Nurse Services RFP # B1. Questions and Responses

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Nurse Services RFP #006.15.B1

Questions and Responses

1. Is the agency involved in the plan of care?

Response: The plan of care is developed through the physician, parent and nurse.

2. Please provided a breakdown of volume usage (by hours) within one school year by the following:

a. LPN 1:1 Approx. 18-20 students full time about 7-8 hours per day b. LPN: Health Room-none.

c. LPN: Field Trips-none. d. RN: 1:1

e. RN: Health Room Substitute only for regular nurse f. RN: Field Trips, LPN can attend

g. Supervisor visits: 1:1

h. Supervisor visits: Health Room i. Supervisor visits: Field Trips Not sure

3. How many companies are providing these services currently under contract? Response: Approximately 18.

4. What companies are currently providing services and at what rates? Response: See Questions and Responses issued for prior solicitation. 5. How many vendors does HCPSS expect to contract for the new school year?

Response: As many or as few as necessary.

6. If there are currently multiple vendors providing these services, please provide a step-by-step process of how needs (broken down by 1:1, health room, and field trip needs) are communicated to vendors? How do you choose which company will ultimately provide the services? Are all companies contacted at the same time via email/phone for the same need? If not, how do you decide which company to contact first?

Response: After the agencies are evaluated by scale the approvals will be made. Health room and field trip usage will depend upon the daily need during the school year.

7. Does HCPSS intend to keep their current incumbents for continuity of care for 1:1 students?

Response: This is possible, but not guaranteed.

If not, how will these students transition into care provided by other companies? Response: Transition time as necessary.

8. How will new 1:1 needs be distributed to winning providers?

Response: Assignments will be based on the best fit between student needs and individual nurse qualifications.

9. What key challenges are you facing in the quality of care provided to students? Response: In addition to acute medical care knowledge and training, we need efficiency and the ability to remain calm in an emergency, have appropriate supplies and equipment, appropriate and current MD orders.

10. What key challenges are you facing in the availability of nurses and healthcare professionals to staff your needs?


Page 2 11. Are there any other concerns HCPSS would like bidders to discuss in our proposals?

Response: No.

12. Can you provide the list of providers that were present for the pre-bid meeting? Response: Yes, see attached sign in sheets.

13. Will HCPSS authorize any extra time before the bus arrives for the nurse to arrive early to ensure all supplies are packed and receive report from the primary caregiver, and any extra time after the bus drops off the child to allow the nurse to briefly stay after to give report to the primary caregiver in the home?

Response: The school day starts with pick-up at the door and concludes with the drop-off at the door. The nurse is expected to be prepared for the assignment prior to the start of the day and HCPSS is not responsible for any preparation time.

14. Can LPNs cover any assignment? Response: No.

15. Will the nursing staff float between cases (Private Duty, Health Room, or Field Trip)? Response: As the need is necessary for substitution but for regular 1:1 assignments 16. Will the supervisor be responsible for covering a staff member in their absence.

Response: The agency is required to locate their own back-up with similar skill level and be properly HCPSS trained.

17. How many nurses will the supervisor have reporting to them?

Response: Each 1:1 nurse is a yearlong assignment. Nursing staff in the health room is dependent on the needs that day.

18. How often will in-services be required by HCPSS?

Response: Agencies are required to supply BBP, CPR, First Aid, and any skill list competencies i.e. trach, G-tube glucometer, insulin, diastat, glucagon and other me training.

19. Are the nurses required to have school nurse certifications? Response: No.

20. Will HCPSS be responsible for initial training? And will HCPSS reimburse the agency for orientation and training?

Response: If they attend ASPEN (twice a year) for health room coverage, no, the agency will be responsible to provide the time for training. There is Private Duty nurse procedure folder that has a checklist, knowledge checklist, and Orientation training packet. 21. What will be the turnaround time for on boarding?

Response: That will vary, but should not be longer than a day. 22. Will the supervisor be required to have a training background?

Response: Delegation Training and be preferable CPR instructor trained. 23. Will all charting be done manually?

Response: Manual for PDN (Private insurance agency uses agency documentation and submit to HCPSS weekly/if not private insurance then uses HCPSS forms and submit daily , ASPEN computer system if HCPSS coverage. Or, is there a

centralized electronic health record?

Response: ASPEN for health room coverage.

24. If a student has an immediate change in medication, how quickly will the covering nurse be notified?

Response: As soon as change is made for the day, cluster is available by cell and will make arrangements to administer when needed

25. Where in the proposal response format does items 2.6 Identifying information fit? Response: It can be covered in the executive summary or attached under Exhibit C.


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26. What are the uniform requirements?

Response: Dress casual and scrubs are appropriate, no open toed shoes And, is the agency responsible for uniform service?

Response: If you use a uniform service then yes, HCPSS is not responsible for uniform

27. Is this a new requirement? If not, who is the current vendor and what was the previous award amount?

Response: See attached responses from prior solicitation. 28. Are there incumbent employees.

Response: No.

31. Are you requesting vendors to submit its entire employee handbook or specific policies and procedures from the handbook?

