State of Arkansas Department of Human Services, Division of Medical Services

Transcription

1 Questio n# Question Response 1 It is our understanding that the State intends to issue an RFP for Behavioral Health Provider Education and Credentialing (Arkansas Center for Provider Resources) services in the near future. Would the Contractor who is awarded this procurement (Behavioral Health Assessments) be precluded from submitting a response to the Arkansas Center for Provider Resources RFP? Yes. Due to the Centers for Medicaid and Medicare s (CMS) 1915(i) regulations, the Independent Assessment must be conflict free. 2 3 Section 4.3, Cost Proposal Requirements, refers to a cost proposal and submission of a price. However, there is no cost proposal template provided to guide bidders regarding the method of submission other than a reference to a final negotiated rate. How should the pricing be submitted? Should the pricing be submitted on a per assessment basis or total annual cost basis? Please elaborate or provide a cost proposal template that bidders can use for submission. Attachment A, Professional Services Contract and Attachment C, Professional Consultant Services Contract appear to be general-use State contracts that are not specific to the scope of work identified in this particular RFP. Specifically, there are financially oriented grids (Attachment A, bottom of page 1, Attachment C 4.B. Calculations of Compensation) that do not appear to be applicable to this RFP. For example, on the first page of Attachment A, how would bidders submitting a proposal complete information such as Funding Source, Reimbursement Method, Payment Limitations, Match Requirements? Attachment C, section 4B. appears to relate to rates for consulting personnel as well as reimbursable expenses. Are bidders expected to complete this? What if bidders are not engaging consultants, using their own staff instead? A cost proposal sheet has been developed to assist in the submittal of pricing. See Addendum A. Attachments A and C are for reference only. Attachment A is a copy of the Department of Human Services (DHS) Standard Terms and Conditions that will be attached to any awarded contract. Attachment C is a copy of the standard Professional Consultant Service contract that will be issued if a contract is awarded. Neither document is to be completed in response to this RFQ. Page 1 of 31

2 Section Price Warranty. By submitting a proposal under this RFP, the respondent warrants their agreement to the pricing methods. Please provide a definition of pricing methods. Pricing Method is Final Negotiated Price See Section and Addendum A. 4 Section Price. The price will include a cost analysis to support the reasonableness of the price. Please elaborate on what is expected in the cost analysis. Any allowable cost associated with developing the price of the individual assessments presented in the cost proposal Section 1.1, Purpose. Bullet point #9 states that the Contractor processes are to include, Providing clients with DBHS home options and assisting with assignment. Will the State clarify the role the Contractor will play in assisting with assignment? Section 1.4, Scope of Services; General Requirements. This section states, The selected Contractor will hire or contract with a board eligible or board certified physician to provide clinical and medical consultation. Will the State provide more detail on the anticipated effort by this physician to fulfill this consultation role? Section 1.1 states Providing clients with behavioral health home options and assisting with assignment as a part of the Independent Assessment process. If the assessed individual is designated as needing behavioral health home services, the Contractor will provide the individual with behavioral health home options in the individual s geographic region and any other necessary assistance for the individual to choose a health home. The Contractor will then assign the individual to a behavioral health home. The Physician consultant will provide clinical consultation as needed regarding complex needs and historical information, clinical data provided, and assessment process. Additionally, the Physician consultant will be available to communicate and collaborate with existing providers, PCMHs, and behavioral health homes. Page 2 of 31

3 8 9 Section 1.4, Scope of Services; General Requirements. This section states, The Contractor may also conduct assessments utilizing telemedicine. The selected Contractor must follow standards as outlined by DMS. Please confirm that the standards referred to here are found in Telemedicine (Interactive Electronic Transactions) RSPMI Services. If this is correct, can the State provide clarification on the following: a. What is the Arkansas TeleHealth Network (ATN) recommended audio and video standards for realtime, two-way interactive audiovisual transmissions? b. The requirement that, Transmitted picture frame rate capable of 30 frames per second at 384Kbps and the transmitted picture frame rate is suitable for the intended application. What is the application referred to here? c. The requirement that we use, UL and FCC Class A approved equipment. What do the initials UL represent? d. Will the State provide an estimate of how many DBHS providers are certified to use telemedicine currently? Section 1.4, Scope of Services; Time Frames. Will the State provide the Contractor a list of the 25,000 Medicaid-enrolled persons receiving DBHS services on day one of the program? Otherwise, how can the Contractor commit to performing 40 percent of the annual total within six months? a.) The standards are as follows and are located in the RSPMI Medicaid Manual at , A., B., C., and D. Minimum bandwidth of fractional T1 (728 kilobytes); Screen size of no less than 20 inch diagonal; Transmitted picture frame rate capable of 30 frames per second at 384Kbps and the transmitted picture frame rate is suitable for the intended application; and All applicable equipment is UL and FCC Class A approved. b.) The application referred to in the current policy is the provision of behavioral health services via telemedicine. With the IA, the application would be the independent assessment. c.) UL is the abbreviation for Underwriters Laboratories. d.) There are currently 16 agencies that have 130 total approved RSPMI telemedicine sites. DHS has approximated that 25,000 assessments will be necessary over the course of a calendar year. This approximation includes anticipated unresponsiveness, training time, and other challenges. Through risk stratification, DHS will provide approximately 25,000 individuals to be assessed throughout the first twelve months. DHS will ensure the selected Contractor is provided with an efficient number of beneficiaries to reach the 40% goal. Additionally, DHS will monitor the number of individuals assessed throughout the contract period. Page 3 of 31

