rfp template - texas · web view4.9 delivery of applications submit all copies of the application...

Charles Smith, Executive Commissioner

Open Enrollment For

Primary Health Care Program

Enrollment Number: HHS0000085

Enrollment Period Opens: September 7, 2017

Enrollment Period Closes: October 7, 2017

CPA Class/Item Code:

193-66 952-42260-82 952-43948-27 952-88948-28 952-90948-32 952-94948-47 958-56948-48 961-48948-97

Health & Human Services CommissionPrimary Health Care ProgramEnrollment Number: HHS0000085

TABLE OF CONTENTS

1. GENERAL INFORMATION...............................................................................................31.1. SCOPE...........................................................................................................................................................31.2. POINT OF CONTACT......................................................................................................................................31.3. PROCUREMENT SCHEDULE...........................................................................................................................31.4. BACKGROUND..............................................................................................................................................41.5. ELIGIBLE APPLICANTS.................................................................................................................................51.6. STRATEGIC ELEMENTS.................................................................................................................................61.7 AMENDMENTS AND ANNOUNCEMENTS REGARDING THIS OPEN ENROLLMENT...............................................71.8 DELIVERY OF NOTICES.....................................................................................................................................8

2 STATEMENT OF WORK...................................................................................................92.1 PROGRAM PURPOSE..........................................................................................................................................92.2 PROGRAM REQUIREMENTS................................................................................................................................9

3 PAYMENT.......................................................................................................................153.1 PAYMENT........................................................................................................................................................15

4 INFORMATION AND SUBMISSION INSTRUCTIONS...................................................174.1 OPEN ENROLLMENT CANCELLATION/PARTIAL AWARD/NON-AWARD..........................................................174.2 RIGHT TO REJECT APPLICATIONS OR PORTIONS OF APPLICATIONS...............................................................174.3 JOINT APPLICATIONS.......................................................................................................................................174.4 WITHDRAWAL OF APPLICATIONS....................................................................................................................174.5 USE OF SUBCONTRACTORS.............................................................................................................................174.6 COSTS INCURRED............................................................................................................................................184.7 APPLICATION SUBMISSION INSTRUCTIONS.....................................................................................................184.8 ORGANIZATION OF ELECTRONIC SUBMISSION OF APPLICATION........................................................................194.9 DELIVERY OF APPLICATIONS SUBMIT ALL COPIES OF THE APPLICATION TO HHSC PROCUREMENT AND CONTRACTING SERVICES (PCS) DIVISION PROVIDED BELOW BY THE DUE DATE AND TIME LISTED IN THE PROCUREMENT SCHEDULE IN SECTION 1.3 OF THIS OPEN ENROLLMENT. ALL SUBMISSIONS WILL BE DATE AND TIME STAMPED WHEN RECEIVED BY PCS. THE CLOCK IN THE PCS OFFICE IS THE OFFICIAL TIMEPIECE FOR DETERMINING COMPLIANCE WITH THE DEADLINES IN THIS PROCUREMENT. HHSC RESERVES THE RIGHT TO REJECT LATE SUBMISSIONS. IT IS THE APPLICANT’S RESPONSIBILITY TO APPROPRIATELY MARK AND DELIVER THE APPLICATION TO HHSC BY THE SPECIFIED DATE....................................................................................................20

5 ELIGIBILITY DETERMINATION.....................................................................................215.1 INITIAL COMPLIANCE SCREENING..................................................................................................................215.2 UNRESPONSIVE APPLICATIONS...........................................................................................................................215.3 CORRECTIONS TO APPLICATION.........................................................................................................................215.4 REVIEW AND VALIDATION OF APPLICATIONS................................................................................................225.5 ADDITIONAL INFORMATION................................................................................................................................225.6 DEBRIEFING........................................................................................................................................................225.7 PROTEST PROCEDURES.......................................................................................................................................22

6 GLOSSARY.....................................................................................................................23


1. GENERAL INFORMATION

1.1. Scope

The State of Texas, by and through the Texas Health and Human Services Commission (HHSC), seeks contractors to provide Primary Health Care (PHC) in accordance with the specifications contained in this open enrollment.

1.2. Point of Contact

The sole Point of Contact for inquiries concerning this open enrollment is:

Point of Contact: Karen Gray

Address: Health and Human Services Commission Office of Primary and Specialty Health To the Attention of: Karen GrayP.O. Box 1493471100 W. 49th Street - Moreton Bldg. Austin, Texas 78714-9347Mail Code: OPSH-1938

Phone: 512-776-2752

Fax: 512-776-7238

Email: [email protected]

Office Hours: 7:30 AM to 4:30 PM Monday through Friday

Applicant must direct all communications relating to this open enrollment to the Health and Human Services Commission (HHSC) Point of Contact named above.

1.3. Procurement Schedule

All dates are subject to change at HHSC's discretion. Applications must be received by the HHSC Point of Contact identified in Section 1.2 by the enrollment closing period provided in the Procurement Schedule below. Late applications will be deemed non-responsive and will not be considered.

Procurement ScheduleOpen Enrollment Period Opens September 7, 2017Open Enrollment Period Closes October 7, 2017


Procurement ScheduleAnticipated Contract Start Date December 1, 2017

1.4. Background

1.4.1. Overview of the Health and Human Services Commission (HHSC)

Since 1991, the Texas Health and Human Services Commission (HHSC) has overseen and coordinated the planning and delivery of health and human service programs in Texas. HHSC is established in accordance with Texas Government Code Chapter 531 and is responsible for the oversight of all Texas health and human service agencies (HHS Agencies). HHSC’s chief executive officer is Charles Smith, Executive Commissioner of Health and Human Services.

