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RFP Section Question Answer

1 Who is the incumbent vendor? Maximus Health Services Inc.


2

Request posting a copy of the current contract?

The contract (No. 4000015039) can be accessed on the PA Treasury website www.patreasury.gov under the Search Public Contracts link.


3

What is the value of current contract? The contract is available per the instructions in the answer to Q,2. The current contract contains different services and a different payment structure than what is included in the current RFP. Offerors should propose pricing based on the RFP requirements and not the current contract.


4

Calendar of Events

Would the Commonwealth consider extending the deadline to submit questions for clarification by one (1) additional business day (April 27 COB) to accommodate any additional questions that may arise from the pre-proposal conference scheduled for April 24?

The Department extended the deadline to April 27; Addendum 2 was issued.


5

I-4 Method of Award Method,

Many bidders may wish to propose an integrated solution, as it will allow them to leverage resources most effectively and to the greatest advantage of the Commonwealth. Requiring vendors to separate lots may result in vendors who can provide comprehensive solutions to submit sub-par proposals. For vendors who would like to propose an integrated solutions, would DHS remove the Lot requirement? If not, would DHS allow vendors to submit an integrated proposal to be evaluation in addition to their proposals for each Lot?

No, Offerors must submit proposals for each Lot they are interested in to ensure a fair and consistent evaluation of all proposals. DHS will not allow vendors to submit an additional integrated solution. However, if it is later determined to be in the Commonwealth’s best interests, the Commonwealth may request Offerors to submit integrated solutions at some point later in the process.


6 I-13 Proposals Please confirm searchable PDF is a Microsoft Office compatible format. Yes, that is an acceptable format.

http://www.patreasury.gov/


7

II-5 Personnel Would DHS consider changing the key personnel to include only the Contract Administrator/Project Manager and Enrollment Services Management personnel?

The Department agrees to not consider the Enrollment Broker(s) as Key Personnel.


8

II-5 Personnel In order to allow bidders maximum time to secure the most talented staff for DHS, would the Department accept detailed job descriptions for Enrollment Brokers in lieu of named resumes?

Yes, the Enrollment Brokers will not be considered Key Personnel.


9

If Enrollment Brokers are designated Key Personnel, they are required to have a “minimum of three (3) client references…” and they must submit the Personnel Reference Questionnaire from Appendix I. This requirement would advantage an incumbent vendor and the questionnaire does not seem to be designed for line level personnel. For instance, it asks about proficiency in managing a large program, proficiency in managing a large staff, proficiency in work plan development, how successful was the individual in administering a human services program, etc. Would the Commonwealth delete the requirement to submit 3 client references and the Questionnaire for Enrollment Brokers?

Yes, Enrollment Brokers will not be considered Key Personnel and the references will not be required.


10

Offerors must “include organizational charts outlining the staffing, reporting relationships, and staff members in its description. Show the total number of staff proposed and indicate the Full Time Equivalency (FTEs) to account for any staff that are not assigned on a full-time basis.” Please provide the above information as it pertains to the current vendor. Please also provide a copy of the current vendor’s organizational chart and staffing plan listing each of the positions with the FTE count.

The current organizational chart and staffing levels are not relevant to submitting a proposal for this RFP as the service model has changed. However, to access the current contract please refer to the answer to Q.2.


11

III-6.C Final Ranking and Award

Requiring that the offeror with the lowest technical and lowest cost scores be excluded from award may prohibit awards to potentially qualified bidders. For example, in a scenario where there are only two bidders, both of whom are highly qualified and receive high scores on the technical, if Bidder A is only a few points behind Bidder B on the technical proposal and offers a slightly lower price than Bidder B, Bidder A cannot win, regardless of the qualifications. Would DHS consider removing this requirement, provided that only offerors who meet the 70% minimum standard on the technical proposal are eligible for contract award, as referenced in III-5.A (p24)?

