KENOSHA COUNTY DEPARTMENT OF HUMAN SERVICES

Division of Aging, Disability & Behavioral Health Services Request for Proposal (RFP) #202401

Benefit Specialist Program

Service: Benefit Specialist Program

Division: DADBHS

Proposal Deadline: Proposals must be submitted electronically no later than

10:00 AM (CST) May 1st, 2024, to:

Single Point of Contact: Monica G. Santos, Contract Specialist monica.santos@kenoshacountywi.gov

Kenosha County Department of Human Services Mission Statement, encompassing the following Divisions:

Aging, Disability, & Behavioral Health Services Health Services

Brookside Care Center Veterans Services

Children & Family Services Workforce Development

To develop, coordinate, and administer a comprehensive network of services to children, youth, families, the elderly, and individuals striving to cope with developmental disabilities, mental illness, and alcohol and drug problems; to preserve and strengthen families, while protecting children from high-risk or abusive situations; to empower individuals and families to become law-abiding and economically self-sufficient; to assure the delivery of public health services necessary to prevent disease; to protect, promote, and preserve a healthy citizenry and environment; to advise and assist military veterans; to provide high quality nursing home services to the elderly and medically disabled; to advocate on behalf of these constituencies on the local, state, and national level.

Kenosha County Department of Human Services – KCDHS

Office of the Director

8600 Sheridan Rd. | Suite 100 | Kenosha, WI 53143 | (262) 697-4554 http://www.kenoshacounty.org/151/Doing-Business-w-DHS mailto:monica.santos@kenoshacountywi.gov http://www.kenoshacounty.org/151/Doing-Business-w-DHS

TABLE OF CONTENTS

I GENERAL INFORMATION & SCHEDULE OF EVENTS 1

II GENERAL REQUIREMENTS 2

III PROGRAM DESCRIPTION & SPECIFICATIONS 4

IV RESPONSE REQUIREMENTS 6

V RFP SUBMISSION 10

VI EVALUATION & SELECTION 11

VII ATTACHMENTS

ATTACHMENT #1 – VENDOR/PROVIDER INFORMATION & CHECKLIST

ATTACHMENT #2 – ASSURANCES

ATTACHMENT #3 – POLICY ON ETHICS IN GOVERNMENT

ATTACHMENT #4 – BUSINESS EXPERIENCE

ATTACHMENT (EXCEL) – BUDGET WORKSHEET

KENOSHA COUNTY DEPARTMENT OF HUMAN SERVICES

Request for Proposal (RFP) #202401

Benefit Specialist Program

I GENERAL INFORMATION

A. This Request for Proposal (RFP) is being issued by the Kenosha County Department of Human

Services (KCDHS) to request competitive proposals from organizations that are interested in providing the Benefit Specialist Program, as further defined in this RFP.

B. The individual responsible for managing the RFP process and Single Point of Contract for all related activities throughout the RFP process is Monica G. Santos, KCDHS Contract Specialist.

The Division of Aging, Disability & Behavioral Health Services will administer any contract resulting from this RFP.

C. Errors or Omissions - If a proposer discovers any significant ambiguity, error, conflict, discrepancy, omission, or other deficiency in this RFP, the proposer should notify immediately the RFP single point of contact of such error and request modification or clarification of the RFP document. Should it be necessary to provide additional or clarifying information, or to revise any part of the RFP, the revisions and supplemental information will be provided by an RFP

Amendment/Addendum for signature posted to the KCDHS website via VendorNet.

D. Questions – All questions must be emailed to the RFP Single Point of Contact.

The summary of applicable questions and answers (Q&A Summary) will be posted by an RFP

Addendum for signature on KCDHS website via VendorNet.

E. Amendments/Addenda – All information posted as RFP Amendments/Addenda for signature on the KCDHS website via VendorNet must be signed and returned with your proposal.

SCHEDULE OF EVENTS

Kenosha County reserves the right to deviate from any timetable related to this RFP.

03/25/2024 Public Notice of RFP

04/12/2024 Deadline for Questions by 2:00 PM CST

04/19/2024 Q & A Summary Posted to VendorNet

05/01/2024 Deadline for Proposals by 10:00 AM CST

1-2 weeks Evaluation Process

TBD Projected Interview Dates

TBD Service Implementation and Transition Period

07/01/2024 Intended Contract Start Date

II GENERAL REQUIREMENTS

A. It is the intent of Kenosha County Department of Human Services (KCDHS) to execute a one-year contract as a result of this RFP and the selection process as further defined in this RFP. Any contract(s) resulting from this RFP are anticipated to commence on 07/01/24. Contract renewals are determined solely by Kenosha County subject to applicable funding requirements and department authorizations, availability of funds, satisfactory contract performance, and when applicable, negotiation of renewal rates.

B. All program specifications stated in this RFP must be addressed in the proposal narrative.

C. Proposals must be typed & organized and clearly, completely & concisely written.

D. KCDHS does not reimburse costs incurred in proposal preparation.

E. KCDHS allows for a maximum of 10% administrative cost.

F. KCDHS reserves the right to negotiate changes in both reporting and billing requirements.

G. As a Federal/State/County funded program, be aware that regulations may change during program operation and the program design may be affected resulting in modification by KCDHS. Request for

Proposals are announced prior to the Division’s budget being finalized, and therefore are tentative, may be modified, and are contingent upon final budget approvals.

