RFP_Nursing Home Placement Beds-Final docx.docx

Request for Proposals Healthcare Organization to Operate Skilled Nursing Home Placement Beds 2027000018 8/10/2026 Basic Information and Timeline

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Colorado Department of Human Services Solicitation Number: 2027000018 Division of Contracts and Procurement (v. 03/26) Page 1 of 15

A. Quick Resources

1. For questions about this solicitation, contact the Single Point of Contact identified above.

2. For help with Vendor Self Service (ColoradoVSS), contact the Vendor Self Service Help Desk vsshelp@state.co.us or 303-866-6464.

3. For information about doing business with the state of Colorado generally, go to: https://osc.colorado.gov/spco/accesscolorado.

4. The Department is always interested in improving. Please take this survey at any time: https://docs.google.com/forms/d/e/1FAIpQLScIgv9lgrT3x5AGzcvT1xkvpucrRhhN5QJ23vLcbyfvc2smaw/viewform (We do actually read the responses)

B. Introduction and Background

The State of Colorado is seeking proposal from qualified healthcare organizations operating skilled nursing facilities (SNFs) to establish and operate enhanced protective placement beds. Pursuant to the legislative mandates set forth in SB 26-149, the Colorado Department of Human Services (CDHS) is required to implement secure, residential options for individuals requiring intensive behavioral and neurocognitive support.

The purpose of this RFP is to secure a qualified Contractor to establish and coordinate the availability of adult Enhanced Protective Placement (EPP) beds. These beds function as an essential intermediate tier of care within the state's clinical continuum, serving as a less restrictive step down residential environment for individuals discharging from state inpatient hospitals, or a highly supported step up environment from traditional community care when clinically necessary.

The State is seeking 12 beds with the potential to add more based on demand and funding availability.

C. How to Submit a Proposal

1. In General. Email the proposal, Signature Page, and any other required documents in one zip file as an attachment to this email address: JG_2027.l8fhvo1cuvd0gm4b@u.box.com Please be aware of email server file size limitations. The maximum file size the Department can accept is 15 GB.

2. Only Attachments. Only the zip file goes through. The Department cannot see any text or messages sent to the email address identified above. Written questions may be emailed to the Single Point of Contact.

3. File Names. The zip file name should start with the solicitation type, solicitation number, and vendor name (e.g., “RFP 2027000018 Vendor Name…”). Vendors may include additional information in the zip file name.

4. Timing. The zip file typically uploads within five minutes; however, vendors should submit zip files at least thirty minutes prior to any deadline to ensure the file is received.

5. Confirmation. Vendors will receive an email confirmation from box.com that the zip file was uploaded correctly. If not, please contact the Single Point of Contact.

6. No Encryption. Do not encrypt emails sent to the submission email as it may prevent full submission.

7. Pre-bid Conference. There will not be pre-bid conference. Questions. Vendors may submit questions by email to the Single Point of Contact prior to the Questions Due Date identified in the Basic Information and Timeline above. The Department may answer some, all, or none of the questions asked by posting them publicly.

8. Late Proposals will not be accepted unless specifically allowed by rule and at the Department’s sole discretion.

D. Proposal Format

1. Maximum Length. Proposals should not exceed 30 pages. The Department may evaluate proposals negatively if this page limit is not followed.

E. Proposal Content To be considered for evaluation, bidder should submit a technical proposal that is no more than thirty (30) pages (excluding mandatory state licensing certificates and financial audits). The proposal should include a separate narrative section addressing each of the following components:

Program Design & Clinical Pathways Provide a detailed comprehensive program design, specifically outlining how the 12 contracted beds will be operationalized. The narrative should explicitly show the administrative and structural protocols that divide the secure memory care settings from the unsecure environments. Vendor should map out their localized rehabilitative schedules, low-stimulus spaces, and exit-seeking de-escalation workflows within the protective placement context for the specialized populations of neurocognitive and brain injury needs.

