Department of Human Services Response to Questions Submitted Regarding the MA LTC Access Study Posted February 21, 2012

Transcription

1 Background The Minnesota Department of Human Services (the Department) issued a Request for Proposals (RFP) on January 17, 2012 for A Qualified Contractor(s) to conduct an Evaluation and Develop Dashboard Measures Related to the Impact of Medical Assistance (MA) Long-Term Care (LTC) Rate Reductions on Recipients Access to LTC Services. The RFP required that responders questions be submitted in writing prior to 4:00 p.m. Central Time on February 15, 2012 (Section IV (A: Responders Questions)). The Department s responses to submitted questions are provided below. The questions are listed in the order in which they were received. Each question is listed as posed by the questioner. Questions and Answers 1. Q: Can the State provide information on any incumbent contracts that exist for the services listed in the RFP; including incumbent information (vendor name, term of contract, and amount of the contract)? A: The Department has determined that providing the requested information is not relevant to responders ability to respond to the RFP. 2. Q: Who is the decision maker(s) for the RFP process? Who will participate in decisions once the project gets underway? A: The Department s Continuing Care Administration issued the RFP. The Continuing Care Administration will be responsible for making decisions once the vendor has been selected. 3. Q: What are some characteristics you hope the evaluator possesses? From your experiences in working with other vendors, are there characteristics you ve found lead to a successful/not successful project? A: Please consult the RFP for this information (Section III (B: Technical Requirements Proposal) (3)). 4. Q: What is the most important thing that happens as a result of this project a milestone that s reached, a product created, etc. A: The purpose of this project and its required deliverables are provided in RFP Section II (A (Overview) and B (Tasks/Deliverables)). Page 1

2 5. Q: How do you expect change to happen as a result of rate changes? For example, will change happen slowly, over the 5 year period? Just once, and then stabilize? Or are multiple rate changes expected, so change might keep re-occurring? A: The RFP has been issued so that the selected vendor examines issues related to payment rate changes (per RFP Section II (A: Overview and B: Tasks/Deliverables)). 6. Q: Will we be looking at all services that might be impacted by rate changes? Or should we focus more on high incidence, or high cost services, or those that experienced the greatest rate change? A: The RFP lists all services that must be included in the analysis. Please consult RFP Section II (B:Tasks/Deliverables)(1)) for this information. 7. Q: How frequently do you anticipate the dashboard being updated? Some items will not be available in real time ; others might be. A: Responders can propose ideas and schedules related to the frequency with which dashboards are updated, within the resources made available for the project. Any proposed schedules should be incorporated into the work plan. 8. Q: Can you provide examples of what information is gathered through the county gaps analysis and provider survey? If additional information would be helpful, could we suggest modifications to these instruments? How frequently administered? A: Respondents are encouraged to consult DHS s public website for background information. For example, background information on the county gaps analysis can be found at: Information on the Waiver Review Project can be found at: N&RevisionSelectionMethod=LatestReleased&dDocName=dhs16_ The RFP states that the vendor must rely on existing data to the extent possible (Section II (B)). However, responders can propose ideas related to the collection of additional data and frequency of data collection, within the resources made available for the project. If the responder s plan calls for the collection of additional information, the responder should include all necessary costs associated with this data collection in the cost proposal. 9. Q: Do you anticipate rolling in choice and quality as measures in later years? A: The RFP specifies a project focus on the most basic measures of access (e.g., distance and time) and the development of operational dashboards (RFP Section II (A and B: Overview and Tasks/Deliverables)). Page 2