H. It is the proposer’s responsibility to check the website for future announcements, addenda, and other related information prior to submitting the proposal by its due date. Failure to respond to the requirements of the RFP in its entirety, including any addenda, supplemental information or revisions may result in disqualification.

I. Kenosha County intends to select the proposal judged to be the most advantageous to the program through the evaluation procedures (selection process). Contractors must be responsible and able to perform successfully under the terms and conditions of the RFP. Consideration will be given to such matters as contractor integrity, compliance with public policy, record of past performance and financial and technical resources.

J. Kenosha County may waive or permit cure of minor irregularities, or may reject any or all proposals received, re-issue any or all parts of the RFP, adjust, cancel, or withdraw in part or entirety the RFP, or extend the deadlines, if the proposals received are not in compliance with the solicitation requirements.

K. All material submitted by proposers become the property of Kenosha County upon submission, and therefore, public information, following completion of all RFP and appeal activities, and are subject to requirements of Wisconsin open records laws.

L. Data reporting requirements serve three purposes:

1) meet Federal and State reporting requirements,

2) provide information for program monitoring and management and

3) provide for component and program evaluation. KCDHS reserves the right to specify its individual reporting requirements.

M. Contract Reimbursement Policy: It is the intent of KCDHS to reimburse the actual approved costs or units of service provided under this RFP and reported each month. Payments will depend on timeliness, accuracy of reporting, and the achievement of quantitative and qualitative goals specified in the Program

Description and Specifications and as otherwise required or negotiated.

N. Performance and Reporting Requirements: Contractors are required to comply with the funding source requirements. Requirements may include submitting reports and attending meetings with KCDHS representatives to review services, to assess progress & performance, to identify barriers, and to determine if any corrective action measures are necessary. It is the responsibility of the service provider to provide corrective action plans and reports as needed.

O. Conflict of Interest: Contractors awarded contracts under this RFP shall ensure the establishment of written policies and employment rules and other safeguards to prevent, and shall prevent, its employees, consultants, or agents from attempting to influence Kenosha County officials, employees, or its various committees, commissions, workgroups, departments, authorities, centers, services, consultants, agents, or members of the Kenosha County Board of Supervisors, from using their public positions for purposes that are, or give the appearance of being, motivated by a desire for private gain for themselves or others with whom they have family, business, or other ties. Please note that it is a crime under Sec. 946.13 Wis. Stats., if any public official or employee shall, in his private capacity, negotiate or bid for or enter into a contract in which he has private pecuniary interest, direct or indirect, if at the same time he is authorized or required by law to participate in his capacity as such officer or employee in the making of that contract or to perform in regard to that contract some official function requiring the exercise of discretion on his part, nor shall any official or employee, in his official capacity, participate in the making of a contract in which he has a private pecuniary interest, direct or indirect, or perform in regard to that contract some function requiring the exercise of discretion.

P. Kenosha County Policy on Ethics is included in this RFP as an Attachment and must be signed and returned with your proposal.

Q. Contractors and KCDHS must comply with the applicable Office of Management and Budget OMB

Uniform Guidance (2 CFR 200), OMB circulars, and other federal and state laws and regulations.

R. A sample of the current KCDHS Contract Compliance Requirements, General Provisions is available at:

http://www.kenoshacounty.org/151/Doing-Business-w-DHS.

http://www.kenoshacounty.org/151/Doing-Business-w-DHS

III PROGRAM DESCRIPTIONS & SPECIFICATIONS

A. SERVICES TO BE PROVIDED

The Kenosha County Division of Aging, Disability, and Behavioral Health Services (DADBHS) provides

Kenosha County residents aged 60 and over or adults 18 and over with a disability and their families, information and assistance regarding questions and issues about Medicare, Social Security, Medicaid, other health insurance, housing and more. Benefit Specialist serves under off-site consultation by law attorneys who are under contract with the state. The employer shall provide consumers with the opportunity to make a voluntary contribution toward the cost of this service in accordance with Bureau on Aging & Disability policy.

1. Staffing: 4 FTE qualified Benefit Specialist and .5 FTE MIPPA Outreach Coordinator will be hired that includes:

a. 1 Supervisor (.5 supervision and .5 EBS caseload)

b. 1 FTE Elderly Benefit Specialist

c. 1 FTE Disability Benefit Specialist

d. 1 FTE Mental Health Disability Specialist.

e. .5 MIPPA (Medicare Improvement for Patients and Providers Act) Outreach Coordinator

f. Trained volunteers or student interns through the employer can help consumers with Medicare and other benefit basics.

2. Qualifications of staff shall have a Bachelor of Arts or Bachelor of Science degree (preferably in a health of human services-related field); or if the person does not meet the requirement, the hiring or supervising agency may submit a request for a waiver form to BADR. with benefit work. Staff shall be trained as a Benefit Specialist with expertise in Social Security, Medicare, Medicaid, and consumer issues. Qualifications for staff will also include excellent verbal and written communication skills.

3. Assistance is provided on a one-to-one basis or group setting through telephone conversations, home visits, appointments, and by outreach.