The Department will evaluate and rank proposals in the manner described in the RFP.


12

IV-1 Objectives Please explain more about the web-based requirement. Is the Contractor responsible for building the web-based application system? If so, what functionalities are to be included?

Refer to Part IV-3. E. Yes, a web based approach is required to afford applicants the opportunity to access their application and application status through the web based approach. The selected Offeror(s) are expected to provide this functionality.


13

IV-2 Nature and Scope of the Project

Please explain the difference between the two numbers (34,000 vs 13,500). Is the difference due to individuals who applied but were not found eligible?

In 2014, there were 13,400 intakes for the under 60 waivers and 21,108 for the Aging Waiver, totaling 34,508. There were 5,430 enrollments for the under 60 waivers and 8,216 enrollments for the Aging Waiver; totaling 13,676. These amounts are provided so Offeror(s) can approximate the labor and daily requirements based on 2014 Commonwealth-wide applicants and enrollments. Refer to Appendix L and the answer to Q.16.


14


If the difference is people who applied but were not eligible, how many were not financially eligible? How many did not meet the level of care determination? How many were not clinically eligible>

The Department does not currently track or maintain the requested information in a reportable format.


15


Of the 34,000 individuals, how many will require a home visit? Any applicant that meets the clinical eligibility requirements will require an in-home visit.


16

IV-2. Nature and Scope of the Project and Appendix L

This RFP references intakes of approximately 34,000 individuals with an enrollment of approximately 13,500 individuals during the first year of the contract. While these numbers are consistent with those provided in Appendix L for 2014 (34,508 statewide intakes; 13,646 statewide enrollments), these are not consistent with the numbers included in Appendix K (8118 enrollments for the first full 12 month period). Please provide the correct number of enrollments by region/lot that an Offeror should use to build its staffing and other level of effort decisions and with which to develop its budget.

Appendix L includes the 2014 data. Appendix K provides estimated enrollments for the Lots/years of the new contract(s) that will be awarded through this RFP process.


17

IV-2. Nature and Scope of the Project

It is anticipated that a number of people will call in with questions about Medicaid services and the enrollment process. Does the “34,000” number referenced include all contacts, or just those that result in an application? Can the Commonwealth provide data on the total number of actual calls (or contacts) made to the current vendor?

No, the 34,000 includes only individuals who initiate an application. No, the Department does not currently track or maintain the requested information in a reportable format.


18

IV-3.C. Requirements. Conflict Free

“The selected Offeror(s) and its subcontractors may not be part of or affiliated with any OLTL Service Coordination Entity or provider of HCBS waiver or ACT 150 services.” Further, Paragraph 2 says that “Offeror(s) may propose to develop a subsidiary corporation. In this situation, the selected Offeror(s) must ensure a conflict free environment and must be an independent agency within six months of the start of the contract. In this situation, the selected Offeror(s) may not be part of or affiliated with an OLTL direct care service provider.”

1) Please define “affiliated” for the purpose of this restriction. 2) Can an Offeror that is fully conflict free submit an alternative plan for

partnering or subcontracting with an entity (or entities) that are not fully conflict free by detailing how it will establish a “firewall” that achieves a conflict free relationship with such an entity for the purpose of conducting the work of this RFP and which would not require that subcontracted entity to create an “independent agency” as detailed in C.2 of the RFP?

3) Can an entity that is “part of or affiliated with any OLTL Service Coordination Entity or provider of HCBS waiver or ACT 150 services” perform certain functions of the enrollment process as long as it is a subcontractor to a fully conflict free Offeror and the duties assigned to it are purely “ministerial” in nature? That is, can such an entity be a subcontractor so long as performance of any functions assigned do not place the entity in the position of potential conflict through self-referral, potentially advantaging any services it may provide or the like?

1) Affiliated refers to a relationship between individuals, corporations, unincorporated organizations or associations, or other similar organizations, whereby one controls, is controlled by, or is under common control with, the other.