3 Page 3 Department of Human Services Response to Questions Submitted As a general guideline, the Department would expect that the first two project years would focus on basic access measures and include the development of dashboards. The Department would expect to roll out operational dashboards and/or consider the inclusion of broader access measures in year three. Responders can propose ideas and schedules related to defining access and developing dashboards, within the resources made available for the project and in accordance with the deliverables specified in RFP (Section II (B: Tasks/Deliverables)). Any proposed schedules should be incorporated into the work plan. 10. Q: Health plan-paid-providers are they required to ensure access? Are they required to provide data? Is there anything we need to know? A: Health plans are required to submit encounter claims to the Department. These claims typically include authorized and paid units and billed and paid costs. Please consult the RFP for additional background information regarding health plans (Section 1(C: Background)). Please consult the RFP for information about the managed care provider survey and encounter data (Section II (B: Tasks/Deliverables)). 11. Q: Do you have a license for a mapping software that you are anticipating the evaluator will use? A: The RFP does not require the use of any particular software. Responders can propose ideas in this area. If a responder s work plan calls for the use of any mapping software, the responder should include all necessary costs associated with the software in the cost proposal. The Department is currently using ARC GIS 10 as its mapping software. 12. Q: Is there a page limit for the technical proposal? A: No. There is no page limit for the technical proposal. 13. Q: Will the survey data described within Task 1 (e.g., waiver reviews, county gaps analysis, and linkage line data) be available electronically? A: Yes. Data will be available electronically for the waiver reviews, county gaps analysis, and linkage line data. 14. Q: Does Task 2 refer to a survey of managed care organizations or to a survey of direct service providers under contract with managed care organizations? A: Task 2 refers to a survey of managed care organizations. As stated in the RFP (Section II (B: Tasks/Deliverables)), the selected vendor will also be expected to

4 examine long-term care service use patterns using encounter data. Health plans submit encounter data to the Department. 15. Q: What are the expectations for Task 4, with respect to operationalization? Is there an expectation that the contractor will program software for DHS use? If so, what format is preferred? A: The Department has no expectations regarding program software. However, the Department does want to assure that developed dashboards are consistent and compatible with Microsoft Office Professional 2010, such as Excel or Access, so that dashboards are accessible to Department staff as needed. 16. Q: On page 6, the RFP says the it is beyond the scope of this study to incorporate broader measures of access, such as quality and consumer choice, at least initially. But the same section states that in examining access, the vendor must: Use the MA Access Requirement, per [42 USC Sect. 1396(a) (30) (A)]. The definition of this requirement (see page 4) appears to be broader in that it mentions efficiency, economy, and quality of care. Can the state clarify whether the proposal should be based on the more narrow definition? A: The RFP specifies a project focus on the most basic measures of access (e.g., distance and time) and the development of operational dashboards (RFP Section II (A and B: Overview and Tasks/Deliverables)). As a general guideline, the Department would expect that the first two project years would focus on basic access measures and include the development of dashboards. The Department would expect to roll out operational dashboards and/or consider the inclusion of broader access measures in year three. Responders can propose ideas and schedules related to defining access and developing dashboards, within the resources made available for the project and in accordance with the deliverables specified in RFP (Section II (B: Tasks/Deliverables)). Any proposed schedules should be incorporated into the work plan. 17. Q: In measuring access for managed care plans, is the state envisioning that the study would look primarily at utilization and geo-access (provider location, provider ratios, distance from provider, pharmacies, etc.) or can provider and member satisfaction, provider disenrollment or termination data be used also. A: The deliverable related to managed care providers is for the selected vendor to survey managed care providers regarding methods and data they use to assure access to long-term care services, and to examine long-term care service use patterns using encounter data (RFP Section II (B: Tasks/Deliverables)). Page 4

5 Responders can propose ideas and schedules related to the managed care deliverable, within the resources made available for the project. Any proposed schedules should be incorporated into the work plan. 18. Q: On page 6, the RFP asks the vendor to determine whether recipients ability to access the service changed in the last five years and to determine the extent to which the change was attributable to rate reductions and to what extent it is attributable to other factors. Are there specific other factors the vendor should consider or are these factors to be proposed by the vendor? A: Responders can propose ideas and schedules related to other factors to consider, within the resources made available for the project. Any proposed schedules should be incorporated into the work plan. 19. Q: Can the state clarify the years to be included in the study and indicate whether these are state fiscal years or calendar years? A: The initial years of study referenced in the RFP ( ) refer to calendar years. Over time it is expected that additional years will be added to the project. 20. Q: Referring to page 7, is the vendor expected to disaggregate all data by county? Or could the vendor look at regions or at urban/rural/ suburban groupings as an alternative? A: Responders can propose ideas and schedules regarding to the aggregation/disaggregation of data, within the resources made available for the project. Any proposed schedules should be incorporated into the work plan. 21. Q: Similar to item 5 above, what degree of granularity is required when looking at demographic characteristics? Are the demographic elements in the RFP related to disabling conditions and complex care, for example, illustrative or must the vendor give attention to them in the analysis? A: Responders can propose ideas and schedules related to the analysis of demographic characteristics, within the resources made available for the project. Any proposed schedules should be incorporated into the work plan. 22. Q: Who are the anticipated users of the access indicators? State program managers? Legislators? County program managers? Case managers? Service Providers? Other groups? A: The Department expects that access indicators will be developed for use by internal and external (public) audiences. The primary users are expected to be state and local program managers and other groups. Page 5

