T202675 - Optometry Services RFQ (Final).pdf

NYS OFFICE OF MENTAL HEALTH

REQUEST FOR QUOTE (RFQ) #: OMH01-T202675-3650275

FOR THE PROCUREMENT OF: Optometry Services for Creedmoor Psychiatric Center

KEY EVENTS

Optional Site Visit Thursday, June 25th, 2026 at 10:00am

Receipt of Questions from Potential Offerors Thursday, July 9th, 2026 by 3:00pm

Questions and Answers sent by OMH Thursday, July 16, 2026

Quote Submission Due Date: Thursday, July 23rd, 2026 by 3:00pm

Anticipated Start/End dates: September 1, 2026 - August 31, 2027

Issuing Office/Permissible Contacts: The issuing office, named below, is the sole point of contact in the State for matters related to this transaction. Pursuant to NY State Finance Law 139-j and 139-k, this transaction includes and imposes certain restrictions on communications between OMH and an offeror during the procurement process. Please reference Attachment J, Summary of OMH Procurement Lobbying Guidelines, included with this Request for Quote.

Primary Contact:

Attention: Brendan Perperian

Address: 75 New Scotland Avenue, Albany NY 12208

Phone: (518) 549-1734

E-Mail: Brendan.Perperian@omh.ny.gov

Secondary Contact:

Attention: Chairmona Mayo

Phone: (518) 549-5210

E-Mail: Chairmona.Mayo@omh.ny.gov

1. Introduction: OMH is seeking quotes for OMH01-T202675-3650275, Optometry Services at Creedmoor Psychiatric Center located at 79-25 Winchester Blvd, Queens Village, NY 11427

2. Scope of work:

THE PROVIDER shall be a qualified NYS licensed optometrist able to perform optometry services on site for the Creedmoor Psychiatric Center consumers.

The NYS licensed optometrist shall:

• Act as an optometry consultant.

• Comply with the Creedmoor Psychiatric Center MSO By-Laws, including credentialing and privileging requirements.

• Assess and evaluate consumer's condition to develop an optometric service treatment plan based upon a physician's request.

• Review consumer's treatment goals, treatment, and medical history.

• Perform and interpret tests.

• Conduct optometry services as needed.

• Administer appropriate optometry treatment when indicated.

• Prepare documentation of assessment, evaluation, delivery/recommendation of treatment services and consumer progress for the consumer's medical record as all services provided must be verified by the appropriate Creedmoor Psychiatric Center staff before payment is approved.

• Consult with consumer's treatment team as needed.

• Be under the supervision of the Creedmoor Psychiatric Center's Medical Director. Ongoing practice evaluation will be conducted at least every six months.

• Submit to the Medical Director and Business Office: monthly statistical information including number of consumers treated, number of modalities administered, and number of evaluations.

• The Creedmoor Psychiatric Center will maintain a performance improvement program related to structure, process, and outcomes.

• The Creedmoor Psychiatric Center will be responsible for conducting follow-up for abnormal findings.

Critical findings will be reported to the Medical Director or the attending physician.

• The Creedmoor Psychiatric Center will be responsible for arranging referrals recommended by the Provider.

Work Hours:

Hours of service will be mutually agreed on by the Provider and the Creedmoor Psychiatric Center.

Qualifications, Licenses and Permits:

Current New York State license.

The Provider will possess, at no cost to the STATE, all qualifications, licenses, permits to perform the work in the specification, engage in the business of Optometry Consultant Services as may be required within the jurisdiction (New York State & Queens County) where the specified work is to be performed and comply with all federal, state and local regulations governing the work to be performed. Each licensed optometrist will have their clinical competency assessed at least annually.

Supplies and Materials:

The Facility will provide all supplies and materials necessary for the provision of said services.

Orientation and Training:

The Facility will provide an orientation and training program which will include a general facility orientation, fire safety, infection prevention and training in the requirements of the privacy and security provisions of HIPAA and the New York State Mental Hygiene Law. All staff must complete this program prior to beginning work at the facility. ln addition, there will be a refresher session provided annually.