Organizational Experience & Past Performance Proposals should present documented organizational experience providing residential or skilled nursing treatment to individuals with severe behavioral health diagnoses, advanced neurocognitive deterioration, or complex medical-behavioral challenges. Bidders should showcase histories working with state hospital systems, complex civil commitments, or forensic clients.

Staffing Matrix & Capacity Check Proposal should demonstrate the operational capacity to provide continuous, 24/7 onsite skilled nursing and clinical support. The technical narrative must verify how the program will deliver clinically appropriate therapeutic, behavioral, rehabilitative, and specialized services individualized to assessed needs, PASRR findings, and interdisciplinary care planning.

Commitment to the SB 26-149 Population Proposals should include an explicit statement of commitment outlining how the organization plans to serve the high-acuity population defined under SB 26-149. Bidders must outline strategies, or provide specific policies for:

· Minimizing discharge barriers

· Maintaining a non-punitive, de-escalating clinical culture

· Addressing guardianship coordination

· Addressing informed consent, treatment refusals, and emergency interventions for individual with SMI or behavioral health needs and

· Collaborating with the Department's EPP Admission & Coordination Team on complex forensic and civil transitions.

2. Cost. Compensation Model & Financial Terms

Financial reimbursement should adhere to a hybrid structure designed to ensure programmatic stability: Please provide a statement of acknowledgement that you have read and understand the following and that you agree or disagree.

· Bed Availability Incentive Rate: OCFMH guarantees a baseline incentive payment of $307.64 per bed per day for all contracted beds that remain available and/or occupied through June 30, 2027 (up to a maximum daily calculation of $3,691.34 total for the 12-bed complement).

· Primary Payer Coordination: The Contractor must actively bill commercial insurance or Health First Colorado (Medicaid) first. For uninsured or Medicaid-ineligible clients, OCFMH will reimburse in alignment with the daily Medicaid rate plus designated incentive.

Capital & Renovation Reimbursement (SFY27): Vendor may request up to a maximum cap of $45,920.00 on a strict cost-reimbursement basis for documented, physical plant renovations executed through June 30, 2027, specifically to meet therapeutic, secure memory care locking systems, low-stimulus environments, or unlocked delayed egress tracking criteria. Criteria: Please provide a response indicating if a need for renovations and identifying what that renovation may entail, including cost.

There will be no opportunity for renovations above the dollar amount listed, but you may request renovations up to that dollar amount

Liquidated Damages & Clawback Provision: Early termination without cause or termination due to acute health/safety/licensing violations within one (1) calendar year of execution requires the Contractor to legally repay 80% of all state-funded renovation, start-up, and capital expenses back to the State of Colorado. :

Criteria: Please provide a statement of acknowledgement that you have read and understand the following and that you agree or disagree.

2. Other Criteria

Criteria: Please provide a written description of the following:

· Bed Availability: dedicate a minimum capacity of twelve (12) EPP beds specifically for individuals referred by CDHS.

· Dual Configuration Options: The facility must provide options for both secure memory care settings and unsecure environments to accommodate varying degrees of cognitive impairment, legal statuses, and behavioral risks. The facility may provide restricted-egress and unlocked rehabilitative environments when clinically appropriate and legally authorized. Any restrictive environmental intervention must be individualized, clinically justified, regularly reassessed, and implemented in the least restrictive manner possible and must maintain compliance with all applicable regulatory requirements, including 6 CCR 1011-1 Chapter 5 Section 23 and 42 CFR ⸹⸹ 483.10 and 483.12.

· Operational Readiness: The facility, clinical programs, physical plant modifications, individualized residential support environments designed to minimize restrictive interventions and promote community integration, and staff onboarding must be fully executed and operational, with the capacity to accept admissions, by October 15, 2026 or the earliest possible date pending the execution of the contract.

Specialized Brain Injury & Neurocognitive Framework Criteria: Proposal should demonstrate a robust clinical and operational capacity to serve individuals with complex neuro-behavioral presentations, including brain injuries (BI), advanced dementia, and other acquired neurocognitive disorders. The proposal should integrate parallel pathways for secure and unsecure care layouts.