2) All Offerors must submit proposals based on the RFP requirements. 3) As is stated in Part IV-3.C, “the selected Offeror(s) and any subcontractors must be free of real or perceived conflicts of interest.”


19

IV-4.D Region Presence/Office

Space and Accessibility

Please explain the connectivity requirements for each of the systems. The selected Offeror(s) must be able to access the systems via the internet. Additional connectivity requirements will be determined during transition.


20



Does the Contractor have responsibility for entering data into any of these systems? If yes, which ones and what data is to be entered?

Yes, HCSIS and SAMS. Application data should be entered including but not limited to demographic, diagnostic, service needs and service plan. Final data collection will be provided upon contract award.


21



For what reasons does the Contractor need to access PROMISe? The selected Offeror(s) may be required to enroll in PROMISe for billing purposes. The Department has not made a final determination on whether this will be necessary.


22



Can applicants apply through COMPASS? Applicants may currently apply for general Medicaid eligibility through COMPASS.


23



For what purposes will the Contractor need to access CIS? Refer to IV-4, C.3. of the RFP. The selected Offeror(s) must utilize CIS to determine if the applicant is already an MA recipient and to verify financial eligibility for completion of the enrollment.


24

IV-3.D. Requirements. Region Presence/Office Space and Accessibility

The selected Offeror(s) must be capable of accessing HCSIS, SAMS, PROMISe, COMPASS, and CIS. Does the current vendor utilize any other IT system to track and report out on enrollment activities? If so, please provide information about their system (e.g., name, where it is located, the state’s ability to access reports, and a new Offeror’s ability to obtain access to the data in an electronic format, etc.).

Yes, the current system is owned by the incumbent vendor. Offerors must propose a website to meet the requirements defined in Part IV-3. C.


25


The selected Offeror(s) must be capable of accessing a number of DHS systems. Will it be possible and allowable for an Offeror to link their data system to the state’s systems in order to facilitate data efficiencies?

Yes, the specifics of such a link will be determined during transition.


26


“The physical site of the selected Offeror(s)’s administrative functions, all satellite offices, and any worksites used by the Enrollment Brokers cannot be co-located with any existing OLTL provider.” Does this include Service Coordination Entities (SCEs) or only providers of direct service? May a conflict free Offeror, not at all related to the OLTL provider referenced above, rent space and/or administrative supports and services only from an OLTL provider, in which no conflict operationally or otherwise would be created.

The language refers to both direct service providers and SCEs. Please refer to IV-3. D. of the RFP.


27

IV-4.E Information Technology/

Website

What functionality is needed in the website? If individuals can apply for the Waiver programs through COMPASS, must the website need to allow application

processing?

Refer to IV-3. C. The web based application system must provide for application processing. COMPASS only allows applicants to apply for general Medicaid.


28

IV-3.E. Requirements. Information Technology/ Website

The selected Offeror(s) must have a functional Website (or plan for one), with the …”primary purpose to provide access to and use of federal executive agencies’ electronic and information technology (EIT) by individuals with disabilities.” Can the Commonwealth please provide additional information about the degree of access individuals should be provided? Would this include just the provision of information specific to waiver services and the enrollment process, or is it the Commonwealth’s expectation that this Website will serve as a “Portal” to interested parties to initiate the application process (i.e., would be linked to the state’s and/or the Offeror(s)’s systems)?

The web based application system must allow Applicants to apply for selected waiver services online and verify their application status. Applicants will not be required to use the web-based application system.


29

IV-3.E. Requirements. Information Technology/ Website

It is understood that, “The selected Offeror(s) must have capabilities to be able to provide and track at all stages of the enrollment process and have adequate technology to support the process.” It is further understood based on Appendix M (#14) that, “All consumer/participant data is contained exclusively within customer specific databases that are accessible only by customer authorized users. Each authorized user is granted access to only the customer specific databases through Active Directory. Assuming a safe and secure environment for housing the database for tracking purposes, can the selected Offeror(s) maintain consumer/ participant data within it? As long as there are network controls that grant secure access based on role, can the selected Offeror(s) maintain their system without use of Active Directory?