Confidentiality:

The Provider shall respect the confidential nature of all information that they have access to, including but, not limited to consumer's protected health information provided to them orally, contained in consumer medical records or maintained on the Facility's electronic information system. The provider is responsible for complying with New York State law and Facility's policies and procedures.

Background Checks and Requirements for Contractor providing services in OMH-operated

Facilities:

A. If the CONTRACTOR is providing services described in the Scope of Work, in his or her individual capacity such that the CONTRACTOR will have regular and substantial contact with any person who is receiving services or support from OMH:

1) CONTRACTOR agrees to be screened by OMH against the Staff Exclusion List (“SEL”) and Statewide Child Abuse Registry List (“SCR”) in accordance with Social Services Law Sections 424-a and 495. In the event that SCR notifies OMH of the existence of an indicated report, CONTRACTOR agrees to provide written consent to the SCR to release to OMH any and all information SCR has regarding CONTRACTOR. CONTRACTOR shall provide such additional information as OMH, in its sole discretion, deems necessary to permit OMH to make a determination about CONTRACTOR’s suitability to provide the contract services. Any fees associated with this procedure will be paid by the OMH Facility.

2) By signing into a Contract Agreement, CONTRACTOR represents and warrants that:

i. CONTRACTOR has not previously engaged in any act in violation of any law which could compromise the health and safety of Facility patients.

ii. During the term of this Agreement, CONTRACTOR shall not engage in any act in violation of any law which could compromise the health and safety of Facility patients.

3) Prior to being permitted to provide services under this Agreement, CONTRACTOR shall execute the Code of Conduct | Justice Center for the Protection of People With Special Needs as required by the Protection of People with Special Needs Act. A copy of the Justice Center Code of Conduct can be found at the following link: code-of-conduct-acknowledgement-form_feb-2021.pdf.

4) OMH may terminate the Agreement for cause immediately in the event that:

i. CONTRACTOR is listed on the SEL;

ii. CONTRACTOR fails to provide consent for release of information from SCR as required in subparagraph (a) above;

iii. CONTRACTOR fails to provide such additional information as OMH, in its sole discretion, deems necessary to permit OMH to make a determination about CONTRACTOR’s suitability to provider for the contract services;

iv. OMH, in its sole and absolute discretion, determines that CONTRACTOR is not suitable to provide the contract services based on information in the SCR or supplemental information provided by CONTRACTOR;

v. OMH receives reliable information that, prior or during the term of the Agreement, CONTRACTOR has engaged in an act in violation of the law which, in OMH’s sole and absolute discretion, could compromise the health and safety of Facility patients;

5) CONTRACTOR fails to execute, or following execution, to comply with the required code-of-conduct-acknowledgement-form_feb-2021.pdf

6) Prior to terminating the Agreement for cause as provided in subparagraph D(3)-(6) above, OMH shall provide CONTRACTOR with written notice and an opportunity to be heard. Contractor shall be suspended from performing services under the Agreement pending OMH’s final determination regarding termination.

https://www.justicecenter.ny.gov/code-conduct https://www.justicecenter.ny.gov/system/files/documents/2021/02/code-of-conduct-acknowledgement-form_feb-2021.pdf https://www.justicecenter.ny.gov/system/files/documents/2021/02/code-of-conduct-acknowledgement-form_feb-2021.pdf https://www.justicecenter.ny.gov/system/files/documents/2021/02/code-of-conduct-acknowledgement-form_feb-2021.pdf

B. If the CONTRACTOR provides the services described in the Scope of Work, via employees, agents, or subcontractors (subject individuals), wherein the subject individuals will have regular and substantial contact with any person who is receiving services or supports from OMH:

1) CONTRACTOR shall assure that the subject individuals agree to be screened by OMH against the SEL and SCR in accordance with Social Services Law Sections 424-a and 495. In the event that SCR notifies OMH of the existence of an indicated report, CONTRACTOR agrees that subject individual must provide written consent to the SCR to release to OMH any and all information SCR has regarding the subject individual. CONTRACTOR shall ensure that subject individuals provide such additional information as OMH, in its sole discretion, deems necessary to permit OMH to make a determination about subject individual’s ability to provide services to OMH patients. Any fees associated with this procedure will be paid by the OMH Facility.

