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REQUEST FOR PROPOSAL (RFP)

Diabetes Prevention Program for Connecticut State Department of Transportation Employees

STATE OF CONNECTICUT

OFFICE OF THE STATE COMPTROLLER

55 ELM STREET

HARTFORD, CT 06106-1775

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Table of Contents

I. REQUEST FOR PROPOSALS INTRODUCTION II. PROPOSAL SUBMISSION REQUIREMENTS III. BACKGROUND AND PURPOSE IV. PLANNED SCHEDULE OF RFP ACTIVITIES V. SCOPE OF WORK VI. PROGRAM REQUIREMENTS / QUALIFICATIONS VII. PARTICIPANT ELIGIBILITY VIII. STAFFING REQUIREMENTS IX. DATA COLLECTION X. REPORTING REQUIREMENTS XI. PATIENT SATISFACTION SURVEY XII. QUALITY PERFORMANCE/OUTCOME MEASURES AND EVALUATION XIII. PARTICIPANT RECRUITMENT AND RETENTION XIV. PROJECT IMPLEMENTATION PLAN XV. COST PROPOSAL XVI. PAYMENT SCHEDULE XVII. DURATION OF CONTRACT XVIII. REQUIRED DOCUMENTS XIX. EVALUATION OF PROPOSALS XX. PROPOSAL REQUIREMENTS QUESTIONNAIRE

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I. Request for Proposals Introduction The State of Connecticut, Office of the State Comptroller (OSC), Healthcare Policy and Benefit Services Division is soliciting proposals from a qualified Vendor(s) to design and implement an evidence-based diabetes prevention program (DPP) that will engage eligible State of Connecticut Department of Transportation (DOT) employees (drivers/operators). The goal of this initiative is to enroll DOT employees identified as having prediabetes in an intensive, intervention program that will teach participants how to make healthy lifestyle changes, thereby delaying or preventing the onset of type 2 diabetes.

II. Proposal Submission Requirements A. Contractors must adhere to all requirements outlined in this RFP. Failure to do so will result in

rejection of the RFP response. B. The Contractor shall submit an original plus eight (8) copies of its proposal in loose-leaf binders. Hard

copies must also be accompanied by an electronic copy on a CD or DVD. Proposals shall be submitted to:

STATE OF CONNECTICUT Office of the State Comptroller

Business Services Office State of Connecticut

55 Elm Street, Room 301 Hartford, CT 06106

ATTN: RFP – CT Department of Transportation Diabetes Prevention Program

Vendors with questions regarding the proposal must submit them in writing addressed to the Office of the State Comptroller at osc.rfp@ct.gov no later than November 8, 2017 by 2:00 p.m. Answers to those questions will be provided on the OSC website http://www.osc.ct.gov/vendor/rfp.html by November 20, 2017. Except as called for in this RFP, from the date of release of this RFP until the right to negotiate a contract is awarded as a result of this RFP, any communication with personnel employed by the Comptroller’s Office, members of the Health Care Cost Containment Committee, and RFP committee members about the RFP are prohibited until the successor bidder is selected. All communications must be directed to the dedicated e-mail address: osc.rfp@ct.gov.

C. Final responses must be in writing and received by 2:00 PM on November 29, 2017. Vendor interviews, if required, will take place on or around December 18, 2017. It is anticipated that the State will make a decision by December 29, 2017.

D. Freedom of Information Act and Confidential Information. All proposals submitted in response to this

RFP will become the sole property of the State and subject to the terms of the Connecticut Freedom of Information Act (FOIA) and its corresponding rules, regulations and interpretations. Those particular sentences, paragraphs, pages or sections that the bidder believes are proprietary or confidential in

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nature, and therefore exempt from disclosure under the FOIA, must be specifically identified as such. If the bidder indicates that certain documentation is submitted in confidence, by specifically and clearly marking said documentation as CONFIDENTIAL, the Division will endeavor to keep said information confidential to the extent permitted by law. The Division however, has no obligation to initiate, prosecute or defend any legal proceeding or to seek a protective order or other similar relief to prevent disclosure of any information that is sought pursuant to a FOIA request.

The bidder shall have the burden of establishing the FOIA exemption in any proceeding where it is an issue. In no event shall the Division or the State have any liability for the disclosure of any documents in its possession which the State or the Division believes are required to be disclosed pursuant to the FOIA or other requirements of law. Note that the Office of the State Comptroller will reject any proposals marked in their entirety as confidential or proprietary.

Copies on a CD ROM (Redacted): Any vendor that claims its proposal contains confidential information that is exempt from disclosure under the Freedom of Information Act shall submit two (2) copies of a CD-ROM of its entire proposal (including all attachments) in a form compatible with Microsoft WORD, current version, with: (1) all confidential and propriety information redacted; (2) a description of those particular sentences, paragraphs, pages or sections that the bidder believes are exempt from disclosure under the FOIA; and (3) an explanation and rationale sufficient to justify each exemption. Should the Division receive a FOIA request for the proposal; the Division will provide a copy of the CD containing the redacted proposal. Failure to provide a redacted CD will signify the bidder’s agreement that all submitted information may be disclosed pursuant to the FOIA.

E. The contractor is expected to respond to each of the following:

1. Title Page

A title page indicating the date, subject, name of the Contractor, central office address and the local office

address (if a local office will be performing the contracted services), and the mailing address, e-mail

address, telephone number, and FEIN, as well as the name, title, telephone number and email address of

the Contractor’s contact person for the purpose of clarifying any information submitted.

2. Organizational Structure

Provide a description of the Contractor’s organization, including the legal structure (corporation,

partnership, franchise, etc.), the number of professional and support staff employed, and the primary

business functions (benefits consulting, actuarial consulting, asset management, insurance provider, etc.).

3. Contractor Experience/Description

Provide a description of the Contractor that will administer the requested lifestyle change program

including the Contractor's experience specific to the services requested in this RFP, along with the relevant

experience of all staff/principal(s) who would be assigned to this project. Include staff qualifications (e.g.

C.V., degrees, credentialing, licensure and certification). List all comparable governmental agencies,

corporations, and organizations that the staff members designated for the engagement of services sought

by this RFP have provided these services to within the past two (2) years, specifying those with a unionized

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workforce. In addition, the listing should include the number of years that the Contractor has been

retained by comparable governmental agencies, corporations, and organizations to provide such services.

