STATE 0000000444SL Page 68

State of Missouri Office of Administration, Division of Purchasing

Request for Proposal (RFP) for Rural Medical Clerkship Development - DHSS

PROPOSAL DUE NO LATER THAN: Friday, July 17, 2026 AT 2:00 PM CENTRAL TIME Proposal response must be submitted electronically through MissouriBUYS, powered by MOVERS, at https://missouribuys.mo.gov.

E-mailed, mailed, courier, or hand-delivered proposal responses will not be accepted.

RFP CONTACT INFORMATION:

BUYER: Amy Raymo

PHONE NO.: (573) 522-1620

EMAIL: amy.raymo@oa.mo.gov See “RFP Questions” in Section 1 for appropriate communications during the procurement process.

DELIVER SUPPLIES/SERVICES FREE ON BOARD (FOB) DESTINATION TO THE FOLLOWING ADDRESS:

Missouri Department of Health and Senior Services Office of Rural Health and Primary Care Post Office Box 570 Jefferson City, MO 65102-0570

ATTENTION:

1. After reviewing the Request for Proposal (RFP), the vendor must complete and return Exhibit A, Proposal Signature Page and all other necessary exhibits.

2. Due to lead times for obtaining the information needed to complete the various Business Compliance Exhibits herein as explained in the RFP’s Vendor Response Exhibits, vendors are encouraged to IMMEDIATELY begin securing these verifications.

3. The vendor must be registered in MissouriBUYS, powered by MOVERS in a “Prospective” or “Spend Authorized” registration status to submit a proposal. The vendor must achieve “Approved” registration status in MissouriBUYS (WebProcure/Proactis) and “Spend Authorized” registration status in MissouriBUYS, powered by MOVERS to be considered for a contract award. Reference Section 5.

AMENDMENT #01 to STATE 0000000444SL

TITLE: Rural Medical Clerkship Development - DHSS

CONTRACT PERIOD Effective Date of Contract Through July 31, 2027

PLEASE BE ADVISED OF THE FOLLOWING CHANGES AND CLARIFICATIONS:

1. The proposal receipt date shall be Friday, July 17, 2026 at 2:00 P.M. CST in lieu of July 10, 2026 at 2:00 P.M. Central Time.

2. Paragraph 1.2.6 has been revised.

3. Paragraph 1.7.3 d. has been revised.

4. Paragraph 2.1.9 has been revised.

5. Paragraph 2.2.2 has been revised.

6. Exhibit F, General Requirements, 10. has been revised.

Vendors may review the revision(s) to the MissouriBUYS, powered by MOVERS electronic solicitation and the amendment document(s) at https://MissouriBUYS.mo.gov. You may be required to acknowledge the electronic amendment.

ATTENTION: IF YOU HAVE ALREADY SUBMITTED A RESPONSE TO THE SOLICITATION, ACCEPTANCE OF THE AMENDMENT AND RESUBMISSION YOUR SOLICITATION RESPONSE IS NECESSARY TO ENSURE THE STATE OF MISSOURI SUCCESSFULLY RECEIVES YOUR SOLICITATION RESPONSE.

Follow the instructions in the Reference Guide for How to Submit Response Online (https://missouribuys.mo.gov/media/pdf/movers-bid-response-instructions ) and outlined below if previously responded to the solicitation prior to the amendment issuance.

1) Log into MissouriBUYS, powered by MOVERS (https://missouribuys.mo.gov/).

2) Under Tasks click View Negotiations below Solicitations.

3) The Active Solicitations page will appear. Utilize the search filters and click on the Solicitation Number to open.

4) The Overview page will display. Click Create Response.

5) A Warning pop-up box will open. The supplier must click Yes to continue to view and acknowledge amendments.

6) The supplier should highlight the Amendment(s) and view the changes made via the amendment(s). Once the review is complete, select the Acknowledgement checkbox for each amendment and click Submit at the top right-hand corner of the page. NOTE: A Warning pop-up box will open if all amendments have not been acknowledged. Click Yes to continue.

7) A Confirmation pop-up box will open confirming amendments have been acknowledged. It will also warn that resubmission of the previously submitted response is necessary prior to response to the amendment. Click OK.

8) Supplier will need to click Create Response again and respond to the amended solicitation. NOTE: The Create Response step includes attaching the supplier’s response again.

Request for Proposal (RFP) for Rural Medical Clerkship Development - DHSS

Amendment 02 revised the proposal receipt date to Friday, July 17, 2026.

PROPOSAL DUE NO LATER THAN: Friday, July 17, 2026 AT 2:00 PM CENTRAL TIME Proposal response must be submitted electronically through MissouriBUYS, powered by MOVERS, at https://missouribuys.mo.gov.

E-mailed, mailed, courier, or hand-delivered proposal responses will not be accepted.

RFP CONTACT INFORMATION:

BUYER: Amy Raymo

PHONE NO.: (573) 522-1620

EMAIL: amy.raymo@oa.mo.gov See “RFP Questions” in Section 1 for appropriate communications during the procurement process.

