REQUEST FOR PROPOSAL ADOLESCENT RESIDENTIAL SUBSTANCE ABUSE TREATMENT PROGRAM AND SUBSTANCE ABUSE INTENSIVE OUTPATIENT PROGRAM RFP #

Full text

(1)

REQUEST FOR PROPOSAL

ADOLESCENT RESIDENTIAL SUBSTANCE ABUSE TREATMENT

PROGRAM AND SUBSTANCE ABUSE INTENSIVE OUTPATIENT

PROGRAM

RFP # 2015-100

APRIL 13, 2015

NOTE:

Alliance reserves the right to modify this RFP to correct any errors or to clarify requirements. Any changes will be posted on our website http://www.alliancebhc.org/

Copies of all postings will be emailed directly to anyone who registers with Alliance. To register, please send an email to AllianceRFP@alliancebhc.org with your name and contact information.

(2)

Purpose:

Alliance Behavioral Healthcare (Alliance) is a Local Management Entity/Managed Care Organization (LME/MCO) responsible for the delivery of publicly-funded mental health, intellectual/development disabilities and substance abuse services for people living in Durham, Wake, Johnston and Cumberland counties, the ‘Catchment Area’.

Alliance has identified the following Network needs and seeks the following services: Adolescent Residential Substance Abuse Treatment Program (the “Adolescent Program”) and Substance Abuse Intensive Outpatient Program (SAIOP) services in Durham County to adolescents with substance abuse and/or co-occurring substance abuse and mental health disorders.

Minimum Qualifications:

Only organizations that meet the following minimum qualifications will be considered for this RFP:

 The organization must be an existing provider with Alliance or any other LME-MCO in North Carolina currently providing evidence-based SAIOP Adolescent services and CASP funded Seven Challenges ® evidence-based Adolescent Residential Substance Abuse Treatment Program(s) for at least two years.

 Providers shall provide proof of a valid applicable North Carolina license issued by the North Carolina Division of Health Service Regulation for the SAIOP and Adolescent Residential services currently being provided.

Good Standing. All providers and organizations applying to participate in the Alliance Closed Network must be in good standing with all applicable oversight entities and continuously meet Good Standing criteria while a member of the Closed Network. This means that the provider or applicant:

(i) is in compliance with the standards and requirements of all applicable oversight entities; (ii) has submitted all required documents, payments and fees to the U.S. Internal Revenue

Service, the N.C. Department of Revenue, N.C. Secretary of State (if applicable), the N.C. Department of Labor, and the N.C. Department of Health and Human Services;

(iii) has not filed for or is not currently in Bankruptcy; and

(iv) has not had any sanctions imposed against it, including, but not limited to the following:  Any LME/MCO: Contract Termination for Cause related to services being

provided or requested to provide, Unresolved Overpayment.

DMA: Contract Termination for Cause related to services being provided or requested to provide, Payment Suspension, Prepayment Review within the past 2 years, Outstanding Overpayment.

DMH/DD/SAS: Revocation, Unresolved Plan of Correction.

DHSR: Unresolved Type A or B penalty under Article 3, Active Suspension of Admissions, Active Summary Suspension, Current Intent to Revoke, Active Notice of Revocation or Revocation in Effect.

(3)

liabilities.

N.C. Department of Labor: Unresolved payroll liabilities.

N.C. Secretary of State: Revocation of Authority, Revenue Suspension.

Sanctions issued by Boards of Licensure or Certification for the applicable Scope of Practice.

Current or pending sanctions issued by Provider’s Selected Accrediting Body.

Providers and applicants are required to disclose any pending or final sanctions under the Medicare or Medicaid programs including paybacks, lawsuits, insurance claims or payouts, and disciplinary actions of the applicable licensure boards or adverse actions by regulatory agencies within the past five years or now pending. The provider’s or applicant’s owner(s) and managing employee(s) may not previously have been the owners or managing employees of a provider which had its participation in any State’s Medicaid program or the Medicare program involuntarily terminated for any reason or owes an outstanding overpayment to an LME/MCO or an outstanding final overpayment to DHHS.

