this RFP. In your response, restate the RFP section and/or Section, followed with your response.

Offerors are encouraged to use a different color font, bold text, italics, or other indicator to clearly distinguish the RFP section from the Offeror’s response. Except for brochures, financials, work samples, or other similar submission items, all electronic Proposals must be submitted in Microsoft Word or Excel, and must not be locked. Offerors are strongly cautioned against including website links or imbedded documents in the Proposal; the State will not be responsible for the RFP Lead or any evaluator’s failure to consider information outside of or imbedded in the Proposal.

4.3. Evaluation Codes

(M) Mandatory Response - failure to respond to any (M) section, or to comply with any mandatory specification or requirement, will render Offeror’s Proposal non-responsive and no further evaluation will occur.

(ME) Mandatory and Evaluated Response - failure to respond to any (ME) section, or to comply with any mandatory specification or requirement in an (ME) section, will render Offeror’s Proposal non-responsive and no further evaluation will occur. Offeror must respond to these sections as directed; points will be awarded based on predetermined criteria.

(E) Evaluated Response - a response is desired and will be evaluated. If Offeror cannot meet the requirement, or chooses not to respond for any reason, zero (0) points will be awarded for the section. If Offeror responds, points will be awarded based on predetermined criteria.

Note: Offerors are directed to IDAPA 38.05.01.074.03.a, as well as IDAPA 38.05.01.091.05, which allow the designated State official to waive minor informalities as well as minor deviations. The State also reserves the right to seek clarification on any (M), (ME), or (E) requirement.

PROPOSAL REVIEW, EVALUATION, AND AWARD

5.

5.1. Overview

The objective of the State in soliciting and evaluating Proposals is to ensure the selection of a firm or individual that will produce the best possible results for the funds expended

5.1.1. All Proposals will be reviewed first to ensure that they meet the Mandatory Submission Requirements of the RFP as addressed in Sections noted with an (M) or (ME). Any Proposal(s) not meeting the Mandatory Submission Requirements will be found non-responsive.

5.1.2. Evaluation Criteria

Technical Proposal:

1.

2.

3.

4.

5.

5.1.

5.2. Technical Proposal

5.2.1. The Technical Proposal will be reviewed first on a “pass” or “fail” basis to determine compliance with those requirements listed in the RFP with an (M) or (ME). All Proposals which are determined by the State, in its sole discretion, to be responsive in this regard will continue in the evaluation process outlined in this Section.

5.2.2. The Technical Proposal will be evaluated and scored utilizing one (1) or more Technical Proposal Evaluation Committee(s).

5.2.3. The scores for the Technical Proposal will be normalized as follows: The Technical Proposal with the highest raw technical score will receive all available Technical Points: 400 points. Other Proposals will be assigned a portion of the maximum available Technical Points, using the formula:

400 X raw score of technical Proposal being evaluated highest raw technical score.

5.3. Oral Presentations/Demonstrations

5.3.1. Following evaluation of Technical Proposals, the State may, in its sole discretion, invite two (2) top scoring Offerors to provide presentations. The State reserves the right to invite as many Offerors as it deems appropriate, based on the Technical Proposal evaluation scores. The State also reserved the right to invite additional Offerors to provide presentations after the initial round, in its sole discretion.

5.3.2. Presentations will take place remotely via Microsoft Teams or another virtual meeting platform.

5.3.3. Presentations will not be scored separately. Following presentations, the Technical Proposal Evaluation Committee(s) will review the Technical Proposal evaluation scores for each Offeror and may adjust the Technical Proposal evaluation scores, as the committee(s) deem appropriate, based on the information provided during the presentations.

5.4. Cost Proposal

5.4.1. The Cost Proposal will only be opened and evaluated for the top three (3) Offerors who receive the highest total normalized points.

5.4.2. The scores for the Cost Proposal will be normalized as follows: The cost evaluation will be based on lowest total cost submitted. The Proposal with the lowest total cost proposed will receive all available Cost Points: 300 points. Other Proposals will be assigned a portion of the maximum available Cost Points using the formula:

300 X Lowest Overall Cost Overall Cost being evaluated.

5.4.3. The State reserves the right to seek clarification of Offeror’s responses and to engage in discussions or negotiations as determined to be in the best interest of the State and permitted by IDAPA 38.052.01.084.

