RFR for Fair Hearing RFR FINAL 3-19-19.docx

RFR: Fair Hearing Officers provided by individuals

THE COMMONWEALTH OF MASSACHUSETTS

EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

MASSACHUSETTS REHABILITATION COMMISSION (MRC)

600 WASHINGTON STREET, BOSTON, MASSACHUSETTS

Request for Response (RFR)

Document Title: MRC Hearing Officers provided by Individuals

COMMBUYS Bid#: BD-19-1071-AO-CON01-37039

Agency Document Number: MRC Hearing Officers Provided by Individuals 07-2019 Purchasing Department:

Massachusetts Rehabilitation Commission (MRC)

617-204-3695 Voice

March 29, 2019 Responses to questions will be posted on COMMBUYS by: April 5, 2019 at 5 PM

Vendor must register on and submit proposals to COMMBUYS https://www.commbuys.com/bso/ COMMBUYS Helpdesk #: 1-888-627-8283 (8am - 5pm ET Monday - Friday)

I. Introduction:

Under this RFR, The Massachusetts Rehabilitation Commission (MRC), is seeking to identify a list of individuals qualified, interested in and available to conduct due process hearings for individual with disabilities who are consumers of the Massachusetts Rehabilitation Commission.

Hearing Officers will be required to conduct a due process hearing pursuant to the informal; adjudicatory Rules of procedure and MRC regulations (107 CMR 1:00 et seq.) as well as all pertinent rules of evidence. The impartial hearings officer shall be required to issue a decision based on the issues and evidence presented in accordance with State regulations and policies as well as good rehabilitation practice. The officer shall be required to conduct a hearing, which will assure that the rights of all parties to the hearing are protected, by eliciting relevant documentary evidence and eliciting pertinent testimony regarding the issues in controversy. The officer shall provide the decision in writing to either the applicant or eligible individual and to MRC. In addition, the officer shall provide the decisions electronically to MRC as directed.

II. Contract Description

1. Acquisition Method This is a Fee for Service contract.

2. Request for Single or Multiple Contractors This RFR is for multiple contractors. Qualification of a Bidder under this RFR and Master Agreement does not guarantee any minimum purchase of services by MRC

3. Use of Procurement by a Single or Multiple Departments This procurement will be issued solely by MRC.

4. Anticipated Duration of Contract, Including Renewal Options The initial Contract term is for 5 years with a 3 year option to renew. The total duration of the Contract, including renewals, shall not exceed 8 years from the original start date (no later than 6/30/2027).

Contract(s) will NOT have a Maximum Obligation Amount (Rate Contract) Rates will be negotiated within a range of $50.00 to $100.00 per hour.

(*) Individual contracts will be renewable annually based on contractor performance, service need, and/or availability of funds. MRC will retain the option to reopen this solicitation for Bidders several times throughout the remaining duration of the Contract. During specified qualification periods announced on COMMBUYS, MRC will accept proposals from new individual seeking to be qualified under this procurement.

5. Contract Specifications, And Contractor Qualifications A qualified Fair Hearing Officer providing services to MRC must have an executed contract prior to preparing for, delivery of and invoicing for services.

The service unit is an hourly unit. MRC will pay for the following services: Preparing for Fair Hearing, conducting the hearing, analyzing data and writing the decision. Services are billed on an hourly basis and in no less that half-hour increments.

Travel: Reimbursement at .45 cents per mile (current reimbursement for Commonwealth of Mass employees) from home to fair hearing site. Should the Commonwealth increase travel reimbursement MRC will increase the rate for Fair Hearing Officers to the same rate.

Bills must be submitted along with the written and recorded Fair Hearing Decision using the Commonwealth of Massachusetts Voucher Input Form (PRC) according to section 8B.

All contract hourly rates will be established within the designated rate range from a minimum of $50.00 per hour to a maximum of $100 per hour. This range of rates has been established by the Agency through past experience under the contract preceding this RFR. The specific hourly rate within the designated range to be paid services is subject to negotiation between the department and the individual providing fair hearing services.