As a result of the consolidation due to House Bill 2292 (HB 2292), some of the contracting and procurement activities for the HHS Agencies have been assigned to the Procurement and Contracting Services (PCS) Division of HHSC.

1.4.2. Project Overview

In the early 1980s, economic recession and cost containment measures on the part of employers and government agencies led to a decrease in the availability and accessibility of health care services for many Texans. A gubernatorial and legislative task force identified the provision of primary health care to the medically indigent as a major priority. The task force recommended the following:

A. A range of primary health care services shall be made available to the medically indigent residing in Texas.

B. HHSC shall provide or contract to provide primary health care services to the medically indigent. These services should complement existing services and/or should be provided where there is a scarcity of services.

C. Health education should be an integral component of all primary care services delivered to the medically indigent population. Preventive services should be marketed and made accessible to reduce the use of more expensive emergency room services.

These recommendations become the basis of the indigent health care legislative package enacted by the 69th Texas Legislature in 1985. The Primary Health Care Services Act, H.B. 1844, was part of this legislation and is the statutory authority for PHC administered by HHSC. The Act delineates the specific target population, eligibility, reporting, and coordination requirements for PHC.


PHC provides primary health care services for individuals who are at or below 200% of the Federal Poverty Level (FPL) and are unable to access the same care through other funding sources or programs. Contractors must assure that services provided to clients are accessible in terms of cost, scheduling and distance, and are provided in a way that is sensitive to the individual’s culture.

1.5. Eligible Applicants

To be eligible to receive an award through this open enrollment, Applicants shall:

1.5.1. Be legally authorized to do business in the State of Texas and determined to be "Active" by the Texas Comptroller of Public Accounts. Applicants can check their status at http://www.cpa.state.tx.us/taxinfo/coasintr.html.

1.5.2. Be a public or private nonprofit, governmental, or for-profit entity that is not currently under a contract to provide HHSC Primary Health Care Program services.

1.5.3. Serve eligible individuals who reside in at least one of the following approved counties: Brewster, Concho, Crockett, Culberson, Denton, Gregg, Hidalgo, Jeff Davis, Kimble, Liberty, Mason, McCulloch, Menard, Pecos, Presidio, San Jacinto, Schleicher, Sutton, Terrell and Tom Green County.

1.5.4. Have a clinic located in at least one of the following approved cities: Cleveland, Denton, Gilmer, Kilgore, Liberty, Lewisville, Longview, Marfa, McAllen, San Angelo and Shepherd.

1.5.5. Be enrolled as a Medicaid (Title XIX) provider with the Texas Medicaid & Healthcare Partnership (TMHP) in order to receive payment for PHC services. PHC contractors must complete required Medicaid provider enrollment application forms and enter into a written provider agreement with HHSC, the single state Medicaid agency. Forms may be downloaded or potential Applicants may complete an online application on the TMHP website: ht t p : / / ww w .tmh p . c o m . Applicants proposing to subcontract all direct medical services may request a waiver to this requirement.

1.5.6. Accept the terms of this open enrollment and not alter HHS procurement language, including but not limited to attachments, appendices and exhibits attached to this procurement;

1.5.7. Have a Texas business address. A post office box may be used when the application is submitted, but the Applicant must conduct business at a physical location in Texas prior to the date that the contract is awarded.

http://www.cpa.state.tx.us/taxinfo/coasintr.html


1.5.8. Be in good standing with the U.S. Internal Revenue Service.

1.5.9. Not be currently debarred, suspended, or otherwise excluded or ineligible for participation in Federal or State assistance programs.

1.5.10. Not have audit reports or financial statements submitted with the application that identify concerns regarding the future viability of the contractor, material non-compliance or material weaknesses that are not satisfactorily addressed, as determined by HHSC.

1.5.11. Not have staff members, including the executive director, that serve as voting members on their employer’s governing board.

In compliance with Comptroller of Public Accounts and Texas Procurement and Support Services rules, a name search will be conducted using the following websites prior to the development of a contract. An Applicant is not considered eligible to contract with HHSC, regardless of the funding source, if a name match is found on any of the following lists:

A. The Office of Inspector General (OIG) List of Excluded Individuals/Entities Search– State h t tps : //o i g.hhsc . st a te . t x .us/E x c l us i o n s/se a r ch.asp x ; and

B. Texas Comptroller of Public Accounts (CPA) Debarment List located at ht t p : / /co m p t ro ll er . te x as . g o v /procur e me n t /pr o g/ v e n d o r_ p e r fo r ma n ce/deb a r r e d / . If this web link does not open, copy and paste to your internet browser window.

C. Applicants must be listed on the following Secretary of State list if they are a Professional Corporation, Professional Association, Texas Corporation, and/or a Texas Limited Partnership Company:

h tt p s :/ /d i rec t .so s .st a t e .t x .us/ ac ct/a c c t - l o g i n.as p .

Applicants are not considered eligible to apply unless the Applicant meets the eligibility conditions to the stated criteria listed above at the time the application is submitted. Applicants must continue to meet these conditions throughout the selection and funding process. HHSC expressly reserves the right to review and analyze the documentation submitted and to request additional documentation, and determine the Applicant’s eligibility to compete for the contract award.

1.6. Strategic Elements

1.6.1. Contract Type and Term

1.6.1.1 It is anticipated that the contract(s) that result from this procurement shall commence upon execution and will terminate on August 31, 2019.

https://oig.hhsc.state.tx.us/Exclusions/search.aspx


1.6.1.2 The contracts may be renewed for up to one (1) additional one year period, with renewal initiated at the sole discretion of HHSC.