For purposes of this procedure, Alliance considers an action of DHHS, including its divisions and LME/MCOs to be final upon notification to the provider, unless such action is under appeal. For

actions by DHHS or LME/MCO under appeal, Alliance may, in its discretion, pend its award or enrollment for up to 90 days to allow for a final resolution or final decision by the NC OAH. If no final decision is rendered in that time period then the provider or applicant is deemed not in Good Standing.

Timeline & Bidders Conference:

Event Date/Time

Public Notice of RFP Monday, April 13

Pre-proposal conference* Monday, April 27 10AM-12PM Room 237 RFP Questions due Friday, May 1 5:00pm

Responses to questions posted on website

Friday, May 8, 2015

PROPOSALS DUE BY 5:00 PM

Thursday, May 21, 2015

* Pre-Proposal Conference. All interested applicants are encouraged to attend the Bidders conference at the date and location listed above. Answers to questions, a tour of the facility if applicable and other helpful information will be provided at that time.

Availability of Funds:

Cross Area Service Program (CASP) funding is the funding source for the residential program and the program shall accept adolescents from across the state, with priority admission given to adolescents in the Central Regional Area of North Carolina (Alliance, Cardinal, CenterPoint and Sandhills LME-MCOs).

The awarding of contracts is subject to allocations and available funding. The funding for the services solicited hereunder is available on a fee-for-service (UCR) basis and non UCR basis. Funds are to be used to provide services to eligible individuals only.

(4)

Scope of Proposal

This RFP encompasses the services set forth herein and service delivery must be consistent with the applicable service definitions and requirements found in Medicaid Clinical Coverage Policy No: 8A which can be found at http://www.ncdhhs.gov/dma/mp/8A.pdf and State Funded Service definitions which can be found at:

http://www.ncdhhs.gov/mhddsas/providers/servicedefs/statefunded-servicedef2003-2014-8-1-14.pdf

Providers’ staff must meet the qualifications to provide behavioral health and developmental disability services, as defined in Medicaid Clinical Coverage Policy, Section 8A.

Provider shall maintain separate licensed facilities for the Adolescent Residential and SAIOP programs, although the services shall complement each other and function as one program.

Adolescent Residential Substance Abuse Treatment Program (Group Living-Moderate Residential Program)

The residential service shall operate 24 hours – 7 days per week for 8-10 male youth ages 14 to 17 and the primary purpose of the service shall be the care and rehabilitation of adolescents who have a substance abuse disorder and require 24-7 supervision. The Provider must maintain licensure under the 10A NCAC 27G Section .5601(c)(4), “D” designation – a facility which serves minors whose primary diagnosis is substance abuse dependency but may also have other diagnoses.

The residential services shall incorporate the evidence-based Seven Challenges® Program and be in good standing with Seven Challenges®.

As required by the state for CASP funding, Provider shall also work with other LME-MCOs to develop agreements to serve youth originally residing in counties outside of the Alliance Catchment Area.

Substance Abuse Intensive Outpatient Program (SAIOP)

Providers’ staff must meet the qualifications to provide behavioral health and developmental disability services, as defined in Medicaid Clinical Coverage Policy, Section 8A. The Provider must maintain licensure under the 10A NCAC 27G Section .5601(c)(4)

The program shall supplement the services provided by the residential program and serve other youth referred from community agencies. Provider shall maintain and abide by rules under the 10A NCAC 27G Section .4400 and the SAIOP Service Definition which can be found at http://www.ncdhhs.gov/dma/mp/8A.pdf

Services / Code Rate

Group Living Moderate / YP770 $100.00

(5)

SAIOP and residential program must work in conjunction with one another. In addition to the services listed in the SAIOP Service Definition, Provider shall provide:

 Family programming;

 Psychiatric assessment and treatment, provide on-site or referral to psychiatrist (preference for on-site); psychiatrist must be available 24/7 to residents who are experiencing a psychiatric emergency;

 Collaborative treatment planning and ongoing monitoring of progress through Child and Family Team approach, to assist the child and family to achieve the goals in their Person Centered Plan;

 Outreach and assertive engagement immediately upon receipt of referral;  Transition planning;

 Continuing care – orienting adolescents and family to community supports. Provider shall refer the adolescent the most appropriate evidence-based treatment at the time of discharge.