Contractors are encouraged to identify other experience, factors, or strengths that they possess which

may assist the State in its selection process.

4. Financials

Each Contractor must provide detailed information on the financial standing of its organization proposing to offer the requested lifestyle change program, and, where applicable, its most recent financial ratings from the independent rating agencies, such as A.M. Best Company, Standard & Poor’s and Moody’s.

5. Lifestyle Change Program Description

Each submission must contain a complete description of the features of the lifestyle change program

being offered. This description must specifically address the requirements listed below:

a) Contractor’s staffing and administration process b) The credentials for staff participating c) List of all requirements and supplies necessary to conduct the program (i.e. size of room, tables,

chairs, internet access, printed materials, etc.) d) Any minimum or maximum number of participants at each location e) The curriculum to be offered f) Scheduling and communications g) Metrics used to measure program participation, retention and attainment of goals

6. References

Provide the names, addresses, and phone numbers of three customers, past or present, who can serve as

references. References should include managers and union officials who have worked directly with the

Contractor in engagements similar to the scope of the work proposed in the RFP.

7. Computer Systems

Each submission will provide a description of any computer system the Contractor will be using in connection

with billing or scheduling and administration of online program offering.

8. Data Security

Contractor must describe its data security protocols to protect confidential information and prevent data

breaches, inclusive of procedures reflecting compliance with Public Act 15-142.

9. Subcontracts

Identify the subcontractor(s), if any, to be utilized in meeting the service requirements of the RFP and a

listing of the specific tasks to be assigned to the subcontractor(s).

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10. Recommended Work Plan

Provide a statement of the Contractor’s capacity to provide each of the deliverables specified in this RFP

within the expressed time frame.

11. Sole or Multi-Vendor Arrangement

Each response must clearly stipulate whether its terms are applicable to a sole vendor arrangement (meaning one Contractor would be selected to administer the Program) or a multi-vendor environment (meaning more than one Contractor would be selected), or both. Where a Contractor is agreeable to participating in both a sole vendor arrangement and a multi-vendor environment, indicate clearly the resulting impact, if any, on its fee schedule.

12. Contract Term

For purposes of this RFP, it is anticipated that the contract term will run from April 2, 2018 to April 1, 2019, with the possibility of two one-year extensions at the option of the Office of the State Comptroller.

13. Financial Terms

Proposals should include fees that are guaranteed for a period of no less than three-years beginning April

1, 2018 through April 1, 2021. The State will have the option to extend the contract annually for up to two

additional one-year periods. Therefore, the State requests that you provide fee proposals for the two

additional one-year time periods. If you are proposing fees, rates or maximum increases for the two

optional one-year extension periods of April 1, 2019and April 1, 2021, please illustrate them accordingly.

14. Acknowledgement

Each proposal must contain the Contractor’s acknowledgement that it accepts as final the determinations of the State Comptroller.

15. Reporting

Each Contractor will be expected to provide ongoing reporting relative to the services offered for

participants.

17. Web Site

Each Contractor must specify and include samples of any proposed State-specific web site relative to the service(s) offered.

18. Conflict of Interest

Disclose any current or past (within the last ten years) business relationships which may pose a conflict of

interest.

19. Regulatory Issues

Disclose any regulatory problems experienced in the past ten years.

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20. Affirmative Action

The contract to be awarded is subject to contract compliance requirements mandated by Sections 4a-60

and 4a-60a of the Connecticut General Statutes; and, when the awarding agency is the State, Sections

46a-71(d) and 46a-81i(d) of the Connecticut General Statutes. There are Contract Compliance Regulations,

codified at Section 46a-68j-21 through 43 of the Regulations of Connecticut State Agencies, which

establish a procedure for awarding all contracts covered by Sections 4a-60 and 46a-71(d) of the

Connecticut General Statutes. According to Section 46a-68j-30(9) of the Contract Compliance Regulations,

every agency awarding a contract subject to the contract compliance requirements has an obligation to

consider certain factors when reviewing the Proposer’s qualifications under the contract compliance

requirements. By submitting a bid, the Proposer is acknowledging that it has reviewed the applicable

statutes and regulations as noted above and is aware of the factors that will be considered by the Board in

this area.

More information about the State of Connecticut's Contract Compliance requirements is available on the

Commission on Human Rights and Opportunities' web site at www.state.ct.us/chro under "Contract

Compliance." The Proposer must complete and submit the CHRO’s Workforce Analysis Affirmative Action

Report-State Proposers form (attached) with the proposal.

Regulations of Connecticut State Agencies Section 46a-68j-30(10) require agencies to consider the following factors when awarding a contract that is subject to contract compliance requirements:

a) The Contractor's success in implementing an affirmative action plan; b) The Contractor's success in developing an apprenticeship program complying with Section 46a-68-

1 to 46a-68-17 of the Connecticut General Statutes, inclusive; c) The Contractor's promise to develop and implement a successful affirmative action plan; d) The Contractor's submission of employment statistics contained in the "Workforce Analysis

Affirmative Action Report," indicating that the composition of its work force is at or near parity when compared to the racial and gender composition of the work force in the relevant labor market area; and

e) The Contractor's promise to set aside a portion of the contract for legitimate small Contractors

and minority business enterprises, where applicable (See C.G.S. 32-9e).

The State of Connecticut's Contract Compliance Forms applicable to State contracts are available at

http://www.ct.gov/chro/cwp/view.asp?a=2525&Q=315900 , please click on the four forms indicated

below to download the pdf files from the CHRO web page:

Notification to Bidders This document gives notice that the contract to be awarded is subject to the contract compliance

requirements mandated by State statutes and regulations.

Workforce Analysis Affirmative Action Report-State Contractors This employment information form is used to report the racial and gender composition of a firm's or

corporation's workplace. The form must be completed by the Contractor and submitted with the

proposal.

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Affidavit for Certification of Subcontractors as Minority Business Enterprises Upon award of a contract, this form is used to document the good faith efforts of a Contractor to include

minority business enterprises as subcontractors (including suppliers) on the State contract.