1.6.1.3 Contracts awarded under this open enrollment and any renewals are contingent upon the availability of funds and the satisfactory performance of the contractor during the prior contract period. Funding may vary and is subject to change each renewal.

1.6.2 Contract Elements

The term “contract” means the contract awarded as a result of this open enrollment, which includes but is not limited to the signature document and all attachments thereto, HHSC’s Uniform Terms and Conditions - Grant, Version 2.14 (UTCs), the HHSC Special Conditions, this open enrollment, and the successful Applicants’ respective application. The UTCs are contained in Appendix F and the HHSC Special Conditions are contained in Appendix G.

HHSC reserves the right to negotiate additional contract terms and conditions. Applicants are responsible for reviewing the UTCs and HHSC Special Conditions and noting any exceptions on the Respondent Information and Disclosures form.

1.6.3 Data Use Agreement (DUA)

By entering into contract with a Texas Health & Human Services agency, you agree to be bound by the terms of the HHS Data Use Agreement (HHS- GC.DUA) Data Use Agreement: This is the general version that should be used for all contractors who access agency confidential information. It is available on the HH S C B us i n e ss Op p or t u n i t i es w e b p a g e .

Information that explains the terms of the DUA and what laws require us to protect and safeguard agency confidential data can be found at: ht t p : / /h h sc x .h h s c .st a te . t x .us/d a t a -us e - a g re e me n t - comp l i a n ce/doc s /u n d e r s t a n d i n g - d u a .p d f .

1.7 Amendments and Announcements Regarding this Open Enrollment

HHSC will post all official communication regarding this open enrollment on the HHS Enrollment Opportunities page at https://apps.hhs.texas.gov/pcs/openenrollment.cfm. HHSC reserves the right to revise the open enrollment at any time and to make unilateral amendments to correct grammar, organization and clerical errors. It is the responsibility of each Applicant to comply with any changes, amendments, or clarifications posted to the HHS Enrollment Opportunities page. Applicant must check HHS Enrollment Opportunities frequently for changes and notices of matters affecting this open enrollment. Applicant’s failure to periodically check HHS Enrollment Opportunities will in no way release the Applicant from “addenda or additional

https://apps.hhs.texas.gov/pcs/openenrollment.cfm


information” resulting in additional costs to meet the requirements of the open enrollment.

All questions and comments regarding this open enrollment should be sent to the HHSC Point of Contact identified in Section 1.2. Questions must reference the appropriate page and section number. HHSC’s will post subsequent answers to questions to the PCS Business Opportunities Page as appropriate. HHSC reserves the right to amend answers prior to the open enrollment closing date.

Applicants must notify HHSC of any ambiguity, conflict, discrepancy, omission or other error in the open enrollment.

1.8 Delivery of Notices

Any notice required or permitted under this announcement by one party to the other party must be in writing and correspond with the contact information noted in Section 1.2 of this open enrollment. At all times, Applicant will maintain and monitor at least one active email address for the receipt of Application-related communications from HHSC. It is the Applicant’s responsibility to monitor this email address for Application-related information.

The remainder of this page is intentionally left blank.


2. STATEMENT OF WORK

2.1 Program Purpose

HHSC PHC services are intended to ensure that low-income Texas residents, whose gross family income is at or below 200% of the adopted federal poverty income guidelines and who are not eligible for similar services through any other publicly funded programs/benefits, have access to primary health care. Priority PHC services include diagnosis and treatment; emergency services; family planning services; preventive health services, including immunizations; health education; and laboratory, x-ray, nuclear medicine, or other appropriate diagnostic services. Specific requirements related to the provision of PHC services can be found online in the HHSC Primary Health Care Policy Manual at: h t tp : // w w w .ds h s.st a te . t x .us/ph c /p a n d p . sh t m .

2.2 Program Requirements

Contractors must provide the following program requirements:

2.2.1. Contractor shall deliver comprehensive health care services to eligible low-income individuals as authorized under the Texas Health and Safety Code, Chapter 31, Primary Health Care Services Act, as amended, and in accordance with the most recent version of the PHC Policy Manual (available at ht t p : / / ww w .ds h s.st a te . t x .us/phc/p a n d p.s h t m ).

2.2.2. In accordance with 25 Texas Administrative Code, §§39.2, 39.3, and 39.4, as amended, contractor shall offer the following priority services directly or by subcontract and/or referral at no additional cost to the client:

A. Di a g n o s i s a n d T re a t me n t S er vi ces : diagnosis and treatment of common acute and chronic disease that affect the general health of the client. Services include first contact with a client for an undiagnosed health concern as well as continuing care of varied medical conditions not limited by cause or organ system. Services must not be limited to only one service (i.e. family planning, breast and cervical cancer screening, or podiatry).

B. P re v e n t i v e H e a l th S ervic e s : must include but are not limited to immunizations, cancer screenings, screenings for chronic conditions, and health screening.

C. F a m il y P l a n n i ng S er vi ce s : preventive health and medical services that assist an individual in controlling fertility and achieving optimal reproductive and general health. Services include health check-up & physical exam, birth control methods, natural family


planning, labs tests for sexually transmitted diseases, counselling regarding abstinence, pre-conception, nutrition and fertility.

D. E me r g e n cy M e d i cal S er vi ce s : for urgent care for an unexpected health condition requiring immediate attention as determined by the appropriate medical staff, and must be services that can be treated in a primary care clinic or setting.

E. H e a l th E d u cati o n : planned learning experiences based on sound theories that provide individuals, groups, and communities the opportunity to increase knowledge and skills needed to make quality health decisions.

