RP040_23 Gwinnett Wellness Center Administrat.xlsx

XLSX spreadsheet 46 KB Posted Oct 6, 2023

Attached to: RP040-23 Provision of On-Site Wellness Center Administration on an Annual Contract
Solicitation number: PE-77023-NONST-2024-000000045
Issued by: Gwinnett County, Georgia

About this file

Written by GovTribe AI · Aug 26, 2024

This document is a Request for Proposal (RFP) from the Gwinnett County government for the provision of on-site wellness center administration on an annual contract (RP040-23). The RFP seeks a service provider to manage a primary care clinic, occupational medicine services, and potentially a pharmacy for eligible participants including employees, spouses, dependents, and retirees. The clinic is currently open 40 hours per week with an existing staff of a physician, medical office assistants, a health advocate, and a licensed nurse practitioner. The RFP provides detailed assumptions on participant volumes, appointment types, and current staffing levels.

The pricing terms in the RFP require the service provider to provide cost estimates for implementation and ongoing annual operations across the primary care, occupational medicine, and pharmacy services. The RFP includes specific assumptions on equipment, certifications, drug screens, and lab tests to be considered in the pricing. The term of the contract is not specified, but the RFP requests pricing for a 5-year period with annual increases of 2% assumed.

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Other files

File	Type	Posted
RP040_23 Notice.pdf	PDF	Oct 6, 2023
RP040_23 Ad1 .pdf	PDF	Oct 6, 2023

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While completing cost proposal, please assume only your own costs for the dispensary / pharmacy.

Implementation Costs

RP040-23, Provision of On-site Wellness Center Administration on an Annual Contract
Implementation Costs
Service Provider	Insert Service Provider's Name
Assumptions to use in proposal
Assumptions		Quarterly Average
Personal Health Eligible Participants
Employees		2,275
Spouses		1,140
Dependents		2,700
Retirees		438
Total Personal Health Appointments
All eligible participants (primary care, biometric screenings & wellness coaching)		798
Current Staff (clinic open 40 hrs./week)		Current hours per week
Physician - 16 hours per week (Occupational Medicine)		20
2 Medical Office Assistants - 40 hours per week		2*40
1 Health Advocate - 40 hours per week		40
1 Licensed Nurse Practitioner - 40 hours per week		40
Clinic Manager - not onsite but a full time Corporate employee of Premise. Currently managing several clinics.		10-20
Occupational Health embedded with current clinic staff		--

Instructions:
Please complete the table below with cost estimates related to implementation based on recommended assumptions for the wellness center. Be sure to add any specific descriptions of cost items in the description column. Ensure to complete the bottom table stating any inclusion and exclusion items in the pricing provided.
Expenses
Primary Clinic Costs	Description	Implementation
Physical Space Renovations		$ - 0
Furnishings, Fixture and Equipment		$ - 0
Staff Recruitment, Training, Implementation		$ - 0
Dues, Licenses and Permits		$ - 0
Information Systems Hardware and Software (includes EMR)		$ - 0
Promotion and Communication		$ - 0
Travel		$ - 0
Other direct expenses- specify in descriptions column		$ - 0
Billed as incurred consumables- specify in descriptions column		$ - 0
Total Annual Cost		$ - 0

Occupational Medicine Costs	Description	Implementation
Physical Space Renovations		$ - 0
Furnishings, Fixture and Equipment		$ - 0
Staff Recruitment, Training, Implementation		$ - 0
Dues, Licenses and Permits		$ - 0
Information Systems Hardware and Software (includes EMR)		$ - 0
Promotion and Communication		$ - 0
Travel		$ - 0
Other direct expenses- specify in descriptions column		$ - 0
Billed as incurred consumables- specify in descriptions column		$ - 0
Total Annual Cost		$ - 0

Pharmacy Cost (If able to offer given State provisions)	Description	Year 1
Furnishings, Fixture and Equipment		$ - 0
Staff Recruitment, Training, Implementation		$ - 0
Supplies		$ - 0
Information Systems Hardware and Software		$ - 0
Promotion and Communication		$ - 0
Other direct expenses- specify in descriptions column		$ - 0
Billed as incurred consumables- specify in descriptions column		$ - 0
Total Annual Cost		$ - 0

Combined Cost (Will be calculated automatically)	Description	Year 1
Primary Care		$ - 0
Occupational Medicine		$ - 0
Pharmacy		$ - 0
Total Implementation Cost		$ - 0

Pricing Details (State below any inclusions/ exclusions of cost estimates provided earlier)

