Financial Mgmt. for PDS in 1915(c)HCBS Waiver Programs C5684

The Commonwealth of Kentucky, Cabinet for Health and Family Services (CHFS), Department for Medicaid Services (DMS) is issuing Request for Proposal (RFP) 746 2500000254 for Financial Management Services (FMS) for Participant-Directed Services (PDS) across five 1915(c) Home and Community-Based Services (HCBS) Medicaid waiver programs: Acquired Brain Injury (ABI), ABI Long-Term Care (ABI-LTC), Home and Community Based (HCB), Michelle P. Waiver (MPW), and Supports for Community Living (SCL). The selected vendor will serve approximately 15,640 current PDS participants and approximately 343 individuals on interest lists, providing comprehensive financial management services including electronic visit verification (EVV) processing, claims and invoice processing, background check administration, paycheck issuance (minimum bi-monthly frequency), tax documentation assistance, financial reporting, and service usage reporting. Vendors must demonstrate a minimum of five years of experience with Financial Management for PDS in 1915(c) HCBS waiver programs, provide documentation of financial capability, submit satisfactory performance attestations from three current state partners, and meet mandatory insurance requirements including Commercial General Liability of $1,000,000 per occurrence/$2,000,000 aggregate and Professional Liability Insurance of $1,000,000. Evaluation criteria allocate maximum points as follows: Technical Proposal and Mandatory Requirements (800 points), Cost Proposal (300 points), and optional Oral Demonstrations/Presentations (200 points), for a total of 1,300 possible points, with proposals scoring fewer than 480 points on technical evaluation being eliminated from consideration. Written questions were due by April 15, 2026, and the original proposal submission deadline of May 6, 2026, was extended via Addendum 1 to August 6, 2026, at 2:00 p.m. Eastern Time. The initial contract term is anticipated to run from November 1, 2026, through June 30, 2028, with the Commonwealth reserving the right to renew for up to two additional two-year periods subject to Secretary of Finance and Administration Cabinet approval and Legislative Research Commission Government Contract Review Committee filing.

The RFP does not specify set-aside designations or restrictions limiting which types of organizations may respond. The incumbent vendors are local Community Mental Health Centers (CMHCs) and Kentucky's 15 Area Development Districts (ADDs); however, DMS is consolidating services under a single statewide vendor, representing a significant transition from the current distributed model. The selected vendor must integrate with the Kentucky Online Gateway (KOG) system utilizing mandatory single sign-on (SSO) and single logout (SLO) functionality through ForgeRock's Security Token Service, comply with Commonwealth Office of Technology (COT) requirements including NIST Special Publication 800-53 moderate-level security controls, HIPAA requirements, and state-specific security standards, and meet a four-hour disaster recovery time objective with 24/7/365 system availability. The vendor must execute a Business Associate Agreement (BAA) compliant with HIPAA requirements and shall bear responsibility for all breach notification costs and HHS Office for Civil Rights penalties resulting from non-compliance. Although specific contract values are not disclosed in the available documentation, the cost proposal form requests pricing as a rate per member per month plus administrative costs per month, calculated against an estimated annual number of 16,750 waiver participants; the contract structure includes liquidated damages of $500 per business day for failure to meet specified time requirements and performance-based penalty structures up to 5 percent of contract value for non-performance across 34 penalty categories ranging from $50 to $30,000 per calendar day depending on violation severity.