F. L a b o rat o r y , x -ra y , n u c l e a r me d i c i n e , o r o th e r a p p r o p r i ate d i a g n o s t i c s e r v i ce s : medically necessary technical laboratory tests and radiological services ordered and provided by, or under the direction of, a physician, in an office or a facility other than a hospital inpatient setting.

2.2.3. In addition to priority services and subject to HHSC funding, Contractor may receive funding to provide one or more of the following optional PHC services, directly or by subcontract and/or referral, at no additional cost to the client:

A. Nutrition services;

B. Health screening;

C. Home health care;

D. Dental care;

E. Transportation;

F. Prescription drugs;

G. Environmental health;

H. Podiatry; and

I. Social services.

2.2.4. Contractor shall develop and implement policies and procedures to ensure that all clients complete an application for program services, and that eligibility is determined according to the eligibility requirements as outlined in 25 TAC, §§ 39.1-39.11, as amended, and the most recent version of the PHC Policy Manual (h t tp : // w w w .ds h s.stat e .t x .us/ph c /p a n d p .sh t m ).


2.2.5 Contractor shall submit monthly, quarterly, and annual programmatic reports and/or financial vouchers/reports as required in the most recent version of the PHC Policy Manual (ht t p : // w w w .ds h s.stat e .t x .u s /p h c/p a n d p .s h t m ). Other data and/or reports deemed necessary by HHSC may be required, upon reasonable notice to Contractor.

2.2.6 Contractor must have a Quality Management program that ensures availability and accessibility of services, and quality and continuity of care. The Quality Management program must include:

A. On-going eligibility, billing, and clinical record reviews to assure compliance with program requirements and clinical standards of care;

B. Tracking and reporting of adverse outcomes;

C. Client satisfaction surveys;

D. Annual review of facilities to maintain a safe environment, including an emergency safety plan;

E. Annual review of policies, clinical protocols and standing delegation orders (SDOs) to ensure they are current; and

F. Performance evaluations to include primary license verification, DEA, and immunization status to ensure they are current.

2.2.7 Work Plan: If an Applicant is awarded a contract to provide PHC services under this open enrollment, the Applicant’s approved Work Plan (Exhibit F) will be used to assess the Applicant’s performance in providing and coordinating the priority PHC services in the proposed service area.

2.2.8 Contractor shall conduct Project activities in accordance with the most recent DSHS Standards for Public Health Clinic Services and the most recent HHSC PHC Policy Manual. Contractor may obtain a copy of the most recent DSHS Standards for Public Health Clinic Services on the DSHS website at: ht t p : / / ww w .ds h s.st a te . t x .us / q m b /ds h s s tn d r d s4c li n i cser v s.p d f .

2.3 Contractor Use of Funds

2.3.1.Contractor will only use funds awarded for the purpose specifically defined in this open enrollment - HHSC PHC services - and not for any other purpose. Funds may be used for personnel, fringe benefits, staff travel, contractual services, other direct costs, and indirect costs,


as allowed in the budget (See Exhibit G: Budget Section), for the purpose of providing the priority PHC services, and any optional PHC services.

2.3.2.All Applicants must allocate funds in the Travel category of the Budget Category Detail Exhibit (See Exhibit G: Budget Section) for the cost for two (2) staff to attend up to two, two-days trainings to be held in Austin, Dallas/Fort Worth, Houston, or San Antonio in fiscal year 2018 and 2019.

2.3.3.Contractor may not use funds to supplant other local, state, or federal funds.

2.3.4. To prevent underutilization of funds, HHSC reserves the right to require contractors to return unused funds for re-allocation if it is determined that the contractor cannot reasonably utilize all funds initially awarded.

2.4 Performance Measures and Associated Remedies

2.4.1. HHSC will monitor the performance of the contract issued under this open enrollment. All services and deliverables under the contract shall be provided at an acceptable quality level and in a manner consistent with acceptable industry standard, custom, and practice.

2.4.2. HHSC will monitor Contractors’ expenditures. A Contractor’s budget may be subject to decrease for the remainder of the budget period if expenditure percentages are below the amount projected and determined by HHSC.

2.4.3. The following performance measure will be used to assess, in part, Contractor’s effectiveness in providing the services required under the resulting contract, without waiving the enforceability of any of the other terms of the contract: the number of unduplicated HHSC PHC clients to be provided services during the contract term (See Exhibit E: Performance Measures).

2.6 Assessment Narrative

2.6.1. As part of its response, Applicants must complete an Assessment Narrative (See Exhibit D) that provides a brief synopsis of the Applicant's current service area as a whole describing in general:

A. Geographic boundaries of the community (urban or rural, physical environment, etc.)

B. General demographic data (age, gender, ethnicity, etc.);


C. General socioeconomic data (per capita income, poverty levels, unemployment, occupation data, etc.); and

D. General description of community-wide health status (e.g., key morbidity/mortality statistics).

2.6.2. Applicants must describe their organization including:

A. Health services the Applicant currently provides to low-income and uninsured populations;

B. Applicant's total budget; and

C. Number of clients currently receiving primary health care services.

2.6.3. Applicant must describe how the PHC Project differs from the Applicant's current population and service base.

2.6.4. Applicant must address gaps in resources and potential barriers improving health status.

2.7 PHC Clinic Site Readiness

2.7.1. Applicants must complete a Clinic Site Readiness assessment (See Exhibit I-1) for all clinic sites that will provide PHC services funded through this open enrollment.