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6. Cultural Competence and Communication Needs

MRC is committed to awarding contracts to providers that demonstrate cultural competency. Programs shall ensure equal access to services. The following strategies are recommended:

Agency Commitment: Agency Board of Directors and administrators make a commitment to creating an environment that clearly supports services for cultural and linguistic minority populations through the mission and goals of the agency.

Job seeker Services: Program policies include language that contributes to enhancing equal access to services for all individuals residing in the Commonwealth. Program design, content, and materials are culturally and linguistically appropriate. Planning, implementation, and evaluation efforts include members of the target population (including LGBTQ+ identified / non-gender conforming persons who may benefit from culturally and linguistically appropriate policies/program design). Where possible, prevention, treatment, and rehabilitation strategies are participatory in nature in order to provide opportunities for skill building and to facilitate self-empowerment. All job seekers receive information on accessing health and human services including education on potential barriers and assistance in overcoming them. The program location and outreach activities are in settings that are most effective in reaching the target population.

Staff: All staff and volunteers, especially those who have direct contact with job seekers, reflect the diversity of the culture and language of the community/target population. Services to non-English speaking job seekers are provided by bilingual/bicultural staff. Policies on recruitment, screening, and interviewing encourage hiring of individuals whose cultural and linguistic backgrounds are appropriate. If the program does not have bilingual/bicultural staff, there is extensive training to ensure sensitive and appropriate prevention, treatment, and rehabilitation services.

7. Audit

During the term of this Agreement and for a period of six years thereafter, the Massachusetts Rehabilitation Commission, its auditors, the Operational Services Division, the Office of the Inspector General or other authorized representatives shall be afforded access at reasonable times to Contractor's accounting records, including sales information on any system, reports or files, in order to audit all records relating to goods sold or services performed pursuant to this Agreement. If such an audit indicates that Contractor has materially overcharged the Massachusetts Rehabilitation Commission, then the Contractor shall remit the overcharged amount and be responsible for payment of any costs associated with the audit.

8. Supplier Diversity Program (SDP)

The Supplier Diversity Program (formerly known as Affirmative Market Program) was established in September, 2010 via Executive Order 524 to promote equality in the state contracting market by ensuring full participation of minority and women owned business enterprises (M/WBEs) in all areas of state contracting including construction, design, goods and services. The Executive Order consolidates the State Office of Minority and Women Assistance (SOMWBA) and Affirmative Market Program (AMP) into a new Supplier Diversity Office (SDO) that is part of the Operational Services Division. Similarly, Executive Order 546 established the Service-Disabled Veteran-Owned Business Enterprise (SDVOBE) Program to encourage the participation of businesses owned and controlled by service-disabled veterans in all areas of state procurement and contracting, thereby including them in the SDP.

The essence of both Executive Orders is to provide policies to promote the award of state contracts in a manner that develops and strengthens certified M/WBEs and SDVOBEs, because a diverse business community strengthens the economy and is beneficial to all of the citizens of the state.

In support of both Executive Orders, the state tracks SDP spending through POS contracts. As a result, providers that are issued a contract from this procurement will be required to submit a “Supplier Diversity Program (SDP) Plan Form for Purchase of Service (POS)” on a yearly basis with their Uniform Financial Report (UFR) through the Operational Services Division (OSD) eFiling site. Providers that file a UFR exemption request are required to submit the SDP Plan Form for POS with their exemption request. The plan will be evaluated yearly by the Commonwealth Department with the most Purchase of Service funding to a provider during the previous fiscal year. This Department is commonly referred to as the Principal Purchasing Agency (PPA).