Contract Compliance Notice Poster This notice concerns the prohibition of discrimination in employment practices. Upon award of a State

contract, the notice must be posted by the Contractor in conspicuous places accessible to all employees

and applicants for employment.

More information about the State of Connecticut's Contract Compliance requirements is available on the

Commission on Human Rights and Opportunities' web site at www.state.ct.us/chro under "Contract

Compliance."

21. Authorized Agent

An authorized agent for the Contractor with authority to negotiate and contractually bind the Contractor

must sign the proposal; such individual’s title, mailing address, e-mail address and telephone number must

also be provided.

22. Executive Summary

At the Contractor’s option, an Executive Summary may be included with the Proposal. 23. Required Forms

a) Agency Vendor Form (SP-26NB), available at:

http://das.ct.gov/Purchase/Info/Vendor_Profile_Form_(SP-26NB).pdf

b) W-9 Form, available at: http://www.irs.gov/pub/irs-pdf/fw9.pdf

c) “BizNet”

The Connecticut Department of Administrative Services (“DAS”) requires that all firms seeking to do

business with the State create a business profile on the DAS Business Network (“BizNet”) system.

Additional required forms as described below must be submitted to or on file with the Biznet system by

the deadline for submission of proposals. Paper or electronic copies need not be provided with the

submission to the Comptroller's office.

Firms create an account on BizNet by using the following link:

https://www.biznet.ct.gov/AccountMaint/Login.aspx.

Once your firm creates an account, login and select “CT Procurement” and then “Company Information”

for access. If you experience difficulty establishing or otherwise managing your firm's account, please call

DAS at 860-713-5095.

DAS has implemented the requirement to create a BizNet account to make doing business with the State

of Connecticut more business friendly. One benefit to using BizNet is that it eliminates certain

redundancies, such as the former requirement to complete and submit forms even though the forms had

been recently submitted in response to another Request for Proposals. In addition to eliminating

redundancy, BizNet has automated the completion and submission of required Ethics Affidavits and Non

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Discrimination forms. Firms must now upload these forms electronically to their BizNet account and

update them on an annual basis, rather than submitting paper copies with each proposal. Firms will have

the ability to view, verify and update their information by logging in to their BizNet account, prior to

submitting responses to an RFP.

i. Ethics Certifications

The following Ethics Forms must be signed, dated, notarized, uploaded or updated on

BizNet. To obtain these forms, you must login to Biznet and follow the instructions referenced above.

• OPM Ethics Form 1: Gift & Campaign Contribution Certification;

• OPM Ethics Form 5: Consulting Agreement Affidavit:

• OPM Ethics Form 6: Affirmation of Receipt of State Ethics Laws Summary

• OPM Ethics Form 7: Iran Certification

For information on how to complete these forms, please access the Office of Policy

and Management website by using the following link:

http://www.ct.gov/opm/cwp/view.asp?a=2982&q=386038&opmNAV_GID=1806

ii. Non-Discrimination Certification Choose one (1) of the forms listed below that applies to your business. Complete and

upload or update the form on Biznet annually. To obtain a copy of these forms, you

must login to Biznet and follow the instructions referenced above.

• Form A: Representation by Individual (Regardless of Value); or

• Form B: Representation by Entity (Valued at $50,000 or less); or

• Form C: Affidavit by Entity (Valued at $50,000 or more); or

• Form D: New Resolution by Entity; or

• Form E: Prior Resolution by Entity

For information on how to complete these forms, please access the Office of Policy

and Management website by using the following link:

http://www.ct.gov/opm/cwp/view.asp?a=2982&q=390928&opmNAV_GID=1806

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III. Background and Purpose

In its ongoing commitment to maintaining a healthy, productive workforce by ensuring state employees have access to necessary health care services, the State of Connecticut initiated the Health Enhancement Program (HEP) in 2011 for active state employees, certain retirees, and their dependents. HEP requires participants to receive age and gender specific wellness exams, such as physicals, cholesterol screenings and at least one annual dental cleaning, plus screening and diagnostic tests for colorectal cancer screening, mammograms and vision exams. In addition, persons diagnosed with any of certain chronic conditions, namely diabetes, heart failure/heart disease (Coronary Artery Disease), asthma / COPD (Chronic Obstructive Pulmonary Disease), hyperlipidemia (High Cholesterol) and hypertension (High Blood Pressure), must comply with care requirements appropriate to their condition(s). Preventive visits are provided without charge; employees receive condition-related prescription medication at reduced copays and have copays waived for office visits related to those conditions. HEP also provides wellness supports in areas such as tobacco cessation, obesity prevention or reduction, and depression screening. Employees who do not comply with HEP requirements or choose to opt out of the program incur a $350 annual deductible per-person (maximum of $1,400 per family) for in-network care and pay $100 more per month for medical and pharmacy coverage. A recent study found HEP has significantly increased screening rates for SOC employees, while lowering the overall medical cost trend, which was 3.2% lower for the HEP population compared to a control group observed during the same study period. While HEP has been successful in encouraging members to be active participants in their own healthcare, newly diagnosed cases of diabetes continue to rise. An estimated 245,000 adults in Connecticut, or 9.3%, have been diagnosed with type 1 and type 2 diabetes with an additional 83,000 adults having undiagnosed diabetes (1). Diabetes and diabetes related conditions are ranked the seventh leading cause of death in Connecticut (2). Approximately $194 million was billed for hospitalizations in Connecticut due to diabetes as a principal diagnosis and roughly $71.7 million was billed for diabetes-related hospitalizations with a non-traumatic lower extremity amputation in 2013 (Hospital Inpatient Discharge Data). Once an individual is diagnosed with this chronic condition, it can have a devastating impact on their quality of life and significantly increase their medical costs.

Prediabetes

Prediabetesis a precursor stage to type 2 diabetes, , where an individual’s blood glucose levels are higher than normal, but are not high enough to be considered diabetes. It can be identified using a blood glucose test or the CDC’s at risk screening quiz. Those with a body mass index of greater than 24, or blood glucose between 5.7%–6.4%, or having had gestational diabetes mellitus (GDM), may be pre-diabetic. The CDC reports that one out of three American adults has prediabetes yet many are unaware they have it. Only 7.2% of Connecticut adults surveyed report having been told that they have prediabetes (2012-2014 CDC Behavioral Risk Factor Surveillance System (BRFSS) data). Without weight loss or moderate physical activity, those with prediabetes are at increased risk for developing type 2 diabetes within 5 years. Unlike diabetes, however, the progression of prediabetes can in some cases be slowed and even reversed. Outcome studies have shown that lifestyle interventions, focused on diet modification and improved exercise habits yielding moderate weight loss of 5% to 10%, can delay and even prevent the progression of the condition (impaired glucose tolerance) to type 2 diabetes in high-risk adults.