Special Conditions:

 Any award of a contract to a provider that is not currently in the Alliance provider Network shall be subject to the successful credentialing process by Alliance.  Alliance anticipates the need for only 1 provider in Durham County.

 Any contract shall be subject to applicable zoning and licensing of the facility.

Submission Instructions:

 Indicate the Applicant name and RFP number on the front of your proposal envelope or package.

 Include the RFP # on the bottom of each page of your proposal.

 Proposals must be submitted according to the below described Eligible Applicant Proposal Format.

 Proposals must address the questions and items set out on the following pages and must be typewritten and signed in ink by the official authorized to bind the applicant to the provisions contained within the proposal.

 Trade secrets or similar proprietary data which the organization or organization does not wish disclosed to other than personnel involved in the evaluation will be kept confidential to the extent permitted by state law and rule if identified as follows: Each page shall be identified in boldface at the top and bottom as "CONFIDENTIAL." Any section of the proposal that is to remain confidential shall also be so marked in boldface on the title page of that section.

 One original, signed copy of the proposal plus one electronic version of the response on a CD. The CD shall include Adobe pdf format versions of all documents, readable by MS Office computers and file names and content must comply with the directions listed below:

(6)

o Content of each scanned document should correspond to the sections noted above. For example, the CD should include separate documents for each numbered section noted above, and separate scans for each reference and attachment.

o Files should be labeled using the format YOURAGENCYNAME_SECTION LETTER. For example, the scanned document for the Financial section would be “YourAgencyName_D.”

They must be delivered in a sealed envelope no later than the date and time specified herein.

 Alliance will not be held responsible for the failure of any mail or delivery service to deliver a proposal response prior to the stated proposal due date and time.

 No fax or emailed responses will be accepted or considered.

All proposals must be received by Alliance on or before 5:00 p.m. on Thursday, May 21, 2015. Late proposals will not be accepted.

Hand-delivered proposals will be time-stamped and the Applicant will receive a receipt upon delivery. All proposals submitted by the deadline become the property of Alliance Behavioral Healthcare.

Proposals shall be mailed or hand delivered to: Alliance Behavioral Healthcare

ATTN: Healthcare Network Project Manager RE: RFP# 2015-100

4600 Emperor Blvd, Suite 200 Durham, NC 27703

PROPOSALS WILL NOT BE ACCEPTED AFTER THE DUE DATE/TIME AND WILL BE RETURNED TO THE PROVIDER.

Questions concerning the specifications in this RFP will be received until 5:00 pm, May 1, 2015. Please submit all questions in writing by e-mail to AllianceRFP@alliancebhc.org. A summary of all questions and answers will be posted by Friday, May 8, 2015 on the Alliance Behavioral Healthcare website at: Alliancebhc.org and emailed to registered providers

Alliance reserves the right to:

 Reject any and all offers and discontinue this RFP process in the sole discretion of Alliance without obligation or liability.

 Award more than one contract.

Eligible Applicants Proposal Format

(7)

Section A. Introduction (3 pages max)

1. Describe why you believe that your organization, from a business, professional, clinical, administrative, financial and technical perspective, should be awarded a contract for the services requested. Describe any distinguishing features Alliance should know about your services and company as well as an overview of your proposal.