6 Page 6 Department of Human Services Response to Questions Submitted 23. Q: On page 6, the RFP refers to a standard definition of access for Medicaid services, specifically comparing availability between Medicaid recipients and the general population. Does Minnesota have data sources available that would allow the respondent to determine the access of the general population to the specific services listed in the RFP? Options may include a master (not only Medicaid) provider list, or a list of provider certifications. A: Responders can propose ideas and schedules related to long term care access measures and analysis, within the resources made available for the project. Any proposed schedules should be incorporated into the work plan. 24. Q: Does Minnesota track whether Medicaid providers covered by this RFP are accepting new clients? A: Through its eligibility and payment systems, the Department can track new publicly-funded long-term care recipients on its Medicaid program. 25. Q: Can the state describe each of the data sources that it anticipates that the vendor will need to analyze, such as: MMIS data, including any data in the provider file, Waiver review data, County gaps analysis, Linkage line. It would be very helpful to obtain data dictionaries or descriptions of core fields that are captured in the following data sources, descriptions of how they data would be transferred to the vendor, and a summary of any challenges the state anticipates that the vendor might have in cleansing and analyzing the data. A: Responders can propose ideas and schedules related to data sources, data transfer, data cleansing and data analysis within the resources made available for the project. Any proposed schedules should be incorporated into the work plan. Respondents are encouraged to consult DHS s public website for background information. For example, background information on the county gaps analysis can be found at: Information on the Waiver Review Project can be found at: ON&RevisionSelectionMethod=LatestReleased&dDocName=dhs16_ Q: Can the state describe what data is provided as part of Medicaid encounter data? A: Health plans (managed care providers) are required to submit encounter claims to the Department. These claims typically include authorized and paid units and billed and paid costs. 27. Q: Has the state received encounter data from the managed care plans? If yes, what level of effort was necessary to cleanse the data so that it was possible to make comparable analyses across plans?

7 A: The deliverable related to managed care providers is for the selected vendor to survey managed care providers regarding methods and data they use to assure access to long-term care services, and to examine long-term care service use patterns using encounter data (RFP Section II (B: Tasks/Deliverables)). Responders can propose ideas and schedules related to data cleansing, within the resources made available for the project. Any proposed schedules should be incorporated into the work plan. 28. Q: How has the state implemented legislatively required provider rate reductions for the following programs? For each it will be helpful to know: a) Were the approaches to implementing rate reductions of the last several years standard throughout Minnesota, or did individual counties determine the size and scope of those reductions? B) If individual counties set different policies, what options were available to them for dealing with budget reductions (rate cuts for some services but not others, across the board cuts, changing rate structures, etc.)? c) If different approaches were used in different counties, does the state have a list of the options chosen by each county? Fee for service HCBS waivers--nursing facility- -ICF/DD PCA--Home health--long term care provided under managed care (e.g., changes to capitation, etc.) A: Yes, the state has implemented legislatively-required provider payment rate reductions. These reductions are statewide and across-the-board, regardless of county and provider type. Whenever Medical Assistance payment rates are reduced or changed for the Elderly Waiver or Personal Care Assistant Program, adjustments are made to both the fee-for-service and managed care capitation payment rates. 29. Q: What is the implementation status concerning standardized rate methodologies for HCBS waiver providers? A: The Home and Community-Based Services Waiver provider standardized rate methodology initiative will not be initiated until January 2013 and therefore initially will not be a factor in this project. 30. Q: What legislatively imposed limits on access (e.g., slots limits) to HCBS waivers have occurred since in the five years covered by the study? A: Several disability Home and Community-Based Waiver programs have imposed limits on enrollment during , including the Community Alternatives for Disabled Individuals (CADI) Waiver, the Brain Injury (BI) Waiver and the Developmental Disabilities (DD) Waiver. These limits have varied by waiver program, year, and would be a factor in the analysis. Page 7