DELIVER SUPPLIES/SERVICES FREE ON BOARD (FOB) DESTINATION TO THE FOLLOWING ADDRESS:

Missouri Department of Health and Senior Services Office of Rural Health and Primary Care Post Office Box 570 Jefferson City, MO 65102-0570

ATTENTION:

4. After reviewing the Request for Proposal (RFP), the vendor must complete and return Exhibit A, Proposal Signature Page and all other necessary exhibits.

5. Due to lead times for obtaining the information needed to complete the various Business Compliance Exhibits herein as explained in the RFP’s Vendor Response Exhibits, vendors are encouraged to IMMEDIATELY begin securing these verifications.

6. The vendor must be registered in MissouriBUYS, powered by MOVERS in a “Prospective” or “Spend Authorized” registration status to submit a proposal. The vendor must achieve “Approved” registration status in MissouriBUYS (WebProcure/Proactis) and “Spend Authorized” registration status in MissouriBUYS, powered by MOVERS to be considered for a contract award. Reference Section 5.

AMENDMENT #01 to STATE 0000000444SL

TITLE: Rural Medical Clerkship Development - DHSS

CONTRACT PERIOD Effective Date of Contract Through July 31, 2027

PLEASE BE ADVISED OF THE FOLLOWING CHANGES AND CLARIFICATIONS:

1. The proposal receipt date shall be Friday, July 10, 2026 at 2:00 P.M. CST in lieu of July 7, 2026 at 2:00 P.M. Central Time.

2. The attendance sheet from the Pre-Proposal Teleconference has been added to MissouriBUYS powered by MOVERS as an attachment.

Vendors may review the revision(s) to the MissouriBUYS, powered by MOVERS electronic solicitation and the amendment document(s) at https://MissouriBUYS.mo.gov. You may be required to acknowledge the electronic amendment.

ATTENTION: IF YOU HAVE ALREADY SUBMITTED A RESPONSE TO THE SOLICITATION, ACCEPTANCE OF THE AMENDMENT AND RESUBMISSION YOUR SOLICITATION RESPONSE IS NECESSARY TO ENSURE THE STATE OF MISSOURI SUCCESSFULLY RECEIVES YOUR SOLICITATION RESPONSE.

Follow the instructions in the Reference Guide for How to Submit Response Online (https://missouribuys.mo.gov/media/pdf/movers-bid-response-instructions ) and outlined below if previously responded to the solicitation prior to the amendment issuance.

9) Log into MissouriBUYS, powered by MOVERS (https://missouribuys.mo.gov/).

10) Under Tasks click View Negotiations below Solicitations.

11) The Active Solicitations page will appear. Utilize the search filters and click on the Solicitation Number to open.

12) The Overview page will display. Click Create Response.

13) A Warning pop-up box will open. The supplier must click Yes to continue to view and acknowledge amendments.

14) The supplier should highlight the Amendment(s) and view the changes made via the amendment(s). Once the review is complete, select the Acknowledgement checkbox for each amendment and click Submit at the top right-hand corner of the page. NOTE: A Warning pop-up box will open if all amendments have not been acknowledged. Click Yes to continue.

15) A Confirmation pop-up box will open confirming amendments have been acknowledged. It will also warn that resubmission of the previously submitted response is necessary prior to response to the amendment. Click OK.

16) Supplier will need to click Create Response again and respond to the amended solicitation. NOTE: The Create Response step includes attaching the supplier’s response again.

Request for Proposal (RFP) for Rural Medical Clerkship Development - DHSS

Amendment 02 revised the proposal receipt date to Friday, July 17, 2026.

Amendment 01 revised the proposal receipt date to Friday, July 10, 2026.

PROPOSAL DUE NO LATER THAN: Friday, July 17, 2026

AT 2:00 PM CENTRAL TIME

Proposal response must be submitted electronically through MissouriBUYS, powered by MOVERS, at https://missouribuys.mo.gov.

E-mailed, mailed, courier, or hand-delivered proposal responses will not be accepted.

RFP CONTACT INFORMATION:

BUYER: Amy Raymo

PHONE NO.: (573) 522-1620

EMAIL: amy.raymo@oa.mo.gov See “RFP Questions” in Section 1 for appropriate communications during the procurement process.

DELIVER SUPPLIES/SERVICES FREE ON BOARD (FOB) DESTINATION TO THE FOLLOWING ADDRESS:

Missouri Department of Health and Senior Services Office of Rural Health and Primary Care Post Office Box 570 Jefferson City, MO 65102-0570

ATTENTION:

7. After reviewing the Request for Proposal (RFP), the vendor must complete and return Exhibit A, Proposal Signature Page and all other necessary exhibits.

8. Due to lead times for obtaining the information needed to complete the various Business Compliance Exhibits herein as explained in the RFP’s Vendor Response Exhibits, vendors are encouraged to IMMEDIATELY begin securing these verifications.