2. Describe generally what you are proposing to do under the scope of services. 3. Provide the following:

(i) Legal Name of Organization (ii) Federal Tax ID#

(iii) Corporate Address

(iv) Organizational contact person, telephone number and email address (v) Facility/Site address or proposed address if available

(vi) Facility /Site contact person

(vii) Printed name and signature of Official authorized to bind the applicant to proposal (viii) Accrediting organization, date accredited, number of years accredited

(ix) Facility National Provider Identifier # (if applicable)

(x) If your organization is using an outside consultant to assist with the RFP, please provide the name of the consultant.

Section B. Minimum Network Enrollment Requirements for Agency-Based

Providers (7 pages max)

1. Disclose any sanctions, past or pending, under the Medicare or Medicaid programs including paybacks, lawsuits, insurance claims or payouts, and disciplinary actions of the applicable licensure boards or adverse actions by regulatory agencies within the past five years.

2. Provide a history of names if the entity has done business under other names or is using a “doing business as” (d/b/a) name.

3. Disclose if your agency has any proposed/pending merger with another entity. Please note that an award of a contract to the organization making the proposal will not be assigned automatically to a new agency resulting from a merger or acquisition.

4. Identify ownership of the organization. A list of all owners for the past 2 years having more than 5% interest and a list of all parent, sister, and subsidiary entities in the entire chain of ownership, including an organizational flow chart, up to the ultimate owner of the holding company shall be provided.

5. Provide a list of the names and addresses for the past 2 years of all members of the organization’s Board of Directors and the addresses of the organization and any parent, sister or subsidiary entities.

6. Disclose if the organization is affiliated by contract or otherwise, with any other provider (defined as any individual or entity providing behavioral health services).

7. Provide the NC DHSR License number(s) and license dates of each Adolescent Residential CASP funded and SAIOP service your organization currently operates in North Carolina.

(8)

Section C. Organizational Background and Expertise (10 pages max)

Providers shall demonstrate experience and competency in the requested service(s). Stability of past operations is important. This section is intended to assess the organization’s past record of services, compliance with applicable laws, standards and regulations, the qualifications and competency of its staff, the satisfaction of consumers and family members served, systems of oversight, adequacy of staffing infrastructure, use of best practices, and quality management systems as they relate to this RFP.

For this RFP describe your organization’s background and expertise in the following: 1. Provide a detailed implementation plan, including timeline, for the services requested. 2. Provide a brief history of your organization, indicating how long your organization has

been in business. Identify your current service location(s) with the physical address and services offered at each site. Also identify the types of funding you utilize (fee for service, non-UCR, IPRS, Medicaid, etc.).

3. Describe how your organization will generate referrals from other MCO’s.

4. Describe how consumers and families will be involved in treatment and services.

5. Describe your service philosophy and models of service delivery for adolescents with Substance Abuse and/or Mental Illness.

6. Describe the clinical infrastructure either through your own agency or through collaboration with other providers to address challenges in meeting specific client needs (such as challenging behaviors or medical problems). Please also describe your staff training and clinical supervision plan.

7. Describe how you will address each of the required elements listed in the Scope of Work, including but not limited to what evidence-based model(s) your organization utilizes for this service.

8. Summarize demographic and clinical profiles of individuals currently served in SAIOP and Adolescent Residential programs.

9. Identify whether the organization has ever reported any Health Insurance Portability and Accountability Act (HIPAA) violations to the U.S. Office of Civil Rights and describe your organization’s procedures for ensuring the privacy and security of protected health information.

10. Describe your organizations protocols for urine drug screening.

11. Identify whether your organization or any past or present owner, director, managing employee, billing professional, or other employee has ever been excluded from participation in a federal healthcare program.

Section D. Management / Administrative Capability (5 pages max)

Financial Sustainability

1. Describe in detail your organization’s strategy to financially sustain the program long term. Disclose any past, pending or proposed bankruptcy proceedings filed by the organization or any of its affiliates or subsidiaries.