8 31. Q: Have any changes occurred during the five years in the Medicaid State plan criteria describing the threshold individuals must meet to qualify (e.g., level of care) for the following: HCBS waivers, NF, ICF/DD and PCA. A: Medicaid State Plan access thresholds were changed for the Personal Care Assistant Program on Jan. 1, The Medicaid State Plan access thresholds were not changed for the other programs mentioned. 32. Q: If no changes to Medicaid State Plan criteria in item 5 above have occurred, has the state made any changes during the five years in how it applies the criteria that may have affected who can access the services mentioned? A: Medicaid State Plan access thresholds were changed for the Personal Care Assistant Program on Jan. 1, The Medicaid State Plan access thresholds were not changed for the other programs. 33. Q: How often does the state collect and analyze data regarding waiting lists for the HCBS waiver services managed through county agencies? A: The Department updates Home and Community-Based Services Waiver data on a monthly basis. 34. Q: Does the state collect and analyze similar data from managed care entities? A: No. The Department does not collect similar (waiting list) data from managed care entities. 35. Q: For Appendix G-1, if a consulting firm or a subcontracting consultant typically uses a weighted hourly rate for proposals, is it allowable to combine rows 1, 2, 9 and 10 into a single line item? A: Yes, combining rows 1, 2, 9 and 10 on RFP Appendix G-1 is allowable if the firm or subcontracting consultant typically uses a weighted hourly rate. However, each individual/type of consultant should be listed in Appendix G-2 (as noted in the RFP) and responders should indicate they are using a weighted hourly rate. 36. Q: Would DHS consider extending the proposal due date beyond March 5, 2012? A: No. 37. Q: Nursing facilities and the number of providers are listed in the table on page 4 but nursing home rates were not reduced. Are they part of this project? A: Medical Assistance State Plan residential services, including nursing facilities, are included, as specified in RFP Section II B (Tasks/Deliverables). RFP Section II B (Tasks/Deliverables) lists all services that must be included in the analysis. Page 8

9 38. Q: Were rates reduced for both managed care and fee for service providers for the waiver populations? A: Whenever Medical Assistance payment rates are reduced or changed for the Elderly Waiver program or Personal Care Assistant Program, adjustments are made to both the fee-for-service and managed care capitation payment rates. 39. Q: It is unclear whether managed care access review is part of this SOW or if it falls entirely under the CMS review. Can you clarify whether managed care access should be included in this project? A: The selected vendor is required to survey Minnesota Health Care Plan managed care providers regarding the methods and data they use to assure access to long-term care services and to examine long-term care services use patterns using encounter data. Please refer to RFP Section II B (Tasks/Deliverables). 40. Q: Can you please clarify whether there has been one or several rate reductions over the past 5 years? Did the rate reductions and amounts vary by provider? A: There have been overall rate reductions for long-term care services as well as targeted rate reductions for specific services. Overall, long-term care services received a 2.58% reduction in state fiscal year 2010, and 1.5% reduction in state fiscal year There were also more targeted reductions related to customized living and congregate care for people with lower needs. 41. Q: CMS has provided guidance to states on protections of rate reductions for Indian health providers. Are Indian health providers and other BIA services part of this project? A: Indian health providers and other Bureau of Indian Affair services are not part of this project unless they have received long-term care service payments through the state s fee-for-service payment system. The scope would be limited only to long-term care access (RFP Section IIB (Tasks/Deliverables)). 42. Q: On page 6 it states an activity is to assist the state in developing dashboard measures (and related processes as appropriate) for monitoring LTC access, assist issues and trends. What is the definition of processes? Is it access to users, data entry requirements, reports? A: Responders can propose ideas and schedules related to defining processes, within the resources made available for the project. Any proposed schedules should be incorporated into the work plan. Page 9