Initial Pilot

The Comptroller’s Office, in conjunction with the Connecticut Department of Transportation (DOT), is seeking to engage a partner to help design and administer a pilot DPP for eligible DOT CDL licensed staff members. DOT drivers are spread across the state and operate out of local and regional garages. The pilot will initially

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serve eligible DOT staff and will be geographically distributed throughout the state. The potential next phase may expand the program to an additional 60 maintenance and 15 specialty garage facilities located throughout the state. Depending on the outcomes of the first phases of the program with DOT, and funding availability, this program may be expanded to serve other eligible CT State employees. The SOC Diabetes Prevention Program will focus on promoting wellness and educating participants about lifestyle change strategies that have proven successful in delaying and preventing the onset of type 2 diabetes. The program will follow the CDC’s year-long diabetes prevention program curriculum. The CDC curriculum is structured to offer participants an opportunity to learn about eating healthy, managing stress, healthy food preparation, increasing physical activity, and adopting healthy lifestyle habits. It will give participants new resources and connect them with peers facing the same obstacles and challenges. Participants will learn methods to adopt meaningful lifestyle changes with the goal of embedding these principles, translating them into practice, and ultimately improving their chances of avoiding disease.

DOT drivers are required to pass regular CDL licensing physical exams to ensure that they can continue to safely operate vehicles. Type 2 diabetes can put drivers at risk of losing their CDL license, jeopardizing their very livelihood. The State seeks to offer an opportunity to pre-diabetic drivers to engage in the year-long program that will teach them new skills to eat healthy, manage stress and increase their physical activity, with the goal of improving their chances of avoiding the onset of type 2 diabetes. The program also aims to enhance the skills learned, such as tracking activity, setting goals and staying physically active, so that participants can remain motivated to maintain the healthy habits they learned.

IV. Planned Schedule of RFP Activities

It is OSC’s intention to comply with the following schedule:

Event Date Time

Release of RFP November 1, 2017

Questions / Requests for Clarification Due November 8, 2017 2:00 PM

Response to Questions / Requests for Clarification November 20, 2017

Closing (Proposals Due) November 29, 2017 2:00 PM

Vendor interviews, if OSC deems necessary December 18, 2017

Issuance of Notice of Intent to Award (approx.) December 29, 2017

These dates represent a tentative schedule of events. The OSC reserves the right to modify these dates at any time, with appropriate notice to prospective bidders.

• This RFP does not commit the OSC to award a contract. The OSC reserves the right to reject all proposals, and at its discretion, may withdraw or amend this RFP at any time.

• The OSC may revise and amend the RFP prior to the due date for the proposal. If, in the opinion of the OSC, revisions or amendments will require substantive changes in proposals, the due date may be extended.

• The OSC reserves the right to reject any and all proposals received, for specific reasons, which include, but are not limited to, non-compliance with RFP requirements.

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• Responses to this RFP will be the primary source of information used in the evaluation process. Each bidder is requested and advised to be as complete as possible in its response. The OSC reserves the right to contact any bidder to clarify any response or make a presentation.

V. Scope of Work The DPP Provider(s) will be required to:

1. Implement a structured, year-long DPP with a CDC-approved curriculum that teaches behavioral self-management strategies for sustainable lifestyle change, physical activity and weight loss

2. Identify, assess, enroll and engage eligible CT DOT participants in the SOC DPP

3. Equip program participants with necessary tools needed for participation (e.g. scale, pedometer, printed materials, and other resources used to encourage healthy, lasting lifestyle changes that are sustainable beyond the completion of the program)

4. Provide each program participant with a dedicated, trained lifestyle coach for the duration of the program, who understands the challenges faced by this population and is accessible to the program participant for continued support outside regular sessions

5. Tailor educational materials to address social, professional and ethnic diversity, that may include:

a. Demonstrating how to prepare healthy versions of popular local or traditional foods

b. Incorporating suggestions and recommendations from group members

c. Providing suggestions on how to eat healthy during holidays and cultural events

d. Informing the group on upcoming events or activities that promote being physically active

e. Sharing informational handouts to participants that highlight areas of concern

f. Providing guidance on making healthy choices when working long hours

6. Have flexibility to provide both group and individual approaches to educating on lifestyle change, restart participants who fell out of the program, and respond to the needs of a culturally diverse population

7. Provide mechanisms and opportunities to include family members, friends and other important supports to assist and encourage the participant throughout their engagement in the program

8. Collect baseline data at the point of enrollment, at set points during the program, and at the end of the program

9. Provide reports to SOC that will include member enrollment information (detailing how members were identified and enrolled), engagement and participation, outcomes reporting (changes in BMI, BP, A1C), member satisfaction survey results, etc.

10. Have the ability to report to a participant’s PCP and coordinate data share with PCP (for those participants who have a designated PCP and consent to sharing their health information)

11. Work with OSC designated staff

12. Integrate trained lifestyle coaches, diabetes prevention program coordinators, and other trained DPP intervention staff into the model

13. Comply with audit requests made by the OSC and/or its designee 14. Design and administer, as approved by the OSC, a member satisfaction survey 15. Have the ability to administer employee incentive programs for DPP participants 16. Invoice the OSC for DPP services

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VI. Program Requirements / Qualifications

The year-long CDC recognized curriculum is designed with an emphasis on preventing prediabetes from developing to type 2 diabetes. While special consideration will be given to those respondents whose programs are based on the CDC recognized curriculum, the respondent is encouraged to share approaches it has used, and proposes to use if awarded. The main focus of the program will be on learning new strategies to make workable and sustainable lifestyle changes that improve one’s overall health. While encouraging participants to complete the year-long program is important, it is equally important to engage participants at a level where the principles of living a healthy lifestyle become embedded, adopted and long-lasting.