Inclusions

Exclusions

Primary Care Cost

RP040-23, Provision of On-site Wellness Center Administration on an Annual Contract
Primary Care Operational Costs		Assumed Annaul Increase	2%
Service Provider	Insert Service Provider's Name

Assumptions to use in proposal
Personal Health Assumptions	Quarterly Average
Personal Health Eligible Participants
Employees	2,275
Spouses	1,140
Dependents	2,700
Retirees	438
Total Personal Health Appointments
Primary Care appointments	459
Wellness Coaching / Chronic Condition Mgmt	88
Biometric Screenings	252
Current Staff (clinic open 40 hrs./week)	Current hours per week	Please provide hours assumptions by resource by projection utilization
2 Medical Office Assistants - 40 hours per week	80
1 Health Advocate - 40 hours per week	40
1 Licensed Nurse Practitioner - 40 hours per week	40
Clinic Manager - not onsite but a full time Corporate employee of Premise. Currently managing several clinics.	10-20

Instructions:
Please complete the table below with cost estimates for ongoing clinic management based on the pre-determined assumptions stated above. Be sure to add any specific descriptions/assumptions of cost items in the description column. Ensure to complete the bottom table stating any inclusion and exclusion items in the pricing provided.
Expenses
Primary Clinic Costs	Year 1	Year 2	Year 3	Year 4	Year 5
Salaries, wages and benefits (Please include hourly rate and annual expected hours in the description column)	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Medical Office Assistant	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Medical Office Assistant	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Receptionist	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Health Advocate	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Licensed Nurse Practitioner	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Clinic Manager	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Other	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Staff Training and Development	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Staff replacement	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Insurance- professional and general liability	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Dues, Licenses and Permits	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Supplies- (Medical supplies, Vaccinations and injections supplies, Office Supplies, Lab Supplies)	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Equipment maintenance	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Professional services- third party lab diagnostic services	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Information Systems Hardware and Software (includes Electronic Medical Record)	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Promotion and Communication	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Travel	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Utilities - (Postal Services, Express Delivery, Gas/Electric, Hazardous & Other Waste Removal, Water/Sewage, Other Utilities)	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Miscellaneous – (Laundry, X-Ray Readings, Third Party Billing, Transcription, Phone, Fuel/Mileage, Taxes (non-income), Janitorial Services)	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
General and Administrative Fee	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Management Fee	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Other direct expenses- specify in description / assumptions column	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Billed as incurred consumables- specify in description / assumptions column	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Total Annual Cost	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0

Pricing Details (State below any inclusions/ exclusions of cost estimates provided earlier)

Inclusions:

Exclusions:

Occupational Medicine 16hrs

RP040-23, Provision of On-site Wellness Center Administration on an Annual Contract
Occupational Medicine Operating Costs - 20hour/week Physician model
Service Provider	Insert Service Provider's Name
Instructions:
Occupational Medical Assumptions		Quarterly Average
Occupational Medicine Participants
Employees - total		6,089
Employees - jobs w/ occupational heealth requirements		2,647
Total Occupational Medical Appointments
Appointments - In facility		373
Appointments - Managed outside Wellness Center contract		111

Job Type	Current Open Job Requisitions
Animal Control Officer	13
Auto/Hvy Tech I,II,III,IV	1
Communications Officer	38
Community Service- Lifeguard	0
Correctional Officer	22
Deputy Sheriff	231
Fire Department	289
Sworn Police Officer	225
Other	101

Please complete the table below with cost estimates for occupational medicine services based on the pre-determined assumptions provided on the prior workbooks. Please include unit costs and assumed annual costs based on utilization provdied.
				Year 1 - 2024		Year 2 - 2025		Year 3 - 2026		Year 4 - 2027		Year 5 - 2028
	Utilization	Description	Comments	Unit Cost	Annual Cost	Unit Cost	Annual Cost	Unit Cost	Annual Cost	Unit Cost	Annual Cost	Unit Cost	Annual Cost
Management Fee	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Computer/Software Costs	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Physician - 16hrs/week	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Equipment		Description	Comments
Trimetrics RA800 Audiometer with Booth	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Phoenix 6.0 Evidential Breath Tester	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Titmus Electronic Vision Screen	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
100 lb. Barbell	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
50 lb. Barbell	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Shipping and Delivery	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
eCW Equipment Integration	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Other	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Equipment Subtotal				$0	$0	$0	$0	$0	$0	$0	$0	$0	$0