10 43. Q: Task 1 clearly requires the design and content of the dashboard. Task 2 is the development of an operationalized dashboard. Does the State anticipate actively using the dashboard during the period of performance of this project or is the active rollout anticipated in year 3? Who is the intended audience for the dashboard? A: The RFP specifies a project focus on the most basic measures of access (e.g., distance and time) and the development of operational dashboards (RFP Section II (A and B: Overview and Tasks/Deliverables)). As a general guideline, the Department would expect that the first two project years would focus on basic access measures and include the development of dashboards. The Department would expect to roll out operational dashboards and/or consider the inclusion of broader access measures in year three. Responders can propose ideas and schedules related to defining access and developing dashboards, within the resources made available for the project and in accordance with the deliverables specified in RFP (Section II (B: Tasks/Deliverables)). Any proposed schedules should be incorporated into the work plan. The Department expects that that dashboard measures will be developed for use by internal and external (public) audiences. The primary users are expected to be state and local program managers. 44. Q: The primary question is about access. Is the State also interested in the consumer s satisfaction with access? A: The RFP specifies a project focus on the most basic measures of access (e.g., distance and time) and the development of operational dashboards (RFP Section II (A and B: Overview and Tasks/Deliverables)). As a general guideline, the Department would expect that the first two project years would focus on basic access measures and include the development of dashboards. The Department would expect to roll out operational dashboards and/or consider the inclusion of broader access measures in year three. Responders can propose ideas and schedules related to defining access and developing dashboards, within the resources made available for the project and in accordance with the deliverables specified in RFP (Section II (B: Tasks/Deliverables)). Any proposed schedules should be incorporated into the work plan. 45. Q: Are the issues of quality and consumer choice of interest to MN in the out years if funding is continued? Page 10

11 A: The RFP specifies a project focus on the most basic measures of access (e.g., distance and time) and the development of operational dashboards (RFP Section II (A and B: Overview and Tasks/Deliverables)). As a general guideline, the Department would expect that the first two project years would focus on basic access measures and include the development of dashboards. The Department would expect to roll out operational dashboards and/or consider the inclusion of broader access measures in year three. Responders can propose ideas and schedules related to defining access and developing dashboards, within the resources made available for the project and in accordance with the deliverables specified in RFP (Section II (B: Tasks/Deliverables)). Any proposed schedules should be incorporated into the work plan. 46. Q: Is the data for access of Individual Personal Care Assistants (n=80,113)? This group might have a different set of other factors. A: The state Medicaid program requires that individuals enroll as individual personal care assistants (PCAs). The figure of 80,113 represents the enrollment of individuals as individual PCAs. PCAs are employed by PCA provider organizations (PCPOs) or Home Health Care Organizations. Responders can propose ideas and schedules related to incorporating the implications of the proposed rule, within the resources made available for the project. Any proposed schedules should be incorporated into the work plan. 47. Q: Task 2 on page 7 indicates that, in addition to surveying MHCP managed care providers the contractor will examine LTC service use patterns using encounter data. Is this separate and removed from MMIS claims and utilization data. A: The Department will provide managed care encounter claims data as part of the MMIS claims and utilization data. 48. Q: Page 7, Section II.B.4: The operational dashboard in Deliverable 4 discusses real-time access issues. a. Q: Is the operational dashboard expected to be a technical reporting solution on the State s intranet or possibly on a public internet site? A: The Department expects that that dashboard measures will be developed for use by internal and external (public) audiences. The primary users are expected to be state and local program managers. b. Q: If so, are design, development, and implementation funds for the technical solution considered included in this award? Page 11