4. The Benefit Specialist assists in the following areas including but not limited to:

• Medicare • Landlord/Tenant

• Medicaid • Disability Benefits

• Social Security • Family Care (financial eligibility)

• Social Security Disability Insurance • Energy Assistance

• Medicare Supplemental Insurance • Housing

• Medicare Advantage Plans • Food Stamps

• Part D and Senior Care • Consumer law issues

• Social Security • Wills/Probate

• Supplemental Security Income • Homestead Tax (appeals only)

B. EXPECTATIONS

1. In office coverage at the Aging and Disability Resource Center located within the Division of Aging, Disability and Behavioral Health, from 8:00-5:00, Monday-Friday, with occasional evening or weekend outreach.

2. The employer and Supervisor are responsible for responding to all grievances both formal and informal. All grievances will be reported to the Manger of Aging and Disability Services within 5 business days of the claim. A determination will be submitted in writing to the Manager of Aging and

Disability Services within 30 days.

3. All personnel matters will be handled by the employer. Matters that impact staffing or the general functioning of the ADRC will be communicated to the Manger of Aging and Disability Services.

4. Staff oversight will be conducted by the employer. This includes but is not limited to professional staff development, job coaching, annual evaluations and disciplinary actions. The Division of Aging, Disability and Behavioral Health does expect all staff to demonstrate professional behavior. Employers will be notified immediately if this is not followed and be expected to take appropriate action.

5. Understand and adhere to DHS’s Scope of Services:

a. DBS Program Services Scope (P-00416) and Disability Benefits Counseling (P-03062-05)

b. Elder Benefit Specialist Program ADRC Operations Manual (P-03062-06)

None of the core benefit specialist program services may be eliminated without prior approval from the

ADRC Manager of Aging, Disability Services, the state EBS program manager and/or DBS program manager.

C. PERFORMANCE REQUIREMENTS & REPORTING METHODS

The DADBHS performance requirements and reporting methods below are designed to reflect the targeted outcomes and measures for the services of this contract. DADBHS reserves the right to modify performance requirements and reporting methods as necessary to achieve program goals.

PERFORMANCE OBJECTIVES MEASURE

Contact for new referrals will be made with persons seeking assistance within

48 hours of the referral date.

Client database report

Case notes must be recorded timely in the consumer database. Contacts must be recorded within one business day of case activity.

Client database report

Medicaid Administrative time reporting will be completed daily and accurate.

Monthly submissions due no later than the 3rd day of the following month.

Time reporting review

All client activities must be reported in the WellSky database application no later than one month after the activity date.

Database reporting

Staff will attend all required trainings and will seek additional opportunities to enhance skills.

Quality Reports

Ninety percent (90%) of persons served will express satisfaction with services received as measured by a survey of persons who had cases opened.

Consumer Surveys

At minimum, one Medicare Workshop will be completed each month during the months of January-September Quality Reports

Open Enrollment Assistance will be offered annually from October 15-

December 7.

Quality Reports https://www.dhs.wisconsin.gov/publications/p0/p00416.pdf https://www.dhs.wisconsin.gov/publications/p03062-06.pdf

IV RESPONSE REQUIREMENTS

COMPLETE PROPOSAL – Proposals must address all requirements and specifications of the RFP and include all required documentation. KCDHS reserves the right to reject incomplete proposals. Thoroughly examine the entire RFP document, including attachments. Completed proposals must include all information listed in this section and as otherwise required in this RFP.

A. PROPOSAL COVER PAGE

B. PROPOSAL NARRATIVE REQUIREMENTS – Must include the following information.

1. Organization/Business Description

Provide a concise statement of the mission, goals, and a brief history of the organization. Include information on business formation, size, number of years in business, scope of services, and highlights of achievements.

2. Service Plan/Methodology

Describe in detail the service to be provided, client groups, service methodology, and goals.

Address and describe the following:

➢ Proposed service methodology and how it meets program specifications.

➢ Program design and how it addresses service needs of the target population.

➢ Service levels and how it addresses service needs of population.

➢ Innovative and creative approaches to service.

3. Business Capacity/Staffing/Organizational Structure

Address and describe the following:

➢ Administrative and management background (management team, administrative support, staff supervision).

➢ Organization’s collaborative and cooperative history and flexibility to meet changing programmatic and administrative requirements.

➢ Staff qualifications, staff retention rates and methods of minimizing staff turnover. Staff qualifications to deliver proposed design, key staff members’ length of service, proposed staffing patterns, and staff to participant ratios. List all staff positions related to proposed services and include the following for each:

▪ Position title, responsibilities, and duties for proposed service.

▪ Percentage of FTE assigned to this component.

▪ Qualifications of staff position (degrees, training, and experience).

4. Knowledge in Field & Program Area and Previous Experience-Similar and Relevant Services

Address and describe the following:

➢ Experience with proposed service & target population.

➢ An understanding of the service needs of the target population.

➢ A record of successful provision of similar services to target population, and achievement of service goals and planned outcomes.

➢ Level of experience in managing proposed services.

➢ Experience with state and local performance tracking systems.

➢ RFP Attachment 4 – Business Experience.

Provide business contact information for most recent business experience, excluding any

KCDHS contracts.

5. Program Performance

Address and describe the following:

➢ Describe plan/method for meeting the performance requirements, and method for collecting, analyzing, monitoring, measuring, documenting, and evaluating service performance and outcomes achieved.

➢ Describe how corrective actions will be completed and reported, if necessary, based on results of performance monitoring.

6. Budget Narrative / Financial Information

➢ Demonstrate that described financial/information systems are adequate to meet the program specifications.

➢ If a previous KCDHS provider, demonstrate that data reports have been accurate and timely, and that other reporting requirements have been met.