2.7.2. Clinic Site Readiness assessment must address the following:

A. Appropriate signage;

B. Space for clinical and administrative staff;

C. Computer system functionality;

D. Existence of at least a;

E. Secure storage of records and medical supplies;

F. Disposal of medical waste;

G. CLIA certification;

H. Accessibility;

I. Facility space;

J. Interpreter services; and


K. ADA compliance.

2.8 Financial and Administrative Requirements

2.9.1. Contractors must comply with the applicable HHSC Uniform Terms and Conditions (Appendix A) and HHSC Special Conditions (see Appendix A) that are a part of the resulting contract.

2.9.2. By completing the Respondent Information and Disclosures, Applicant is agreeing to abide by the referenced Uniform Terms and Conditions and Special Conditions and Assurances and Certifications.

2.9.3. Contractor must comply with applicable cost principles, audit requirements, and administrative requirements. Applicants must complete the Financial Management and Administrative Questionnaire (See Exhibit H) and submit with their application.

1.9.4 Contractors and as applicable, their Board of Directors or other oversight authority, accept responsibility for complying with the resulting contract's management and administration of programmatic, financial and reporting requirements.

1.9.5 Contractors are required to maintain a financial management system (See Exhibit H) that meets state standards for expending and accounting for funds. Documents and records must be maintained that identify the receipt and expenditure of funds separately for each HHSC contract and will records expenditures by the budget cost categories in the approved budget for a cost reimbursement contract. All financial reports should be prepared with information that comes directly from the organization's accounting system. There should be a reconciliation of the information that is reported to amounts recorded in the accounting system.



3. PAYMENT

3.1 Payment

3.1.1 Availability of Funds

Contract awards resulting from this announcement are contingent upon the availability of funds.

If funds for these Contracts become unavailable during any budget period, HHSC may immediately terminate or reduce the amount of the resulting Contract at the discretion of HHSC. Contractor will have no right of action against HHSC if HHSC cannot perform its obligations under this Contract due to a lack of funding for any activities or functions outlined within the Scope and Statement of Work Sections of this open enrollment.

3.1.1.1 HHSC does not guarantee funding at any level and may increase or decrease funds at any time during the term of a Contract resulting from this open enrollment.

3.1.1.2 Contractor may not use funds received from HHSC to replace any other federal, state, or local source of funds awarded under any other Contract.

3.1.2 Method of Payment: Reimbursement for PHC Services

3.1.2.1 Each Applicant must base their budget proposal on the Program Requirements described in Section 2.2 and an assessment of current community needs and identified gaps in the community's primary care delivery system for the target population of low-income individuals at or below 200% of the adopted FPL guidelines. The budget proposal should include any business, economic, legal, programmatic, or practical assumptions that underlie the proposed budget. HHSC reserves the right to accept or reject any assumptions. All assumptions not expressly identified and incorporated into the contract resulting from this open enrollment are deemed rejected by HHSC.

3.1.2.2 Each awardee under this open enrollment shall receive a cost reimbursement Contract. Payments will be made for allowable costs incurred and will be supported by reporting the services provided and client-level data. To be reimbursed for expenses incurred through a cost reimbursement method, contractors must develop a categorical budget and submit the budget with their response to this open enrollment (See Exhibit G: Budget Section), allocating HHSC approved costs to the following categories, as identified during the contractor’s budget development process:


a. Personnelb. Fringe Benefitsc. Traveld. Equipmente. Suppliesf. Contractualg. Otherh. Indirect Costs

Final budgets (including equipment purchases) must be approved by HHSC.

1.1.2.3 Contractor shall request reimbursement by using the Purchase Voucher (Form 4116) and supporting documentation to report costs and fees/co-pays/other party reimbursements collected and received. HHSC Purchase Voucher (Form 4116) and back-up cost and revenue reporting must be submitted monthly by the last business day of the following month. The final voucher is due within 45 days after the end of the contract term.



4. INFORMATION AND SUBMISSION INSTRUCTIONS

4.1 Open Enrollment Cancellation/Partial Award/Non-Award

At its sole discretion, HHSC may cancel this open enrollment, make partial award, or no awards.

4.2 Right to Reject Applications or Portions of Applications

At its sole discretion, HHSC may reject any and all responses or portions thereof.

4.3 Joint Applications

HHSC will not consider joint or collaborative responses that require it to contract with more than one Applicant.

4.4 Withdrawal of Applications

Prior to the Open Enrollment period close date set forth in Section 1.3, an Applicant may withdraw its application by submitting a written request for withdrawal to the HHSC Point of Contact.

4.5 Use of Subcontractors

The selected contractor may enter into contracts with subcontractors unless restricted or otherwise prohibited in the resulting contract to this open enrollment. Prior to entering into a subcontractor agreement equaling or exceeding $100,000.00, contractor shall obtain written approval from HHSC. The contractor is responsible to HHSC for the performance of any subcontractor or sub-grantee.

If the selected Applicant enters into contracts with vendor or subrecipient subcontractors, the documents must be in writing and must comply with the requirements specified in articles of the applicable Uniform Terms and Conditions posted on the HHSC Business Opportunities website in conjunction with this open enrollment.

Subcontractors providing services under the contract shall meet the same requirements and level of experience as required of the Applicant. No subcontract under the contract shall relieve the Applicant of the responsibility for ensuring the requested services are provided. Applicants planning to subcontract all or a portion of the work to be performed shall identify the proposed subcontractors to HHSC in its response to this open enrollment.


4.6 Costs Incurred

Applicants understand that issuance of this open enrollment in no way constitutes a commitment by the HHS agency to award a Contract or to pay any costs incurred by an Applicant in the preparation of an application to this open enrollment. The HHS agency is not liable for any costs incurred by an Applicant prior to issuance of, or entering into a formal agreement, Contract, or purchase order. Costs of developing applications, preparing for or participating in oral presentations and site visits, or any other similar expenses incurred by an Applicant are entirely the responsibility of the Applicant, and will not be reimbursed in any manner by the State of Texas.