Response: No, but you may be called upon to provide at some time.

32. What is the county’s student to nurse ratio for the general population? Varies by school, 1 nurse to each HS and 1 nurse to a pair of ES/MS each building has a health assistant.

Student populations requiring daily services or interventions? Response: Varies by school, daily medications, diabetics etc. And student populations with complex health care needs? Response: Varies by school, may have PDN for specific care

Can you provide a breakdown on each of the student populations mentioned? Response: Diabetics, seizure/diastat usage, asthmatic, cardiac concerns, severe food allergies

Nurse Services RFP #065.14.B1

Questions and Responses

1. What are the approximate expenditures for various nurse services?

Response: The school system spent the follow amounts from July 1, 2013 to date with the various agencies as follows.

Home Health $35,000 Maxim 49,000 Med. Staffing 64,000 Care Resources 125,000

Staffing Etc. (Porter) 6,000 Comprehensive 61,000 Continuum 74,000

Hourly rates will range from $30-35/hour for LPN and $40-48/hour for RN. 2. Are there LPN’s in the health room?


3. Are there LPN’s for 1:1?

Response: Yes

4. How many 1:1 students are covered by agencies?

Response: Approximately 20 students. 5. Is orientation training paid by HCPSS?

Response: No. History has shown that we expend a good deal of time and effort to train staff that end up not being available when needed.

6. How often do you do the training?

Response: Twice a year (At the beginning of the school year and in the middle of the year)

7. Do you tend to continue using agencies that supply the nurses now?

Response: Yes, as long as they can continue supplying competent professional nurses.

8. Is there a limit on contract awards?

Response: No, the school system will award the number of contracts necessary to maintain services for the schools.

9. Is the RN paid for all days of the school year (1:1)?

Response: Agencies will only be paid when nurses perform and are on duty. If there is a holiday or snow day, HCPSS does not pay.

10. When a nurse is assigned (1:1) to a student, does that same nurse stay with the child thru the school year?

Response: Yes, and in certain cases services may be extended to cover Summer School.

11. Does the RN who staffs have to be a delegating nurse?

Response: No.

12. How many health rooms are there?

Response: 76

13. Where can we print vendor applications?

Response: The school system is separate from the County Government. All information regarding this solicitation and doing business with the school system can be found at

14. What are the number of hours the nurses work?

Response: Nurses work 7 hours a day.

15. Is the 25% Minority Business Enterprise (MBE) requirement mandatory?

Response: No.

16. The RFP references a bid number of 055.14.B1, but the web page lists 065.14.B1, which is correct?

Response: The correct number is 065.14.B1.

17. Pg. 9, Section 3.4 A, 9: says invoice on monthly basis; we invoice weekly since we pay our Temp Staff weekly. Would you accept weekly invoices?

Response: Include this request/deviation request in your proposal.

18. Page 14-Insurance- asks for 60 days of any change in insurance policies; would you accept 30 days? Industry standard is 30 days’ notice of change; also our PL limit is 1M per claim, not 3M, this is also industry standard; will you accept modifications to this section? Our


Underwriter is unable to make any changes to accommodate these insurance requirements; Favorite is a large enough company that the large deductibles do not matter.

Response: Please include this deviation request in your proposal.

19. Pg. 17, 3.7.4 and 3.7.5- Indemnification and Waiver of Sub.: Will you accept for us to add “to the extent” before the wording “arising out of” in both sections?

Response: Please include this deviation request in your proposal.

20. Appendix A, Section VI.: Would you accept for us to add “to the extent” before “arising out of” on the 2nd and 7th line of this section?

Response: Please include this deviation request in your proposal.

21. Appendix A, Section IX, C. : Would you accept for us to add “to the extent” before both of the “arising out of” on the 3rd line of this section?

Response: Please include this deviation request in your proposal.

22. Other than the Medication Training, will our staff be able to conduct the school based trainings to subsequent nurses after the initial trainings are given?

Response: This may be possible, but will vary depending on the training and training delivery method.

23. How many nurses can each agency send to the twice a year Electronic Medication Trainings?

Response: The number will vary subject to availability of space and time.

24. As the meeting was winding up, background checks and fingerprinting was discussed. Are you requesting that the agency send this information to you or is that info to be retained at each agency in the event the information is needed?

Response: Agencies need to verify that there will be no “Registered Sex Offenders” assigned to HCPSS. Furthermore, Agencies must be prepared to submit verification of fingerprinting and background checks.

25. Do we have to provide all the services like Private Duty Nursing, Health nurses, field trip nurses mentioned in the RFP?

Response: No, the services will vary depending on the assignments.

26. Will the RN ‘1:1’ rates will always be higher than health room nurse?

Response: No.

27. Respondent’s cost proposal and other financial documents which are the confidentiality of the company must not be made public. How can we ensure that that is taken care of?

Response: You can identify items/information as confidential. However, as a public entity, we are subject to the Maryland Freedom of Information Act.

28. In the past the RN Supervisor has been requested to come for meeting to the school (IEP Meeting, Signing of PDN contract, family meeting etc.) – Are these types of visits billable at supervisory rate?