Bidders are to submit a copy of their most recently submitted “SDP Plan Form for POS” with their proposal to signify to the Procurement Management Team that a form has been submitted. Bidders that do not currently hold POS contracts with Commonwealth Departments are required to complete the Form and include it with their proposal. The “SDP Plan for POS” can be found in the File Attachments Section of the respective Bid Solicitation on www.COMMBUYS.com

The evaluation criteria for this POS solicitation do not dedicate a specific percentage of the total evaluation points to the SDP Plan. However the Strategic Sourcing/Procurement Management Team (SST/PMT) has developed strong evaluation benchmarks in order to identify robust plans. While the Plan is not assigned any points in the evaluation process, the Department is unable to issue a contract to an organization that has not submitted a Plan that demonstrates a strong commitment to working with M/WBEs and SDVOBEs.

Resources available to assist providers in identifying SDP Certified Partners include:

9. Debriefings And Appeals

Debriefing Any Bidder that has filed an Eligible Response, but that is not selected may request a debriefing to understand the basis for the decision, and review all materials relevant to the review and the qualification and selection process. The request must be in writing and received within 14 calendar days of notification of such being sent to the Bidder. A Bidder aggrieved by the decision must participate in a debriefing as a prerequisite to filing a request for an administrative appeal. For applicants that select MRC as the agency they are applying to under this procurement, all requests for a debriefing must be sent by certified mail and addressed to:

If a debriefing is properly requested, one will be scheduled within 14 calendar days of the date the request was received. If necessary, a brief extension shall be allowed by mutual agreement of the Bidder and MRC. At the debriefing, a Bidder shall be allowed to review public records directly related to the selection decision.

Administrative Appeals A Bidder that is not selected and who attends a debriefing may appeal the decision to the Commissioner of MRC. Requests for appeal must be sent by certified mail and addressed to:

The appeal must be filed within 14 calendar days of the debriefing meeting. The appeal must be in writing specifying the basis for the appeal and it must be based on one or more of the following grounds:

The burden of proof rests with the Bidder to provide sufficient and specific evidence in support of it claim.

Requests for an appeal must specify in sufficient detail the basis for the appeal. Sufficient detail requires the identification of an applicable regulation or guideline that was not complied with or the specific facts that demonstrate that the procurement was unfair. MRC reserves the right to reject appeal requests based on grounds other than those stated above, or those submitted without sufficient detail on the basis for the appeal.

Administrative appeals are not subject to the formal procedures specified in M.G.L. c. 30A, §§ 10 & 11.

A pending appeal will not prohibit MRC from proceeding with the selected Bidder, awarding a contract or making referrals to the selected Bidder.

Acceptance/Denial of the Appeal Within 21 calendar days of the receipt of request for an appeal, MRC will schedule a hearing date or notify the Bidder that the appeal has been deemed without merit and that it will not be heard. The Bidder and the MRC may mutually agree to extend the date for the hearing. The Commissioner’s decision on the appeal will be put in writing and sent to the Bidder within 60 calendar days of the date of the hearing on the Bidder’s appeal.

Appeals to the Operational Services Division Non-successful Bidders who participate in the appeal process described in this Section and remain aggrieved by the decision of the Agency may appeal the decision to the Operational Services Division (OSD). The basis for an appeal to OSD is limited to the following grounds:

a. The competitive procurement conducted by MRC failed to comply with applicable regulations and guidelines. These would be limited to the requirements of 801 CMR 21.00 or any successor regulations, the policies in the OSD Procurement Information Center, subsequent policies and procedures issued by OSD and the specifications of the RFR; or

b. There was a fundamental unfairness in the procurement process. The allegation of unfairness or bias is one that is easier to allege than prove; consequently, the burden of proof rests with the Bidder to provide sufficient and specific evidence in support of its claim. OSD will presume that MRC conducted a fair procurement absent documentation to the contrary.

Requests for an appeal must be sent to OSD to the attention of the State Purchasing Agent at Room 1017, One Ashburton Place, Boston, MA 02108 and be received within 14 calendar days of the postmark of the notice of the Agency’s decision on the appeal. Appeal requests must specify in sufficient detail the basis for the appeal. Sufficient detail requires a description of the published policy or procedure which was applied and forms the basis for the appeal and presentation of all information that supports the claim under paragraphs a or b above. OSD reserves the right to reject appeal requests based on grounds other than those stated above or those submitted without sufficient detail on the basis for the appeal.