(9)

2. Describe what accounting systems your agency has in place sufficient to ensure fiscal responsibility and integrity.

3. Identify whether the organization has any outstanding debt or overpayment in relation to any State or Federally-funded healthcare program (including but not limited to DMA and other LME-MCOs).

Quality Improvement

The successful applicant will be required to develop a quality improvement plan (if the organization doesn’t already have one) that includes expected outcomes, performance indicators (or related goals), and how individual and program progress will be measured in accordance with the applicable service definition.

4. For this RFP, describe how your organization will utilize the data generated by the performance indicators, outcomes, survey results, stakeholder feedback to improve the quality of care.

5. Provide information about your strategies for recruitment, retention and support of qualified staffing.

6. Demonstrate the organization’s compliance with Program Integrity requirements outlined in the State and Federal law, which includes but is not limited to the False Claims Act and Patient Affordable Care Act.

7. Describe how you evaluate consumer outcomes and how you determine whether your consumers are benefitting from your services. Attach a sample of consumer outcome data for the requested services for the most recent two years, including but not limited to the outcomes achieved through use of the identified evidence-based practice model(s). Describe how you monitor the program for fidelity with the model you use. Include an example of the fidelity monitoring.

Section E. Technological Capabilities (1 page max)

Provider must have the ability to create and test electronic 5010 compliant 837 Professional and Institutional claims and send via secure FTP to Alliance Behavioral Healthcare, the ability to send and receive encrypted electronic communications for transfer of PHI, and have secure access to the internet to utilize the Alliance Behavioral Healthcare web based provider portal (AlphaMCS). 1. For this RFP, describe how your organization will comply with claims submissions

requirements.

Section F. Other Attachments

1. Provide the organizations audited financial statements for the previous two (2) years of operation for the past consecutive two years.

2. Submit your proposed budget identifying expenses as well as an annual 12 month budget using the attached Budget Request Form. Please include your anticipated expenditures and revenue sources. Expenditures should include full-time equivalent positions both clinical and administrative, operating expenses, and capital expenses if any. Revenues should include First and Third Party payers, Medicaid, State funding and any other grants or sources of revenue. Additionally, using the Budget Request Form, develop a separate proposed Start-Up Budget.

(10)

3. Provide information about your organization’s procedures for promoting and ensuring consumer rights, including but not limited to how you ensure privacy and security of protected health information and storage and maintenance of medical records.

Proposal Evaluation:

Award of a contract resulting from this RFP will be based upon the application(s) best aligned with the cost, service objectives, and other factors as specified herein.

Providers shall demonstrate experience and competency in the requested service(s). Stability of past operations is important.

RFP Proposals will be evaluated using a standardized evaluation sheet for the elements from the RFP outline. Applications will be pre-screened by Provider Network Management to ensure the organization (i) meets the minimum qualifications (ii) has completed all material sections of the RFP, and (iii) is responsive to the questions. Any applicants that are rejected for failing to meet the pre-screen criteria shall be notified in writing along with the reasons why the application was rejected.

Once an application passes the pre-screen process, it will be reviewed by a Selection Committee designated by Alliance which may include Alliance staff, Area Board members, and other stakeholders deemed needed. Reviewers will utilize the Evaluation Tool attached and scores will be calculated from all the reviewers. An interview process may be utilized to gain additional information and pose questions of providers. The evaluation will include the extent to which the Applicant’s proposal meets the stated requirements as set out in this RFP as well as the Applicants’ stability, experience, and record of past performance in delivering such services.

All applicants will receive written notification of the results of the evaluation of their application.

Contract Award:

The successful applicant(s) chosen by Alliance will be required to execute a contract that includes a Scope of Work outlining the requirements of this RFP as well as federal certification(s) regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions, Drug Free Workplace Requirements, Lobbying and Environmental Tobacco Smoke.