Yes, provided the Offerors technology solution meets the requirements of defined in Part I-30 and Appendix M of the RFP. No.


30 IV-4.F Staffing Requirements

Would DHS please provide staffing levels for the current vendor? Refer to the answer to Q.10.


31

IV-4.F Staffing Requirements

What is the average caseload for an Enrollment Broker? Current caseloads do not conform to the requirements of the RFP. The Offeror is expected to propose adequate staffing for the management of the enrollment process as described in the RFP.



On average, how many home visits are completed by the current vendor per day?




How many contacts come through the Service Center on a monthly basis? The Department does not currently track or maintain the requested information in a reportable format.



Would DHS please provide call volume statistics (e.g., call volumes, talk times, abandonment rates, etc.) by month for the last year?




What percent of calls/inquiries results in a home visit? The Department does not currently track or maintain the requested information in a reportable format.


36

IV-4.F Staffing Requirements

Please confirm that if a bidder is submitting proposals for all four Lots, they must provide four separate Project Managers (one for each region) to meet this requirement.

Offerors must submit a separate and distinct proposal for each Lot. The Offeror may propose different individuals or the same person for the project manager position in each Lot.


37 IV-4.J Programmatic Requirements

What are the standard turnaround times for the CAOs to complete the financial eligibility determinations?



38

IV-4.J Programmatic Requirements

What are the standard turnaround times for the AAAs to complete the level of care determination?



39


Item 3: “The County Assistance Office (CAO) will determine financial eligibility for each Applicant. The CAO has a total of 45 calendar days to send a notice of financial determination.” Please confirm that financial eligibility is part of program eligibility (as described in item 4 in the same list). Through HCSIS, SAMS, or the current vendor’s database, please provide the mean, median, and range of days it has taken the CAO to provide notice of financial determination over the past calendar year.

Program eligibility is separate from financial eligibility. The Department does not currently track or maintain the requested information in a reportable format.


40


Item 5: “A physician must complete the Physician Certification form (MA-51) to indicate the disability and the level of care needed for each Applicant.” Through HCSIS, SAMS, or the current vendor’s database, please provide the mean, median, and range of the days it has taken the physician to provide the MA-51.



41 IV-4.J Programmatic

Requirements

Item 7: “Area Agencies on Aging (AAA) have 15 calendar days to conduct and submit a LCD to the selected Offeror(s) from the date of the request, for each Applicant. Please provide the mean, median, and range of days it takes the AAAs to conduct and provide the LCD to the current vendor?




Requirements

If a person is found to not meet the level of care eligibility requirements (as determined by the AAA with the LCD), is completion of the in-home visit and CMI no longer required?

If the participant does not meet clinical eligibility criteria, the completion of the CMI and in-home visit are not required.



Requirements

Item 5: Does the physician who signs the MA-51 have to be the Applicant’s primary physician or could any physician licensed in the State of Pennsylvania sign the MA-51 if the Applicant consents to this? If yes, could they work for an Area Agency on Aging (AAA) or the Offeror? Could they be subcontracted to perform this function independently?

No, the physician does not have to be the primary physician. The selected Offeror(s) may not subcontract this service.


44 IV-4.B Intake What is the electronic application system? See Part IV-3, E. and IV-4, C. 2. of the RFP.


45 IV-4.B Intake

Is the Contractor responsible for building the electronic application system? Yes, see Part IV-3, E. of the RFP. Refer to IV-4, C. 2. of the RFP, the selected Offeror(s) must provide the means for a consumer to complete an application online.


46 IV-4.B Intake If the Contractor does not build the electronic application system, how do they access it?

N/A. Refer to the answer to Q. 45


47 IV-4.C Application

Process

What are the differences between the application process as it currently stands and the application process detailed in the RFP?