➢ Demonstrate that audit report displays acceptable financial practices and reflects a sound financial position.

➢ Provide information for reviewers to determine reasonableness of the cost and revenues included in the budget. In this section also indicate the not-to-exceed percentage increase for three (3) succeeding years. Identify the administrative cost and method for the allocation basis.

Attach a detailed explanation of allocation method used to the Budget Worksheets.

7. Quality of Proposal

Proposal must be complete, thorough and demonstrate professional organizational and writing abilities. Proposal must address all requirements and specifications of the RFP and include all required documentation.

8. RFP Addenda – You are required to include all RFP Addenda (signed) as posted on the KCDHS website via VendorNet. (If applicable)

C. SUPPORT DOCUMENTATION

Do not omit. If documentation does not apply, you must submit a statement in lieu.

1. RFP Attachment 1 - Vendor/Provider Information & Checklist

2. RFP Attachment 2 - Assurances

3. RFP Attachment 3 - Ethics

4. Excerpts of Personnel Policies to include Employee Benefits relating to time off (vacation, sick, holidays, leave of absence, etc.)

5. Organization Chart - organizational chart.

6. Board of Directors (if applicable) – list of current Board of Directors and owners identified by name with middle initial, position held on Board office, address, employer, and occupation; and provide statement that Board members are 18 years of age or older.

7. Evidence of Board Approval (if applicable) - documentation stating that the governing board has given its approval for the submittal of the proposal.

8. Evidence of Insurance Coverage – your current insurance certificate/coverage information. Contracts resulting from this RFP will not be considered authorized until a contract compliant copy of the insurance certificate is received by KCHDS. Current KCDHS minimum expectations for contract compliance is as follows: list Kenosha County as additional insured and as a certificate holder, maintain minimum commercial general liability for personal and bodily injury and property damage against any claim(s) that might occur in carrying out the Contract [including professional malpractice;

errors and omissions coverage, if the services being provided are professional services], with minimum liability amount of $1,000,000 per occurrence/$2,000,000 aggregate and minimum

$100,000 in property damage, Worker’s Compensation insurance as required by WI Statutes, and minimum $500,000 combined single limit commercial auto/motor vehicle insurance for all owned, non-owned, and hired vehicles used in carrying out the services of the contract.

9. Annual Report (if applicable) – most current annual report.

10. Audit/Fiscal Report – last completed fiscal year audit, completed by an independent auditor, or the year-end financial reports if audits are not required, and a statement as to why audits are not required.

11. County Employee Disclosure – list of all Kenosha County employees or former employees to a wage, a salary or an independent consultant fee was paid during the preceding 1 and 1/2 years.

12. Licenses and Accreditations – information on current licenses and accreditations held or required for staff and/or the organization.

13. KCDHS reserves the right to request additional documentation or information if necessary to adequately review proposals and/or as needed at time of contract award.

D. PROGRAM BUDGET GUIDELINES AND BUDGET WORKSHEET

1. Submit the budget worksheet with your proposal, using the separate worksheet file for each proposal submitted. The budget worksheet is an EXCEL file, with five separate worksheet tabs. All worksheets are designed to have proposers enter information in designated blue areas only. Begin on worksheet tab #1. Once entered, specific information will automatically copy to other worksheets. The yellow and gray areas of the worksheets are calculations and should be verified for accuracy.

2. Proposed program budgets cannot exceed the dollar amount described in the program specifications.

However, proposers may identify funds beyond this proposal for purposes of coordination or collaboration. Use worksheet tab #5 to report additional revenue sources and related expenditures;

these must not be included in the specified program budget.

3. Proposers must comply with the Uniform Guidance 200 (2CFR 200) for allowable costs. Wisconsin

4. Local policy does not allow:

➢ Any charges for program costs not directly applicable to the funded program.

➢ Any charges or costs deemed unreasonable or excessive to operations of the program or service.

➢ For profit agencies may not exceed 5% of profit

5. KCDHS may, in the negotiation of a contract budget, disallow certain proposed cost items, reduce certain proposed cost items, and/or realign or increase proposed cost items.

6. The proposed budget shall include all costs associated with the operation of this program.

7. When there is a correlated Medicaid benefit, KCDHS expects providers to make every reasonable effort to control service rates and maximize revenue, billed through such methods as third-party payments and MA billing.

8. All questions including those regarding the budget worksheets, must be emailed to the RFP single point of contact.

COMPLETING THE BUDGET WORKSHEET EXCEL FILE INFORMATION

Provide detailed information on the proposed program budget. The following information further defines each worksheet tab.

1. Budget Worksheet Tab #1–FTE & Salary Allocation: Complete the blue shaded section that summarizes the percent of personnel time allocated to complete each program:

a. Insert the name of business/organization and the contract period in the applicable cells near the top. [Contract IDs are entered by Kenosha County when applicable.]

b. Insert the RFP Program name as the column heading. Distribute the percentage of each individual’s time across: (1) Direct Staff FTE and (2) Admin/Clerical/Supervision. To ensure unit rates are based on consistent information, the following explanation is offered to assist in distinguishing between the two columns: 1) Direct Staff includes personnel who have face-to-face client contact, prepare case management/documentation, or are involved in any other program-related activity that relates to the client served; 2) Admin /Clerical/Supervision includes the support staff (secretarial, receptionist, file clerk, etc.), supervision of direct staff, and administration of the overall program. The FTE allocation for personnel time listed in this column does not have direct contact with client served.

c. Insert each employee's position title, annual salary, and full-time equivalents in the applicable columns of the budget grid. (One Full-Time Equivalent is equal to 2,080 hours of work per year for RFP purposes.) The Total FTE counts cannot exceed 1.0 per line; only one employee or position can be entered per line.