9. The vendor must be registered in MissouriBUYS, powered by MOVERS in a “Prospective” or “Spend Authorized” registration status to submit a proposal. The vendor must achieve “Approved” registration status in MissouriBUYS (WebProcure/Proactis) and “Spend Authorized” registration status in MissouriBUYS, powered by MOVERS to be considered for a contract award. Reference Section 5.

RFP Organization:

RFP Vendor Response Exhibits (Return these exhibits with the proposal)

BUSINESS COMPLIANCE EXHIBITS

Separate Documents: The vendor is advised that the separate documents to this document referenced above provide additional requirements, information, and/or instruction. The separate documents must be downloaded from the Division of Purchasing’s MissouriBUYS, powered by MOVERS, website at: https://missouribuys.mo.gov/. The separate documents are downloadable from the same web page where the solicitation document is downloadable. It shall be the sole responsibility of the vendor to obtain each of the separate documents. The vendor shall not be relieved of any responsibility for performance under the subsequent contract due to the failure of the vendor to obtain a copy of the separate documents.

INTRODUCTION AND BACKGROUND INFORMATION SECTION

Introduction:

Purpose: This document constitutes a request for competitive, sealed proposals for the provision of a new medical student clerkship program in rural health facilities (clerkship program) or expansion of an existing clerkship program in rural health facilities, as set forth herein for the Department of Health and Senior Services (hereinafter referred to as “state agency”).

Minimum Qualification and Experience Requirements: There are minimum qualification and experience requirements in the RFP (See Section 2.2, Minimum Qualification and Experience Requirements in Section 2.2 Scope of Work).

Titles: Titles of paragraphs used herein are for the purpose of facilitating reference only and shall not be construed to infer a contractual construction of language.

Background and Historical Usage Information:

Missouri currently lacks an adequate supply of primary care physicians in most areas of the state. In addition to overall shortages, there is a maldistribution of providers, with rural and other underserved communities experiencing the greatest shortages. According to the National Center for Health Workforce Analysis (NCHWA) this shortage will only grow especially in non-metro areas without significant intervention.

About one-third of Missouri’s population, or 2.05 million individuals, live in rural communities. People living in rural communities have higher rates of chronic conditions, mental health and substance use disorders, preventable hospitalizations, and lack of access to timely care compared to their urban counterparts. Eighty percent (80%) of areas designated as a primary care health professional shortage area (HPSA) are in rural or partially rural areas.

The physician shortage is partly driven by the departure of more than 270 third- and fourth-year medical students to other states for required clerkship placements. Once they have left the state, many choose to remain out-of-state for the remainder of their training. This occurs because Missouri lacks sufficient medical education clerkships. Furthermore, students who complete clerkships in-state are primarily assigned to urban areas, limiting their exposure to rural practice settings.

Retention of Missouri physicians is optimized when physicians do both medical school and residency training in the state. For students who completed their training in Missouri between 2013 and 2023, the in-state retention of those physicians was 52.7%. https://www.aamc.org/data-reports/students-students/data/report-students/2023/table-c6-physician-retention-state-residency-training-state. In a 2021 Association of American Medical Colleges (AAMC) Missouri Physician Workforce Profile for 2019-2020, the retention rate for graduate medical education (GME)-trained physicians who also attended medical school in Missouri was 47% higher than for those who only did GME in-state (0.56 vs 0.38, respectively).

Strengthening in-state clerkship programs is an effective way to ensure Missouri-educated physicians serve Missouri communities. This initiative will help rural hospitals/healthcare facilities launch and sustain clinical training programs for medical students through funding for initial setup, faculty development, and coordination. Over time, these clerkships will strengthen rural care by increasing access to local physicians.

Paragraph 1.2.6 has been revised by Amendment 02

This funding opportunity is part of the state’s commitment to addressing longstanding health inequities and expanding the pipeline of health care providers serving rural and other underserved communities. It is the intention of the Department of Health and Senior Services to offer this opportunity of clerkship development again in the future, dependent upon funding and appropriations.

Current and/or Previous Contract Information:

No current or previous contract exists for the products and/or services being obtained via this RFP.

RFP Questions:

Buyer is Single Point of Contact for Solicitation: Vendors and their agents (including subcontractors, employees, consultants, or anyone else acting on their behalf) must direct all of their questions or comments regarding the RFP, the evaluation, etc., to the buyer indicated on the first page of this RFP. It is preferred that questions be emailed to the buyer.

Except as noted herein, vendors and their agents are instructed not to contact any other state employee regarding any of these matters during the solicitation and evaluation process. Inappropriate contacts are grounds for suspension and/or exclusion from specific procurements. Vendors can be sanctioned for unauthorized contact with any evaluator under 1 Code of State Regulation (CSR) 40-1.060(8)(G) and (H) available at http://www.sos.mo.gov/adrules/csr/csr.asp.