4.7 Application Submission Instructions

Applicant may submit an application using one of the following methods:

Electronic submission via email or portable media devices Hard copies via hand delivery or regular mail

It is the Applicant's responsibility to periodically check HHS Enrollment Opportunities for updates to the procurement prior to submitting an application. The Applicant's failure to periodically check HHS Enrollment Opportunities will in no way release the Applicant from "addenda or additional information" resulting in additional costs to meet the requirements of the open enrollment.

DO NOT submit an Application by both email and regular mail or hand delivery service.

It is the Applicant’s responsibility to appropriately mark and deliver the Application and related materials in response to this open enrollment by the Application due date.

Submission of an Application does not execute a Contract.

4.7.1 Electronic Submission Applicant may submit the Application packet electronically by: (1) emailing the Application packet to: [email protected] ; or (2) mailing or hand delivering two (2) electronic copies of the Application packet as scanned versions (.pdf) on separate portable media devices, such as flash drives or compact discs.

The portable media devices must be compatible with Microsoft Office 2010. Applicants must ensure there are no encryptions on these devices, so as to prevent HHSC from opening the documents.

Each flash drive must be placed in an envelope and the envelope must be labeled with Applicant’s legal name, the point of contact, the point of contact’s job title, the point of contact’s telephone number and email address, the HHSC Procurement number on this Open Enrollment, and the date of submission.

mailto:[email protected]


Each compact disk must be labeled with Applicant’s legal name, the point of contact, the point of contact’s job title, the point of contact’s telephone number and email address, the HHSC Procurement number on this Open Enrollment, and the date of submission.

The electronic Application submission must be organized as directed in Section 4.8 of this open enrollment. If Applicant is having difficulty providing an electronic Application submission, contact the Point of Contact identified in Section 1.2 of this open enrollment for hard copy submittal accommodations.

4.8 Organization of Electronic Submission of Application

Applicant must organize its scanned and signed Application packets in the following order and format. Each electronic copy of the Application packet must include the following three (3) file folders with the respective listed documents included, and the documents must be in the following order, and numbered and labeled accordingly:

File Folder 1 Exhibits

Exhibit A: Face Page and Instructions Exhibit A-1: Texas Counties and Regions Exhibit B: Contact Person Information Exhibit C: Applicant’s BackgroundExhibit D: Assessment Narrative Exhibit E: Performance MeasuresExhibit E-1: Exception to Statewide Average Cost Per ClientExhibit F: Work Plan and Guidelines Exhibit G: Budget Exhibit/Forms and Detail PageExhibit H: Financial Management and Administration QuestionnaireExhibit I: Clinic Site and Instructions Exhibit I-1: Clinic Site Readiness

File Folder 2: Supporting Documentation Exhibits

Exhibit 1 – One-page executive summary Exhibit 2 – Current organization chart and a Table of Contents from organization’s

operating policies and procedures Exhibit 3 – Attach a minimum of three (3) letters of support from government officials

and/or community partners

File Folder 3: Required Exhibits

Applicants may also access the list of Required Forms at the following alternative link: HHS Required Forms

Exhibit J – Primary Health Care Program CertificationExhibit K – HHSC Uniform Contract Terms and Conditions

https://hhs.texas.gov/doing-business-hhs/hub-program/required-hub-forms


Exhibit L – HHSC Special Conditions Version 10Exhibit M – HHSC Data Use AgreementExhibit N – Child Support Certification Exhibit O – Debarment, Suspension, IneligibilityExhibit P – Federal Lobbying CertificationExhibit Q – Completed and Signed Certification LetterExhibit R – Respondent Information and DisclosuresExhibit S – Anti-Trust CertificationExhibit T - HHS Information Security and Privacy Initial Inquiry

NOTE: Each individual item being requested in File Folders 1, 2, and 3 must be collated and sequentially numbered.

4.9 Delivery of Applications Submit all copies of the Application to HHSC Procurement and Contracting Services (PCS) Division provided below by the due date and time listed in the Procurement Schedule in Section 1.3 of this open enrollment. All submissions will be date and time stamped when received by PCS. The clock in the PCS office is the official timepiece for determining compliance with the deadlines in this procurement. HHSC reserves the right to reject late submissions. It is the Applicant’s responsibility to appropriately mark and deliver the Application to HHSC by the specified date.

Delivery OptionsPhysical Address for Delivery

(Operating Hours - 8:00 A.M. to 5:00 P.M.)Health and Human Services Commission

Office of Primary and Specialty HealthTo the Attention of: Karen Gray

P.O. Box 1493471100 W. 49th Street - Moreton Bldg.

Austin, Texas 78714-9347Mail Code: OPSH-1938


5. ELIGIBILITY DETERMINATION

5.1 Initial Compliance Screening

HHSC will perform an initial screening of all Applications received. Unsigned Applications and Applications that do not include all required documentation, exhibits and sections are subject to rejection without further evaluation.

If the Application passes the initial screening, the contract manager will contact the Applicant for further instructions or actions.

5.2 Unresponsive Applications

Unless Applicant has taken action to withdraw the Application for this open enrollment, an Application will be considered unresponsive and will not be considered further when any of the following conditions occurs:

5.2.1 The Applicant fails to meet major open enrollment specifications, including, but not limited to:

5.1 The Applicant fails to submit the required Application, supporting documentation, or any exhibits.

5.2 The Applicant is not eligible under Section 1.5 of this open enrollment.

5.3 The Applicant does not accept the payment rate established in this open enrollment.

5.4 The Applicant alters HHS procurement language, including but not limited to attachments, appendices and exhibits attached to this procurement.