If the successful applicant is not a credentialed provider in Alliance’s closed network, the award of a contract shall be subject to successful credentialing by Alliance. The applicant will be required to complete an application to join the network, agreeing: (a) to comply with all network requirements for reporting, inspections, monitoring, consumer choice requirements; and (b) to participate in the corporate compliance process and the network continuous quality improvement process.

(11)

Providers shall have a “no-reject policy” for referrals within the capacity and the parameters of their competencies. Providers shall agree to accept all referrals meeting criteria for services they provide when there is available capacity; a Provider’s competency to meet individual referral needs will be negotiated between Alliance and the Provider.

The initial term of any contract awarded hereunder will be through June 30, 2016, with the option to renew by Alliance for one (1) successive one (1) year period under the same terms and conditions. Any renewal shall be based on satisfactory performance by the Provider during the previous years for the services provided.

Cancellation of Contract: Alliance reserves the right to cancel and terminate any resulting contract(s), in part or in whole, without penalty, upon thirty (30) days written notice to the Provider. Any contract cancellation shall not relieve the Provider of the obligation to deliver and/or perform outstanding prior to the effective date of cancellation and transition consumers and consumer’s records.

Other General Information:

The following outlines additional information related to the submission of proposals:

• Alliance reserves the right to reject any and all proposals for any reason, including but not limited to false information contained in the proposal and discovered by Alliance.

• Any cost incurred by an organization in preparing or submitting a proposal is the bidder’s sole responsibility. Alliance will not reimburse any bidder for any pre-award costs incurred. All materials submitted to Alliance will become the property of Alliance and will not be returned.

• All proposals are subject to the terms and conditions outlined herein. All responses will be controlled by such terms and conditions. The attachment of other terms and condition by any organization may be grounds for rejection of that organization's proposal.

• In submitting its proposal, organizations agree not to use the results therefrom or as part of any news release or commercial advertising without prior written approval of Alliance. • All responses, inquiries, or correspondence relating to or in reference to the RFP, and all

other reports, charts, displays, schedules, exhibits, and other documentation submitted by the organization or organization will become the property of Alliance when received. • The signer of any proposal submitted in response to this RFP certifies that this proposal

has not been arrived at collusively or otherwise in violation of either Federal or North Carolina antitrust laws.

(12)

Authorization to Submit Proposal

To the best of my knowledge, my organization is able to meet all requirements necessary to apply for the services solicited in RFP # 2015-100. I am submitting the attached proposal, which, to my knowledge is a true and complete representation of the requested materials.

________________________________________________ Authorized Signature ________________________________________________ Printed Name ________________________________________________ Title ________________________________________________ Date

(13)

Budget Proposal

RFP # 2015-100

(14)

Evaluation Form

Alliance Behavioral Healthcare

RFP # ______________

Evaluator: _______________________

SECTION A: INTRODUCTION (max. 15 POINTS)

Evaluate the response to Section A.1. (Refer to Section A.1 of the RFP submission)

Value Explanation Comments

0 Not addressed or response of no value

1 Limited applicability

3 Some applicability

5 Substantial or total applicability

Evaluate the response to Section A.2. (Refer to Section A.2 of the RFP submission)

Value Explanation Comments

0 Not addressed or response of no value

1 Limited applicability

3 Some applicability

5 Substantial or total applicability

Evaluate the response to Section A.3. (Refer to Section A.3 of the RFP submission)

Value Explanation Comments

0 Not addressed or response of no value

1 Limited applicability

3 Some applicability

5 Substantial or total applicability

SECTION B: MIN. NETWORK ENROLLMENT REQUIREMENTS

(max. 30 POINTS)

Evaluate whether the organization has had any sanctions, past or pending, under the Medicare or Medicaid programs within the past five years. (Refer to Section B.1 of the RFP submission)

Value Explanation Comments

0 Not addressed or response of no value

1 Limited applicability

3 Some applicability

(15)

Evaluate response to affiliations in Section B. 2 (Refer to Section B.2 of the RFP submission)