Certifications		Description	Comments
Audiometry	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Breath Alcohol	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
DOT Urine Drug Screen	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
DOT Medical Certification	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Annual Audiometer Calibration	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Fill-In for Audio Certification	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Initial On Site Training	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Other	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Certifications Subtotal				$0	$0	$0	$0	$0	$0	$0	$0	$0	$0

Drug Screens and Lab Tests	Monthly Average	Type of Drug Screens	Types of Lab Tests
Animal Control Officer		5 Panel Regulated-47643N	PPD (TB Skin Test)	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Auto/Hvy Tech I,II,III,IV		No Drug Screen	No Lab Tests	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Communications Officer		6 Panel Rapid POCT-20909N	No Lab Tests	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Community Service- Lifeguard		6 Panel Rapid POCT-20909N	No Lab Tests	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Correctional Officer		6 Panel Rapid POCT-20909N	Lab Codes - 10231, 7600, 6399, 5463, 499, PPD (TB Skin Test)	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Deputy Sheriff		6 Panel Rapid POCT-20909N	Lab Codes - 10231, 7600, 6399, 5463, 499, PPD (TB Skin Test)	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Fire Department		11 Panel Firefighter-28490N	Lab Codes - 10231, 7600, 6399, 5363, 5463, 499, Heavy Metals, PPD (TB Skin Test)	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Sworn Police Officer		6 Panel Rapid POCT-20909N	Lab Codes - 10231, 7600, 6399, 5463, 499, PPD (TB Skin Test)	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Miscellaneous				$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Drug Screen and Lab Subtotal					$0		$0		$0		$0		$0

Total Annual Cost $0 $0 $0 $0 $0

Occupational Medicine 40hrs

RP040-23, Provision of On-site Wellness Center Administration on an Annual Contract
Occupational Medicine Operating Costs - 40hour/week Physician model
Service Provider	Insert Service Provider's Name
Instructions:
Occupational Medical Assumptions		Quarterly Average
Occupational Medicine Participants
Employees - total		6,089
Employees - jobs w/ occupational heealth requirements		2,647
Total Occupational Medical Appointments
Appointments - In facility		373
Appointments - Managed outside Wellness Center contract		111

Job Type	Current Open Job Requisitions
Animal Control Officer	13
Auto/Hvy Tech I,II,III,IV	1
Communications Officer	38
Community Service- Lifeguard	0
Correctional Officer	22
Deputy Sheriff	231
Fire Department	289
Sworn Police Officer	225
Other	101

Please complete the table below with cost estimates for occupational medicine services based on the pre-determined assumptions provided on the prior workbooks. Please include unit costs and assumed annual costs based on utilization provdied.
				Year 1 - 2024		Year 2 - 2025		Year 3 - 2026		Year 4 - 2027		Year 5 - 2028
	Utilization	Description	Comments	Unit Cost	Annual Cost	Unit Cost	Annual Cost	Unit Cost	Annual Cost	Unit Cost	Annual Cost	Unit Cost	Annual Cost
Management Fee	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Computer/Software Costs	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Physician - 40hrs/week	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Equipment		Description	Comments
Trimetrics RA800 Audiometer with Booth	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Phoenix 6.0 Evidential Breath Tester	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Titmus Electronic Vision Screen	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
100 lb. Barbell	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
50 lb. Barbell	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Shipping and Delivery	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
eCW Equipment Integration	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Other	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Equipment Subtotal				$0	$0	$0	$0	$0	$0	$0	$0	$0	$0

Certifications		Description	Comments
Audiometry	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Breath Alcohol	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
DOT Urine Drug Screen	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
DOT Medical Certification	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Annual Audiometer Calibration	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Fill-In for Audio Certification	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Initial On Site Training	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Other	N/A			$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Certifications Subtotal				$0	$0	$0	$0	$0	$0	$0	$0	$0	$0

Drug Screens and Lab Tests	Monthly Average	Type of Drug Screens	Types of Lab Tests
Animal Control Officer		5 Panel Regulated-47643N	PPD (TB Skin Test)	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Auto/Hvy Tech I,II,III,IV		No Drug Screen	No Lab Tests	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Communications Officer		6 Panel Rapid POCT-20909N	No Lab Tests	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Community Service- Lifeguard		6 Panel Rapid POCT-20909N	No Lab Tests	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Correctional Officer		6 Panel Rapid POCT-20909N	Lab Codes - 10231, 7600, 6399, 5463, 499, PPD (TB Skin Test)	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Deputy Sheriff		6 Panel Rapid POCT-20909N	Lab Codes - 10231, 7600, 6399, 5463, 499, PPD (TB Skin Test)	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Fire Department		11 Panel Firefighter-28490N	Lab Codes - 10231, 7600, 6399, 5363, 5463, 499, Heavy Metals, PPD (TB Skin Test)	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Sworn Police Officer		6 Panel Rapid POCT-20909N	Lab Codes - 10231, 7600, 6399, 5463, 499, PPD (TB Skin Test)	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Miscellaneous				$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Drug Screen and Lab Subtotal					$0		$0		$0		$0		$0