5.4.4. Best and Final Offer. The buyer must establish a common time and date for submission of best and final offers. Best and final offers must be submitted only once unless the buyer makes a written determination before each subsequent round of best and final offers demonstrating another round is in the purchasing authority’s interest, and additional discussions will be conducted, or the requirements will be changed. Otherwise, no discussion of, or changes in, the best and final offers must be allowed prior to award. Offerors must also be informed that if they do not submit a notice of withdrawal or another best and final offer, their immediate previous offer will be construed as their best and final offer

5.5. Billing Procedure

Contractor must submit a weekly bill outlining the following information:

Invoice/Report Requirements:

1. SUD Treatment Services

1.1. Assessments

1.2. RSS Services

1.3. Treatment

2. Administration Fee

2.1. Services Coordination

2.2. Fiscal Management

SUD Budget Tracking Report must be submitted weekly with the invoice to IDOC.

Idaho Department of Correction Attn: SUD Team Supervisor 1299 N Orchard, Ste 110 Boise, ID 83706 Email to: contracts@idoc.idaho.gov, IDOCSUD@idoc.idaho.gov, and fiscal@idoc.idaho.gov

5.6. Responsibility

Pursuant to IDAPA 38.05.01.081, the RFP Lead may, in the State’s sole discretion, require the apparent high point Offeror to provide documentation to demonstrate its responsibility. The RFP Lead may request documentation including, but not limited to: credit or financial reports, and references. Failure to provide requested documentation may result in the Offeror being deemed non-responsible. Nothing herein shall prevent the State from using other means to determine Offeror’s responsibility.

5.7. Award

Award of Contract will be made to the responsive, responsible Offeror whose Proposal receives the highest number of total normalized points.

MANDATORY SUBMISSION REQUIREMENTS

The technical proposal begins with the mandatory items identified in this list and the following sections. NOTE: THIS CHECKLIST IS PROVIDED AS A COURTESY ONLY; OFFERORS ARE RESPONSIBLE FOR SUBMITTING ALL MANDATORY SECTIONS, ATTACHMENTS, SUBMITTAL ITEMS, ETC., REGARDLESS OF WHETHER THEY ARE IDENTIFIED IN THIS LIST.

☐ (M) Signature Page: All Proposals must be submitted with a state supplied Signature Page, attached separately in IPRO. For electronically submitted Proposals, submit a completed, scanned signature page. For manually submitted Proposals, the signature page must contain an ORIGINAL HANDWRITTEN signature executed in INK OR AN ELECTRONIC SIGNATURE and be returned with the relevant Solicitation documents. Your ORIGINAL Signature Page should be included at the FRONT of your ORIGINAL Technical Proposal

☐ (M) Cover Form: Complete, sign, and submit Attachment 4, Cover Form.

☐ (M) Acknowledgement of Amendments: If the RFP is amended, the Offeror must acknowledge each amendment with a signature on the acknowledgement form provided with each amendment. Failure to return a signed copy of each amendment acknowledgement form with the Proposal may result in the Proposal being found non-responsive. See IDAPA 38.05.01.52.

☐ Section 7: Provide response to all (M) and (ME) sections, and any other required submittal items.

☐ Section 8: Provide response to all (M) and (ME) sections, and any other required submittal items

☐ Section 9: Provide response to all (M) and (ME) sections, and any other required submittal items

☐ (ME) Cost Proposal: Provide your cost information on the form provided in Attachment 5, Cost Proposal. Submit the Cost Proposal in a separately uploaded file or separately sealed envelope.

☐ Redacted copy of Technical Proposal and list of Trade Secret redactions, as detailed in Section 3.2.

☐ Review the required types and levels of insurance—these are mandatory requirements. If you do not already have the required types and levels of insurance, you are strongly encouraged to contact your insurance representative to find out if you will be able to obtain the required insurance. (The Offeror should not purchase additional insurance in reliance of being awarded a contract). If you are awarded a Contract, failure to provide proof of the required insurance will be grounds for termination of the Contract.