4 10 Section 1.4, Scope of Services; Training. Is there any cost to the Contractor for the training provided by DHS The initial training will be provided by DHS. Necessary trainings beyond the initial training will not be provided by DHS. Please see Section 4.1 of the RFP. 11 Section 1.4, Scope of Services; Time Frames. The State has included, Adults involved in the criminal justice system and Clients identified and referred by DBHS in the list of priority populations. Will the State provide an estimate of how many individuals would fall into each of these groups annually? DHS is unable to approximate this figure at this time 12 Section 1.4, Scope of Services; Population to be assessed. How is the beneficiary notified of their Tier based upon the CoCentrix system and does the Independent Assessor have any role in that notification. Based on the level of need, if the individual is assigned to a behavioral health home, the Contractor will communicate the results of the assessment to and consult with the behavioral health home. 13 Section 1.4, Scope of Services; Partial Assessments. Do partial assessments (i.e., those that are stopped prior to being fully completed) count towards the 25,000 and the requirement to perform 40 percent of assessments within the first six months No. 14 Section 1.4, Scope of Services; Management Information System. This section states, The selected Contractor will participate in the State Health Alliance for Records Exchange (SHARE), the statewide interoperable health information exchange. What is the process of participation? If all assessment data is loaded directly to the State s Web-based system through CoCentrix, please clarify what type of data the contractor would be expected to supply and/or support the In order for the assessor to receive secured collateral information on the patient being assessed, it will be necessary for them to receive the patient s EMR. This can be done in multiple formats; however, utilizing one platform and having that interface in place is necessary. This HIE will also be used to exchange EMR information from the selected Contractor to the Behavioral Health Home when necessary. Page 4 of 31

5 statewide HIE. Is there specific information the Contractor is required to contribute to SHARE? 15 Section 1.4, Scope of Services; Interview Methodology. This section states, Interpreters must be available face-to-face. Will ensuring an interpreter is available through a telemedicine connection meet the face-to-face requirement? Yes, utilization of telemedicine for interpreter services is acceptable. 16 Section 1.4, Scope of Services; Management Information System. To ensure compliance with the client s hardware requirements, how often are the base hardware/software requirements reviewed and updated? How will changes in requirements be communicated, and how far in advance? Hardware baselines will be evaluated on an annual basis. Hardware and requirements will be reviewed and updated as needed or minimum of every three years. Baselines will be managed and maintained by the DHS network team. Any changes to requirements for servers or hardware will need to be reported by the vendor to the network engineering team. 17 Section 1.4., Scope of Services; Licenses. This section states, The selected Contractor will be responsible for obtaining necessary licenses to conduct assessments. Licenses may include a variety of software licenses. Can the State provide a list of software licenses that they will require the Contractor to obtain? The Contractor will be required to obtain a Microsoft Office License. The Contractor will also be responsible for obtaining each assessor a basic non-adhs employee access CoCentrix license. The Contractor will be responsible for the license cost and any annual fees associated with that. Annual maintenance is escalated at 5% per year. Basic Access provides full read write access to all functions including customized processes defined by Full users. Can create local reports and dashboards, but these cannot be shared. Users that will be developing Care Plans, Conducting Assessments, and Reporting Outcomes, Progress Notes will need this access. Does not include EHR functions. Page 5 of 31

6 18 Section 1.4, Scope of Services; Appeals. The information entered from the interrai and fed into the CoCentrix system determines the Tier and the Independent Assessor does not have any role in that determination. Please clarify the Independent Assessor s role in the appeals process? The selected Contractor must be available to participate in the appeals process. This may involve attending hearings or answering questions regarding the assessment process and assessment findings. 19 Section 1.4, Scope of Services; Reporting Requirements. Will the Contractor be required to report on any elements entered off the interrai into the CoCentrix system or is it DHS expectation that our reporting responsibilities are focused on capturing key data points in regards to contacts attempts, number of completed assessments, and other operational items? The Contractor s reporting responsibility will be focused on operational components. 20 Since referrals will come directly from providers, how prepared will they (providers) be to make referrals and provide reliable contact information by start-up date? Referrals will be made by providers on an on-going basis and therefore not all referrals will be made prior to the start-up date. Will the Business Associate Agreement cover the permission from guardian s issue as it has for similar DHS assessment projects Unable to respond due to the ambiguity of the question. 21 Can a number be provided of DBHS Beneficiaries by DHS regions and/or county? DHS is unable to approximate this figure at this time. 22 Page 6 of 31