Minority Business Enterprise/Women Business Enterprise (MBE/WBE) and Service Disabled Veteran Enterprise certification or subcontract questions should be directed to the Office of Equal Opportunity (OEO) at http://oeo.mo.gov.

Vendor is Responsible for Asking Questions About the RFP: It is the vendor’s responsibility to ask questions, request changes or clarifications, or otherwise advise the Division of Purchasing if the vendor believes that any language, specifications, or requirements are: (1) ambiguous, (2) contradictory or arbitrary, (3) violate any state or federal law or regulation, (4) restrict or limit the requirements to a single source, or (5) restrict or limit the vendor’s ability to submit a proposal.

Vendor Question Deadline: Every attempt shall be made to ensure that the vendor receives an adequate and prompt response. However, in order to maintain a fair and equitable procurement process, all vendors will be advised, via the issuance of an amendment to the RFP, of any relevant or pertinent information related to the procurement. All questions and issues should be submitted no later than ten (10) calendar days prior to the proposal closing date and time of the proposals. If not received prior to ten (10) calendar days before the proposal closing date and time, the Division of Purchasing may not be able to fully research and consider the respective questions or issues.

State’s Response to Vendor Questions: Upon the Division of Purchasing’s consideration of questions and issues, if the Division of Purchasing determines that changes are necessary, the resulting changes will be included in a subsequently issued RFP amendment(s); absence of such response indicates that the questions and issues were considered but deemed unnecessary for an RFP amendment. All vendors will be advised of any change to the RFP’s language, specifications, or requirements by a formal amendment to the RFP. There will be no posted written records of the questions/communications (i.e., formal question/answer document).

RFP is State’s Only Official Position: The only official position of the State of Missouri shall be that which is contained in the RFP and any amendments thereto.

Amendments:

If the Division of Purchasing determines that changes to the RFP are necessary, the resulting changes will be included in a subsequently issued RFP amendment(s) prior to the proposal closing date and time.

Pre-Proposal Teleconference:

Pre-proposal Teleconference Date and Time: A pre-proposal teleconference regarding this RFP will be held on Thursday, June 25, 2026 at 11:00 a.m., Central Time. Vendors are encouraged to participate in the pre-proposal teleconference as it will be used as the forum for questions, communications, and discussions regarding the RFP. The vendor should become familiar with the RFP and develop all questions prior to the pre-proposal teleconference in order to ask questions and otherwise participate in the public communications regarding the RFP.

Pre-Proposal Teleconference Agenda: The vendor should have a copy of the RFP for the pre-proposal teleconference since it will be used as the agenda for the pre-proposal teleconference.

Communication Prior to the Teleconference: The vendor is encouraged to review the RFP prior to the pre-proposal teleconference and may submit written communications and/or questions regarding the RFP, which reference the RFP paragraph numbers, to the buyer identified on page one. Such prior communication will provide the State of Missouri with insight into areas of the RFP which may be brought up for discussion during the conference and which may require clarification.

Communication During the Teleconference: During the pre-proposal teleconference, it shall be the sole responsibility of the vendor to orally address all issues previously presented to the buyer by the vendor, including any questions regarding the RFP or areas of the RFP requiring clarification.

Amendment to the RFP: Any modifications needed to the RFP as a result of discussions from the pre-proposal teleconference will be accomplished as an amendment to the RFP. Neither formal minutes of the pre-proposal teleconference nor written records of the questions/communications will be maintained.

Pre-Proposal Teleconference Special Accommodations: Vendors are strongly encouraged to advise the Division of Purchasing within five (5) state business days of the scheduled pre-proposal teleconference of any special accommodations needed for people with health conditions or impairments who will be participating in the pre-proposal teleconference so that these accommodations can be made.

Pre-Proposal Teleconference Dial-In Information: The vendor should contact the buyer from the Division of Purchasing as indicated on the first page of this RFP to obtain dial-in instructions. The vendor will be provided with a telephone number to dial and/or webinar information to access, in order to listen and participate in the pre-proposal teleconference. The vendor shall refrain from contacting anyone other than the buyer to obtain the dial-in information.

Glossary of Terms and Acronyms:

Whenever the following terms and acronyms appear in the RFP document or any amendment thereto, the definitions or meanings described below shall apply.

General Glossary, Acronyms, and Abbreviations:

Agency and/or State Agency means the statutory unit of state government in the State of Missouri for which the equipment, supplies, and/or services are being purchased by the Division of Purchasing (Purchasing). The agency is also responsible for payment, unless otherwise specified herein.

Amendment means a written, official modification to a solicitation or contract.

Attachment applies to all documents which are included with an RFP to incorporate any informational data or requirements related to the performance requirements and/or specifications.

Buyer means the procurement staff member of Purchasing.

Code of State Regulation (CSR) contains the current administrative rules of executive agencies of Missouri government. The regulations are arranged by agency rather than by subject.

Contract means a legal and binding agreement between two or more competent parties, for a consideration for the procurement of equipment, supplies, and/or services.