Value Explanation Comments

0 Not addressed or response of no value

1 Limited applicability

3 Some applicability

5 Substantial or total applicability

Evaluate response to affiliations in Section B. 3 (Refer to Section B.3 of the RFP submission)

Value Explanation Comments

0 Not addressed or response of no value

1 Limited applicability

3 Some applicability

5 Substantial or total applicability

Evaluate whether the organization has a valid North Carolina license issued by the North Carolina Division of Health Service Regulation (if applicable for type of provider) for the services requested? (Refer to Section B.4 of the RFP submission)

Value Explanation Comments

0 Not addressed or response

of no value

1 Limited applicability

3 Some applicability

5 Substantial or total

applicability

Evaluate whether the organization or any owner, director, managing employee, billing professional, or other employee has ever been excluded from participation in a federal healthcare program.(Refer to Section B.5 of the RFP submission)

Value Explanation Comments

0 Not addressed or response

of no value

1 Limited applicability

3 Some applicability

5 Substantial or total

applicability

Evaluate whether the organization has at least two years of experience successfully providing evidence-based SAIOP and Adolescent Residential Program and where is your organization currently providing these services within the state of North Carolina?

(Refer to Section B.6 of the RFP submission)

Value Explanation Comments

0 Not addressed or response

(16)

1 Limited applicability

3 Some applicability

5 Substantial or total

applicability

NC DHSR License number(s) and license dates of each Adolescent Residential CASP funded and SAIOP service your organization currently operates in North Carolina.

(Refer to Section B.7 of the RFP submission)

Value Explanation Comments

0 Not addressed or response

of no value

1 Limited applicability

3 Some applicability

5 Substantial or total

applicability

SECTION C: ORGANIZATIONAL BACKGROUND AND EXPERTISE

(max. 45 POINTS)

Evaluate the organizations detailed implementation plan for the services. (Refer to Section C.1 of the RFP submission)

Value Explanation Comments

0 Not addressed or response

of no value

1 Limited applicability

3 Some applicability

5 Substantial or total

applicability

Evaluate the organization’s history. (Refer to Section C.2 of the RFP submission)

Value Explanation Comments

0 Not addressed or response of no value

1 Limited applicability 3 Some applicability

(17)

Evaluate how the organization will generate referrals from other MCO’s. (Refer to Section C.3 of the RFP submission)

Value Explanation Comments

0 Not addressed or response of no value

1 Limited applicability

3 Some applicability

5 Substantial or total applicability

Evaluate how consumers and families will be involved in treatment and services (Refer to Section C.4 of the RFP submission)

Value Explanation Comments

0 Not addressed or response of no value

1 Limited applicability 3 Some applicability

5 Substantial or total applicability

Evaluate the organization’s service philosophy and models of service delivery for adolescents with Substance Abuse and/or Mental Illness. (Refer to Section C.5 of the RFP submission)

Value Explanation Comments

0 Not addressed or response of no value

1 Limited applicability 3 Some applicability

5 Substantial or total applicability

Evaluate the organization’s clinical infrastructure and staff training and clinical supervision plan. (Refer to Section C.6 of the RFP submission)

Value Explanation Comments

0 Not addressed or response of no value

1 Limited applicability

3 Some applicability

5 Substantial or total applicability

Evaluate how the organization will address each of the required elements listed in the Scope of Work, including but not limited to what evidence-based model(s) your organization utilizes for this service. (Refer to Section C.7 of the RFP submission)

Value Explanation Comments

0 Not addressed or response of no value

1 Limited applicability

3 Some applicability

(18)

Evaluate the organization’s demographic and clinical profiles of individuals currently served and numbers (Refer to Section C.8 of the RFP submission)

Value Explanation Comments

0 Not addressed or response of no value

1 Limited applicability

3 Some applicability

5 Substantial or total applicability

Evaluate whether the organization has ever reported any Health Insurance Portability and Accountability Act (HIPAA) violations to the U.S. Office of Civil Rights and describe your organization’s procedures for ensuring the privacy and security of protected health information (Refer to Section C.9 of the RFP submission)