7 23 Section 1.1 #9; Please explain what this means, Providing clients with DBHS home options and assisting with assignment.... This is not referenced in Attachment D, Performance Indicators. See response to Question 6. Section 1.4 page 5, paragraph 7; Is White Hall, AR within the geographical boundaries of the Little Rock, AR metropolitan area? No. 24 Section 1.4, page 5, 1 st paragraph; Will a psychiatrist qualify as a Board Certified Physician Yes, as long as the Psychiatrist is Board Certified Section 1.4, Time Frames page 6 Paragraphs 6; How do priority populations differ from those beneficiaries identified on page 6, paragraph 7, as those who are thought to need a change in tier assignment? Under paragraph 7, groups a, b, e and f. Are these trigger groups; or could they be individuals of longstanding in their given category? See Section 1.4. Priority populations include but are not be limited to: a. Youth involved in the juvenile justice system b. Individuals involved in the foster care system c. Individuals discharging from acute hospital stays d. Individuals discharging from crisis residential stays e. Adults involved in the criminal justice system f. Clients identified and referred by DBHS Priority populations differ from but can include individuals experiencing a trigger event or in need of a change in tiers. Page 7 of 31

8 Section 1.4 Interview Methodology, page 8 1. Paragraph 2; The selected contractor will be responsible for obtaining the InterRAI user manual. Does this mean manuals will not be provided by DHS for the initial training? 2. Paragraph 6; Regarding locations for assessments. Will assessors be allowed to secure and use locations/facilities other than those listed? 3. Paragraph 7; Will interpreters be provided by DHS? Section 1.4 Interview Methodology, page 9, paragraph 1; 1. Is this a routine activity? 2. How are results communicated? 3. Please clarify if this means up to five reports are expected. Is report generated by the software? 4. Will Tier Recommendations be produced in the report generated by the software Section 1.4 Licenses, page 9; Can examples be given of types of software which may require licensing 1. InterRAI user manuals will not be provided by DHS. The selected Contractor will be responsible for purchasing the InterRAI user manuals. 2. The location of the assessment must be mutually agreed upon by assessor and beneficiary. See Section 1.4 Interview Methodology Paragraph 4. Confidentiality and privacy must be a priority in selecting a location. 3. No. The Contractor will be responsible for hiring or contracting with interpreters. 1. Yes, The selected Contractor will communicate results of the assessment and the independent assessment report with the beneficiary, the beneficiary s guardian when applicable, the beneficiary s providers, the beneficiary s PCP, and, when applicable, the beneficiary s Behavioral Health Home. on a routine basis. 2. Communication can be conducted in a variety of means, for example telephonically or verbally. 3. Question regarding the need for five reports is unclear. 4. The Independent Assessment Report will be generated by the web-based platform, not the Contractor. The Independent Assessment Report will provide Tier designations. See response to question 17. Page 8 of 31

9 30 31 Section 1.5 Contract Duration; This is only for six months. Please clarify. This is in apparent conflict with paragraph 1 under heading Time Frames in Section 1.4 on page 6. Section 3.9 If subcontractors will consist of qualified individuals and not agencies, hiring of subcontractors will not occur until after the award has been made. Is this an allowance to the requirement of statements from said subcontractors as specified in paragraph 2 of Item 3.9. Selected Contractor must complete at least 40% of the approximately 25,000 assessments by end of 6 month period. If Contractor continues into the next State Fiscal Year, then the 12 month completion rate shall be accomplished in the subsequent 6 month period. DHS policy does not allow contracts to extend past State Fiscal Year (July 1 June 30 th ). Initial term will be from contract start through June 30, 2015 and extensions will be granted on a 12 month basis after the initial term. See Section 1.5. Yes 32 Attachment D, Program Deliverable C- Performance Indicators #2 and #3; Will DHS provide updated information on beneficiaries continuing in services? The Contractor will be notified by the DHS or will receive a referral from the individual s current behavioral health provider or primary care physician when a reassessment is necessary. 33 Will the AR DHS be handling all licensure for the interrai CMH and Child and Youth Mental Health questionnaires? Yes, Contractor will not be responsible for purchasing any interrai license. State contractual rules/guidelines will apply to Contractor s use. Page 9 of 31