2) CONTRACTOR, solely at its own expense, shall pre-screen and conduct background checks which shall consist of an investigation to determine evidence of criminal history; verification of education, professional license, certification or other credentials required. CONTRACTOR assumes responsibility for ensuring that no subject individual has previously engaged in any act in violation of any law which could compromise the health and safety of Facility patients.

3) CONTRACTOR must assure that subject individuals agree to read and sign the code-of-conduct-acknowledgement-form_feb-2021.pdf. OMH reserves the right to bar any subject individual from performing contract services under this Agreement in the event that such individual fails to meet the requirements set forth herein. OMH may terminate the Agreement for cause immediately in the event that CONTRACTOR is unable to provide services to the OMH facility via a subject individual who has complied with all requirements identified in items (i) – (iii) above.

3. Site Visit: There is an optional site visit scheduled for Thursday, June 25, 2026 at 10:00am at 79-25 Winchester Blvd, Queens Village, NY 11427. No one will be admitted to the conference or site visit after the time cited above.

Conference & Site visit registration can be accomplished by completing and sending the Site Visit Registration Form, Attachment C via email to Brendan.perperian@omh.ny.gov, with a cc. to Chairmona.mayo@omh.ny.gov no later than Wednesday, June 24, 2026 by 3:00pm.

4. Method of Award: As per NYS Finance Law and NYS Procurement Council Guidelines, this RFQ will result in a Discretionary "T" contract. Selection will be based upon lowest cost, reasonableness of price and justification for vendor selection.

5. Quote Submission:

The Quote Submission, Attachment D, must be submitted via email to Brendan.Perperian@omh.ny.gov, with a cc’ to Chairmona.Mayo@omh.ny.gov no later than Thursday, July 23rd, 2026 by 3:00pm

6. Quote Requirements:

A. The submission of a quote constitutes a binding offer. Such binding offer shall be firm and not revocable for a period of one hundred and twenty (120) days after the deadline for a quote submission.

B. The quote is to be submitted via email only to Brendan.Perperian@omh.ny.gov on or before the date and time defined by this RFQ. No late submissions will be considered.

https://www.justicecenter.ny.gov/system/files/documents/2021/02/code-of-conduct-acknowledgement-form_feb-2021.pdf https://www.justicecenter.ny.gov/system/files/documents/2021/02/code-of-conduct-acknowledgement-form_feb-2021.pdf mailto:Chairmona.mayo@omh.ny.gov

7. Procurement Lobbying Law Requirements: Does apply to this RFQ.

Upon notification of selection, the awardee will be required to complete the two forms listed below:

1. Attachment J-1: Offeror’s Affirmation of Understanding

2. Attachment J-2: Offeror Disclosure of Prior Non-Responsibility Determinations

8. Consultant Disclosure Legislation: Does apply to this RFQ.

Upon notification of selection, the awardee will be required to complete the Consultant Disclosure Form A.

9. New York State Worker Compensation (WC) & Disability Benefits (DB) insurance Requirements:

Upon notification of selection, the awardee will be required to provide current WC and BD certificates or WC and DB Exemption certificate.

10. Liability Insurance Requirement:

Upon notification of selection, the awardee will be required to provide current general liability insurance certificate in a form that is acceptable to OMH.

11. Prevailing Wage: Does Not apply to this RFQ.

12. Minority and Women-owned Business Enterprise (MWBE) and Service Disabled Veteran-Owned Business (SDVOB) Requirements: Does Not apply to this RFQ.

The MWBE goal established for this solicitation is 0%. MBE: 0% and WBE 0%.

The SDVOB goal established for this solicitation is 0%.

Upon notification of selection, the awardee will be required to complete the applicable forms regarding the MWBE/SDVOB Utilization Plan(s) or Applications for Waiver as appropriate.

13. Reserved Rights of New York State:

A. Withdraw the RFQ at any time, at its sole discretion;

B. Disqualify any offeror whose conduct and/or quote submission fails to conform to the requirement of the RFQ;

C. Seek clarifications of quote;

D. Use information obtained through site visits, management interviews and the State’s investigation of an offeror’s qualifications, experience, ability or financial standing, and any material or information submitted by the offeror in response to the OMH’s request for clarifying information in the course of evaluation and/or selection under this RFQ.