Value Explanation Comments

0 Not addressed or response of no value

1 Limited applicability

3 Some applicability

5 Substantial or total applicability

Evaluate the organizations protocols for urine drug screening. (Refer to Section C.10 of the RFP submission)

Value Explanation Comments

0 Not addressed or response of no value

1 Limited applicability

3 Some applicability

5 Substantial or total applicability

Evaluate response to Section C. 11 (Refer to Section C.11 of the RFP submissions

Value Explanation Comments

0 Not addressed or response of no value

1 Limited applicability

3 Some applicability

5 Substantial or total applicability

SECTION D. MANAGEMENT/ADMINISTRATIVE

CAPABILITY

(max. 35 POINTS)

Evaluate the organization’s strategy to financially sustain the program long term (Refer to Section D.1 in RFP submission)

Value Explanation Comments

0 Not addressed or response

of no value

(19)

3 Some applicability

5 Substantial or total

applicability

Evaluate the organization’s accounting systems to ensure fiscal responsibility and integrity. (Refer to Section D.2 of the RFP submission)

Value Explanation Comments

0 Not addressed or response

of no value

1 Limited applicability

3 Some applicability

5 Substantial or total

applicability

Evaluate whether the organization has any outstanding debt or overpayment in relation to any State or Federally-funded healthcare program (including but not limited to DMA and other LME-MCOs). (Refer to Section D. 3 of the RFP submission)

Value Explanation Comments

0 Not addressed or response

of no value

1 Limited applicability

3 Some applicability

5 Substantial or total

applicability

Evaluate how the organization will utilize the data generated by the performance indicators, outcomes, survey results, stakeholder feedback to improve the quality of care. (Refer to Section D. 4 of the RFP submission)

Value Explanation Comments

0 Not addressed or response

of no value

1 Limited applicability

3 Some applicability

5 Substantial or total

applicability

Evaluate the organization’s strategies for recruitment, retention and support of qualified staffing. (Refer to Section D.5 of the RFP submission)

Value Explanation Comments

0 Not addressed or response

of no value

1 Limited applicability

3 Some applicability

5 Substantial or total

applicability

Evaluate the organization’s compliance with Program Integrity requirements outlined in the State and Federal law (Refer to Section D. 6 of the RFP submission)

(20)

Value Explanation Comments

0 Not addressed or response of no value

1 Limited applicability 3 Some applicability

5 Substantial or total applicability

Evaluate consumer outcome information. (Refer to Section D. 7 of the RFP Submission)

Value Explanation Comments

0 Not addressed or response of no value

1 Limited applicability 3 Some applicability

5 Substantial or total applicability

SECTION E: TECHNOLOGICAL CAPABILITIES (max. 5 POINTS)

Evaluate how the organization will comply with claims submissions requirements. (Refer to Section E.1 of the RFP submission)

Value Explanation Comments

0 Not addressed or response of no value

1 Limited applicability

3 Some applicability

5 Substantial or total applicability

Section F. OTHER ATTACHMENTS (max. 25 POINTS)

Evaluate audited financial statements for the previous two (2) years (Refer to Section F.1 of the RFP submission)

Value Explanation Comments

0 Not addressed or response of no value

1 Limited applicability

3 Some applicability

5 Substantial or total applicability

Evaluate proposed budget. (Refer to Section F.2 of the RFP submission)

Value Explanation Comments

0 Not addressed or response of no value

1 Limited applicability

(21)

5 Substantial or total applicability

Evaluate the organization’s procedures for promoting and ensuring consumer rights. (Refer to Section F.3 of the RFP submission)

Value Explanation Comments

0 Not addressed or response of no value

1 Limited applicability

3 Some applicability

Figure

Updating...

Related subjects :