10 What percentage or how many referrals come from the risk stratification grouper and how many from the provider? DHS is unable to approximate this figure at this time; however, the initial risk stratification pull from the grouper is estimated to be approximately 25, Can they provide a breakdown of beneficiaries by adult, youth and adolescent? Based on Medicaid claims data from 2011, approximately 110,000 individuals received Medicaid reimbursable behavioral health services. Of those individuals, approximately 80,000 are youth and 30,000 are adults. 36 Can they provide a breakdown of beneficiaries by location (i.e. receiving services at home, receiving services in a hospital, receiving services in jail or youth detention center, receiving services in a treatment facility)? DHS is unable to approximate this figure at this time. 37 Are beneficiaries required to complete an assessment in order to receive services and/or receive reimbursement for services? To receive Medicaid reimbursable Tier 2 or 3 services, all beneficiaries will require an assessment. What is the number of new beneficiaries per year DHS is unable to approximate this figure at this time. 38 Page 10 of 31

11 What proportion of beneficiaries do they anticipate will agree to an assessment? What is the typical completion rate? DHS is unable to approximate this figure at this time What proportion of beneficiaries will need re-assessments? What proportion of beneficiaries will continue to utilize services and what proportion are thought to need a change in tier? All beneficiaries continuing to receive Tier 2 or 3 services will require an annual reassessment. DHS is unable to approximate this figure at this time. What percentage is reassessed due to a trigger event? DHS is unable to approximate this figure at this time Does a beneficiary have to complete a reassessment in order to continue to receive services and/or receive reimbursement for services? All beneficiaries continuing to receive Tier 2 or 3 services will require an annual reassessment. 43 The RFP states the contractor must contact the beneficiary within 48 hours of referral. Does this mean that the first telephonic attempt to contact the beneficiary must be made within 48 hours of the referral? Yes. Page 11 of 31

12 What percentage of referrals will be in the priority population? What percentage of assessments does this represent? DHS is unable to approximate this figure at this time. 44 Can they breakdown the priority population by location (justice system, foster care, hospital, residential care)? DHS is unable to approximate this figure at this time. 45 The RFP states that the DHS will conduct the initial training. How do they define initial? DHS will facilitate one training for staff of the selected Contractor at the start of the contract period. 46 Can we employ a train the trainer model? Yes On page 5 the RFP states that The Contractor may also conduct assessments utilizing telemedicine. The selected Contractor must follow standards as outlined by DMS. What are DMS s standards for conducting telephonic assessments? See response to question 8. Page 12 of 31

13 What is the method of training? In-person? Telephonic? On-line? Live/scheduled or self-paced training? The initial training will be done in-person and facilitated for by DHS. New staff hired to conduct assessments must be trained face-to-face The RFP states, The selected Contractor will consult with individuals and/or organizations involved with the beneficiary, as appropriate, including family members, support service providers, and school personnel. Can this consultation take place telephonically if needed? Who defines as appropriate? Yes, the consultation may take place telephonically if needed. 51 The RFP states, Information collected using the interrai assessments will serve to develop an independent assessment report tailored to the unique life circumstances of the individual, insuring that each limiting or potentially limiting factor is managed to maximize his or her quality of life. Is the DHS looking for the contractor to do this, too or is the RFP for assessments and reassessments only? See Section 1.1. The selected Contractor will be responsible for conducting assessments and reassessments. The Independent Assessment Report will be generated by the information collected through the assessment process. The Independent Assessment report will be generated by the assessment web based platform. However, operational data collection will be required from the Contractor and will be utilized to create reports by the Contractor. 52 The RFP states, The assessment process requires communication with the person and the primary support individual (if available), observation of the person, communication with current provider, and review of medical records and other available documents. Where possible, the person is the primary source of information. Is there a specification as to how medical records and/or other available documents are obtained/reviewed? What if the beneficiary is at home and the medical records or other documents are not available The selected Contractor will be expected to coordinate with the beneficiary s PCP and behavioral health provider to obtain and review necessary documentation. Pertinent records should be reviewed prior to conducting the assessment with the beneficiary. Additionally, pertinent records should be reviewed prior to the completion of the assessment. Page 13 of 31

14 53 On page 5 under Scope of Service the RFP states that...the Contractor may also conduct assessments utilizing telemedicine. What is the current or expected breakdown of in-person assessments versus telemedicine assessments? DHS has not established an expected breakdown. 54 Will the web-based system have functionality that allows the vendor to review assessor entered interrai scoring and text entries for assessments prior to finalizing each assessment? The vendor will be able to review and edit the assessment and the entered information prior to submitting the assessment to CoCentrix Re page 4,5,&7 Please provide an estimate of individuals falling in the following categories within the first year of the project: Youth involved in juvenile justice system Individuals involved in the foster care system Individuals discharging from acute hospitals stays Individuals discharging from crisis residential stays Adults involved in the criminal justice system Clients identified and referred by DBHS 1.4 Population to be assessed; In the first year of the project, does the 25,000 annual volume estimate include both initial risk stratified grouper assessments and provider referred assessments? DHS is unable to approximate this figure at this time. Yes. Page 14 of 31