2. Budget Worksheet Tab #2–Benefit Computation: Complete the blue sections. Include an explanation of other benefits listed. Verify that all salary information has been carried over correctly from

Worksheet Tab #1.

3. Budget Worksheet Tab #3–Expense Summary: Complete Tab #3, this tab summarizes all expenses.

a. In the Other Expenses section, insert the expense figures that are applicable to the proposed program and the organization. Input the Contracted Program, Contracted Other, Equipment

Purchases, and all Other Expenses on Budget Worksheet Tab #4–Other Services Explanation

(see item #4 below); these expenditure totals will carry back to Tab #3 and will be listed under

Other Expenses near the top.

b. Insert the applicable administrative allocation rate in the box for Administration Allocation

Rate. Indicate in narrative form, the basis by which administrative costs are allocated to the proposed program budget (see item #6 below.) A maximum of 10% administrative rate will be allowed.

4. Budget Worksheet Tab #4-Detail of Other Expenditures & Equipment

a. Use this tab to list Contracted Program, Contracted Other, Equipment Purchases, and all Other

Expenses not listed on Tab #3. Include a detailed description with the dollar amount.

b. If equipment purchases with a unit cost of over $500 and a useful life of more than one year is included in Worksheet #3, list the items and the cost separately per item.

5. Budget Worksheet Tab #5–Revenue Sources (Optional): Use this tab to provide other revenue sources

(Medicaid Revenue, United Way, grants, etc.) that will be used to provide services in the proposed program area. List how the proposed expenditures will be used to enhance the program along with the additional revenue sources.

6. Budget Narrative/Rate Justification: Provide information for reviewers to determine the reasonableness of the cost and revenues included in the budget, for example, indicate which salaries are higher due to staff education or experience levels. If applicable, the administrative allocation basis should be explained in narrative form. In this section, also indicate the not-to-exceed percentage increase for three (3) succeeding years.

V. RFP SUBMISSION

It is the responsibility of the proposer to thoroughly examine the entire RFP document and to ensure the proposal is received on time.

Proposers must submit their RFP response, support documentation, addenda’s (if applicable), and budget worksheets via email to the single point of contact:

Monica G. Santos monica.santos@kenoshacountywi.gov

Subject: Proposal in Response to RFP #202401 Benefit Specialist Program

Your proposal response should include:

1. All sections requested within one (1) electronic PDF document.

2. The budget worksheet must be submitted in Excel format.

IMPORTANT

If attachments exceed limit of email service, save your files to a cloud service, and share the link.

Late proposals will NOT be considered.

Proposals that do not meet the deadline date and time requirements will not be reviewed.

No exceptions will be allowed.

KCDHS reserves the right to reject incomplete proposals.

Kenosha County is not responsible for the content of any proposal information received through any 3rd party RFP/bid service. It is the sole responsibility of the proposer to ensure the completeness of the documents received from any 3rd party.

mailto:monica.santos@kenoshacountywi.gov

IV EVALUATION & SELECTION

A. The evaluation and selection process is generally a two-part process that includes:

1) a Proposal Review and

2) an Interview Meeting

The process uses standard forms, evaluation criteria, raw scores, and ranking. The Interview Meeting is approximately one hour and will provide an opportunity to present proposal highlights (NTE 10 minutes), followed by uniform set of interview questions based on the categories below asked at each

Interview Meeting, and any proposal specific clarification questions.

Proposal Review Categories Possible

Points Interview Meeting Categories

Possible

Points

Service Plan / Methodology 20 Service Plan / Methodology 20

Business

Capacity/Staffing/Organizational

Structure

Business

Capacity/Staffing/Organizational

Structure

Knowledge in Field & Program Area and Previous Experience-Similar &

Relevant Services

Knowledge in Field & Program Area and

Previous Experience-Similar & Relevant

Services

Program Performance 15 Program Performance 15

Budget / Financial Information 20 Budget / Financial Information 20

Quality of Proposal, Professionalism, Responsiveness

Quality of Proposal, Professionalism, Responsiveness

B. After the evaluation process is completed, the scoring results are ranked, summarized, and reviewed. A contract award recommendation is made based on the results, and proposers receive a notification letter.

(Any contract resulting from this RFP process is contingent on the applicable program funding and the

Department’s contracting and budget approval process.)

C. Funding levels and performance requirements may change from those listed within the RFP; therefore, Kenosha County may negotiate the terms of any resulting contracts, award amount, authorized budget items, and performance plans prior to entering into an agreement.

D. Appeal Process-only the RFP respondents (proposers) who have submitted a proposal can make an appeal request. The appeal process is to determine if decision making for the award followed evaluation procedures (outlined in the RFP); proposers can only appeal violations of those procedures; scoring by the evaluation panel and ranking are not subject to appeal. An Appeal request must be submitted in writing by the director or board president, must state the basis of the appeal, fully identifying the procedural violation and reasons to support the claims, and must be received by the date/time specified in the notification letter, to be considered valid. The Appeal request and applicable information will first be reviewed with KCDHS and discussed with the proposer. If resolution cannot be achieved, the proposer may be invited to an appeal review before an Appeals Committee for an opportunity to present the violations noted in the appeal request. If all submitted proposals are rejected, there is no appeal process.