Contractor means a supplier, offeror, person, or organization who is a successful vendor as a result of an RFP and who enters into a contract.

Exhibit applies to forms which are included with an RFP for the vendor to complete and submit with their proposal prior to the specified closing date and time.

May means that a certain feature, component, or action is permissible, but not required.

Must means that a certain feature, component, or action is a mandatory condition.

Party refers to either the State of Missouri or the contractor as an entity that may enter into a contract pursuant to the terms herein.

Pricing Page(s) applies to the form(s) on which the vendor must state the price(s) applicable for the equipment, supplies, and/or services required in the RFP. The pricing pages must be completed and submitted by the vendor with the proposal prior to the specified proposal closing date and time.

Proposal Closing Date and Time and similar expressions mean the exact deadline required by the RFP for the receipt of sealed proposals.

Purchase Order means the authorized document issued by the state agency to the contractor indicating descriptions, quantities, and agreed prices for products and/or services.

Reasonable, Necessary or Proper as used herein shall be interpreted solely by the State of Missouri.

Request for Proposal (RFP) means the solicitation document issued by Purchasing to potential vendors for the purchase of equipment, supplies, and/or services as described in the document. The definition includes the following sections: Introduction and Background Information; Scope of Work; Terms and Conditions (“terms and conditions” and “Terms and Conditions” are used interchangeably throughout the RFP); General Contractual Requirements; and Vendor Submission, Evaluation, and Award Information; and the RFP Vendor Response Exhibits, Attachments, and Amendments of the RFP.

RSMo (Revised Statutes of Missouri) refers to the body of laws enacted by the Legislature which govern the operations of all agencies of the State of Missouri. Chapter 34 of the statutes is the primary chapter governing the operations of Purchasing.

Shall has the same meaning as the word must.

Should means that a certain feature, component and/or action is desirable but not mandatory.

State collectively referring to the state government and/or the agencies thereof.

Supplier has the same meaning as the word, vendor.

Vendor means the supplier, offeror, person, or organization that responds to an RFP by submitting a proposal with prices to provide the equipment, supplies, and/or services as required in the RFP document.

Technical Glossary:

Academic Year refers to the timeline of July 1 through June 30.

Health Professional Shortage Area (HPSA) refers to a geographic area, population group or health care facility that the Health Resources and Services Administration (HRSA) designates as having a shortage of health professionals.

Medically Underserved Area (MUA) and Population (MUP) refers to geographic areas and populations lacking adequate access to primary care services.

Paragraph 1.7.3 d. has been revised by Amendment 02

Medical Clerkship refers to the training period where third- and fourth-year medical students practice medicine under the supervision of established doctors. Each rotation lasts several weeks and focuses on a single medical specialty. May also be referred to as a clinical rotation. Required clinical rotations include internal medicine, surgery, pediatrics, obstetrics and gynecology, psychiatry, emergency medicine and family medicine.

Medical Clerkship Program (Clerkship Program) refers to a program offered by a medical facility with an affiliation agreement with an eligible medical school to fulfill the clinical training requirements for third- and fourth-year medical students.

Eligible Medical School refers to a nonprofit medical school with their primary location in Missouri and whose sponsoring institution does not operate a teaching hospital and exports at least 20% of their third-year medical students out-of-state due to lack of access to in-state clerkship position. The school must be accredited by the Liaison Committee on Medical Education (LCME) or the Commission on Osteopathic College Accreditation (COCA).

Medical School Partner refers to a medical school in which the contractor has or intends to have an executed affiliation agreement to host third- and fourth-year medical students for their medical clerkship required training.

Medical Facility refers to any location that is equipped and staffed to provide health care services to patients. These services can include diagnosis, treatment, prevention, and management of illnesses or injuries. Medical facilities vary in size and function, but generally include hospitals, clinics, urgent care centers, specialty centers, and long-term care facilities. The Department prioritizes medical facilities that do not have affiliation agreements with medical schools from outside of Missouri.

Medical Student (student) refers to a person enrolled in a Missouri medical school (allopathic or osteopathic program) who is actively training to become a physician, gaining knowledge and clinical skills through coursework and supervised patient care rotations to eventually diagnose, treat, and provide compassionate care for patients. They progress from classroom learning to hands-on clinical experience, developing ethical principles, research abilities, and communication skills essential for a life in medicine. For the purposes of this RFP, medical student (student) refers to third- and fourth-year medical students”.

Accuracy of Background Information:

Although an attempt has been made to provide accurate and up-to-date information, the State of Missouri does not warrant or represent that the background information provided herein reflects all relationships or existing conditions related to this RFP.

****END OF INTRODUCTION AND BACKGROUND INFORMATION SECTION****

SCOPE OF WORK SECTION

General Requirements:

The contractor shall provide rural medical clerkship development for the Department of Health and Senior Services in accordance with the provisions and requirements stated herein and to the sole satisfaction of the state agency.

The contractor shall develop a new medical student clerkship (clerkship) program or expand an existing clerkship program through formal collaboration with at least one eligible medical school.