15 57 The RFP states: The selected Contractor will be required to assess approximately 25,000 persons; and, The selected Contractor must reassess individuals whose DBHS Home or DBHS provider requests a reassessment; and, Additionally, the selected Contractor must conduct an annual reassessment for those continuing to receive DBHS services. a. Please provide a breakdown of the referral source for the persons receiving DBHS services to be assessed per year. Init ial yea Category r 1 vol um e Referred by risk stratification grouper Identified as needing annual reassessment due to continued use of DBHS services Non-priority, referred by PCP or Tier 1 provider, due to need for change in tier assignment or trigger event Priority, referred by PCP or Tier 1 provider Subsequent year volumes b. Please provide an estimate of the total number of assessments projected to be conducted in each of the potential contract periods. a. DHS is unable to approximate this figure at this time. b. It is expected that the selected Contractor complete 40% of the anticipated assessments, approximately 10,000 assessments, in the first six months of the contract. Approximately 25,000 assessments or reassessments will need to be conducted on an annual basis. Year: Initial 6 month s July 1, July 30, 2016 July 1, July 30, 2016 July 1, July 30, 2016 July 1, July 30, 2016 Page 15 of 31

16 In subsequent years of the project, does the 25,000 annual volume estimate include both annual reassessments and provider referred assessments? a. Is it anticipated that the Department will also identify new individuals to be assessed each year through ongoing risk stratification analysis? b. If so, are these individuals also included in the projected estimate of 25,000 assessments to be conducted each year? a. Please provide current utilization statistics for the Arkansas Telehealth Network. b. How are sessions scheduled (i.e. with individual sites or centrally)? c. What is the typical wait time? d. Does each site set its own scheduling policies (e.g. How far in advance can a session be scheduled? How are session start and stop times enforced?). Are the 48 and 24 hour turnaround times to contact beneficiaries calculated in business hours? Yes, but this figure is an approximation. Yes. Yes, but this figure is an approximation. a. DHS is unable to approximate this figure at this time. b. Site specific. c. DHS is unable to provide this information. d. Yes. No. Are the requirements for 14 and 7 day turnaround times calculated in calendar or business days? Calendar. 61 Page 16 of 31

17 The RFP states on page 7: The selected Contractor will consult with individuals and/or organizations involved with the beneficiary, as appropriate, including family members, support service providers, and school personnel; and on page 8: The assessment process requires communication with the person and the primary support individual (if available), observation of the person, communication with current provider, and review of medical records and other available documents. a. Contractor is expected to do due diligence to gain sufficient information to complete the assessment. b. Contractor is expected to do due diligence to gain sufficient information to complete the assessment. c. DHS is unable to approximate this figure at this time a. Some individuals may receive services from multiple providers. Is it the expectation of the Department that the vendor contact/interview all current DBHS providers? b. If a reliable picture of the individual s support needs can be gained through contact/interview with the primary provider or a subset of all current providers, is it permissible to contact/interview the primary provider or a subset of current providers? c. If all current providers must be contacted/interviewed, please indicate the percent of individuals likely to have more than two current DBHS providers. The RFP states: DHS will provide the selected Contractor with an initial list of beneficiary names, contact information, and provider information. The selected Contractor will be responsible for locating and contacting these and subsequent individuals who require assessment. Please describe the frequency with which the contact information is updated within the database from which contact information is pulled. For example, is the beneficiary information populated with contact information that is dynamically or frequently updated, or might it contain historical or out-of-date contact information? The contact information is not dynamically or frequently updated, and may contain out-of-date information. Page 17 of 31

18 64 Partially completed assessments: Typically appointment "no show" patterns among high DBHS need beneficiaries are disproportionately higher than other beneficiary populations. It is likely that this pattern may occur for this project despite active efforts to engage beneficiaries and encourage participation. a. Although pilot project methodology assured assessor access to individuals and medical records, as providers completed interrai assessments for persons they served, information regarding partial assessments experienced in the pilot project may be helpful for anticipating the volume of partial assessments to be expected. In order for the bidders to factor associated travel and opportunity costs associated with cancellations, no shows or partial assessments, what information can you provide about the expected volume of partial assessments? What percentage of assessments during the pilot projects were considered partial? b. When information can be obtained from current providers and from medical records, but the individual does not show for scheduled interviews/observations or refuses to participate in the interview, would the information obtained be considered valid or a partial assessment? c. If assessment and medical record information is obtained from the individual/guardian and at least one knowledgeable provider, will the assessment be considered complete? d. If the individual is a reliable respondent (or a primary support individual is available if applicable), will the assessment be considered valid (and billable) If the provider is unavailable to participate in the interview within the required timeframes? Please clarify situations in which assessments would be considered a. DHS is unable to approximate this figure at this time. The purpose of the pilot is to collect data and to develop and refine assessment processes. b. Partial. c. Contractor is expected to do due diligence to gain sufficient information to complete the assessment. d. Yes For an assessment to be deemed complete, the assessor must have sufficient information to answer the required questions in the assessment. Page 18 of 31