Secure Memory Care Setting Requirements Provide responses to each of the components listed below indicating how you will be able to meet and/ or exceed the expectations.

For individuals presenting with severe cognitive decline, advanced dementia, or BI-induced executive dysfunction who exhibit high elopement risks or active safety hazards, the Contractor may operate licensed enhanced-support memory care environments consistent with SNF licensure requirements, resident rights protections, and all applicable federal and state regulations.

· Physical Plant Security: Continuously locked perimeter doors utilizing secure electronic access control systems, keypad egress, and anti-wandering technology (e.g., magnetic door locks tied to resident proximity badges).

· Legal & Regulatory Compliance: Strict alignment with Colorado Department of Public Health and Environment (CDPHE) guidelines for secure units, ensuring all placements comply with court-ordered holds, involuntary treatment certifications, or legal guardianships.

· Environmental Design: Inclusion of enclosed, secure outdoor courtyards that permit safe wandering without risk of community elopement. Visual camouflage on exit doors must be utilized to minimize agitation and exit-seeking behaviors.

Unsecure Setting Requirements Provide responses to each of the components listed below indicating how you will be able to meet and/ or exceed the expectations.

For individuals with milder cognitive impairments, stable TBI presentations, or those undergoing advanced stages of transitional rehabilitation, the Contractor must operate an unlocked wing emphasizing community re-entry:

· Open Layout & Independence: Unlocked residential access that fosters autonomy, independent ADL progression, and uninhibited internal movement.

· Delayed Egress Alerts: Implementation of non-restrictive monitoring, such as auditory delayed egress notifications or alarm systems, to notify staff of movement without physically detaining the resident. Safety monitoring interventions shall be clinically justified, minimally restrictive, and regularly reassessed to ensure consistency with resident rights protections.

· De-escalation Spaces: Easily accessible, unlocked low-stimulus environments where residents can self-refer during periods of sensory overstimulation.

Shared Clinical and Rehabilitative Programming Provide responses to each of the components listed below indicating how you will be able to meet and/ or exceed the expectations.

· Neurocognitive Rehabilitation: Provision of specialized cognitive retraining, adaptive functional skill building, and physical/occupational/speech therapies tailored to neurodegenerative or post-traumatic trajectories.

· Behavioral De-escalation: Implementation of specialized, non-pharmacological behavioral management strategies designed specifically for neurological agitation, disinhibition, or memory-loss anxiety.

· Multi-Disciplinary Staffing: Direct oversight from a board-certified or specialized neurologist, neuropsychologist, or a psychiatric clinician with certified competencies in neuro-behavioral and memory care.

· Antipsychotic Stewardship: Ongoing psychotropic medication oversight, gradual dose reduction, behavioral-first intervention strategies, and quality review procedures designed to minimize unnecessary chemical restraint risks.

Inclusion, Prioritization, and Exclusion Criteria Provide responses to each of the components listed below indicating how you will be able to meet and/ or exceed the expectations.

Intake Prioritization The CDHS may prioritize referrals for populations identified under SB 26-149, subject to individualized clinical appropriateness and least restrictive setting determinations including:

1. Individuals diagnosed with a Severe Mental Illness (SMI), an acquired neurocognitive disorder/TBI, or co-occurring substance use disorders (dual diagnoses).

2. Individuals actively under short-term or extended outpatient treatment certifications pursuant to C.R.S. 27-65-111.

3. Clinical step downs from State Hospitals, with a designated emphasis on forensic clients (e.g., individuals adjudicated as Incompetent to Proceed/Not Restorable (ITP/NR) and individuals facing complex community discharge barriers.

Admissions Authority: Client admissions must be supported Monday through Friday. CDHS shall coordinate referrals and placement recommendations in collaboration with the Contractor. Final admission appropriateness shall remain subject to PASRR findings, nursing facility level-of-care determinations, individualized clinical appropriateness, operational capacity, and resident rights protections.