The contractor shall develop a clerkship program that supports at least three medical students per year for the duration of the medical student’s medical clerkship. For example, by year two of the program the contractor shall host at least three third-year and at least three fourth-year students concurrently.

In the event the contractor has an existing clerkship program, the contractor shall expand the program by increasing the number of medical students hosted (increase in clerkship positions) by at least two clerkship positions per student year. For example, by year two of the program the contractor shall host at least two additional third-year and two additional fourth-year students concurrently.

More than 50% of clinical rotation shall take place in a Missouri county participating in Missouri’s Rural Health Transformation Program’s TORCH Care model, which includes all counties except, Boone, Cass, Clay, Cole, Greene, Jackson, Jefferson, Platte, St. Charles, St. Louis, and St. Louis City.

The contractor shall begin hosting third-year medical students or implement an expanded clerkship program no later than August 30, 2027.

The contractor shall have an executed affiliation agreement to host third- and fourth-year medical students with at least one eligible medical school no later than August 30, 2027.

The contractor shall develop and implement a clerkship program that is compliant with all medical school accreditation requirements for clerkship placements. This includes focusing on hands-on patient care, integrating pre-clerkship knowledge, defining learning objectives, and providing real-world clinical experience to build skills and prepare students for residency.

The contractor shall ensure that their curriculum and training plan incorporate the following elements to lead to readiness for clinical practice in residency program and encourage future practice in rural settings following training completion:

Interprofessional training;

· Culturally and linguistically appropriate care;

· Rural clinical training experience and activities that promote practice in rural and other underserved Missouri communities; and

Community engagement activities.

The contractor shall work with medical school partner(s) to recruit and support a diverse cohort of medical students, including outreach to current medical students, and students enrolled in college, high schools, or other educational programs with ties to Missouri.

The contractor shall have the organizational capacity and program governance for hosting a clerkship program to meet the medical school partner requirements as agreed to in the affiliation agreement.

Paragraph 2.1.9 has been revised by Amendment 02

The contractor shall develop and implement a preceptor recruitment and development plan, including recruiting preceptors to meet requirements for the core required clinical rotations which include internal medicine, surgery, pediatrics, obstetrics and gynecology, psychiatry, emergency medicine and family medicine.

The contractor may work with other medical facilities or the American Association of Medical Colleges (AAMC) for placing students in specific external rotations if the facility meets the requirements of the medical school partner affiliation agreement.

Contractor’s Obligation: Unless otherwise specified herein, the contractor shall furnish all material, labor, facilities, equipment, and supplies necessary to perform the services required herein.

Minimum Qualification and Experience Requirements:

Minimum Qualifications: The contractor must meet the following minimum qualifications at the time of proposal submission and for the duration of the contract

The contractor shall be physically located in a Missouri county participating in Missouri’s Rural Health Transformation Program’s TORCH Care model, which includes all counties except, Boone, Cass, Clay, Cole, Greene, Jackson, Jefferson, Platte, St. Charles, St. Louis, and St. Louis City.

The contractor shall have a formal letter of commitment with at least one eligible medical school that outlines willingness by both parties to collaborate on the development and implementation of a new clerkship program or expansion of an existing clerkship program. The formal letter of commitment shall be signed by an authorizing official from the eligible medical school and the medical facility establishing or expanding the clerkship program.

Minimum Experience: The contractor must meet or exceed the following minimum experience requirements at the time of proposal submission and for the duration of the contract:

Paragraph 2.2.2 a. has been revised by Amendment 02

The contractor shall have a minimum of three (3) years of experience operating as one of the following organization types:

Missouri hospital facility licensed as a hospital under Chapter 19 CSR 30-20. 100.

A rural community-based ambulatory patient care center which includes:

· A federally qualified health center, as defined by §1905(1)(2)(B), Social Security Act (42 U.S.C. §1395x(ff)(3)(B)).

· A community mental health center, as defined by §1861(ff)(3)(B), Social Security Act (42 U.S.C. §1395x(ff)(3)(B)).

· A rural health clinic, as defined by §1861(aa)(2), Social Security Act (42 U.S.C. §1395x(aa)(2)).

OR, a minimum of three (3) years of collective experience operating as a formal partnership or consortium:

A formal partnership or consortium between the two organization types listed in subparagraphs 2.2.1 a. 1) and 2.2.1 a. 2) to form an entity that serves as the sponsor and operator of a clerkship program. In the event the contractor is a consortium, the contractor must sponsor clerkships in health care facilities in a Missouri county participating in Missouri’s Rural Health Transformation Program’s TORCH Care model, which includes all counties except, Boone, Cass, Clay, Cole, Greene, Jackson, Jefferson, Platte, St. Charles, St. Louis, and St. Louis City.

The contractor and each participating health care facility must be in good standing with the accreditation body responsible for accrediting the organization type and meet all affiliation agreement requirements.

The contractor shall have a minimum of five years of experience providing care services to rural communities.

