and 2 of this RFR, and should explain how the bidder intends to fulfill the purpose of the grant The Programmatic Response should specifically address how the bidder meets each of the

bidder qualifications outlined in Section 1.6. Proposals should be innovative and as specific as

possible in describing how and to whom the organization will conduct outreach to difficult-to-reach populations in the bidder’s geographic area.

Programmatic proposals may not exceed six pages for Model A and eight pages for Model B. The

cover letter and any other supporting documentation or forms specifically required by this RFR will not be counted in calculating the bidder’s page limits. Model B project plans, deliverables and sample marketing materials will not be counted in calculating the bidder’s page limits.

Pages should besingle-sided and single-spaced. Minimum font size is 11. Minimum margin size is

¾ inch.

All bidders must answer the following questions:

1. Provide a brief abstract of the proposed program (no more than 1-2 paragraphs),

including the dollar amount of the grant being requested; and anticipated outcomes (including but not limited to approximations, per month and per grant cycle, of how many applicants will be assisted, how many enrolled, how many reached via outreach efforts).

2. Provide the following information about your organization:

a. Describe your mission and programs.

b. Briefly describe your experience in providing this type of service. Include

information about your organization’s level of readiness including a list of current staff that will be involved and their qualifications and any proposed staffing including job description/qualifications for this project.

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c. Address any cultural capacities, foreign language expertise, experience with low-

income populations, or other specialized capabilities or experience of your staff or your organization that would be beneficial to this project.

d. Briefly describe your plan of sustainability in order to continue these services beyond

the grant cycle.

3. Provide a detailed description of the programmatic activities you will implement with the

grant funds, including:

a. A timeline for the activities you propose to perform, listing each identified activity

and deliverable and measure of success;

b. A plan for collecting qualitative data timely regarding programmatic activities,

including outcome measurements you propose to use and the staff responsible for this task; and

c. A description of your target population or market, if any (e.g., individuals with

disabilities, homeless, families, working adults, specific ethnic groups, or specific geographic areas).

4. Explain how information technology (IT) is currently used by your organization for

MassHealth outreach and eligibility assistance, if at all. Describe your organization’s IT resources. Specify what type of internet connection is maintained. If no internet

connection is in place, state whether broadband service is available in your location and your organization’s vision for future enhancements to its internet capacity.

5. Affirm in writing the following:

a. that if awarded a grant, the Contractor will attend all Contract-required MassHealth-

sponsored orientations, including Contractor training sessions and all MassHealth Training Forums during the Contract period;

b. that if awarded a grant, the Contractor will participate in a statewide evaluation

strategy to collect and monitor all quantitative data related to specific outreach and enrollment activities, including the number of applications submitted for MassHealth and Commonwealth Care);

c. that if awarded a grant, the Contractor distribute marketing materials developed by

MassHealth and the Connector; and

d. that all program-specific materials will be submitted to MassHealth for approval prior

to distribution.

e. Furthermore, Model B bidders that intend to use a subcontractor must affirm their

understanding that they will not be relieved of any legal obligations under any Contract resulting from this RFR as a result of any contract with a subcontractor; that they shall be fully responsible for the subcontractor’s performance; and that all subcontracts and other agreements or arrangements for reimbursement will be in

writing, will incorporate the contents of the Business Associate Agreement (Exhibit

10), and will contain terms consistent with all terms and conditions of the Contract.

Model B bidders, in addition to answering all of the foregoing questions, must also:

6. Provide copies of project plans used to carry out broad-scale comprehensive media or

grassroots campaigns, including timelines, deliverables, samples, spending plans and proposed success measures. Describe your organization’s experience in designing consumer-friendly and culturally appropriate outreach materials.

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3.3 Mandatory Forms and Certifications: The bidder shall submit the Commonwealth-required

forms 1-9 identified below. All of the referenced forms (1-10) will be incorporated by reference into

the RFR and all forms, except Attachment B, Exhibit 10 (which is attached to this document), are

available either as separate files within the “Forms and Specifications” tab of the Comm-PASS posting for this RFR, or on the website of the state’s Operational Services Division. From the

Comm-PASS home page (www.comm-pass.com) click on the “OSD homepage” link on the bottom

right side of the page. On the OSD home page, in a blue box on the right, click on “Related links,” then select “OSD Forms” and a list of all forms appears.

1. Commonwealth of Massachusetts Standard Contract 2. Commonwealth Terms and Conditions

3. Request for Taxpayer Identification Number and Certification (W-9) 4. Contractor Authorized Signatory Listing

5. Affirmative Market Program Plan (see Section 6.10 for more information)

6. Affirmative Action Plan Form

7. Consultant Contractor Mandatory Submission Form

8. Northern Ireland Notice and Certification (see Section 6.13 for more information)

9. Authorization for Electronic Funds Payment Form (see Section 6.14 for more information)

10. Business Associate Agreement (This form is only included with the RFR for bidders’

information – see Attachment B, Exhibit 10 and Section 6.9 for more information.

Bidders are not required to return this form with their proposal. Only those bidders awarded grants will be required to execute the Business Associate Agreement.)

3.4 Cost Response Requirements (Budget Worksheet and narrative):Bidders shall complete the

Budget Worksheet, attached to the RFR as Attachment C. Bidders must also submit narrative (no

more than one page) to clarify any elements of their Budget Worksheet.