BUSINESS INFORMATION

6.

7.

7.1. (ME) Business Profile Provide a profile of your business including Offeror’s business history, description of current service area, and customer base.

7.2. (ME) Experience Describe in detail your knowledge and experience in providing services similar to those required in this RFP. Offeror must have a minimum of five (5) years’ experience providing managed care services to individuals with behavioral health needs.

7.3. (M) Organizational Chart Provide a copy of your organizational chart, including detail of any relationships with parent and subsidiary organizations.

7.4. (ME) Demonstrated Success Provide specific data demonstrating previous success with providing managed care behavioral services to include functions such as: client engagement services, client utilization of funds, provider relationships, establishing and maintaining state-wide networks of professionals providing behavioral health services, timely reconciliation of billing/invoices for services rendered, and history of: types of communication or information sharing with previous contracts or contractors, including frequency, type (written vs verbal, monthly meeting with agenda cadence).

7.5. (E) Customer Satisfaction Over the last ten (10) years, approximately what percentage of customers have chosen to remain with your company when given an option (e.g. exercising option renewals, extending agreements, selecting your company again upon re-solicitation, etc.)

7.6. References

Provide contact information for at least three (3) references. See Section 5.5.

ORGANIZATION AND STAFFING

Describe your qualifications to successfully complete the requirements of the RFP by providing a detailed response to the following:

8.

8.1. (ME) Project Lead Identify the person who will be the dedicated Project Lead if Offeror is awarded a contract. Provide a description of the proposed Project Lead’s experience and qualifications. You may submit a resume in response to this section.

8.2. (ME) Key Personnel and Qualifications Provide a list of key management, customer service and other roles to be used in the fulfillment of this Contract (in addition to the Project Lead). Provide role descriptions, including requisite qualifications and experience of the person(s)/role(s) identified, as well as an explanation of how the person in that role will contribute to the project. Your response should demonstrate the extent to which you have the expertise to accomplish the Scope of Work.

8.3. (M) Subcontractors If you intend to utilize subcontractors, describe the extent to which they will be used to comply with Contract requirements. Include each position providing service and provide a detailed description of how the subcontractors are anticipated to be involved under the Contract. Include a description of how the Offeror will ensure that all subcontractors and their employees will meet all Scope of Work requirements. NOTE: The information provided for subcontractors, if any, will be evaluated as part of Section 8.2, Other Key Personnel and Qualifications.

If you do not intend to utilize subcontractor(s), provide a statement to that effect.

SCOPE OF WORK

All sections of the Scope of Work are required contract services. Use this Proposal outline as part of your response to the RFP. Keep in mind, the evaluators will be scoring your Proposal based on the methodologies proposed and the completeness of the response to each item listed below. You must describe in detail how you will meet each requirement marked (M) or (ME) below. Include personnel, proposed timelines, methodologies, and any pertinent information that will be required from the Agency in order to achieve full compliance with all tasks and deliverables.

General Requirements IDOC Responsibilities Oversight of this management services contract will reside with the Idaho Department of Correction (IDOC).

With the exception of Safe and Sober Housing providers IDOC will provide the Offeror with an initial list of approved providers to be included in the network. Throughout the term of the contract, IDOC may add or remove providers from this list and will work with the Offeror on timelines in each instance. The treatment provider network and Recovery Support Services (RSS) shall be developed and maintained at the discretion of IDOC, and quality concerns will be communicated to the Offeror in a timely fashion.

(ME) Offeror Responsibilities: The Offeror must:

Comply with IDAPA rules, standards and policies as outlined by the IDOC for their respective priority populations and as defined in the subsequent subsections of this Scope of Work.

Provide staff, during normal business hours, Monday through Friday from 8:00 a.m. to 6:00 p.m., Mountain Time (MT), excluding holidays, to provide crisis management during all working hours. Client Intake and Service Coordination staff must be available during business hours. Closure on State holidays is approved (Idaho State holiday calendar is available at: https://www.idaho.gov/government/state-holidays/ The business(es) must be accessible through a U.S. Post Office, telephone, facsimile, email, and web-based communication.