Total Annual Cost $0 $0 $0 $0 $0

Pharmacy Cost

RP040-23, Provision of On-site Wellness Center Administration on an Annual Contract
Pharmacy Operating Costs		Assumed Annaul Increase	2%
Service Provider	Insert Service Provider's Name

Assumptions to use in proposal

Pharmacy Utilization Assumptions

See Primary Care Cost tab for participant/utilization assumptions as the basis for Pharmacy Operating Cost assumptions

Instructions:
Please complete the table below with cost estimates for ongoing clinic management based on the pre-determined assumptions stated above. Be sure to add any specific descriptions/assumptions of cost items in the description column. Ensure to complete the bottom table stating any inclusion and exclusion items in the pricing provided.
Pharmacy Cost (If applicable)	Description / Assumptions	Year 1	Year 2	Year 3	Year 4	Year 5
Staff Training and Development		$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Staff replacement		$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Supplies		$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Equipment maintenance		$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Information Systems Hardware and Software		$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Promotion and Communication		$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Utilities - (Postal Services, Express Delivery, Other Utilities)		$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
General and Administrative Fee		$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Management Fee		$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Other direct expenses- specify in description / assumptions column		$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Billed as incurred consumables- specify in description / assumptions column		$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Total Annual Cost		$ - 0	$ - 0	$ - 0	$ - 0	$ - 0

Pricing Details (State below any inclusions/ exclusions of cost estimates provided earlier)

Inclusions:

Exclusions:

Ideal State

RP040-23, Provision of On-site Wellness Center Administration on an Annual Contract
Primary Care Operational Costs - Proposed Ideal State		Assumed Annaul Increase	2%
Service Provider	Insert Service Provider's Name

Assumptions to use in proposal
Personal Health Assumptions	Quarterly Average
Personal Health Eligible Participants
Employees	2,275
Spouses	1,140
Dependents	2,700
Retirees	438

	Assumptions and Projections
	Total Personal Health Appointments
	Primary Care appointments	459
	Wellness Coaching / Chronic Condition Mgmt	88
	Biometric Screenings	252
	Projected Clinic Staff (clinic open 40 hrs./week)
Clinical Staff	Proposed hours per week	Please provide hours assumptions by resource by projection utilization

Instructions:
Please complete the table below with cost estimates for ongoing clinic management based on the pre-determined assumptions stated above. Be sure to add any specific descriptions/assumptions of cost items in the description column. Ensure to complete the bottom table stating any inclusion and exclusion items in the pricing provided.
Expenses
Primary Clinic Costs	Year 1	Year 2	Year 3	Year 4	Year 5
Salaries, wages and benefits (Please include hourly rate and annual expected hours in the description column)	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Medical Office Assistant	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Medical Office Assistant	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Receptionist	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Health Advocate	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Licensed Nurse Practitioner	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Clinic Manager	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Physician	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Other	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Other	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Staff Training and Development	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Staff replacement	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Insurance- professional and general liability	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Dues, Licenses and Permits	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Supplies- (Medical supplies, Vaccinations and injections supplies, Office Supplies, Lab Supplies)	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Equipment maintenance	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Professional services- third party lab diagnostic services	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Information Systems Hardware and Software (includes Electronic Medical Record)	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Promotion and Communication	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Travel	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Utilities - (Postal Services, Express Delivery, Gas/Electric, Hazardous & Other Waste Removal, Water/Sewage, Other Utilities)	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Miscellaneous – (Laundry, X-Ray Readings, Third Party Billing, Transcription, Phone, Fuel/Mileage, Taxes (non-income), Janitorial Services)	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
General and Administrative Fee	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Management Fee	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Other direct expenses- specify in description / assumptions column	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Billed as incurred consumables- specify in description / assumptions column	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
Total Annual Cost	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0

Pricing Details (State below any inclusions/ exclusions of cost estimates provided earlier)

Inclusions:

Exclusions:

File details come from the government source that posted it. Updated Aug 26, 2024.