The DPP Provider’s curricula for the SOC DPP should be modeled after CDC-recognized lifestyle change programs, and will:

• Emphasize the goal of preventing type 2 diabetes

• Focus on making lasting lifestyle changes

• Encourage moderate changes in diet and physical activity that lead to 5% to 7% weight loss in the first 6 months

• Review strategies for self-monitoring of diet and physical activity, developing participant self-efficacy and social support to sustain lifestyle changes, and problem-solving capabilities to reach weight loss, physical activity, and healthy eating goals.

• Record participant’s weight at each session

• Equip participants with the tools necessary to achieve program goals

Methods used to achieve these lifestyle goals may include some of the following key features: 1) individual case managers or “lifestyle coaches;” 2) frequent contact with participants; 3) a structured, state-of-the-art, 24 session (consisting of 16 weekly sessions followed by once-monthly sessions) core-curriculum that teaches behavioral self-management strategies for weight loss and physical activity; 4) supervised physical activity sessions; 5) a more flexible maintenance intervention, combining group and individual approaches, motivational campaigns, and “restarts” (where a participant may drop out – but rejoin); 6) individualization through a “toolbox” of adherence strategies; 7) tailoring of materials and strategies to address ethnic diversity; and finally 8) an extensive network of training, feedback, and clinical support.

Inclusion of supervised physical activity sessions in the pilot program will be at the discretion of the DOT. The respondent is encouraged to share any results it has experienced in the provision of supervised physical activity sessions (inside and outside of regular working hours) as part of its curriculum. If the Contractor elects to make supervised physical activity sessions available, it is the Contractor’s responsibility to have procedures in place to assure participant safety.

Both in-person and online programs must have the capacity to measure and/or coordinate the measure of hemoglobin A1C for program participants, which may also be used to determine program eligibility. The OSC will also use this data to measure outcomes for program participants. As part of eligibility determination, a minimum of 50% of a program’s participants must have had a recent (within the past year) blood glucose test (which may be self-reported) or claim code indicating they have prediabetes, or a history of gestational diabetes mellitus (GDM).

Web-based programs must have the ability to ensure ease and success of online connectivity (sufficient technical support must be made available to participants). It must also provide sufficient flexibility for continuous enrollment (enrollment opportunities to be made available bi-weekly) throughout the year. In addition, participants (in both online and in-person programs) must be placed appropriately within groups

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having similar backgrounds, challenges and goals, to encourage peer learning and supports. Online programs must also have the ability to reproduce and offer to participants, any materials covered during online sessions.

VII. Participant Eligibility

All potentially eligible participants, (approximately 1,300 DOT CDL licensed employees) will be invited to participate in an initial, informational session where they will have the opportunity to learn about prediabetes, type 2 diabetes, and the DPP lifestyle change program being offered. Prediabetes screening will be offered at this session for the purpose of raising awareness and identifying members who may meet program eligibility criteria, based on the current Centers for Disease Control DPP eligibility guidelines and other criteria. Prediabetes can be determined using the CDC screening tool, and can be diagnosed via oral glucose tolerance tests, fasting blood glucose tests, or an A1C test. Blood-based testing is the most accurate way to determine if a patient has prediabetes; therefore, the successful bidder must have the ability to administer or coordinate A1C testing for a minimum of 50% of program enrollees.

To be eligible for participation in the SOC DPP, participants must meet the following criteria:

1. Be a current employee with the State DOT assigned to, or within close geographic proximity to, a location identified in the pilot, classified as (driver), holding a valid Commercial Driver’s License and

2. Be 18 years of age or older, with a body mass index (BMI) of ≥24 and

3. Have no previous diagnosis of type 1 or type 2 diabetes and

4. Have had a blood test result in the prediabetes range within the past year where:

a. Hemoglobin A1C is between 5.7%–6.4%,

b. Fasting plasma glucose is 100–125 mg/dL, or

c. Two-hour plasma glucose (after a 75 gm glucose load) is 140–199 mg/dL or

5. Have been previously diagnosed with gestational diabetes

A minimum of 50% of program participants must have been deemed eligible based on a blood test or a claim code indicating they have prediabetes, or a history of gestational diabetes according to the following specifications:

a. Fasting glucose of 100 to 125 mg/dl b. Plasma glucose measured 2 hours after a 75 gm glucose load of 140 to 199 mg/dl c. A1c of 5.7 to 6.4 d. Clinically diagnosed gestational diabetes during a previous pregnancy

The OSC may decide to change the eligibility criteria in the future. Bidders should feel free to offer suggested edits to the basic CDC criteria based upon documented experience and/or best practices, for consideration.

VIII. STAFFING REQUIREMENTS (will incorporate with Training/Certification piece below)

Preferred staffing and requirements for a diabetes prevention, lifestyle change program should include trained lifestyle coaches to lead the DPP and Program Coordinators to oversee operations. Scoring of this RFP will take into consideration staffing and qualifications.

Lifestyle Coaches who lead DPP group sessions should:

• Have the ability to support, engage, encourage and motivate program participants within a diverse group setting

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• Have knowledge of basic health, nutrition, and fitness principles

• Be willing to travel within the State of Connecticut to deliver the program where it is needed and teach multiple classes

• Provide individualized support to those participants assigned to them

• Have strong communication skills and excellent facilitation skills to guide participants in behavior change, with the ability to tailor curricula to those employees who speak a language other than English.

• Be supportive and empathetic of their participants’ needs, which may also include engaging individuals whom participants have designated as being part of their support system (e.g. family, friends, colleagues, physicians)

Program Coordinators who oversee daily operations of the lifestyle change program, should:

Have the ability to support and guide lifestyle coaches, and ensure that the program meets quality performance standards and outcomes

Assist Lifestyle Coaches in the proper placement of individual participants within a group

Coordinate the collection of data for the purpose of analyzing and reporting to the OSC

Have the ability to create and maintain an electronic record of member participation and other program data

Data Coordinator will be responsible for:

Gathering, reporting and submitting data

Monitoring and assessing completeness of data collected and used for reporting

Coordinate data sharing with SOC and/or its designee

IX. DATA COLLECTION The DPP will be required to collect and report on program specific data for each program participant. These reports will be due to the OSC no later than 30 days following the reporting month. Data collection and documentation should include:

1. Participant attendance at sessions during months 1 through 6, will be averaged over all participants who attend a minimum of four sessions. The average number of sessions attended must be a minimum of nine.