E. Amend RFQ specifications to correct errors or oversights, or to supply additional information as it becomes available;

F. Change any of the scheduled dates stated herein;

G. Adjust or correct cost or cost figures with concurrence of the offeror if mathematical or typographical errors exist;

14. Quote Confidentiality:

All quotes submitted for OMH’s consideration will be held in confidence. However, the resulting contract is subject to New York State Freedom of Information Law (FOIL). Therefore, if an offeror believes that any information in its quote constitutes a trade secret or should otherwise be treated as confidential and wishes such information not to be disclosed if requested, pursuant to FOIL. (Article 6 of the Public Officer’s Law), the offeror shall submit with its quote a separate letter specifically identifying the page number(s), line(s), or other appropriate designation(s) containing such information, explaining in detail why such information is a trade secret and formally requesting that such information be kept confidential. Failure by an offeror to submit such a letter with its bid identifying trade secrets will constitute a waver by the offeror of any rights it may have under Section 89(5) of the Public Officers’ Law relating to protection of trade secrets. The proprietary nature of the information designated confidential by the offeror may be subject to disclosure if ordered by a court of competent jurisdiction. A request that an entire quote be kept confidential is not advisable since a bid cannot reasonably consist of all data subject to FOIL proprietary status.

15. Contract Payment:

All contractors are required to participate in the Electronic Payment program offered by the NYS Office of the State Comptroller (OSC). Payment for invoices submitted by contractors will only be rendered electronically unless payment by paper check has been expressly authorized by OMH’s Office of Financial Management, at OMH’s sole discretion, due to extenuating circumstances. Electronic payments will be made in accordance with ordinary State procedures and practices. Contractors shall comply with the State Comptroller’s procedures to authorize electronic payments. For additional information and to apply for Electronic Payments, the CONTRACTOR is directed to the following web site:

http://www.osc.state.ny.us/epay/index.htm.

http://www.osc.state.ny.us/epay/index.htm

ATTACHMENT D

QUOTE SUBMISSION

RFQ #:OMH01-T202675-3650275

FOR THE PROCUREMENT OF: Optometry Services at Creedmoor Psychiatric Center

Attention: Brendan Perperian, Brendan.Perperian@omh.ny.gov

Name of Firm: ______________________________________________________________________

Address: __________________________________________________________________________

Federal ID (FEIN) #: ______________________ NYS Vendor ID #: ____________________________

Please check all that apply:

NYS Minority-owned Business (MBE) Registration #:

NYS Women-owned Business (WBE) Registration #:

NYS Service Disabled Veteran-Owned Business

(SDVOB)

Registration #:

NYS Small Business (SB) Registration #:

NYS Disadvantaged Business Enterprise (DBE) Registration #:

None of the Above

Note: Offerors are not to change, delete, or make any additions to this form, and are to supply only the quote information that is required. If any changes, deletions, or additions are made by the bidder, or if all of the required information is not provided, then at OMH’s discretion, the quote may be disqualified.

Service Unit Cost Number of Services

Per Month

Total Monthly

Cost

Months Total Annual Cost

92002 Ophthalmological Services:

(complete eye examination) medical examination and evaluation with initiation of diagnostic and treatment program; intermediate, new patient (with/without refraction)

1 12

92004 Ophthalmological Services: comprehensive, new patient (with/without refraction)

16 12

92012 Ophthalmological Services: complete eye examination) medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; intermediate, established patient (with/without refraction)

1 12

92014 Ophthalmological Services: comprehensive, established patient (with/without refraction)

4 12

ATTACHMENT D

QUOTE SUBMISSION

92201 Ophthalmoscopy, Extended with retinal drawing and scleral depression of peripheral retinal disease (eg, for retinal tear, retinal detachment, retinal tumor) with interpretation and report, unilateral or bilateral.