12 Page 12 A: Design, development and implementation funds are considered part of this award, per the time noted below: The RFP specifies a project focus on the most basic measures of access (e.g., distance and time) and the development of operational dashboards (RFP Section II (A and B: Overview and Tasks/Deliverables)). As a general guideline, the Department would expect that the first two project years would focus on basic access measures and include the development of dashboards. The Department would expect to roll out operational dashboards and/or consider the inclusion of broader access measures in year three. Responders can propose ideas and schedules related to defining access and developing dashboards, within the resources made available for the project and in accordance with the deliverables specified in RFP (Section II (B: Tasks/Deliverables)). Any proposed schedules should be incorporated into the work plan. c. Q: Would the State be hosting a production solution on State hardware? A: The Department would expect that whatever solution is developed would be compatible with State hardware and software or easily transferred to hardware/software used by the State. d. Q: Would maintenance of this solution be considered part of this award? A: The selected vendor is expected to provide ongoing data and information to update dashboards on a format prescribed by the Department. Once the dashboards are transferred to the Department, the vendor will not be required to maintain hardware or software. Responders can propose ideas and schedules related to dashboard maintenance, within the resources made available for the project. Any proposed schedules should be incorporated into the work plan. e. Q: Does the State have existing dashboard solutions that could be used to support the objectives of this procurement? A: At this time the State does not have an existing dashboard solution for this project. Responders can propose ideas and schedules related to operationalizing dashboards, within the resources made available for the project. Any proposed schedules should be incorporated into the work plan. 49. Q: Page 9, Section III.B.3: If subcontractors are proposed as part of our team, is it acceptable to provide reference for subcontractors in addition to our own references?

13 A: It is acceptable and helpful for responders to include references for subcontractors, particularly if subcontractors are expected to contribute a particular expertise. 50. Q: Page 18, Section VI.C provides guidelines for travel reimbursement. It is not clear whether an out-of-state contractor s travel expenses to State offices are acceptable to include in our budget. Should we break out travel expenses to/from State offices separately or should these costs be incorporated into our hourly rates? A: Responders can include travel costs that are necessary to fully carry out the contract agreement. If travel expenses are included, they should be listed separately (e.g., under other costs: list in RFP Appendix G-I). 51. Q: Page 36, Appendix G-1: Our hourly rates are inclusive of fringe benefits, supplies/equipment, indirect costs, and fees. Is it acceptable to leave those budget line items blank and provide an explanation that these costs are included in Line 1? Please clarify Line 8 s requirement to attach a separate Budget Summary for each subcontractor. Are you seeking a narrative description of subcontractor expenditures or a separate Table G-1 for each subcontractor we propose? A: Appendix G-1 is the overall budget for the project. It includes the vendor s and the subcontractor s costs. The vendor s costs must be provided using the line item categories in G-1. The total costs of subcontracts should be entered in line 8. For each subcontract, the responder should provide budget line item detail (using the line items in G-1). The State Time Allocation (Appendix G-2) must include both the vendor s employees and contracted staff working on the project. The cost per hour is the hourly amount charged for that employee or contracted staff. Typically the cost per hour includes personnel and other costs (e.g., equipment, supplies, etc.) 52. Q: Will there be 2011 bi-annual Long Term Care Gaps Analyses data or a report available? A: The 2011 bi-annual Long-Term Care Gaps Analysis data and report will not be available in the near future and therefore will not be available for analysis in this project, at least initially. 53. Q: Does the State license analytical software such as SAS, ARC GIS, or other packages that DHS would expect the vendor to use, or would the State prefer the vendor provide its own analytical toolsets? Page 13

14 A: The State s mapping software is ARC GIS 10. The Department would expect the selected vendor to use software that is similar and compatible to facilitate easy transfer of information. 54. Q: Are all data elements from Service Agreements available in your MMIS; and for how many years is this available? If not, what data elements from Service Agreements are in the MMIS or available from another system? A: Service agreement data is available in MMIS for the years for , for those recipients for whom service agreements were required. 55. Q: Does your provider file for all provider types listed in your RFP include a code for location of the agency or facility and any of its affiliates? A: Certain services such as nursing facilities can be identified by location using the provider number. For other providers, information on the county of service is available. 56. Q: Does the claim include a code for the physical location of the agency, or its affiliate that renders the service? A: MMIS claims data includes the provider identification number of the agency that is providing the services. The provider number includes the address of the agency that is billing for services. Other MMIS information includes the county where the service is provided. 57. Q: Are the Individual Personal Care Assistants listed in the table enrolled as providers; do they bill under their own provider number? A: Personal Care Assistants (PCAs) bill for their services under an organization provider number, such as the provider number for a Personal Care Provider Organization. PCAs do not bill as an independent provider number. 58. Q: Please clarify the scope of work as it relates to the proposed rule, Methods for Assuring Access to Covered Medicaid Services, issued on May 6, 2011 (42 CFR Part 447). A: Responders can propose ideas and schedules related to incorporating the implications of the proposed rule, within the resources made available for the project. Any proposed schedules should be incorporated into the work plan. 59. Q: Will the information transfer between the state and the contractor require a Business Associates Agreement? Is there an example available for review? A: A sample Professional and Technical Service contract is provided in RFP Appendix I. This contract incorporates information privacy and security Page 14