2. Participant attendance from months 7 through 12, based on an average of attendance for those participants who attended a minimum of four sessions.

3. Participant body weight, which will be based on all participants who attend a minimum of four sessions. Body weight must be recorded at a minimum of 80% of all attended sessions.

4. Participant physical activity must have been recorded at 60% or more of sessions and will be based on participants who have attended a minimum of four sessions

5. Participant Weight loss achieved at six months. The average weight loss (mean percentage weight loss) achieved by participants attending a minimum of four sessions must be a minimum of 5% of “starting” body weight (defined as the body weight measured at the first intervention session attended). Weight loss will be averaged over all participants attending a minimum of 4 sessions. The

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first and last weights recorded for each participant during months 1-6 will be used to calculate this measure.

6. Participant weight loss achieved at 12 months. This is the entire weight loss achieved by individual participants over the intervention period.

7. Participant eligibility used to enroll: A minimum of 50% of participants must be eligible for the lifestyle intervention based on either a blood test indicating prediabetes or a history of GDM. The remainder (maximum of 50% of participants) must be eligible based on the CDC Prediabetes Screening Test, the American Diabetes Association Type 2 Diabetes Risk Test or a claims-based risk test. Calculation of these percentages will be based on all participants who attended a minimum of four sessions. Refer to Section II for participant eligibility requirements.

8. Drop-out rates: Provide reporting on participant dropout rates at specified milestones, as determined by OSC, throughout the course of the program.

X. REPORTING REQUIREMENTS The Office of the Comptroller expects, at a minimum, monthly reporting that will include the data points identified above. Please indicate that your organization will be able to provide this level of reporting. In addition, the Comptroller’s Office contracts with a vendor for the administration of the state employee Health Enhancement Program (a value based insurance design health plan) and chronic disease management and education services. Please indicate your willingness to coordinate with this vendor. XI. PATIENT SATISFACTION SURVEY In order to better assess the Contractor’s performance, the Office of the State Comptroller expects the DPP provider to utilize patient satisfaction surveys that provide unbiased feedback from participants. At the end of the initial 12 months and again 6 months post program completion. The DPP Provider(s) will develop (in conjunction with the OSC) and administer a participant satisfaction survey that seeks to measure participant experience with the SOC DPP. The participant will be notified at the time of enrollment that they will be asked to participate in a survey. The survey will include questions around the clarity of the curriculum and course content as well as the attentiveness and availability of assigned lifestyle coaches appointed to deliver the curriculum in a clear and concise way, applicability of the options presented, value of the curriculum, indication of intent to continue the program life changes, use of or value of other resources identified and the participants ability to adopt and adhere to healthy lifestyle change strategies acquired during the program. XII. QUALITY PERFORMANCE/OUTCOME MEASURES AND EVALUATION Performance measures will be based upon the data collection and documentation described above, with the potential addition of A1C levels. The Contractor will be required to provide performance guarantees associated with each of the above measures, and any additional guarantees the Contractor wishes to offer. XIII. PARTICIPANT RECRUITMENT AND RETENTION Evidence has shown a year-long program is most effective in embedding lifestyle change principles. For this reason, it is imperative that program participants remain engaged throughout the duration of the program. The DPP Provider will be responsible for encouraging continuous engagement in the program which may require additional outreach to program participants and one-on-one contact from the lifestyle coach to the participant and any family member, friend or other support the participant has agreed to designate as being in their support system.

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The successful bidder will be expected to develop and employ effective participant recruitment and retention strategies in its DPP which should include how it engages family or other supports in the program. XIV. PROJECT IMPLEMENTATION PLAN DPP Provider(s) will be required to describe in detail how it would carry out the major activities of this Project in context with the Scope of Work and illustrate how the plan will serve to coordinate and accomplish the work with the OSC on requirements outlined in the RFP. XV. COST PROPOSAL Submit a detailed Cost Proposal (Attachment A) in a separate electronic file on the USB drive, DVD or CD stating the cost for each deliverable and the total cost for the entire project. Include a breakdown as indicated in the worksheet. The Cost Proposal is scored as set forth in the Cost Evaluation section. XVI. PAYMENT SCHEDULE The Contractor shall submit monthly invoices to the OSC based on work performed in the previous month for the SOC DPP, for payment. XVII. DURATION OF CONTRACT Contract Period The OSC is seeking a contract-effective date commencing April 2, 2018. Proposals should include fees that are guaranteed for a period of one year beginning April 2, 2018 through April 1, 2019. There will also be the potential for two one-year extensions. The template that should be used for your organization’s financial terms is included in this RFP as Attachment A. COST PROPOSAL.

XVIII. REQUIRED DOCUMENTS - STANDARD CONTRACT TERMS AND CONDITIONS

Be advised that the State has certain contract requirements. Contractors responding to this RFP must adhere

to the Comptroller’s contract requirements, as set forth in a sample contract attached hereto as Exhibit 2,

and must affirmatively state their willingness to adhere to these terms and conditions in a transmittal letter

appended to their proposal response.

1. Timing and Sequence - All timing and sequence of events resulting from this RFP will ultimately be determined by the State. 2. Stability of Proposed Prices - Any price offerings from Contractors must be valid for a period of three

years from the proposed start date of the contract.

3. Oral Agreements - Any alleged oral agreement or arrangement made by a Contractor with any agency

or employee will be superseded by the written agreement.

4. Amending or Canceling Requests - The State reserves the right to amend or to cancel this RFP prior to the due date and time, if such action is deemed to be in the best interest of the State.

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5. Rejection for Default or Misrepresentation - The State reserves the right to reject the proposal of any Contractor that is in default of any prior contract or for misrepresentation. 6. State’s Clerical Errors in Awards - The State reserves the right to correct inaccurate awards resulting from its clerical errors. 7. Rejection of Qualified Proposals - Proposals are subject to rejection in whole or in part if they limit or modify any of the terms and conditions and/or specifications of the RFP. 8. Changes to Proposal - No additions or changes to the original proposal will be allowed after submittal. While changes are not permitted, clarification at the request of the State may be required at the Contractor’s expense. 9. Collusion - By responding to this RFP, the Contractor implicitly states that the proposal is not made in connection with any competing Contractor submitting a separate response to the RFP, and is in all respects fair and without collusion or fraud. It is further implied that the Contractor did not participate in the RFP development process, had no knowledge of the specific contents of the RFP prior to its issuance, and that no employee of the agency participated directly or indirectly in the Contractor’s proposal preparation.