19 partial assessments The RFP states: Initial training for conducting assessments will be provided by DHS. The selected Contractor must ensure the training of assessors regarding the skills necessary to effectively engage with and interview persons with DBHS symptoms is obtained by each assessor at the next available regularly scheduled trainings conducted by DHS. a. Yes. b. The selected Contractor will be responsible for ensuring new staff is trained in the administration of the InterRAI assessment and for providing continued training of existing staff. 65 a. Will the Department collaborate with the vendor to ensure that this initial training occurs at the critical time in implementation? b. What will be required for the vendor s trainers to take over this training? 66 The RFP states: The assessment process requires communication with current provider, and review of medical records and other available documents. a. Is it the expectation of the Department that providers across all 8 provider types serving the population to be assessed will collaborate with the vendor to provide access to review medical records as needed for the conduct of these assessments? b. The vendor must locate and contact individuals to ensure necessary permissions are obtained from the individual or guardian and to arrange assessments. If contact information is inaccurate, will the vendor be permitted to contact providers to obtain location and contact information? Does the Department anticipate that providers a. It is the expectation of DHS that the selected Contractor will communicate and collaborate with the providers serving the beneficiary. b. Yes, the selected Contractor can contact a beneficiary s providers to ask for assistance. DHS anticipates referring providers to collaborate. Page 19 of 31

20 will collaborate with the vendor to provide information necessary to contact and locate individuals? The RFP states: The assessment process requires communication with current provider, and review of medical records and other available documents. Some individuals may receive services from multiple providers. Is it the expectation of the Department that the vendor review the medical records of all current DBHS providers? Census data suggest that approximately 5% of households in Arkansas report a primary language other than English. Many state s Medicaid programs have implemented programs to provide or reimburse the cost of interpreting and translation services for Medicaid beneficiaries. a. Does the Department have differing or more accurate estimates of the percentage of beneficiaries in the target population requiring interpreter or translation services? b. Does the Department have interpreting or translation services that the vendor can arrange on the behalf of individuals requiring such services? c. Will the Department want the bidder to incorporate the cost for all interpreting and translation services into the cost proposal? See response to question 66. a. No. b. No. c. Yes. Page 20 of 31

21 69 70 The department estimates the assessment will take approximately 90 minutes to complete and reviewing medical record information will take approximately 2 hours. To the extent that assessors complete both aspects of the assessment in the same location, efficiencies are gained. To the extent that the face-to-face and the record review occur in separate or multiple locations, efficiencies are decreased. a. Does the Department anticipate most interviews to occur in the individual s home/current residence necessitating separate travel to the provider location to review the individual s records? b. Is it the Department s expectation that assessors review records at the primary provider location or at multiple provider sites, when multiple providers currently serve the individual? The RFP notes that selected Contractor will be responsible for obtaining interrai user manuals. Shall the bidder include the costs for interrai user manuals in the cost proposal? Yes. a. The expectation of DHS is that the assessment of the beneficiary occurs in a mutually agreeable location that is convenient for the beneficiary. b. It is the expectation of DHS that the selected Contractor will communicate and collaborate with the providers serving the beneficiary. 71 The RFP states: At least five attempts per referral for initial assessment and for re-assessments should be made by the selected Contractor to schedule an assessment; and, under performance indicators, page 47; The Contractor will make at least five attempts to contact a client and on page 49; The Contractor will consult with individuals or organizations involved with the beneficiary. Contractor must make at least 5 attempts to contact said individuals or organizations and document these attempts. a. Must five attempts be made for every provider involved with the beneficiary? a. For an assessment to be deemed complete, the selected Contractor must collect sufficient information to answer the required questions in the assessment. This will require contacting the providers working with the beneficiary to collect the necessary information. b. Page 21 of 31 i. Yes ii. Yes iii. The selected Contractor must do due diligence to reach the beneficiary. This due diligence must be recorded. This effort may include telephonic, mail, electronic mail, and etc.

22 i. If the vendor assures that providers and respondents participating in the assessment provide a valid representation of the individual s needs, might just those respondents/providers be contacted? b. Please describe the Department s expectation for/definition of attempts. i. If calls are made but the individual does not answer the phone, and the individual has no phone messaging service, will the call be considered an attempt? ii. If messages are left, will this be considered an attempt? iii. If an individual has no phone, what are the Department s expectations of the vendor with regard to attempts to schedule? 72 Appeals: Please provide the maximum annual volumes that the Department anticipates to occur over the life of the contract, given the Department s intended use of the interrai. Activity Estimated annual volume Formal requests for reconsideration Appeals requiring preparation of hearing packet and materials Total number of appeal hearings Appeal hearings requiring in person testimony Appeal hearings requiring assessor participation Appeal hearings requiring a physician s testimony DHS is unable to approximate this figure at this time. No. The selected Contractor must be available to participate in the appeals process. This may involve attending hearings or answering questions regarding the assessment process and assessment findings. If the number of appeals cannot be estimated, would the Department consider an appeal rate for hearing preparation and hearing participation? Page 22 of 31