Licensing, Operations, and Compliance The Awarded Contractor must adhere to state regulatory and licensing policies: Criteria: Please acknowledgement that you understand and agree to the following:

· Licensure Alignment: The Awarded Contractor must maintain verified, active state licensure matching the specific level of care delivered: Nursing Home and maintain qualifications for Medicaid Supplemental Behavioral Services (10 CCR 2505-10 Section 8.443.10.B.4. and 5). Secure units must hold specific locked memory care endorsements compliant with 6 CCR 1101.1 Chapter 5.

· Institution for Mental Disease (IMD) Capacity Cap Criteria: Proposal shall disclose ownership structures, affiliated operations, psychiatric programming, and total licensed bed counts sufficient for the State to evaluate potential IMD implications under federal Medicaid law.

· Geographical Spacing: To align with community integration mandates, separate residential structures operated by the same Contractor must maintain a minimum physical distance of 750 feet from one another.

F. Demographic Form

1. In an effort to best comply with Colorado Procurement Code rule R-24-103-901 re maximizing opportunities, we like to gather certain voluntary demographic information from potential vendors where possible. This is entirely voluntary and does not affect an organization’s application/proposal/quote/bid or contract whatsoever in any way. It is not taken into consideration in this procurement process or reviewed by evaluators in this process. The information gathered is submitted directly to a data gathering team at CDHS who provide general statistics on outcomes and trends to CDHS Contracts & Procurement leadership on approximately a quarterly basis so that this leadership can look for ways to generally and overall maximize opportunities as described in the Code. Please fill out the following form regarding your organization’s demographic information if and to whatever extent you are willing. This is again entirely voluntary and has no impact on your potential work for the State: https://app.smartsheet.com/b/form/219f6db8803b4994afb9bf70e84fa421 G. How Proposals are Evaluated

1. In General. The Department will identify the proposal(s) most advantageous to the State through an objective and competitive process. A committee will review all acceptable proposals and may request more information or clarifications from any vendor. The committee will then recommend one or more proposals for award. The Single Point of Contact will notify all vendors of the final decision.

2. Mandatory Criteria. The Department may identify mandatory criteria. However, the Department reserves the right to waive mandatory requirements pursuant to Rule 24-103-301-03.

3. Evaluation Factors. The Department may evaluate proposals based on the information requested or referenced in the proposal content section, or as noted throughout the solicitation.

4. References. The Department may contact references, whether provided or not, and also consider them as part of the evaluation.

5. Standard Contracting Terms. Vendors must submit any requested changes to the attached standard CDHS Contract/PO terms and conditions and exhibits ("State Agreement Pieces") in redline with their submission. These terms are difficult to modify and the State does not guarantee acceptance of any changes, even after a notice of intent to award. Requested modifications increase risk and cost to the State, which may negatively impact any evaluation or award. Changes also significantly delay contract execution, as approvals are required from multiple State agencies (e.g., DPA, AG, OIT, CDHS). If no exceptions are noted, the Vendor accepts the State's terms as-is. A notice of intent to award does not imply acceptance of any proposed changes.

H. Ethics and Accessibility

1. Any person involved in the purchasing process for the State, any end users of such goods and services, any vendor or contractor that does business with the state, and any other interested third parties to the procurement process shall enhance the proficiency and stature of the purchasing process by adhering to the highest standards of ethical behavior.

2. Accessibility Requirements. All work performed as a result of this solicitation must comply with all applicable provisions of §§24-85-101, et seq., C.R.S., and the Accessibility Standards for Individuals with a Disability, as established by the Office Of Information Technology pursuant to Section §24-85-103 (2.5), C.R.S. and 3) all State of Colorado technology standards related to technology accessibility and with Level AA of the most current version of the Web Content Accessibility Guidelines (WCAG), incorporated in the State of Colorado technology standards.