5.2.2 The Application is not signed.

5.2.3 The Applicant’s response is not clearly legible. Typewritten is preferred.

5.2.4 The Application is not received by the closing of the open enrollment period provided in Section 1.3 of this open enrollment.

5.3 Corrections to Application

Applicants have the right to amend their Application at any time prior to an unresponsive decision or Contract award decision by submitting a written amendment to the Point of Contact, as designated in Section 1.2. HHSC may request modifications to the Application at any time.


5.4 Review and Validation of Applications

The Applicant must provide full, accurate, and complete information as required by this open enrollment.

5.5 Additional Information

By submitting an Application, the Applicant grants HHSC the right to obtain information from any lawful source regarding the Applicant’s, its directors’, officers’, and employees:

5.2.1 Past business history, practices, and conduct;

5.2.1 Ability to supply the goods and services; and

5.2.1 Ability to comply with Contract requirements.

By submitting an Application, an Applicant generally releases from liability and waives all claims against any party providing HHSC information about the Applicant. HHSC may take such information into consideration in screening or the validation of information on Applications or supporting documentation.

5.6 Debriefing

Any Applicant who is not awarded a Contract may request a debriefing by submitting a written request to the Point of Contact as provided in Section 1.2 of this open enrollment. The debriefing provides information to the Applicant on the strengths and weaknesses of their Application.

5.7 Protest Procedures

The protest procedure for an Applicant who is not awarded a Contract to protest an award or tentative award made by any HHS agency is allowed for competitive Procurements. This Procurement is non-competitive and cannot be protested as provided in 1 TAC §391.301.


http://texreg.sos.state.tx.us/public/readtac$ext.TacPage?sl=R&app=9&p_dir=&p_rloc=&p_tloc=&p_ploc=&pg=1&p_tac=&ti=1&pt=15&ch=391&rl=301


6 GLOSSARY

TERM DEFINITIONAmendment A formal revision or addition to a contract.

Applicant Any individual or entity that submits an application for enrollment pursuant to this open enrollment.

Application An Application submitted by an Applicant in response to this Open Enrollment.

Barrier to CareA factor that hinders a person from receiving health care (i.e., proximity (or distance), lack of transportation, documentation requirements, co-payment amount, etc.).

Best Interests of the State

Most advantageous to the state in light of all relevant circumstances.

Budget

A financial schedule documented in the contract that describes how funds will be used and/or describes the basis for reimbursement for the provision of contracted services. Types of budget may include categorical (line item), fee for service, or lump sum. Exhibit G, The Budget Section is required.

Budget PeriodThe duration of the budget (stated in the number of months the contract will reflect from begin date to end date of the term of the contract). Each contract renewal will have its own budget period.

ClientAn individual who has been screened, determined to be eligible for services, and successfully completed the eligibility process.

Contract A promise or a set of promises, for breach of which the law gives a remedy, or the performance of which the law in some way recognizes as a duty. It is an Agreement between two or more parties creating obligations that are enforceable or otherwise recognizable by law. The term also encompasses the written document that describes the terms of the Agreement. For State Contracting purposes, it generally describes the terms of a purchase of goods or services from a vendor or service provider.

Complaint A concern reported to HHSC contract staff about the Contractor’s professionalism and/or quality of work.


TERM DEFINITIONConfidential Information Any communication or record (whether oral, written

electronically stored or transmitted, or in any other form) that consist of: (1) Confidential Client information, including Protected Health Information; (2) All non-public budget, expense, payment and other financial information; (3) All privileged Work Product; (4) All information designated by HHSC or any other State agency as confidential, including all information designated as confidential under the Texas Public Information Act, Texas Government Code, Chapter 552; (5) Unless publicly disclosed by HHSC or the State, the pricing , payments, and terms and conditions of the Agreement; and (6) Information that is utilized developed, received, or maintained by HHSC, the Contractor, or participating State agencies for the purpose of fulfilling a duty or obligation under this Agreement and that has not been publicity disclosed.

Conflict of Interest A conflict of interest is a situation that creates a risk that professional judgement or actions will be unduly influenced by a personal interest or relationship and creates substantial conflicts with the proper discharge of duties required by this contract and the public interest

Contract TermThe period of time during which the contract will be effective from begin date to end, or renewal date. The contract term may or may not be the same as the budget period.

Contractor Any Applicant who is awarded a contract pursuant to this open enrollment or who has an existing contract to provide inpatient, outpatient hospital services and acute inpatient comprehensive medical rehabilitation services


TERM DEFINITION

Cost Reimbursement

A payment mechanism by which contractors are reimbursed for allowable costs incurred up to the total award amount specified in the contract. Costs must be incurred in carrying out approved activities, and must be based on an approved eight -category line- item (categorical) budget. Amounts expended in support of providing services and goods, if any, in accordance with the contract terms and conditions must be billed on a monthly basis for reimbursement unless otherwise specified in the contract. Reimbursement is based on actual allowable costs incurred that comply with the cost principles applicable to the grant and subgrants.

DebarmentAn exclusion from contracting or subcontracting with state agencies on the basis of cause set forth in Title 34, Texas Administrative Code Chapter 20, Subchapter C, §20.105 et seq.

Deliverables Goods or services contracted for delivery or performance.

Due DateEstablished deadline for submission of a document or deliverable.

Effective Date The date the contract term begins.

Federal Poverty Level (FPL)

The set minimum amount of income that a family needsfor food, clothing, transportation, shelter and other necessities. In the United States, this level is determined by the Department of Health and Human Services. The FPL varies according to family size. The number is adjusted for inflation and reported annually in the form of poverty guidelines. Public assistance programs, such as Medicaid in the U.S., define eligibility income limits as some percentage of FPL.