Maintain a Substance Use Disorder (SUD) network that consists of treatment and RSS providers. This network must provide services throughout all seven (7) IDOC districts, including those areas deemed as rural and or frontier. A map of the districts can be found at the following link and choosing the District Offices link: https://www.idoc.idaho.gov/content/locations Treatment and RSS services must be provided for qualifying individuals as defined by the IDOC and will only be paid when insurance or other funding does not cover the service.

Establish a website that includes, but is not limited to, information on all available SUD treatment and RSS, service accessibility, eligibility requirements, contact information and a list of all regional providers.

The Offeror must comply with the following:

The Indian Health Service is the payor of last resort of persons defined as eligible for contract health services under these regulations, notwithstanding any State or local law or regulation to the contrary;

Ensure that if an eligible applicant or client objects to the religious character of a service provider, the client is entitled to receive services from an alternative provider;

Ensure Faith-based Organization providers refer clients to alternative services on request; and Fund and or provide alternative services. The term “alternative services” means services determined to be accessible, comparable, and provided within a reasonable period of time from another provider to which the client has no religious objection.

Utilize Web Infrastructure for Treatment Services (WITS) for the IDOC’s network model for the delivery of SUD services as described in Attachment 1, WITS Overview or a similar EHR or user interface, agreed upon by IDOC.

Comply with all State and federal billing and funding requirements for each of the identified priority populations (See Attachment 2). All funding for services available through this contract are to be accessed as a last resort.

Ensure all providers maintain professional liability, commercial general liability, automobile, and additional insurance coverage, if necessary, as defined in Appendix C.

Meet budgetary allocations as represented in the contract and as amended to each fiscal year.

Establish a collaborative relationship with the Idaho Medicaid Managed Care Contractor for behavioral health, and any third-party payor to ensure care coordination.

Utilize WITS as described within the Data Management of this Scope of Work, or a similar EHR or user interface, agreed upon by IDOC.

Provide a detailed description on how you will meet or exceed the requirements listed in this section. If what you propose deviates at all from these requirements, identify the deviation and explain how what you propose is functionally equivalent to what is required. Additionally, describe in detail your knowledge and experience in providing behavioral health and substance use disorder services.

(ME) Administration/Organization The Offeror must:

Provide and maintain adequate administration, management support and organizational infrastructure to ensure that all contracted services meet or exceed the requirements of this Scope of Work.

Deploy staff and resources to meet or exceed Scope of Work requirements. Required staff must include an Idaho-licensed physician with a background in addictionology to be actively involved in clinical programs. Staff with additional mental health and or co-occurring experience is preferred.

Provide staff with decision-making authority and full-time availability in Boise, Idaho.

Provide a detailed description on how you will meet or exceed the requirements listed in this section. If what you propose deviates at all from these requirements, identify the deviation and explain how what you propose is functionally equivalent to what is required. Additionally, describe in detail your knowledge and experience in administering and managing contracted services similar to what is proposed in the scope of work as well as the oversight of the staff required to provide these services.

(ME) Provider Network Management The Offeror must maintain: a clinical treatment and recovery support service network that meets geographical access needs throughout the state, in accordance with Scope of Work This network must be supported by written agreements and must be sufficient to provide adequate access to all services covered under the contract.

IDOC clients as identified in Attachment 2 - IDOC Population Definitions and Pathways The Offeror must:

Require network providers to meet provider eligibility criteria that effectively responds to the client pathways (Attachment 2) set forth by the IDOC to serve the respective priority populations as established in appropriation or policy.