The decision of the State Purchasing Agent shall be rendered, in writing, setting forth the grounds for the decision within 60 calendar days of receipt of the appeal request. Pending appeals to the State Purchasing Agent shall not prohibit MRC from proceeding with executing contracts.

10. Additional Information

11. Submission Components And Attachments

COMMBUYS is the official source of information for this Bid and is publicly accessible at no charge at www.COMMBUYS.com. Information contained in this document and in COMMBUYS, including file attachments, and information contained in the related Bid Questions and Answers (Q&A), are all components of the Bid, as referenced in COMMBUYS, and are incorporated into the Bid and any resulting contract.

Bidders are solely responsible for obtaining all information distributed for this Bid via COMMBUYS. Additionally, bidders are responsible for posting their response (called “quote”) on the system. Bidders should review the “COMMBUYS Market Center” and “COMMBUYS Registration” sections in Appendix 2 of the Appendix document for an overview of electronic submission. Additional detail is provided in the “Instructions for Vendors Responding to Bids Electronically through COMMBUYS” section, found in Appendix 5.

COMMBUYS Registration. Bidders may elect to obtain a free COMMBUYS Seller registration which provides value-added features, including automated email notification associated with postings and modifications to COMMBUYS records. However, in order to respond to a Bid, Bidders must register and maintain an active COMMBUYS Seller account. If a Bidder requires assistance with the registration process, they may contact the COMMBUYS Help desk by email at COMMBUYS@state.ma.us or by phone at 1-888-627-8283.

Quote Submission Method. Online Quote Submission via COMMBUYS is required. All Bidders must submit Quotes online using tools available only to Sellers registered in COMMBUYS. COMMBUYS provides Seller registration functionality at no charge. To register, go to www.COMMBUYS.com and click on the “Register” link on the front page. All Bidders who are awarded a contract resulting from this Bid, if any, will be required to maintain an active account during the duration of the Contract, by reviewing their registration information regularly and maintaining its accuracy.

Electronic Signatures Quotes submitted via COMMBUYS must be signed electronically by the Bidder or the Bidder’s Agent by accepting the terms and conditions of the bid on the “Terms & Conditions” tab of the Bid in COMMBUYS. By selecting “Save & Continue” on the “Terms and Conditions” tab after accepting the terms and conditions of the bid, the submitter attests that s/he is an agent of the Bidder with authority to sign on the Bidder’s behalf, and that s/he has read and assented to each document’s terms

12. Pricing Rates of Reimbursement for CIES Components and Hours Rates of reimbursement are described in Section IV of this RFR and have been regulated under 144.4 CMR 10.00 as required by Chapter 257 of the Acts of 2008. See www.mass.gov\DHCFP for these regulations.

12. Electronic Communication/Update of Bidder’s/Contractor’s Contact Information It is the responsibility of the prospective Bidder and awarded contractor to keep current the email address of the Bidder’s contact person and prospective contract manager, if awarded a contract, and to monitor that email inbox. MRC assumes no responsibility if a prospective Bidder’s/awarded contractor’s designated email address is not current, or if technical problems, including those with the prospective Bidder’s/awarded contractor’s computer, network or internet service Provider (ISP) cause email communications sent to/from the prospective Bidder/awarded contractor and the MRC to be lost or rejected by any means including email or spam filtering.

13. Filing Requirements Successful Bidders must have filed their Uniform Financial Statements and Independent Auditor's Report (UFR), as required for current contractors, with the Operational Services Division via the Internet using the UFR eFiling application by November 15th for the most recently completed fiscal year before a contract can be executed and services may begin. Other contractor qualification/risk management reporting requirements and non-filing consequences promulgated by secretariats or Departments pursuant to 808 CMR 1.04(3) may also apply. In the event immediate services are required by a Department, a contract may be executed and services may begin with the approval of OSD and the appropriate secretariat. However, unless authorized by OSD and the appropriate secretariat, the contractor will not be paid for any such services rendered until the UFR has been filed.