No Contractor or Contractor's representative may contact an employee of the State or their representatives

regarding their proposal until final selections have been made. Until such time as final selections are made,

any such contact will be considered collusion under the "Terms and Conditions" herein and may be grounds

for disqualification of the Contractor's proposal.

10. “Not to Exceed” Quotations – All cost estimates will be considered as “not to exceed” quotations. 11. Contractor’s Conference - There will be no Contractors’ conference. 12. Additional Contract Provisions: The contract with the State will require the following provisions:

The contract shall be governed by, construed, and enforced in accordance with the laws and court decisions of the State of Connecticut without giving effect to its principles of conflicts of laws. Under no circumstances may State contract contain limited liability and/or binding arbitration provisions. The State will not indemnify a Contractor or waive its sovereign immunity.

At all times, Contractor shall utilize approved, qualified personnel necessary to perform the services under this Agreement.

Contractor shall advise the State promptly, in writing, of any labor related occurrence known to Contractor involving Contractor's employees which may reasonably be expected to affect Contractor's performance of services under this agreement. Notwithstanding such occurrence, the Contractor shall at all times assign competent personnel/staff to perform the services contracted for under this agreement. If at any time the State in its sole discretion determines that the personnel/staff assigned to perform the services under this agreement is incompetent, dishonest or uncooperative, State reserves the right to request that Contractor reassign personnel/staff and arrange for an employee(s) or subcontractor(s) satisfactory to State to provide the services otherwise performable by the Contractor hereunder.

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Contractor shall review any requests by State to reassign personnel/staff. In requesting such reassignment of personnel/staff, State shall give thirty days (30) notice to Contractor of State's desire for such reassignment. Contractor will then have fifteen (15) days to investigate the situation and attempt, if it so desires, to resolve the situation to the mutual satisfaction of the parties. Should the parties not reach a mutual resolution, then fifteen (15) days thereafter, or thirty (30) days from the date of the notice of reassignment, the State may terminate this agreement by providing written notice.

XIX. EVALUATION OF PROPOSALS

Each Proposal will be evaluated by a screening committee against the following criteria to determine which Contractor is most capable of implementing the State’s requirements. 1. The benefit of the service to State employees. 2. The price or rate of the product or service including the competitiveness of proposed cost. 3. The skill, ability, competence and integrity of the Contractor and Contractor’s personnel to deliver such service, including the Contractor’s understanding of the project and its purpose and scope, as evidenced by the proposed approach and the level of effort. 4. The past performance of the Contractor. In considering past performance, the Comptroller will evaluate the skill, ability and integrity of the applicant in terms of the applicant’s fulfillment of past contract obligations, and experience or lack thereof in delivering the same or similar products and services. 5. At the Comptroller’s option, presentation to a screening committee. 6. Any other information the Comptroller deems necessary.

XX. PROPOSAL REQUIREMENTS QUESTIONNAIRE

Experience

1. How long has your organization been providing / managing wellness education and/or diabetes prevention programs? Document the applicant’s business history and experience. Provide detailed information on past performance.

2. Provide a detailed description of the program(s) offered by your organization including information on program engagement and available outcome data for engaged members. Describe how you measure member engagement and the metrics used to measure success. Provide statistics for your book of business around recruitment and retention strategies your organization has employed.

3. Does your organization deliver its wellness program curriculum(s) online and/or in person? Explain in detail the curriculum(s) used and how it is delivered. Provide a detailed description of the services and any limitation in either hours of operation or location of proposed services that would affect the applicant’s ability to provide the services.

4. What is your organization’s typical class size?

5. What is your organization’s average instructor to participant ratio?

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6. In what other state(s) does your organization operate and how many participants does your organization service?

7. Does your organization contract with other states to provide DPP to state employees (and dependents)? If yes, may we contact them to discuss their experience?

8. Describe the value of the programs your organization offers (i.e. cost-benefit analysis, improved health outcomes, improved absenteeism and presenteeism rates, etc.). a. How do programs integrate with other DPP providers if separate (e.g., pharmacy, medical,

employee assistance program (EAP)? b. How do they integrate with other health care management programs (e.g., case management,

disease management)? c. How does your organization incorporate the results into other health care management

programs? d. What type of consumer tools/services does your organization provide to enable participants to

make the best choices when they need health care? Describe in detail your organization’s web-based member tools and transparency capabilities?

9. In your organization’s experience, what return on investment (ROI) has been realized with its diabetes

prevention, health promotion, wellness and/ or prevention programs? Describe in detail the specific programs your organization has managed and methods used to calculate the ROI.

10. What strategies have been implemented by your organization in its DPP programs and what

measurable outcomes have been realized? Be specific. 11. Provide any other findings and outcomes your organization has experienced with its health

promotion, wellness and/or prevention programs. 12. Provide a description of the standard health promotion, wellness and/or prevention reports provided

by your organization. Indicate the frequency, level of reporting (e.g., book of business, specific to the state) and define the data included. Provide a copy of the report template.

13. Would your organization be willing to partner with other providers, such as physicians, provider

groups such as ACOs, or other organizations, to manage health promotion, wellness, and prevention programs? Provide examples of such partnerships your organization has successfully managed?

Eligibility Determination

14. How does your organization outreach to potential program participants? What eligibility screening tools are used by your organization to determine eligibility? Describe how your organization identifies or targets potential eligibles?

15. Of those participants deemed to be eligible, what percentage has enrolled in the program? What percentage of participants remained engaged throughout the entire duration of the program?

Outreach and Engagement

16. Provide examples of marketing tools used or campaigns conducted by your organization to outreach to potential participants.

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17. Explain whether your organization administers incentives to participants to encourage ongoing engagement and program completion. If yes, explain the strategies employed and their overall effectiveness.