The contractor shall have a minimum of three years of experience training medical sciences students.

The contractor shall have a minimum of three years of experience successfully engaging partners, communities, and populations in strategies to improve health care services and access to those services.

The contractor shall have a minimum of five years of experience in budget management and administration with the capacity to establish financial procedures and track, monitor, and report expenditures.

Team Qualifications:

The contractor shall include the following team members to administer and perform the contract requirements:

Leadership Team: The contractor’s leadership team shall, at minimum, consist of a Clerkship Program Director. The contractor may designate an Assistant Program Director to assist the Program Director in the administrative and clinical oversight of the educational program.

The Clerkship Program Director must have three (3) years of documented experience working as part of an interdisciplinary, interprofessional team to create an educational environment that promotes high-quality care, patient safety, and student well-being, and working with diverse populations.

The contractor’s Clerkship Program Director, and if applicable, the Assistant Program Director, must meet all the medical school partner requirements for the Program Director and Assistant Program Director role, respectively. The contractor’s Program Director shall have authority and accountability for the overall clerkship program, including compliance with all applicable program requirements.

By no later than five (5) business days after receipt of the state agency’s authorization to proceed with services, the contractor shall provide the state agency with the Clerkship Program Director’s contact information including name, telephone number, physical address, and electronic mail (e-mail) address.

Working Team: The contractor’s working team shall consist of a Program Coordinator, and other qualified staff, subcontractors, or consultants, as needed.

The Program Coordinator shall have a minimum of three (3) years of experience in:

a. Establishing clerkships or managing the planning, implementation, monitoring, and reporting of state or federal program funding requirements.

b. Engaging partners, communities, and populations in strategies to improve health care services and access to those services.

The contractor shall designate a Program Coordinator who shall serve as the liaison and primary contact between the contractor and the state agency. The Clerkship Program Director may serve as the Program Coordinator, or the contractor may identify a different staff member to provide program coordination. The contractor shall provide the state agency with the name, address, email address, and telephone number of the Program Coordinator no later than five (5) business days after receipt of the state agency’s authorization to proceed with services.

· The Program Coordinator shall assume responsibility and liability for services performed per the contract.

· The Program Coordinator shall manage the planning, implementation, monitoring, and reporting of the contract requirements and serve as a liaison and facilitator between the learners, preceptors, other staff members, and the medical school.

The contractor shall identify additional personnel involved in establishing or expanding a clerkship program and provide the level of effort indicated by full-time equivalent.

Prior to the launch of the clerkship program, the contractor shall identify key faculty including preceptors who will support the program as agreed upon in the medical school partner affiliation agreement.

The contractor shall notify the state agency via email within two (2) business days of any changes in staffing under the contract.

The contractor shall understand and agree that the state agency reserves the right to request any of the contractor’s personnel assigned to provide the services be removed without just cause. The contractor shall understand and agree that the state agency will allow the contractor a reasonable time to find a replacement. The state agency shall approve all replacement personnel. The state agency reserves the right to require background checks and non-disclosure agreements (NDA) of selected contractor personnel, at the contractor’s expense.

Work Plan Requirements:

Annual Work Plan Meeting: Within 30 calendar days after the state agency’s notification to proceed with services, the contractor shall meet virtually or in-person at a mutually agreed upon location by the contractor and the state agency. The contractor shall meet with the state agency to review the contractor’s annual work plan and make changes as deemed necessary to accomplish and fulfill the needs of the state agency.

Work Plan Content:

The contractor’s work plan shall include, but not be limited to, a step-by-step plan of action to complete the new or expanded clerkship program development, as shown in Attachment 1, Sample Work Plan Template.

In addition, the work plan must itemize specific tasks that will be completed prior to each quarterly progress report, personnel who will perform each task, anticipated work hours each person will provide in completing each task, and a detailed timeline for completion of the specified tasks.

Within ten (10) calendar days following the work plan meeting, the contractor shall revise the work plan submitted in the contractor’s awarded proposal pursuant to the requirements of the state agency as specified during the work plan meeting and shall finalize and submit the work plan to the state agency for review and approval, if modifications are necessary as identified during the workplan meeting.

Work Plan Approval: The contractor shall understand and agree that the state agency shall have complete and total approval authority of the contractor’s work plan and shall have the right to request the contractor modify and/or provide additional elaboration to the work plan to accomplish the objectives and goals of the state agency.

Implementation of Work Plan: Within 60 calendar days after the state agency’s notification to proceed with services, the contractor must have obtained the state agency’s approval of the work plan and must be fully operational which shall include completion of all necessary function, action, set-up, providing required personnel, etc. necessary for full implementation of all required services for program development or expansion pursuant to the requirements herein and the approved work plan.

Modifications to Work Plan: As work progresses in accordance with the work plan, modifications to the approved work plan shall be permitted due to changes in state agency needs or for other reasons approved by the state agency.