14. Virtual Gateway Virtual Gateway Business Services. The Executive Office of Health and Human Services (EOHHS) operates a number of online business services through the Virtual Gateway. These include but are not limited to, Provider Data Management (PDM), Common Intake (IE&R), Enterprise Invoice / Service Management (EIM/ESM), Home and Community Service Information System (HCSIS), Senior Information Management System (SIMS) Service and Transition Planning System (STARS).

These services permit users to access a variety of EOHHS programs and services. Virtual Gateway business services are accessible by end users with web browsers such as Internet Explorer (6.0 or above), and a broadband Internet connection that is capable of high-speed data transmission, such as a Local Area Network (LAN), a cable modem, or DSL.

Enterprise Invoice / Service Management (EIM/ESM): If MRC directs contractor during the term of this amended contract to access the EIM/ESM service through the Virtual Gateway for the purpose of conducting business with MRC , contractor agrees to use such services as directed and execute all required Use or Service Agreements required by the Virtual Gateway and to comply with all applicable Virtual Gateway, MRC and EOHHS policies and procedures related to such services, including policies pertaining to data security and protection of confidential information. Contractor further agrees to submit all information as directed by MRC, including, but not limited to, invoices, contract and/or other information to MRC through these web-based applications. Contractor further agrees to take all necessary steps to ensure that it, and its subcontractors or affiliates, complies with these requirements and has access to and utilize all required web-based services in the Virtual Gateway.

Provider Data Management (PDM): Pursuant to its obligation hereunder regarding the use of EOHHS Virtual Gateway Business Services, contractor agrees to complete and maintain an organizational profile in the Virtual Gateway’s Provider Data Management (PDM) system. PDM is a web-based service managed by the Executive Office of Health and Human Services (EOHHS) that presents information about a provider’s organizational structure, financial health, and state contracting activity. If your organization does not currently access and update PDM, you must contact the EOHHS Provider Data Management team at pos.pdm@massmail.state.ma.us or call the Virtual Gateway Helpdesk at 1-800-421-0938 for assistance.

15. System and Data Security Section 6 of the Commonwealth Terms and Conditions states:

“Confidentiality. The Contractor shall comply with M.G.L. c. 66A if the Contractor becomes a “holder” of “personal data”. The Contractor shall also protect the physical security and restrict any access to personal or other Department data in the Contractor’s possession, or used by the Contractor in the performance of a Contract, which shall include, but is not limited to the Department’s public records, documents, files, software, equipment or systems.”

In addition to the foregoing requirements, the Bidder MUST agree that as part of its work effort under the agreement entered pursuant to this RFR, the Bidder will be required to use the following Commonwealth personal data under M.G.L. c. 66A and/or personal information under M.G.L. c. 93H, or to work on or with information technology systems that contain such data in order to fulfill part of its specified tasks. For purposes of this work effort, electronic personal data and personal information includes data provided by MRC to the winning Bidders which may physically reside at a location owned and/or controlled by the Commonwealth or MRC or winning Bidder. In connection with such data, the winning Bidders will implement the maximum feasible safeguards reasonably needed to:

· Ensure the security, confidentiality and integrity of electronic personal data and personal information;

· Prevent unauthorized access to electronic personal data or personal information or any other Commonwealth Data from any public or private network;

· Prevent unauthorized physical access to any information technology resources involved in the winning Bidder’s performance of a contract entered under this RFR;

· Prevent interception and manipulation of data during transmission to and from any servers; and

· Notify MRC immediately if any breach of such system or of the security, confidentiality, or integrity of electronic personal data or personal information occurs.