ATTACHMENT #1 – PROPOSER INFORMATION & CHECKLIST

Complete, sign, and return with your proposal

Proposer/Business Name ______________________________________________ Years in Business _________

Federal Tax ID Number _______________________________________________________________________

Business Type: Corporation Non-Profit Corp LLC Sole Proprietorship Other ___________________

Mailing Address: _____________________________________________________________________________

City: _________________________________________________ State: ________________ Zip: ____________

Proposer Email Address _______________________________________________________________________

Contract Signor Name _________________________________________________________________________

Contract Signor Title ____________________________________ Contract Signor Phone # _________________

Contract Signor Email Address __________________________________________________________________

Billing Contact Name: ________________________________________ Title ____________________________

Billing Address ______________________________________________ Billing Phone # ___________________

City: _________________________________________________ State: ________________ Zip: ____________

Billing Email Address _________________________________________________________________________

COMPLETE & SUBMIT THE FOLLOWING:

Required Proposal Information & Support Documentation Checklist

RFP Attachment 1 Proposer Info RFP Attachment 2 Assurances

RFP Attachment 4 Business Experience RFP Attachment 3 Ethics Notice

RFP Attachment KCDHS Excel Budget Worksheet & Attach Explanation for the Administrative Cost

Proposal Narrative-Address all items Excerpts of Personnel Policies

Organizational Chart Board of Directors Listing

Evidence of Insurance Annual Report

Audit/Financial Report County Employee Disclosure

Licenses, etc. All RFP Signed Addenda (if any/applicable)

CERTIFICATION: In making this proposal, the proposing organization certifies:

1) that all applicable regulations and policies of KCDHS, the State of Wisconsin Department of Workforce

Development, and the Federal WIOA will be adhered to;

2) that all proposal information submitted is complete and correct, and that it is submitted in response to the KCDHS

Request for Proposal (RFP) with acknowledgment of all RFP content, information, and addenda;

3) that the signor of this proposal is authorized by the proposing organization to submit and certify this proposal, and

4) that the proposing organization is a legal entity under laws of the State of WI or authorized to operate in the State of

WI. An original signature is required below with the original proposal.

Authorized Signature: _____________________________________________________ Date: _________________

Print Name / Title: ________________________________________________________ Date: _________________

ATTACHMENT #2 - ASSURANCES

Complete, sign, and return with your proposal

Funds: The contractor agrees that (a) funds granted as a result of this request for proposal are to be expended for the purposes set forth within and in accordance with all applicable laws, regulations, policies and procedures of the State of Wisconsin or the Federal Funding Agency, as applicable; (b) no expenditures occurring prior to the effective date of a grant/contract award will be eligible for inclusion; and (c) funds awarded by the funding source(s) may be terminated at any time for violation of any terms and requirements of this agreement.

Title VI of Civil Rights Act of 1964: The contractor will ensure compliance with the Title VI of the Civil Rights

Act of 1964 (P.L. 88-342), and all requirements imposed by or pursuant to the regulations HHS (45 CRF Part 80) and issued pursuant to that title. To that end, and in accordance with Title VI of that act and the regulations, no person shall, on the grounds of race, color or national origin, be excluded from participating in, be denied the benefits of, or be otherwise subjected to discrimination under any program or activity in which the designated contractor received federal assistance, or financial assistance from the Department; and HEREBY GIVES

ASSURANCE THAT it will immediately take any measures necessary to effectuate this agreement.

Title IX of the Education Amendment of 1972: The contractor shall ensure compliance with Title IX of the

Education Amendment of 1972 which state that no person in the United States shall, on the basis of sex, be excluded from participating in, be denied the benefit of, or be otherwise subjected to discrimination under any education program or activity for which the contractor receives or benefits from Federal financial assistance.

Rehabilitation Act of 1973 and Age Discrimination Act of 1975: The contractor shall comply with Section 504, Rehabilitation Act of 1973, which prohibits discrimination on the basis of a physical condition or handicap, and the Age Discrimination Act of 1975, which prohibits discrimination because of age.

Wisconsin Statues: 946.10 and 946.13: The contractor shall ensure the establishment of safeguards to prevent employees, consultants, or members of governing bodies from using their position for purpose that are, or give the appearance of being, motivated by a desire for private gain for themselves or others, such as those with whom they have family, business, or other ties as specified in Wisconsin Statutes 946.10 and 946.13.

Alcohol and Substance Abuse and Drug Testing: The contractor shall ensure that it maintains and enforces alcohol and substance abuse policies appropriate to the organization and consistent with the fullest extent allowed by law, including mandatory drug and alcohol testing for all driving personnel who drive clients, to ensure drivers are free from intoxicants or drugs that impair driving.

Privacy Rules and Regulations and Confidentiality: The contractor shall ensure that it maintains compliance with the Health Insurance Portability and Accountability Act of 1996, (HIPAA) Privacy Rules and Regulations.

The contractor understands and agrees to comply with the “Assurances” if awarded a contract.

The undersigned has the legal authority and capacity to enter into this agreement and a motion has been duly passed as an official act of the governing body authorizing the execution of this agreement and authorizing the person identified as the official representative of the business to act in connection with the business and to provide such additional information as may be required.