23 The RFP states: The selected Contractor will be responsible for obtaining necessary licenses to conduct assessments. Licenses may include a variety of software licenses. See response to question a. Will the vendor be required to pay a license fee to the vendor Arkansas utilizes for interrai data entry? i. If so, can the Department provide access to the schedule of fees for use of this system? b. What additional software licenses are known (or anticipated) that must be obtained by the vendor? Will a letter of credit suffice for the Performance Bond for this contract as it has for other similar contracts with DHS? Yes Will the web-based data application allow interrai assessment information to be entered when disconnected from the internet? Yes The RFP states: The Contractor must have sufficient hardware, described above, to allow assessors to upload assessment information within 24 hours of collection. Will the data entry application for the interrai have the capacity to store uploaded information supporting assessor s interrai scoring? Yes Page 23 of 31

24 77 The RFP states: The selected Contractor will be granted access to a webbased data entry system. a. Does this refer to web-based interrai item and assessment entry? b. Please describe the functionality offered by the web-based data entry system: i. Please describe any charges to the vendor associated with use of the web-based system, for example, will a licensing fee be incurred for data entry or use of the system? ii. Will the web-based system auto score completed assessments? iii. Will the web-based system auto score tier assignment from completed assessments? iv. Does the web-based system have capacity to capture assessor notes? v. Will the web-based system have the capacity to generate a PDF or printed copy of scores and findings? a) Yes b) i. The Contractor will also be responsible for obtaining each assessor a basic non-adhs employee access CoCentrix license. The Contractor will be responsible for the license cost and any annual fees associated with that. Annual maintenance is escalated at 5% per year. Basic Access provides full read write access to all functions including customized processes defined by Full users. Can create local reports and dashboards, but these cannot be shared. Users that will be developing Care Plans, Conducting Assessments, and Reporting Outcomes, Progress Notes will need this access. Does not include EHR functions. ii. Yes iii. Yes iv. Yes v. Reports can be generated from the web-based data entry system. Specific reports are currently being developed Does the web-based data entry system for the interrai support multiple languages? No 78 Page 24 of 31

25 79 The RFP states: The selected Contractor will utilize the web-based platform provided by DHS to develop an independent assessment report. a. Is it anticipated that the web-based system will be able to generate a PDF or printed copy of this report for completed assessments? b. Please describe the Department s preferred content for this report. For example, will the report be comprised of calculated summary scores, or will it require clinical summary writing? c. If the report requires clinical summary writing, will the webbased system support entry of clinical summaries and generation of the required report? a) See response to question 77. b) The independent assessment report will be generated through the web-based platform provided by DHS. c) The independent assessment report does not require clinical summary writing. 80 The RFP states: The selected Contractor will participate in the State Health Alliance for Records Exchange (SHARE), the statewide interoperable health information exchange. Proposals must contain a plan for participating in SHARE. a. Since CoCentrix is used for the assessments, in what circumstances will the vendor use SHARE? b. Will SHARE be used for transfer of individual PHI data from the Department to the vendor? c. Is it anticipated that SHARE will be used for secure in Phase 1? Are there other anticipated uses for SHARE? d. The RFP notes: Phase two (Year 2) should include the capacity to integrate with other health system platforms. Please describe more fully the vendor s responsibility in Phase 2 to integrate with other health platforms. a) The Selected Contractor will be expected to utilize secure messaging and secure file sharing. b) Yes, and also between the Selected Contractor and providers. c) Yes, and file sharing. d) It is expected that the Selected Contractor has the capability to securely interface with other entities as needed. Page 25 of 31

26 81 82 The RFP states: The hardware must be compatible at all times with the hardware and software utilized by the Arkansas DHS. The selected Contractor must ensure that assessors conduct the assessment utilizing hardware and software which meets the following specifications: a minimum of 4 GB of RAM with an operating system of Window 7 Enterprise, ad Trusted Platform Module 1.2 (TPM 1.2). a. When do you anticipate using Windows 8? b. Given the specifications, is BitLocker also required? c. To ensure the vendor has the capability to be compatible with the appropriate hardware/software, are there any other AR DHS systems the vendor would need to use with specific hardware/software requirements? If so, please provide these requirements. Please describe the types of circumstances in which it would be permissible to utilize a paper version of the assessment instrument to conduct the assessment. Hardware baselines will be evaluated on an annual basis. Hardware and requirements will be reviewed and updated as needed or minimum of every three years. Baselines will be managed and maintained by the DHS network team. Any changes to requirements for servers or hardware will need to be reported by the vendor to the network engineering team. BitLocker is required. In order to obtain tier categorization, electronic back up is necessary Does the Department prefer or require the respondent to submit an EEO policy at the time the proposal is submitted? Yes 83 Page 26 of 31