Maintain a written plan for the selection and retention of providers of Staffed Safe and Sober Housing services for adults. The Offeror must use established standards for these providers which ensure quality, access, safety, non-discrimination, and other ethical criteria. The plan must include, at a minimum, the following:

A documented process for receiving initial requests and continuing authorization for Safe and Sober Housing services;

A documented process for selection and credentialing or re-credentialing of Safe and Sober Housing providers who have signed contracts or participation agreements with the Offeror. The process must include the following requirements:

Policies and Procedures. A program providing Safe and Sober Housing must have written policies and procedures that establish house rules and requirements to include procedures for monitoring participant compliance and consequences for violating house rules and requirements;

Staff required. A staff person must be available to residents twenty-four (24) hours per day, seven (7) days a week, and conduct daily site visits. At a minimum, staff must include:

A house manager who is on-site at a minimum of twenty (20) hours a week; or A housing coordinator who is off-site, but monitors house activities on a daily basis;

Certified Home Inspection. Each Safe and Sober Housing program for adults must have a certified home inspection for each location prior to being approved for the network. There must be documentation that any major health and safety issues identified in the certified home inspection are corrected; and Weekly Safety Inspection. Each Safe and Sober Housing location must be inspected weekly by staff to determine if hazards or potential safety issues exist. A record of the inspection must be maintained that includes the date and time of the inspection, problems encountered, and recommendations for improvement.

Include a process for utilizing out-of-State providers, in accordance with, and ensure out-of-State providers utilize WITS or a similar EHR or user interface, agreed upon by IDOC. A program or facility licensed or certified by another State that is located, maintained, or operated within the State of Idaho, irrespective of the program headquarters, must comply with rules and minimum standards set forth in the provider agreement.

Work collaboratively with the IDOC to invite IDOC-approved subcontractors to apply for Offeror network status.

Maintain Statewide access to clinically appropriate evidence-based practice (EBP) for Opioid Use Disorder (OUD) treatment, particularly the use of medication assisted treatment (MAT). Ensure that the network is capable of working with individuals with OUD and supports MAT.

Ensure clients are tracked so as to not duplicate payment for services.

Ensure all treatment provider clinical staff meet the qualified professional requirements outlined in IDAPA 16.07.17 and the Offeror's internal established requirements for the provider network:

Ensure no staff, employees or contractors have been debarred, suspended or excluded as documented on Medicaid/Medicare debarment, exclusion or suspension lists;

Ensure no staff, employees or contractors have had their professional certification or license suspended or revoked based on disciplinary action by the Idaho Board of Alcohol/Drug Counselor Certification, or the Idaho Board of Occupational Licenses due to an ethics violation; and Ensure all individuals who have contact with clients or who have access to confidential client records, including Managed Services Contractors and provider staff (including treatment and RSS providers), employees, contractors and volunteers provide verification of:

Receiving enhanced criminal history clearance pursuant to IDAPA 16.05.06.

Ensure compliance with all data collection requirements, and require all network treatment providers to fully utilize components of the Idaho WITS system as determined relevant for the SUD treatment system for the IDOC, or a similar EHR or user interface, agreed upon by IDOC All State funded community SUD treatment and RSS providers in the State of Idaho agree to utilize the WITS system, or a similar EHR or user interface, agreed upon by IDOC;

The utilization of WITS functions, or a similar EHR or user interface, agreed upon by IDOC, will be determined by the IDOC for their priority populations. Network providers serving the respective priority populations must comply with WITS requirements of the IDOC; and Ensure compliance with all the criteria of the WITS, or a similar EHR or user interface, agreed upon by IDOC, management system:

Network providers must attend WITS training and Offeror must assure that all network providers are trained and effectively utilize the WITS system to maintain an electronic treatment record, to assure timely and accurate accounting of client services authorized, received and billed, to track and document all services delivered eliminating the possibility of duplication of charges billed to the system, and to record mandatory data about client demographics and outcomes, or a similar EHR or user interface, agreed upon by IDOC;

Active providers must enter client demographics and outcomes data, as well as data for billing purposes as determined by the IDOC, weekly;

WITS data, or a similar EHR or user interface, agreed upon by IDOC, must be entered within five (5) business days of the activity occurring (WITS time stamps all data elements); and The Provider Enrollment Report must be delivered to IDOC monthly.

Maintain a documented process to ensure that providers abide by Idaho Code and IDAPA Rules as it relates to SUD services.

Maintain an effective Provider Relations component in your operations to assure timely communications with providers.