SIGNATURE OF AUTHORIZED BUSINESS REPRESENTATIVE:

Authorized Official Signature _______________________________________________ Date ______________

Print Name & Title of Authorized Official

Print Name of Business

ATTACHMENT #3 - KENOSHA COUNTY POLICY ON ETHICS IN GOVERNMENT

Complete, sign, and return with your proposal.

In addition to ethical standards set forth in Wisconsin Statutes Section 19. 59 for all County employees and officials [either elected or appointed] Kenosha County has adopted an Ethics Policy that is applicable to County employees in conducting county business. Kenosha County Ordinances, Chapter 20 includes the Ethics Code for Officials and Employees.

The Ethics Policy is intended to ensure that public trust in Kenosha County government is maintained and that decisions affecting the county and its citizens are made fairly and impartially for the benefit of all citizens and not for personal gain.

This policy precludes the misuse or misappropriation of County property or funds for personal use or otherwise, use or disclosure of confidential information for personal gain or otherwise, elimination of conflicts of interests, receipt of gifts or favors or other considerations of value by County employees, the use of the employee’s public position to influence or gain unlawful benefits or to influence or gain advantages or privileges for the employee, and the conducting of personal business or campaigning during working hours.

This policy, furthermore, requires employees to disclose and report to the proper authorities any violation of this policy by either other employees or by any non-employee or citizen seeking to or aiding or abetting in efforts to circumvent this policy.

Any employee failing to make such disclosure or report is subject to discipline. Contracts with Kenosha County also require that any party contracting with Kenosha County also report any violation to either the District Attorney or Corporation

Counsel for Kenosha County.

In addition, Wisconsin Statutes Sections, 946.12 involving misconduct in public office and 946.13 involving a private interest in a public contract are considered Class 1 felonies and activity considered in violation of these statutes will be reported to the Kenosha County Sheriff for investigation and the Kenosha County District Attorney for prosecution.

IN SUBMITTING A BID OR PROPOSAL IN RESPONSE TO A REQUEST FOR BIDS OR PROPOSALS, A PARTY

MUST ACKNOWLEDGE BOTH IN THIS RESPONSE AS WELL AS IN ANY SUBSEQUENT CONTRACT THAT:

1. THE PARTY HAS READ THIS NOTICE IN ITS ENTIRETY, UNDERSTANDS ITS CONTENT AND AGREES

TO BE BOUND BY THE PROVISIONS HEREIN, AND

2. THE PARTY KNOWS OF NO CONFLICTS OF INTEREST OR APPEARANCE OF A CONFLICT OR

APPEARANCE OF AN IMPROPRIETY ON THE PART OF ANY CURRENT OR FORMER COUNTY

OFFICIAL OR EMPLOYEE WHO MAY HAVE HAD A ROLE ON DECIDING WHICH PROPOSAL OR BID

WILL BE ACCEPTED, AND

3. IT IS ACKNOWLEDGED THAT IT IS A CRIME UNDER SEC. 946.13 WIS. STATS., IF ANY PUBLIC

OFFICIAL OR EMPLOYEE SHALL, IN HIS OR HER PRIVATE CAPACITY, NEGOTIATE OR BID FOR OR

ENTER INTO A CONTRACT IN WHICH HE OR SHE HAS A PRIVATE PECUNIARY INTEREST, DIRECT

OR INDIRECT, IF AT THE SAME TIME HE OR SHE IS AUTHORIZED OR REQUIRED BY LAW TO

PARTICIPATE IN HIS OR HER CAPACITY AS SUCH OFFICER OR EMPLOYEE IN THE MAKING OF THAT

CONTRACT OR TO PERFORM IN REGARD TO THAT CONTRACT SOME OFFICIAL FUNCTION

REQUIRING THE EXERCISE OF DISCRETION ON HIS OR HER PART, NOR SHALL ANY OFFICIAL OR

EMPLOYEE, IN HIS OFFICIAL CAPACITY, PARTICIPATE IN THE MAKING OF A CONTRACT IN WHICH

HE OR SHE HAS A PRIVATE PECUNIARY INTEREST, DIRECT OR INDIRECT, OR PERFORMS IN

REGARD TO THAT CONTRACT SOME FUNCTION REQUIRING THE EXERCISE OF DISCRETION ON HIS

OR HER PART.

IN THE EVENT WIS. STAT, SECS. 946.12 AND 946.13 ARE VIOLATED, IT IS UNDERSTOOD THAT THIS

CONTRACT MAY BE VOIDED AT THE DISCRETION OF KENOSHA COUNTY.

4. QUESTION PERTAINING TO CONFLICTS OR APPEARANCE OF AN IMPROPRIETY MAY BE

ADDRESSED TO THE OFFICE OF THE KENOSHA COUNTY CORPORATION COUNSEL.