I. Administrative Information

1. Communication. All communication regarding this solicitation must be done through the Single Point of Contact identified above. Unauthorized contact with any Department personnel other than the Single Point of Contact regarding this solicitation is prohibited and may result in disqualification.

2. Notices. The Department may modify this solicitation by posting changes via the Colorado VSS website. All communications will be posted on the VSS, www.colorado.gov/vss , and/or through a direct email from the Single Point of Contact.

3. Modifications of Proposals. Proposals may be modified or withdrawn by the vendor prior to the established proposal due date and time.

4. Public Opening. On the date and time shown above, the Department will hold a public opening pursuant to Rule 24-103-201-13. Vendors may request an accommodation to attend the public opening from the Department.

5. Presentations or Site Visits. At the Department’s sole discretion, the Department may request presentations or site visits. Vendors should not, however, prepare the proposal with the assumption that an opportunity for oral presentations or revisions will be offered.

6. Acceptance of solicitation terms. A proposal submitted in response to this solicitation shall constitute a binding offer and acknowledgment that all terms and conditions of this solicitation are accepted. Vendors must identify any variations between its proposal and the solicitation. Failure to do so shall be deemed a waiver of any rights to subsequently modify the terms of performance.

7. Contract. Vendors must agree to the State’s contract terms, found here: https://cdhs.colorado.gov/procurement or as an exhibit to this solicitation. Please note that any referenced or attached model contract lists the State’s standard required legal provisions but may not include the specific scope of work and other specific terms or requirements for this solicitation. Vendors must review any attached contract terms and note any exceptions. If no exceptions are noted, Vendor is indicating an intent to accept the terms as-is. Modifications to the State’s contract terms constitute increased risk and costs to the State. Therefore, Vendor’s noted exceptions may be considered in any evaluation.

8. Award. The Department will notify all vendors who submitted a proposal when it issues a Notice of Intent to Award. The awarded vendor(s) must act in good faith to execute an agreement on or before the Anticipated Contract Start Date identified above. If this date is not met, through no fault of the State, the State, at its sole discretion, may cancel the Notice of Intent to Award.

9. Protests. Any actual or prospective vendor who is aggrieved in connection with the solicitation or award of a contract may protest to Lauren Ingalls (email to lauren.ingalls@state.co.us), Procurement Director, Division of Contracts and Procurement, Department of Human Services. The protest shall be submitted in writing within ten business days after such aggrieved person knows, or should have known, of the facts giving rise thereto.

10. CORE Registration. Unless otherwise noted, before the Department can award to any vendor, that vendor must be registered in CORE, which can be completed through Vendor Self Service at www.colorado.gov/vss.

11. EFT. Awarded vendors are encouraged to sign up for EFT transfers.

12. Secretary of State Registration. Before Contract execution, the awarded vendor must be registered to do business in the State of Colorado. If a vendor is a foreign corporation (formed under a statute or common law in a jurisdiction other than Colorado) or other foreign entity transacting business in the State of Colorado, it shall warrant that it currently has obtained and shall maintain any applicable certificate of authority to transact business in the State of Colorado and has designated a registered agent in Colorado to accept service of process.

13. System for Award Management. Before Contract execution, the awarded vendor(s) must be registered with the System for Award Management (SAM.gov).