2 12

92340 Fitting of Spectacles

12 12

92341 Fitting of Spectacles

5 12

Yearly Service Total

*Number of Services are estimates only, contractor will only be paid for the actual number of Services

Training Hourly Rate Number of Hours Total Cost for Training

X16

September 1, 2026 – August 31, 2027

Total Contract Value (Service Total + Training Total)

By offering a quote, vendor agrees to all terms of the RFQ; Quotes are not to include sales tax as New York State Agencies are tax-exempt.

Printed name: _____________________ Authorized signature: ____________________________

Date: ___________ E-mail address: ________________________ Phone #: ___________________

ATTACHMENT C

SITE VISIT REGISTRATION FORM

SITE VISIT DATE: Thursday, June 25, 2026, by 10:00am

Bid #: OMH01-T202675-3650275

PLEASE RETURN NO LATER THAN: Wednesday, June 24, 2026 by 3:00pm

# of pages including this cover sheet: 1

Today’s Date: _________________________

PLEASE SUBMIT REGISTRATION TO:

Attention: Brendan Perperian

Phone: (518) 549-1734

E-Mail: Brendan.Perperian@omh.ny.gov

FROM: COMPANY _________________________________

REPRESENTATIVE NAME _________________________________

TELEPHONE # _________________________________

FAX # _________________________________

EMAIL ADDRESS for designated contact: _________________________________

Number of attendees (maximum of two): __________

ATTACHMENT E

SOLICITATION COVER SHEET

Bid #: OMH01-T202675-3650275

Number of Years in Business: ____ Number of Years of Experience Providing Solicited Service: ____

Form submitted to show compliance with New York State Workers Compensation Insurance requirements:

CE-200____ or C-105.2____ or U-26.3____ or SI-12____ or GSI-105.2____

Form submitted to show compliance with New York State Disability Benefits Insurance requirements:

CE-200____ or DB-120.1____ or DB-155____

PLEASE CHECK THE APPROPRIATE BOX:

NYS Minority-owned Business (MBE) Registration #

NYS Women-owned Business (WBE) Registration #

NYS Small Business (SB) Registration #

NYS Disadvantaged Business Enterprise

(DBE) Registration #

NYS Service-Disabled Veteran Owned Business (SDVOB) Registration #

None of the above

(Note: Information provided on this form should match, when applicable, to information provided on Vendor Responsibility Questionnaire/ or on the online version of the document.)

NEW YORK STATE OFFICE OF MENTAL HEALTH

ATTACHMENT J

Summary of OMH Procurement Lobbying Guidelines

OMH has issued Guidelines pursuant to the New York State Finance Law Sections 139-j and 139-k, which prohibit lobbying on procurement contracts. For purposes of the law, procurement contracts include most contracts/Purchase Orders with an estimated annual expenditure in excess of $15,000 per year, as well as amendments and modifications to such contracts which were not contemplated by the original contract and represent a material change in the scope of the contract.

The law provides that, during the Restricted Period of an agency procurement for goods or services, vendors (or offerors) may only contact the agency’s designated contact person(s), and all contacts, whether permissible or impermissible, shall be recorded:

Vendor Requirements

• Must limit communications with OMH during the Restricted Period of each procurement to the OMH-designated point(s) of contact

• The Restricted Period is the period from the date of the earliest method by which an agency solicits a response from vendors to a contract opportunity until the date the contract is awarded and, if applicable, approved by the Comptroller’s Office.

• Must affirm in writing vendor’s understanding of and agreement to comply with the OMH Procurement Guidelines

• Must certify whether vendor has been found non-responsible within the previous four years by any Governmental Entity for failure to comply with State Finance Law 139-k or for the intentional provision of false or incomplete information regarding its procurement lobbying law compliance.

OMH Requirements

• Must include a summary of OMH’s procurement lobbying guidelines in each initial solicitation document

• Must designate a single point or points of contact for each procurement

• Must require OMH staff to record all Contacts from offerors during the Restricted Period of each procurement

• A Contact is any communication with OMH under circumstances where a reasonable person would infer that the communication was intended to influence the procurement

• Must refer all impermissible Contacts for investigation by OMH

• Must make a responsibility determination with regard to State Finance Law Section 139-j and 139-k compliance prior to award of the contract

• Must include a provision in all procurement contracts which allows OMH to terminate the contract if the vendor’s certification is found to be intentionally false or intentionally complete.