State Agency Requested Changes: If, after implementation of services, the state agency determines that modifications to the approved work plan are necessary or desired, the state agency will document the requested changes to the contractor in writing with any new instructions. Based on the written instructions provided by the state agency, the contractor must revise the work plan according to the requirements for the work plan specified herein, including any resulting changes in the assignment of percentage of completion factors ties to the contractor’s payment.

Contractor Requested Changes: If, after implementation of services, the contractor determines that modifications to the approved work plan are necessary, the contractor must submit a written request to the state agency for changes. The written request must include the reason for the modification and must detail the contractor’s proposed changes to the work plan. The contractor shall agree and understand that the state agency will review the written request of the contractor and shall send written notice of approval or disapproval of the request to the contractor.

The contractor shall understand and agree that the state agency will have final approval of all individual components of the work plans revised as specified herein and reserves the right to require modifications, deletions, and/or additional elaboration to the work plan as the state agency deems necessary. The contractor shall agree and understand that the decision by the state agency shall be final and without recourse.

The contractor shall not proceed with implementation of services related to the modifications until final written approval of the state agency is obtained.

The contractor shall submit a revised annual work plan for renewal period(s) that includes specific objectives, activities, deadlines, and responsible parties to meet the contract deliverables and project goals to the state agency at least 30 days prior to the end of the original contract period and any subsequent renewal periods for the state agency’s approval.

Performance Requirements:

The contractor shall, at a minimum, continue to operate the new or expanded clerkship program for the duration of the contract.

The contractor shall meet at least quarterly, and as needed, with the state agency to report on implementation progress and contract deliverables.

The state agency will coordinate the quarterly meetings at a time that is mutually agreeable to both the contractor and state agency.

The meetings may be conducted in person, by phone, or online.

The contractor shall evaluate the activities outlined in the approved workplan and report the progress to the state agency. The evaluation shall provide the contractor with information to identify if the contractor is meeting the project goals and affiliation agreement requirements, identify project outcomes, and identify opportunities for program improvement.

Program Sustainability Requirements:

The contractor’s clerkship program shall be sustainable long-term through viable and stable funding mechanisms beyond the scope of the contract agreement.

The contractor shall develop and submit to the state agency for review and approval by the end of the first contract renewal period, a sustainability plan that includes a description of how the contractor intends to sustain the clerkship program once the program is established or expanded. The contractor’s sustainability plan shall include:

The projected five (5) year annualized, ongoing training program costs.

The annual ongoing training cost per student.

Plan for obtaining sustainment funds.

The contractor’s long-term commitment to the program and the contractor’s ability to support ongoing program costs following start-up.

Reporting and Recordkeeping Requirements:

The contractor shall submit progress reports quarterly by the 15th of the month for the activities conducted in the quarter prior, including activity updates and work plan progress. This report shall include:

Summary of progress to date on developing the new or expanding clerkship program as well as any additional successes (e.g., identified through evaluation results or lessons learned) achieved during the quarter;

Challenges that affected the contractor’s ability to complete work plan activities and any additional challenges (e.g., identified through evaluation results or lessons learned) encountered during the quarter; and

Activities planned and timelines for the subsequent quarter(s).

The contractor shall submit an annual performance report to the state agency within thirty (30) calendar days after the end of the contract period. The report shall include:

Summary of progress to date on developing or implementing the new or expanded clerkship program as well as any additional successes (e.g., identified through evaluation results or lessons learned) achieved in the past year;

Challenges that affected the contractor’s ability to achieve annual and project period outcomes, gather data, and complete work plan activities and any additional challenges (e.g., identified through evaluation results or lessons learned) encountered in the past year; and

Summary of lessons learned and recommendations on ways to improve the new program development program.

Once the contractor has implemented the new or expanded clerkship program, the contractor shall also include the following information in the annual report:

List of medical school partners and number of students in the clerkship program by year of medical school per partner.

Locations of clerkship rotations (if different than the contractor’s location).

Aggregated data on students participating in the clerkship program within the facility to include:

· Age, sex, race, and ethnicity; and

Intent to be employed in a rural area once licensed to practice; intent to practice in primary care (by primary care area, i.e. pediatrics, family practice, internal medicine, OB/GYN) vs. pursuing additional specialty training; and intent to apply to Missouri residency programs.

Number of preceptors precepting students and the number of total FTE required for program implementation.

Estimated economic impact, if known, of adding or expanding the clerkship program.

Publicity: Any publicity release mentioning contract activities shall reference the contract number and the state agency. Any publications, including audiovisual items produced with contract funds, shall give credit to the contract and the state agency. The contractor shall obtain approval from the state agency prior to the release of such publicity or publications.

Final Report: The contractor shall complete and submit the final report to the state agency within thirty (30) calendar days after the end of the contract period.

However, by at least two (2) weeks prior to the due date for submission of the final report, the contractor shall submit a preliminary draft of the final report to the state agency for review and comment.

If required by the state agency, the contractor shall modify and/or provide additional elaboration as deemed necessary to ensure a comprehensive and…