27 84 The RFP states: The selected Contractor will maintain hardcopies of any notes that may have been taken during the assessment in order to validate data uploaded onto the web-based system. Will the data entry application for the interrai have the capacity to store an uploaded image file of assessor notes taken during the assessment? Yes 85 a. Please clarify why the initial term is limited to 6, rather than 12 or 18 months. b. The RFP, on Page 23 states: The price included in the proposal will be the price for the period of the initial award as specified in Section 1.5., which is for the 6 month period. The initial 6 month budget will include implementation costs as well as project operations. Implementation costs will not recur in subsequent contract terms. i. How will the Department arrive at an annual contract amount given the inclusion of implementation costs within the initial term s budget? ii. How will the Department arrive at each subsequent contract years budget (e.g., is this negotiated annually)? iii. Will the Department consider separating the implementation costs from the cost of operations during that period? iv. Is the Department intending this project to be a monthly capitated, a monthly fee-for-service rate, or a monthly blend of a project management rate and fee-for-service rates? If there is a fee-for-service element, should the vendor provide a fee-forservice rate in the Cost Proposal, in addition to the implementation rate? a) See answer question #30 b) See answer question #2 i please see pricing template in Addendum A ii please see Section and Addendum A iii no iv please see pricing template Addendum A Page 27 of 31

28 What is the annual contract maximum for this project? None Many privately held companies do not make financial records available to Dunn and Bradstreet (D&B) because D&B make such information public, which can enable competitors access to information that may provide an unfair advantage. Our company does not submit financial records to D&B. Therefore, D&B scores may not accurately reflect our financial stability. Our company will happily submit complete audited financial statements (e.g., 3-5 years) in addition to the D&B SQR report to demonstrate our financial stability and capacity to operate this project. Would the Department permit bidders to submit additional financial information? Section states: Services provided under this contract will be reimbursed based on the following method: Final Negotiated Rate. Refer to 4.2.1, A Dun & Bradstreet Supplier Qualifier Report (SQR) shall be submitted with respondent's proposal for evaluation. It is the duty of the respondent to ensure the SQR accurately reflects the proposing entity. If it cannot be determined on the face of the report that the SQR is for the Respondent, the Respondent's proposal will be disqualified. Monthly 88 What is the typical and/or expected frequency by which the vendor will be reimbursed for services provided (e.g., monthly)? 89 If the vendor has existing, proprietary, web-based applications customized to project management for projects such as these, hosted on our servers, to license continual use to the Department would require maintaining and hosting after the contract ends. It seems unlikely the Department would continue to use the system upon termination of contract. In lieu of licensing upon termination of contract, would the department allow the vendor to simply return all assessment data to the department; for example, in ASCII delimited format? The Department The Department will have continual access to all assessment data throughout the contract period. Page 28 of 31

29 would then have complete ownership of all project data. RFP DMS Medicaid Behavioral Health Assessments Attachment D, Deliverable A, Performance Indicator requires adherence to the schedule provided on page 11, Section 2.1 with an anticipated start date of January 1, a. If the contract is not executed within the dates anticipated, will the Department adjust those dates accordingly? b. The RFP indicates that 40% of the 25,000 assessments must be completed within the first 6 months. Please describe the month the Department considers Month 1 (e.g. from award date, contract execution date, post-implementation phase)? Attachment D, Deliverable B, Performance Indicator 1 States: By the end of the 12th month of the contract period, the Contractor will have completed 100% of the anticipated total number of assessment. National trends indicate that high behavioral health need populations demonstrate higher than typical cancellation, no show, unable to contact/locate and refusal rates than other populations. a. Does the Department anticipate no individuals will be unable to be assessed? b. Does the Department anticipate referring over 25,000 assessments in the first year, and maintaining completion of 25,000 assessments as a benchmark for acceptable performance? If so, please provide the anticipated total number of referrals, so that staffing can be configured equally among bidders to accommodate total referral potential. a) Yes. b) From contract execution date a) No. b) Yes. DHS does not have this figure at this time. Page 29 of 31

30 This RFP is a reissuance of an RFP originally issued 2/5/2014 and then cancelled. Please clarify the reason for the initial cancellation. Due to Special Language being introduced, the contract cannot be issued until January 1, Please confirm that neither Attachments A nor C are required to be completed or returned with the proposal application. Please refer to answer # The RFP states: Any applications software developed by the Contractor in the performance of the services under this contract must become the property of the at no additional cost. Any existing software applications owned by the Contractor and used in the performance of the services under this contract must be granted to the at no additional cost, subject to customary confidentiality and other license terms and conditions. a. Does license terms mean the Department will pay the contractor s licensing fee if the contractor uses software that is also used by other customers? b. Will the Department pay licensing fee upon termination of contract? a) No. b) No. Page 30 of 31