16. Confidentiality The Bidder agrees to conform to all applicable regulatory and statutory requirements relating to confidentiality and privacy, including, but not limited to, those set forth in M.G.L. c. 66A. The Bidder shall not disclose or release personal data to any person or entity other than to its authorized agents in the performance of any contract awarded under this RFR, unless the Contractor seeks and obtains written authorization from MRC prior to the disclosure or release. The Bidder shall immediately notify MRC both orally and in writing if any of the personal data in its possession is subpoenaed, improperly used, copied, or removed by anyone except an authorized representative of MRC or the Bidders.

Response Timeline:

Responses must be submitted to COMMBUYS (https://www.commbuys.com/bso/) by Monday, April 29th, 2019 at 4:00 pm, for contracts starting 7/1/2019, deadline time is based on the time according to the COMMBUYS system.

The electronic response in COMMBUYS must include the following and documents should be submitted in the order listed below:

· Completed Provider Information, 1 original, 1 copy

· Resume, 1 original, 1 copy

· MRC may at a future date, request evidence of advance degree or license

· Writing Sample (decision-opinion)

· A statement (1 page) why you want to be a Fair Hearings Office for MRC and how you meet the qualifications.

· Verification of Taxation Reporting Information Mass. Substitute W-9. If you are currently registered with the Commonwealth and have either changed your name and/or address, you must submit a hand signed explanation of the change and/or a hand signed copy of an official document confirming the change. 1 Original, 1 copy.

· Signed Commonwealth of Massachusetts Terms and Conditions. The bidder information on the Terms and Conditions MUST be the same as the information on the W-9. 1 original and 1 copy.

· CORI Assurance letter

· Contractor Authorized Signature Verification Form. 1 original, 1 copy

· Executive Order 504, completed signed 1 original, 1 copy

· Business Reference Form

· EFT (Electronic Funds Transfer) this is required for all contracts. 1 original, 1 copy

· Massachusetts Department of Revenue Certificate of Good Standing (https://wfb.dor.state.ma.us/webfile/Certificate/Public/WebForms/Welcome.aspx )

· Financial Pre-Qualification requirements, as listed below in “Additional Requirements for Financial Pre-Qualification” section

· Supplier Diversity Office (SDO) Certification (if applicable)

· Supplier Diversity Program (SDP) Form

The proposal must not exceed 10 pages double-spaced, with 1 inch margins, 12 pt. font, and must include page numbers.

Contact Help Desk with submission difficulties COMMBUYS@state.ma.us or 888-627-8283.

Additional Requirements for Financial Pre-Qualification Provider Organizations delivering services regulated by 808 CMR 1.00 must follow the pre-qualification procedures described in this regulation. Additional information is accessible through the links below:

As a prerequisite for an organization entering into a contract with MRC, a bidder must demonstrate that it meets minimum administrative and fiscal standards, or is “pre-qualified.” Pre-qualification is the process the Commonwealth uses to be assured it has minimized possible risks to job seekers being served through purchased programs. Bidders who are already pre-qualified by the Commission or any other Executive Office of Health and Human Services (EOHHS) agency do not need to submit pre-qualification materials as part of the RFR process as long as they are fulfilling submission requirements for the current re-qualification process. That information will automatically be requested of the provider during the annual re-qualification process for current providers.

Bidders who are not pre-qualified must submit a completed package as part of the RFR response.

Pre-qualification requires the additional following documents: Corporations/Organizations:

· Articles of Organization

· Resumes of Principals (i.e., Chief Executive, Financial and Clinical Program Offices)

· Board of Directors Information

· Current Financial Statements including notes prepared by an independent auditor

· Certificate of Good Standing (https://wfb.dor.state.ma.us/webfile/Certificate/Public/WebForms/Welcome.aspx )

· Copy of Current Public Charities Annual Filing for non-profit organizations http://www.charities.ago.state.ma.us/

· Contractor Qualification Form

All required forms and related instructions can be found in the “File Attachments” section of the bid on COMMBUYS.