Fee For Service

Payment mechanism for services that are reimbursed on a set rate per unit of service (also known as unit rate). Fee-for-service reimbursement rates may be based on a prescribed set of Current Procedural Terminology (CPT) codes and Medicaid fee-for-service physician reimbursement rates.

Fiscal Year (State of Texas)

The period beginning September 1 and ending August 31 of each year.


TERM DEFINITION

Fully Executed

When a contract is signed by each of the parties to form a legal binding contractual relationship. No costs chargeable to the proposed contract will be reimbursed before the contract is fully executed.

Indirect Costs

Costs incurred for a common or joint purpose benefiting more than one project or cost objective of the Applicant’s organization and not readily identified with a particular project or cost objective. Typical examples of indirect costs may include general administration and general expenses such as salaries and expenses of executive officers, personnel administration and accounting; depreciation or use allowances on buildings and equipment; and costs of operating and maintaining facilities.

Uniform Terms and Conditions

Basic provisions that are essential in administering the contract, which include assurances required by law, compliance requirements, applicable federal and state statutes and circulars, financial management standards, records and reporting requirements, funding contingency, sanctions, and terms and conditions of payment.

Procurement and Contracting Services Division (PCS)

Central contracting unit within HHSC that is responsible for statewide procurements and their certifications. PCS oversees, coordinates, and assists the Divisions with procurement needs, issues competitive procurements, finalizes development, and executes contracts. PCS maintains the official contract file from procurement to contract closeout.

Program

Depending upon the context, either a coordinated group of activities carried out by HHSC, as authorized by state or federal law, for a specific purpose (program) or HHSC staff located in a program, region, or hospital that identify and request procurement needs (Program) The Program partners with PCS on procurements.

Statement of WorkThe part of the contract that describes the services and/or goods to be delivered by the HHSC contractor specifying the type, level and quality of service, that directly relate to program objectives.


TERM DEFINITION

Subcontract

A written agreement between the HHSC contractor and a third party to provide all or a specified part of the services, goods, work, and materials required in the original contract. The contractor remains entirely responsible to HHSC for performance of all requirements of the contract with HHSC. The contractor must closely monitor the subcontractor’s performance. Subcontracting can be done only when expressly allowed in the program attachment.

Supplant (verb)

To replace or substitute one source of funding for another source of funding. A recipient of contract funds under this open enrollment must not use the funds to pay any costs that the recipient is already obligated to pay. If a contractor, prior to responding to an open enrollment, had committed to provide funding for activities defined in the contract’s statement of work (i.e., as represented in the open enrollment Budget Summary), then the contractor must provide the amount of funding previously committed in addition to the amount requested under this open enrollment.

Unit Rate

Payment mechanism for services that are reimbursed at a set rate per unit of service; for example, treatment services at a prescribed rate per hour (also known as fee-for-service).


TERM DEFINITION

Vendor

A type of contractor or subcontractor that provides services, and goods, if any, that assist in, but are not the primary means of, carrying out the HHSC-funded Program. Under a vendor contract, the vendor will have few if any administrative requirements. (For example, a vendor might be required only to submit a summary report of services delivered and an invoice.) A vendor generally will deliver services to HHSC-funded clients in the same manner the vendor would deliver those services to its non-HHSC-funded clients.

A vendor contractor generally has most of the following characteristics: a) provides goods and services within normal business operations, b) provides similar goods and services to many different purchasers, c) operates in a competitive environment, d) is not subject to compliance requirements of the federal or state program, e) provides goods and services that are ancillary to the operation of the program. Note: Characteristics a, b, c, and d do not apply to vendor contractors that are universities.

Vendor Identification Number (Vendor ID No.)

Fourteen-digit number needed for any entity, whether vendor or subrecipient, to contract with the State of Texas and which must be established with the State Comptroller’s Office. It consists of a ten- digit identification number (IRS number, state agency number, or social security number) +check digit + 3 digit mail code. The Vendor ID No. includes all the numbers in the TINs (defined above), including a three digit mail code for a total of 14-digits.

Work Plan

A plan that describes how services will be delivered to the eligible population and includes specifics such as what types of clients will be served, who will be responsible for the work, timelines for completion of activities, and how services will be evaluated when complete. To be an enforceable part of the contract, details from the work plan must be approved by HHSC and incorporated in the contract.


7 EXHIBIT DOCUMENT LIST

Exhibit TitleReturn with Application Package

Exhibit A Face Page and Instructions YesExhibit A-1 Texas Counties and Region List YesExhibit B Contact Person Information YesExhibit C Applicant Background YesExhibit D Assessment Narrative YesExhibit E Performance Measures YesExhibit E-1 Request for Exception to Statewide

Average Cost per Client Yes

Exhibit F Work Plan YesExhibit G Budget Forms and Guidelines Section YesExhibit H Financial Management and Administrative

QuestionnaireYes

Exhibit I Clinic Site and Instructions YesExhibit I-1 Clinic Site Readiness YesExhibit J Primary Health Care Program Certification YesExhibit K HHSC Uniform Contract Terms and

ConditionsNo

Exhibit L HHSC Special Conditions Version 1.0 NoExhibit M HHSC Data Use Agreement YesExhibit N Child Support Certification YesExhibit O Debarment, Suspension, Ineligibility

CertificationYes

Exhibit P Federal Lobbying Certification YesExhibit Q Completed and Signed Certification Letter YesExhibit R Respondent Information and Disclosures YesExhibit S Anti-Trust Certification YesExhibit T HHS Information Security and Privacy

Initial InquiryYes