18. Describe how your organization structures its program to encourage inclusion of family and/or other supports to encourage ongoing engagement of program participants.

19. Describe how your organization customizes its curricula to accommodate diverse cultures and backgrounds. Provide specifics such as languages other than English spoken by your lifestyle coaches, the ability to produce materials in languages other than English, the ability of your coaches to structure curricula that accommodates a diverse group, etc.

Staffing / Training

20. Indicate who would be the designated, key staff assigned to the SOC DPP. Provide their titles, background, education and experience.

21. Does your organization have experience with culturally diverse populations? Describe the training your staff have received to teach effectively to a culturally diverse group.

22. Describe the level of training your organization’s lifestyle coaches receive. Include whether they have successfully completed CDC lifestyle coach training.

23. Explain how your organization’s instructors propose to keep participants engaged for the duration of the year long program? Discuss how your instructors have worked to overcome challenges they’ve encountered in teaching the curriculum.

24. Confirm/define geographic availability of staff.

25. Confirm/Define regular hours of operation and after-hours availability

Implementation

26. Describe in detail your organization’s implementation strategy and how it proposes to carry out the major activities of this project in context with the Scope of Work, including its approach to setting customized lifestyle modification goals for individual participants.

27. Provide a detailed implementation timetable, including developing the vendor contract with the OSC, and a comprehensive management plan that the DPP Provider intends to follow that includes pre-implementation, implementation and a communications plan.

28. Describe the workability of the proposed implementation schedule such as sufficiency of member communication programs and systems, educational materials/tools, notices required by ACA and other federal laws. Illustrate how the plan will serve to coordinate and accomplish the work with the OSC on requirements outlined in the RFP.

29. Provide a sample detailed invoice. Confirm that your organization has the ability to provide invoices/billing on a monthly basis and that invoices will contain a detailed disclosure of all invoice line items (e.g. number of participants, weeks completed, participant data collected, etc.) and will be submitted electronically.

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Member and Provider Services (i.e., Customer service, Internet access)

30. Will there be a Customer Service team established strictly for SOC DPP participants?

31. Confirm that a specific toll-free number will be made available at no additional charge to handle service or other issues.

32. What hours will the telephone lines be staffed by actual customer service representatives? (Please do not include hours the telephone line is staffed by an answering service. Include weekend hours.) Hours: ________

33. Provide details on any smartphone or other online applications available.

34. Provide the specific location(s) of your customer service, provider service, and information technology centers.

Data Collection and Reporting

35. How does your organization collect, maintain, share and report data related to program participation, participant demographics, and other measures identified in this RFP? Be specific in describing the mechanism(s) used for data collection, the methodology applied to measurement and software used.

36. What types of reporting has your organization done for other customers? Provide sample reports.

37. Does your organization have the ability to securely transfer electronic data files? If yes, explain the format and protocols your organization uses to do so.

38. How would your organization propose coordinating blood draws and collecting results, for the purpose of tracking eligibility and outcomes?

Quality Management

39. List the top five member complaints your organization received in 2016 and describe how your organization addressed them.

40. When your organization receives a member complaint, how and when would your organization relay

that information back to the OSC? 41. Does your organization conduct patient satisfaction surveys and report on results? If yes, please

explain how your organization conducts surveys, who administers the survey, what survey methodology your organization uses, and the typical response rate experienced.

42. Provide a sample patient satisfaction survey and submit the results of your organization’s last two completed surveys. Confirm that your organization will submit the results of any customer satisfaction surveys conducted during the course of the agreement if awarded the contract, to OSC.

43. How does your organization protect the privacy of the participants’ personal health information and

maintain member confidentiality? 44. Has your organization experienced a data breach? If yes, explain the circumstance, the size and scope

of the breach, any corrective action taken and whether your organization was penalized as a result.

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Cost and Quality Controls 45. Detail the performance guarantees, including the amounts of performance penalties, that your

organization is offering the State in connection with: (1) Implementation, (2) Overall Account Management/Client Satisfaction, (3) Reporting Accuracy, (4) Eligibility Processing, (5) Any additional guarantees your organization wishes to offer. The State expects that vendors will put forth aggressive guarantees as part of their overall proposal.

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Attachment A. COST PROPOSAL

State of Connecticut Office of the State Comptroller (OSC): Cost Proposal Worksheet

- Bidders must provide a detailed cost proposal for the State of Connecticut, OSC - Department of Transportation, Diabetes Prevention Program.

- Bidders must break out the quoted price between the direct and indirect components. Failure to break out the price as indicated may result in your Proposal being rejected.

- The quoted price is guaranteed for the first year of the contract. - Input cells are shaded in yellow. Cells not shaded in yellow will calculate. Please fill in all cells as requested and return the cost

proposal in Excel format.

Agency / Company Name:

Address:

Budget period:

Name of Program: CT OSC - Department of Transportation Diabetes Prevention Program

Direct Expenses

Personnel Expense

Salaries and wages: FTE Start Up Budget Year 1 Budget Year 2 Budget Year 3 Budget

Position / Title:

Position / Title:

Position / Title:

Position / Title:

Position / Title:

Position / Title:

Position / Title:

Position / Title:

Position / Title:

Total Salaries and Wages: $0.00 $0.00 $0.00 $0.00

Payroll Taxes and Benefits

FICA

Unemployment Insurance

Workers Compensation

Retirement Benefits

Health Insurance

Other (please describe)

Total Payroll Taxes and Benefits $0.00 $0.00 $0.00 $0.00

Total Personnel Expenses $0.00 $0.00 $0.00 $0.00

Operating Expenses

Communications

Office Maintenance

Equipment Maintenance

Office Supplies

Postage

Printing

Rents & Leases of Equipment

Rents & Leases of Structures

Professional Services

Software

Small Tools and Equipment

Training Materials

Training Related Travel

Travel and Mileage

Utilities

Other (please identify)

Other (please identify)

Miscellaneous (please identify)

Total Operating Expenses $0.00 $0.00 $0.00 $0.00

Total Direct Expenses $0.00 $0.00 $0.00 $0.00

Indirect Expenses

Indirect Cost / Administrative Overhead 0.00% $0.00 $0.00 $0.00 $0.00

Total Cost of Contract $0.00 $0.00 $0.00 $0.00