5. VIOLATIONS ARE REQUIRED TO BE REPORTED, AND

6. NO ATTEMPT HAS BEEN MADE BY ANYONE ON BEHALF OF THE PARTY SUBMITTING THE

PROPOSAL OR BID TO DIRECTLY OR INDIRECTLY ILLEGALLY INFLUENCE THE AWARDING OF A

CONTRACT BY PROMISE OF OR DELIVERY OF ANY CONSIDERATION OR ANY THING OF VALUE TO

A CURRENT OR FORMER COUNTY OFFICIAL OR EMPLOYEE OR FAMILY OR HOUSEHOLD MEMBER

OF A CURRENT OR FORMER COUNTY OFFICIAL OR EMPLOYEE, OR IN ANY OTHER MANNER

CONTRARY TO LAW, AND

7. KENOSHA COUNTY PROHIBITS COMMUNICATION RELATIVE TO THIS REQUEST FOR PROPOSAL OR

BID BY A PROPOSER OR BIDDER WITH ANY COUNTY ELECTED OFFICIAL OR EMPLOYEE PRIOR TO

THE TIME AN AWARD HAS BEEN MADE, EXCEPT AS PROVIDED FOR IN THIS REQUEST FOR

PROPOSAL OR BID INVITATION. VIOLATION OF THIS SECTION IS GROUNDS FOR

DISQUALIFICATION OF THE PARTY'S PROPOSAL.

8. OTHER THAN THE COUNTY REPRESENTATIVE NOTED HEREIN, NO OTHER EMPLOYEE OR

REPRESENTATIVE OF KENOSHA COUNTY IS AUTHORIZED TO INTERPRET ANY PORTION OF THE

REQUEST FOR PROPOSAL OR BID OR GIVE INFORMATION AS TO THE REQUIREMENTS OF THIS

REQUEST OR AMENDMENT THERETO. BIDDERS ARE INSTRUCTED NOT TO CONTACT ANY OTHER

COUNTY DEPARTMENT OR EMPLOYEE REGARDING THIS PROPOSAL.

9. WRITTEN QUESTIONS WILL BE ANSWERED IN WRITING TO THE PROPOSER REQUESTING A

RESPONSE. PROPOSER'S QUESTIONS AND THE COUNTY'S RESPONSES WILL BECOME A PUBLIC

RECORD, AND

10. THE PARTIES ACKNOWLEDGE THAT KENOSHA COUNTY IS A MUNICIPAL CORPORATION LEGALLY

BOUND TO COMPLY WITH THE WISCONSIN OPEN MEETINGS AND PUBLIC RECORDS LAW AND

THAT AS SUCH, UNLESS OTHERWISE ALLOWED FOR BY LAW, ALL ASPECTS OF THIS AGREEMENT

ARE SUBJECT TO OPEN DISCUSSION AND DISCLOSURE AND ARE A MATTER OF PUBLIC RECORD.

IT IS FURTHERMORE AGREED TO THAT NO PARTY WILL TAKE ANY ACTION TO OBSTRUCT THE

OPERATION OF THESE LAWS. IF RECORDS ARE CREATED OR MAINTAINED OR IN THE CUSTODY OF

THE PROPOSER, AS AN INDEPENDENT CONTRACTOR, THEY, ALONG WITH THE RAW DATA USED

TO CREATE THE RECORD, ARE, NEVERTHELESS, PUBLIC RECORDS. WITHIN LEGAL CONSTRAINTS

RELATED TO CONFIDENTIALITY AND PRIVACY PROTECTION, SUCH RECORDS MUST BE MADE

IMMEDIATELY AVAILABLE TO THE PUBLIC UPON REQUEST AND IN THE FORMAT IN WHICH THEY

WERE CREATED. PROPOSER AGREES TO HOLD THE COUNTY HARMLESS AND TO INDEMNIFY THE

COUNTY FOR ALL COSTS, FEES, INCLUDING ALL ATTORNEY FEES AND JUDGMENTS AND

DAMAGES OF WHATEVER KIND FOR WHICH THE COUNTY MAY BE HELD LIABLE DUE TO THE

PROPOSER’S FAILURE TO COMPLY WITH THE WISCONSIN PUBLIC RECORDS AND OPEN MEETINGS

LAWS, OR THIS AGREEMENT.

11. THAT ANY SUBSEQUENT FINDING OF A VIOLATION OF THE COUNTY’S ETHICS POLICY BY ANY

PARTY OR ANY AGENT OF ANY PARTY ACTING EITHER ALONE OR ACTING IN CONCERT WITH A

CURRENT OR FORMER KENOSHA COUNTY OFFICIAL OR EMPLOYEE MAY RESULT, AT THE SOLE

OPTION OF KENOSHA COUNTY, IN ANY SUBSEQUENT AGREEMENT BEING DECLARED NULL AND

VOID AND / OR MAY RESULT IN THE PARTY VIOLATING THIS POLICY BEING DEBARRED FROM

SUBMITTING PROPOSALS, BIDS OR CONTRACTING WITH KENOSHA COUNTY FOR A SPECIFIED

PERIOD OF TIME IN THE FUTURE.

SIGNATURE OF AUTHORIZED BUSINESS REPRESENTATIVE:

Authorized Official (Signature) Date

Print Name & Title of Authorized Official

Print Name of Business

ATTACHMENT 4 – BUSINESS EXPERIENCE

Complete and return with your proposal.

Provide business contact information for the most recent business experience, EXCLUDE ANY CONTACTS

FOR KCDHS. Kenosha County reserves the right to contact any number of the business listed for purposes of this

RFP.

1. Business / Company Name____________________________________________________________

Address

City, State, Zip _____________________________________________________________________

Contact Name/Title

Phone # __________________________ E-mail Address ___________________________________

Contract Start and End Date

Reason for Contract Ending ___________________________________________________________

Services provided ___________________________________________________________________

2. Business / Company Name____________________________________________________________

3. Business / Company Name____________________________________________________________