14. Confidentiality. The State of Colorado is subject to the requirements of §24-72-200.1, C.R.S., et seq., Colorado Open Records Act. Anything submitted by a vendor is likely to become public information. Vendors may submit, as a part of its solicitation response, a written request for classification of certain portions of the proposal as confidential information pursuant to Colorado Procurement Code R-24-101-401-03. Material for which confidentiality has been requested shall be readily identifiable and separable from other portions of the solicitation to facilitate public inspection of the non-confidential portion of the solicitation response, if it is not, the confidentiality request will not be considered. Commingling of confidential and non-confidential information is not acceptable and any confidentiality request made in this fashion will not be considered. In no event shall an entire proposal be classified as confidential. Marking an entire proposal as confidential is a confidentiality request that will not be considered. Price information will not be considered confidential. In addition to complying with the aforementioned restrictions, in order for the confidentiality request to be considered, the vendor must include the rationale for the request to classify portions as confidential, as specified in the Colorado Procurement Code R-24-101-401-03, specifying by line which section of §24-72-204, C.R.S. is the purported authority for the requested confidentiality determination ("Confidentiality Request Justification"). The confidentiality request shall also include both a proposed redacted version and an unredacted version of the submission. The Procurement Official or his or her designee shall determine if the information identified in the Offeror’s request is exempt from disclosure in accordance with §24-72-204, C.R.S., and shall inform the Offeror in writing of his or her determination. If the Offeror does not agree with the determination, the Offeror may protest the determination in accordance with article 109 of the Colorado Procurement Code and the terms of this solicitation. Reference Procurement Rule R-24-101-401-03. A confidentiality request, even if granted, will not render any potential later mutually-negotiated contract terms confidential, as such a resulting contract would be a matter of public record.

15. Background Checks. Pursuant to C.R.S. §27-90-111 and Department policy, any vendor, and its agent(s), who has direct contact with vulnerable persons in a state-operated facility, or who provides state-funded services that involve direct contact with vulnerable persons in the vulnerable person’s home or residence, shall:

i. submit to and successfully pass a criminal background check, and

ii. report any arrests, charges, or summonses for any disqualifying offense as specified by C.R.S. §27-90-111 to the Department.

16. Proposal Prices. Estimated proposal prices are not acceptable. Best and final offers may be considered in determining the apparent successful vendor. Proposals shall be firm for a period of not less than 180 calendar days from the date of award.

17. Cancellation. A solicitation may be cancelled only when there are cogent and compelling reasons to believe that the cancellation of the solicitation is in the state's best interest. An award of a contract under a solicitation may be cancelled, in whole or in part, when the procurement official determines in writing that such action is in the state's best interest.

18. Costs. The Department is not liable for any cost incurred by vendors prior to any formal contract, purchase order, or other agreement. No property interest of any nature shall occur until a contract is signed by all concerned parties.

19. Proposal Rejection. The Department may reject a proposal, waive informalities, and minor irregularities, or accept any portion.

20. Tax ID. Any tax identification number provided must be that of the vendor responding to the solicitation. The vendor must be a legal entity with the legal right to contract.

21. News Releases. Vendors may not issue any news releases pertaining to this solicitation without the Department’s prior written approval.

22. Taxes. The Department is exempt from all federal excise taxes under Chapter 32 of the Internal Revenue Code (Registration No. 84-730123K) and from all state and local government use taxes C.R.S. §39-26-114(a). The Colorado State and Local Sales Tax Exemption Number is 98-02565. When materials are purchased in certain political subdivisions (for example - City of Denver), the vendor may be required to pay sales tax even though the ultimate product or service is provided to the State of Colorado. This sales tax will not be reimbursed by the State.

23. E-Verify. Vendors must participate in the federal E-Verify program or the Colorado Department of Labor and Employment Program as required by C.R.S. §8-17.5-101.

24. Services Outside of Colorado or the United States. Vendors must disclose services performed outside of Colorado or the United States as required by C.R.S. §24-102-206.

25. Notice to NonResident Bidders. If a nonresident vendor is from a state that provides a bidding preference to vendors from that state, then a comparable percentage disadvantage will be applied to the bid of that nonresident vendor pursuant to C.R.S. §24-103-908. The vendor may obtain additional information from the department of personnel's website.

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J. Exhibit List

· Agreement Terms and Conditions (informational, terms will be included in the agreement)

· Exhibit A – Statement of Work (informational and contains additional requirements, will be included as part of the agreement)

· Exhibit B – HIPAA Business Associates Agreement (informational and a requirement that will be a part of the agreement)

K. Signature Page The vendor must complete and submit the Signature Page along with the bid.

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