Ink Signatures Original ink signatures are required only after contracts have been awarded. The Commonwealth of Massachusetts requires Contractors to submit original ink-signature versions of the following forms:

· Standard Contract Form

· Commonwealth Terms and Conditions for Human and Social Services

· Contractor Authorized Signatory Listing

· Request for Taxpayer Identification and Verification (Mass. Substitute W9 Form)

· Electronic Funds Transfer Sign Up Form

Successful Bidders who agreed to the terms and conditions of these forms electronically via COMMBUYS online Quote submission tool must still submit the above forms with ink signatures within seven (7) calendar days of award notification or their contract may not be executed by the Commonwealth. Bidders who have previous contract(s) with the Commonwealth and have up-to-date, ink-signature versions of the Commonwealth Terms and Conditions and Request for Taxpayer Identification and Verification (Mass. Substitute W9 Form) on file with the Office of the State Comptroller may submit copies of the signed forms. However, a new Standard Contract Form and Contractor Authorized Signatory Listing with original ink signatures must be submitted for each new contract with the Commonwealth.

Upon selection, bidders will receive a Standard Contract packet for signature. No services should be rendered until the bidder is notified that the contract process is complete.

17. Additional Specifications

This RFR includes additional specifications, as described in the Appendix document. The document includes the sections below:

ATTACHMENT 1

COVER PAGE / RFR RESPONSE SHEET

MRC Hearing Officers Provided by Individuals

RFR: MRC Hearing Officers Provided by Individuals 07-2019

Type or Print

Individual Name:

Address:

City/State/Zip:

Telephone:

Federal Tax ID #:

Contact Phone: _________________________________________________ Contact E-mail:

ATTACHMENT 2

EXECUTIVE ORDER 504 CONTRACTOR CERTIFICATION FORM

Effective January 1, 2009, Executive Order 504 establishes new requirements designed to adopt and implement the maximum feasible measures reasonably needed to ensure the security, confidentiality and integrity of personal information, as defined in MG.L. c. 93H and personal data, as defined in M.G.L. c. 66A, maintained by state agencies (herein collectively “personal information”). This requirement only pertains to contracts that require the Contractor’s access to personal information owned or controlled by the contracting agency and systems that contain such data. The Executive Order applies to all state agencies in the Executive Department, including all executive offices, boards, commissions, agencies, departments, divisions, councils, bureaus, and offices, now existing and hereafter established.

In order to comply with the contractor certification requirements of Executive Order 504, agencies must require that all vendors executing contracts on or after January 1, 2009 certify compliance with applicable security measures. The Commonwealth’s Standard Contract Form and Instructions will be amended to include certification of compliance; however, until such time as the Standard Contract Form has been amended, agencies that are subject to Executive Order 504 can comply with this obligation by having vendors entering into any new agreements execute the separate certification form attached. The instructions below provide guidance concerning how to comply with the certification requirements of Executive Order 504.

1. For procurements that use the Standard Contract Form:

a. Until the revised Standard Contract form is issued, if the RFQ or RFR was posted on or before January 1, 2009, but the contract will not have been executed as of January 1, 2009, then vendors contracting with agencies must execute the separate Executive Order 504 Contractor Certification Form attached hereto as Exhibit A for all new contracts.

b. Once the Commonwealth’s Standard Contract Form has been amended, agencies will be in compliance with the certification requirements of Executive Order 504 by having vendors execute the Standard Contract Form as part of the bidder’s response to an RFR or RFQ.

2. After January 1, 2009, in any instances where the agency is not using the Commonwealth’s Standard Contract Form, the agency must have all vendors execute a separate Executive Order 504 Certification Form, which will be available on OSD’s website under “OSD Forms”

3. After January 1, 2009, Departments executing contract amendments or renewals with existing vendors are encouraged to request execution of a separate Executive Order 504 Contractor Certification Form by those vendors if the vendor has not executed the new version of the Standard Contract Form containing the Executive Order 504 certifications.

