RFP-Managed Care at YSCs

The Colorado Department of Human Services, Division of Youth Services (DYS) is soliciting proposals for managed medical care services through RFP IHHA 2026000150 for Pueblo County and statewide delivery across 12 secure youth services centers serving youth ages 10-21. The procurement seeks integrated managed medical care services including medical, mental health, dental, and pharmacy services; claims processing; specialty network administration; and direct physician services for youth in state custody. Key service deliverables include weekly on-site physician services at each facility, 24/7 on-call physician coverage, utilization management and concurrent review services, psychiatric services through board-certified child and adolescent psychiatrists, a dedicated full-time RN position for quality management, comprehensive specialty provider networks with pharmacy guarantees of 48-hour on-site medication delivery and four-hour stat order fulfillment, and administrative reporting including monthly cost projections, IBNR analysis, and year-end reports due by October 1. The contract period runs from July 1, 2026, through June 30, 2027, with four optional one-year renewal periods. Required qualifications include HIPAA covered entity status or ability to execute a Business Associate Addendum, registration in CORE and SAM.gov, E-Verify compliance, and successful criminal background checks for personnel with direct youth contact. Proposals must not exceed 65 pages and are due electronically by April 7, 2026, at 10:00 a.m. Mountain Time; questions are due by March 17, 2026; and public opening occurs April 7, 2026, at 10:30 a.m. via Google Meet. Vendors must submit the Budget with Justification Form (Exhibit C) with detailed cost estimates for all managed care components, and the state will conduct secondary reviews and override authorizations as deemed appropriate.

The RFP documents do not identify set-aside designations, disadvantaged enterprise restrictions, or incumbent vendor information. However, the RFP indicates that behavioral health and medical providers are currently supplied through state full-time employees and are not part of this RFP, though the contract includes five part-time contracted psychiatrists to serve all locations and physician time from the current vendor, suggesting some incumbent service delivery structure exists. Vendors must comply with all state contracting terms and conditions as outlined in Exhibit D, maintain comprehensive insurance coverage including workers' compensation, general liability ($1,000,000 minimum), professional liability, crime insurance, and cyber liability insurance, and implement double-entry accounting systems compliant with generally accepted accounting principles. Contractors receiving $400,000 or more annually must undergo independent audits with results submitted within six months of fiscal year-end. Historical utilization data shows medical, mental health, dental, and pharmacy costs of $2,945,214.61 in FY 2024 and $3,672,299.54 in FY 2025, with offsite hospitalization and specialty referral claims totaling $2,336,428.10 in FY 2025, providing reference points for budgeting; however, specific award values or budget ranges are not stated in the RFP documents, with reimbursement based on actual monthly expenditures requiring vendors to manage cash flow independently.