Conduct new provider orientation for providers as they join the network to include:

Administrative processes specific to IDOC/funding source;

Clinical documentation expectations;

Recovery support expectations as outlined in IDAPA 16.07.17;

Clinical treatment and recovery support services as defined by the Offeror’s internal established requirements for the provider network;

A training plan to guide provider in the Offeror application interface;

Performance and results data collection and reporting; and A plan for follow-up, and corrective action, if necessary, with a new provider within ninety (90) calendar days of provider enrollment in the network.

Maintain a communication system with network providers to ensure the IDOC are kept apprised of:

General information including changes in standards, policies and procedures.

Complaints, questions, and concerns.

All alleged or confirmed quality of care concerns.

Ensure that network providers or any subcontractor, during any form of performance monitoring, provide to the IDOC any client’s treatment records, behavioral health records, logbooks, staffing charts, time reports, claims data, administrative documents, complaints, grievances, and any other requested documents and data as requested when at the discretion of the IDOC it is determined to be required to assess the performance of the Offeror, a subcontractor or a network provider.

Ensure network providers submit claims within thirty (30) calendar days of service.

Provide a detailed description on how you will meet or exceed the requirements listed in this section. If what you propose deviates at all from these requirements, identify the deviation and explain how what you propose is functionally equivalent to what is required. Additionally, describe in detail your knowledge and experience in provider network management.

(ME) Customer Service System The Offeror must ensure a toll-free number, dedicated to customer service inquiries is established and publicized throughout Idaho and ensure multiple lines are available to accommodate clients, providers, IDOC staff and others that may be calling.

The Offeror must:

Provide a communications system to ensure timely and reasonable access to services, staff, and providers and maintain sufficient equipment and staff;

Callers, when transferred, must be connected with a service coordination specialist (a.k.a. Care Manager, etc.) within forty-five (45) seconds;

Provide periodic live monitoring of service calls for quality management purposes.

Ensure call tracking and record keeping is established and utilized for tracking and monitoring phone lines. Ensure a call back number is obtained for each client calling to request services.

Respond to clients with limited English proficiency through the use of bilingual/multicultural staff or language assistance services, at Offerors expense. The Offeror must notify clients that oral interpretation is available for any language and written information is available in English and Spanish and inform the clients how to access such services.

Ensure every reasonable effort is made to overcome any barrier that clients may have to receiving services, including any language or other communication barrier.

Ensure network providers have staff available to communicate with clients in his or her spoken language, and or access to a phone-based translation service so that someone is readily available to communicate verbally with the client in his or her spoken language.

Have available, at all times, a Telecommunications Device for the Deaf (TDD) and or relay systems.

Interact with callers in a courteous, respectful, polite, culturally responsive, and engaging manner.

Respect the caller’s privacy during all communications and calls.

Provide a detailed description on how you will meet or exceed the requirements listed in this section. If what you propose deviates at all from these requirements, identify the deviation and explain how what you propose is functionally equivalent to what is required. Additionally, describe in detail your knowledge and experience in customer service skills and applications.

(ME) Client Intake and Service Coordination The Offeror must provide client intake and service coordination through the WITS intake, or a similar EHR or user interface, agreed upon by IDOC, and authorization modules for the following client populations:

IDOC clients as identified in Attachment 2- IDOC Population Definitions and Pathways.

The Offeror must:

For non-Medicaid IDOC clients, utilize WITS, or a similar EHR or user interface, agreed upon by IDOC, to create the client profile, determine client financial eligibility, screen the client, create the intake, consent, and refer the client to a contracted network provider and, for certain client populations, create the authorization for the client.

For IDOC Medicaid clients, coordinate with IDOC staff to determine eligibility for RSS services, utilize WITS, or a similar EHR or user interface, agreed upon by IDOC, to create the client profile for eligible clients, create the intake, consent, and refer the client to a contracted network provider and, for certain client populations, create the authorization for the client.