ATTACHMENT J1

OFFEROR’S AFFIRMATION OF

UNDERSTANDING OF,

AGREEMENT TO,

AND COMPLIANCE WITH

OMH PROCUREMENT LOBBYING GUIDELINES

New York State Finance Law 139-j(6)(b) provides that OMH shall seek written affirmation from all Offerors on their understanding of and agreement to comply with OMH’s procedures relating to permissible contacts during each procurement pursuant to State Finance Law 139-j(3). OMH is expanding on that requirement, requiring that

(1) Offerors affirm they have complied with the OMH Guidelines throughout the procurement process, and (2) Offerors agree that OMH shall have the right to terminate any contract, purchase order or purchase authorization resulting from the procurement in the event that the affirmation is found to be intentionally false or intentionally incomplete.

Solicitation # and/or OMH descriptive name of solicitation: OMH01-T202675-3650275, Optometry Services at Creedmoor Psychiatric Center

I hereby affirm that I have read and understand the OMH Procurement Lobbying Guidelines, and agree to comply with the OMH procedures relating to permissible contacts during this New York State governmental procurement pursuant to State Finance Law 139-j(3). Unless I provide notice otherwise, my execution of this affirmation shall be an ongoing representation that I have complied with, and continue to be in compliance with, the OMH Guidelines.

I understand and agree that: 1) OMH shall have the right to terminate the contract, purchase order or purchase authorization resulting from this solicitation in the event that this affirmation is found to be intentionally false or intentionally incomplete; and 2) upon such finding, OMH may exercise its termination right by providing written notification.

Date:_______________

Signature of Offeror’s Authorized Representative _______________________________

Printed Name and Title ___________________________________________________

Name of Offeror_________________________________________________________

Offeror’s Address: ______________________________________________________

OMH Attachments J1

NEW YORK STATE OFFICE OF MENTAL HEALTH

ATTACHMENT J2

OMH OFFEROR DISCLOSURE OF

PRIOR NON-RESPONSIBILITY DETERMINATIONS

New York State Finance Law 139-k requires Offerors to disclose findings of non-responsibility within the last four years by a governmental entity where such prior finding of non-responsibility was due to unlawful contacts during a procurement as stated under State Finance Law §139-j or the intentional provision of false or incomplete information to a governmental entity.

Failure to submit this form, the submission of a form with false, misleading or incomplete information, or failure to update this form when required may result in a determination of non-responsiveness and disqualification of the bid, proposal or offer. If the failure to comply is discovered after the contracting process has been completed, it may result in termination of the contract.

Solicitation # and/or OMH descriptive name of solicitation: OMH01-T202675-3650275, Optometry Services at Creedmoor Psychiatric Center

(1) Has any New York State agency or authority made a finding of non-responsibility regarding the Offeror in the last four years? (Please circle): No Yes

If yes, what was the basis for the finding of the Offeror’s non-responsibility?

Please check all that apply:

__ Unlawful Contacts during a procurement contract (State Finance Law §139-j) __ The intentional provision of false or incomplete information

If yes, please provide details regarding the finding of non-responsibility below:

New York State Agency or Authority: ____________________________________ Year of Finding of Non-Responsibility:____________________________________ Facts Underlying Finding of Non-Responsibility:_____________________________ Add additional sheets if necessary

(2) Has any New York State agency or authority terminated or withheld a procurement contract with the Offeror due to the intentional provision of false or incomplete information?

(Please circle): No Yes

If yes, please provide details regarding the termination/withholding below:

New York State Agency or Authority: _____________________________________ Date of Termination/Withholding of Contract:____________Contract #: __________

Facts Underlying Termination: __________________________________________ Add additional sheets if necessary

Offeror certifies that all information provided to OMH with respect to State Finance Law 139-k is complete, true and accurate.

Date:___________ _________________________________________________

Signature of Offeror’s Authorized Representative

Printed Name and Title of Authorized Representative

Name and Address of Offeror

OMH Attachments J2