15 requirements. Therefore a separate Business Associates Agreement is not needed. 60. Q: In terms of the timing of deliverables in the first year, is there an expectation that the dashboard measurement system will be completed first year or is that a year 2 deliverable? A: The RFP specifies a project focus on the most basic measures of access (e.g., distance and time) and the development of operational dashboards (RFP Section II (A and B: Overview and Tasks/Deliverables)). As a general guideline, the Department would expect that the first two project years would focus on basic access measures and include the development of dashboards. The Department would expect to roll out operational dashboards and/or consider the inclusion of broader access measures in year three. Responders can propose ideas and schedules related to defining access and developing dashboards, within the resources made available for the project and in accordance with the deliverables specified in RFP (Section II (B: Tasks/Deliverables)). Any proposed schedules should be incorporated into the work plan. 61. Q: Apart from publicly available data, can the State describe the type of data that will be available to the contractor to perform the tasks and services requested under the RFP? For example, how many years are available, what sample size, longitudinal or cross-sectional, at what level of detail, e.g. patient, facility. A: The RFP specifies that service access be examined for the years (Section II (B Tasks/Deliverables)). MMIS claims data is available for this five year period and includes client specific and provider specific information. Other sources of existing data are listed in RFP Section II (B (Tasks/Deliverables)). 62. Q: How many years of utilization data does the State have? Is the information at the patient and clinical level of detail? A: The RFP specifies that services access be examined for the years (Section II B). MMIS claims data is available for this five year period and includes client specific and provider specific information. 63. Q: Does the clinical detail include co-morbidities or primary diagnosis only? A: MMIS claims data includes primary diagnosis information. 64. Q: Can the utilization data between facility, physician and pharmaceutical expenses be tracked for the full time period that data is available for? Page 15

16 A: MMIS claims data provides data by facility and provider and can be tracked for the entire period of time. It should be noted that the purpose of the project relates to access to long-term care services. 65. Q: Does the state have financial records for the past 5 or more years for each company/provider referenced in the table of the 7 categories of Medicaid Waiver provider types? Do these financial records also include other sources of revenue these providers may have been able to develop in the wake of the State s cuts? A: Financial records are available for nursing facility. Financial records of other providers are not available. 66. Q: Has the State performed a GeoAccess report for its own employee health plan? What standards of access has the state used in the selection of vendors for its own State plan? A: The Department has determined that providing the requested information is not relevant to responders ability to respond to the RFP. 67. Q: Will the State encourage or support interviews of market stakeholders to gauge their reaction and/or strategic business decisions sparked from the reduced reimbursements? A: The RFP states that the vendor must rely on existing data to the extent possible (Section II (B)). However, responders can propose ideas related to the collection of additional data and frequency of data collection, within the resources made available for the project. If the responder s plan calls for the collection of additional information, the responder should include all necessary costs associated with this data collection in the cost proposal. 68. Q: Does the State expect to rely on this analysis and the subsequent year s ongoing support in any legal-related activity? Alternatively, is the State planning to use or report the results of the analysis to outside/third parties? A: The selected vendor is required to submit periodic and annual reports to DHS and to provide reports and updates to internal and external stakeholders (RFP Section II (B: Tasks/Deliverables)). It is expected that annual reports would be public information. 69. Q: Can you elaborate on the factors that will determine whether the option to extend for additional periods after the initial two year study will be exercised? A: It can be expected that the same criteria used as a condition of payment in the sample contract (RFP Appendix I) would apply to extending the contract (i.e., satisfactory performance in accordance with laws, rules, etc.). Page 16

17 Satisfactory performance typically includes such factors as completion of deliverables, quality of work, responsiveness to requests, and flexibility in working with the State. Page 17