Ensure no duplication exists between payment sources and utilize the Partner Data Access Portal (PDAP) to check IDOC client's eligibility for Medicaid at the time of screening. The Offeror must complete a PDAP User Agreement for each staff person requiring access. The User Agreement is available at https://www.yourhealthidaho.org/wp-content/uploads/2018/08/PDAP-User-Agreement.pdf. Assistance or clarification of this process can be obtained through the IDOC Central Office SUD Team idocsud@idoc.idaho.gov. The Offeror must refer all individuals identified through PDAP as Medicaid recipients to the State's Managed Services Organization for services.

Ensure clients who need the standardized assessment, treatment and/or RSS are referred to a contracted network provider.

Provide crisis response and stabilization during business hours.

Ensure compliance with the IDOC SUD Rate Matrix – Treatment Services.

Ensure that all treatment providers are using the American Society of Addiction Medicine (ASAM) criteria for assessment and placement determinations. https://www.asam.org/resources/the-asam-criteria Ensure that utilization determinations are based on written criteria and guidelines developed or adopted with involvement from practicing professionals and nationally recognized standards.

Provide a detailed description on how you will meet or exceed the requirements listed in this section. If what you propose deviates at all from these requirements, identify the deviation and explain how what you propose is functionally equivalent to what is required. Additionally, describe in detail your knowledge and experience in guiding clients through the intake process and coordinating the services required for client success.

(ME) Fiscal Management The Offeror must perform fiscal management functions including, but not limited to, budgetary analysis, trend analysis and tasks necessary to meet or exceed federal, State and the IDOC requirements.

The Offeror must:

Provide System Setup and Maintenance - Enter and maintain Offeror staff security access.

Manage Vouchers - Manage client vouchers (i.e., authorizations) for IDOC in WITS, or a similar EHR or user interface, agreed upon by IDOC. The Offeror must create electronic authorizations and approve or deny authorizations in WITS, or a similar EHR or user interface, agreed upon by IDOC, in accordance with SUD Populations Rules.

Maintain SUD Population Rules to accurately reflect eligibility changes implemented by IDOC for the SUD program. Timelines to achieve changes to populations will be mutually agreed upon.

Manage and Adjudicate Claim Submissions for IDOC.

Adjudicate claims in WITS, or a similar EHR or user interface, agreed upon by IDOC, manually or by batch, submitted by providers for acceptance or denial.

Document receivables and expenditures in a manner that provides processes to:

Provide for claims adjustment.

Ensure timely provider payment;

Maintain a claims payment system that is efficient and effective and meets all contract requirements.

All claims must be processed within thirty (30) calendar days.

Clean claims must be paid within thirty (30) calendar days.

Contractor must work with IDOC to establish and support a comprehensive appeal process for providers.

Ensure separation of the administrative fees and treatment fees.

Report timeliness of claims processing and payment quarterly to IDOC.

Generate and extract from WITS, or a similar EHR or user interface, agreed upon by IDOC, or provide an application interface that must integrate with WITS, or a similar EHR or user interface, agreed upon by IDOC, specifically for payment review and accounts payable/receivable that enables the Offeror to provide regular electronic or manual payment to providers on claims approved for payment.

In the event of a disaster, meet performance requirements for claims payment. If the disaster impacts WITS, or a similar EHR or user interface, agreed upon by IDOC, the WITS (FEI.com) or similar EHR host, the Offeror must inform the Contract Monitor of disposition of claims payment and planned mitigation. The Offeror must work with the Contract Monitor to develop a plan of resolution.

Manage and implement changes to billing codes, diagnosis codes or fee schedules.

Implement waste, fraud and abuse prevention, detection and resolution measures to:

Ensure providers receive a description of IDOC-approved services and contracted rate matrix;

Recover all overpayments through accounts receivable, cash control, and adjustment processes; and Ensure all claims, financial transactions, attachments, and adjustments received are assigned a unique internal control number within one (1) business day of receipt.

Provide a detailed description on how you will meet or exceed the requirements listed in this section. If what you propose deviates at all from these requirements, identify the deviation and explain how what you propose is functionally equivalent to what is required. Additionally, describe in detail your knowledge and experience in fiscal management functions.

(M) Data Management The Offeror…