Executive Order 504 Contractor Certification Form

BIDDER/CONTRACTOR LEGAL NAME:

BIDDER/CONTRACTOR VENDOR/CUSTOMER CODE:

Executive Order 504: For all Contracts involving the Contractor’s access to personal information, as defined in M.G.L. c. 93H, and personal data, as defined in M.G.L. c. 66A, owned or controlled by Executive Department agencies, or access to agency systems containing such information or data (herein collectively “personal information”), Contractor certifies under the pains and penalties of perjury that the Contractor (1) has read Commonwealth of Massachusetts Executive Order 504 and agrees to protect any and all personal information; and (2) has reviewed all of the Commonwealth of Massachusetts Information Technology Division’s Security Policies available at www.mass.gov/ITD under Policies and Standards.

Notwithstanding any contractual provision to the contrary, in connection with the Contractor’s performance under this Contract, for all state agencies in the Executive Department, including all executive offices, boards, commissions, agencies, departments, divisions, councils, bureaus, and offices, now existing and hereafter established, the Contractor shall:

(1)obtain a copy, review, and comply with the contracting agency’s Information Security Program (ISP) and any pertinent security guidelines, standards and policies; (2) comply with all of the Commonwealth of Massachusetts Information Technology Division’s Security Policies (“Security Policies”) available at www.mass.gov/ITD under Policies and Standards;

(2) communicate and enforce the contracting agency’s ISP and such Security Policies against all employees (whether such employees are direct or contracted) and subcontractors;

(3) implement and maintain any other reasonable appropriate security procedures and practices necessary to protect personal information to which the Contractor is given access by the contracting agency from the unauthorized access, destruction, use, modification, disclosure or loss;

(4) be responsible for the full or partial breach of any of these terms by its employees (whether such employees are direct or contracted) or subcontractors during or after the term of this Contract, and any breach of these terms may be regarded as a material breach of this Contract;

(5) in the event of any unauthorized access, destruction, use, modification, disclosure or loss of the personal information (collectively referred to as the “unauthorized use”): (a) immediately notify the contracting agency if the Contractor becomes aware of the unauthorized use; (b) provide full cooperation and access to information necessary for the contracting agency to determine the scope of the unauthorized use; and (c) provide full cooperation and access to information necessary for the contracting agency and the Contractor to fulfill any notification requirements.

Breach of these terms may be regarded as a material breach of this Contract, such that the Commonwealth may exercise any and all contractual rights and remedies, including without limitation indemnification under Section 11 of the Commonwealth’s Terms and Conditions, withholding of payments, contract suspension, or termination. In addition, the Contractor may be subject to applicable statutory or regulatory penalties, including and without limitation, those imposed pursuant to M.G.L. c. 93H and under M.G.L. c. 214, § 3B for violations under M.G.L. c. 66A.

Bidder/Contractor Name: .

Bidder/Contractor Authorized Signature: .

Print Name and Title of Authorized Signatory: .

Date: .

This Certification may be signed once and photocopied to be attached to any Commonwealth Contract that does not already contain this Certification Language and shall be interpreted to be incorporated by reference into any applicable contract subject to Executive Order 504 for this Contractor.

ATTACHMENT 3

CURRENT LIST OF LOCATIONS OF

MASSACHUSETTS REHABILITATION COMMISSION

AREA OFFICES

Fair Hearing Officers RFR 07-19 INDICATE AREA PREFERENCE FOR PROVIDING SERVICE (indicate up to five preferences in order of preference, then check all others that would be considered)

BROCKTON _________ BOSTON_____________ FALL RIVER__________

FITCHBURG____________ GREENFIELD__________ HOLYOKE___________

HYANNIS _______________ LAWRENCE___________ LOWELL _____________

MALDEN ______________ MILFORD_____________ NEW BEDFORD________

PITTSFIELD__________ PLYMOUTH___________ ROXBURY___________

SALEM_______________ SOMERVILLE__________ SPRINGFIELD________

TAUNTON_________ WORCESTER__________

(Listed above our MRC’s area offices. Each office covers specific towns in that catchments Area.)

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