The purpose of the Question and Answers process is to assist Offerors in responding to the solicitation requirements. Offerors must develop their proposals based on the requirements of this RFP and not on the current contract requirements.



Process

Does the Contractor mail application packets to all applicants, or only those who are MA recipients?

Only for those who are not currently MA recipients, or by request. Refer to Part IV-4. C. 4. of the RFP.



Process

If the Contractor sends the application packet to all applicants (MA recipients and non-MA recipients), do the timeframes for when they are sent vary according to MA status?

Refer to the answer to Q. 48.



Process How many application packets are mailed per month? None. Currently, the Department does not

require the mailing of application packets.


51 IV-4.C. Application

Process

Item C.1.a: “If the Applicant is a MA recipient, the selected Offeror(s) will proceed to Part IV-4. Tasks, Section D. Eligibility Determination.” Please confirm that a person currently receiving MA does not require an Applicant Packet (items a-h associated with sending the Application Packet on page 39). Please confirm that a person currently receiving MA is not required to complete a 600L.

Yes, a person currently receiving MA does not require an Application Packet. Current Medicaid recipients are not required to complete the 600L.


52 IV-4.D.1.a Physician

Certification

What system does the Contractor load the Physician Certification into? The selected Offeror(s) are not required to load the document to a system; however, it must be maintained, which is at the selected Offeror(s) discretion.


53 IV-4.D.1.b Level of

Care Determination

What is entailed in the level of care determination? The Level of Care Determination (LCD) is completed by the Area Agencies on Aging (AAAs), who also determines nursing facility clinical eligibility. The selected Offeror(s) will have access to the completed LCD for program eligibility determination.


54 IV-4.D.1.b Level of

Care Determination

How is the Contractor notified of the result of the level of care determination? The AAA will notify the selected Offeror(s).


55 IV-4.E. In-Home

Visit

Is the Enrollment Broker expected to conduct the in-home visit within a specific period of time (i.e., calendar days) following the initial intake?

The Offeror must propose a process to ensure the 60-day timeframe requirement is met. No specific timeframe is prescribed for the initial intake or in-home visit.


56 IV-4.E. In-Home

Visit

The IEB vendor will “develop the initial Individual Service Plan” with the applicant. The Independent Service Plan exhibited in Appendix O is dated October 2010 and appears to be one page in length, while the MA 546 (OLTL Individual Service Plan) is dated December 2010 and is 5 pages long. Please clarify which Individual Service Plan (ISP) will be used by the IEB vendor with the applicant. If the ISP in Appendix O is longer than the one page provided, please provide information about what sections of the initial ISP the IEB vendor would complete and what sections the selected SC entity would complete?

Refer to the correct Appendix O provided with this Addendum. The selected Offeror(s) are expected to complete it in its entirety.


57 IV-4.E. In-Home

Visit

The IEB vendor will “develop the initial Individual Service Plan” with the applicant. Currently, Service Coordinators are required to receive 40 hours of initial training and 20 hours of annual refresher training in order to develop an Individual Service Plan. Will the selected Offeror(s) be provided this training in order to develop the initial ISP? If not, please explain.

OLTL will conduct training as appropriate and necessary.


58

IV-4.J. Coordinate Nursing

Home Transition/ Money

Follows the Person

Who currently completes the intake, eligibility determination, and enrollment of participants transitioning into the Money Follows the Person program (prior to transitioning to the targeted waiver)? To what extent is the IEB vendor expected to assume any or all of these activities?

The selected Offeror(s) will provide applicants consent forms and related information about Money Follows the Person options and procedures if a person is transitioning from a nursing facility. The selected Offeror(s) will be responsible to coordinate with the Nursing Home Transition Coordinator throughout the process. The selected Offeror(s) are required to submit completed forms to two entities.


59

IV-4.J. Coordinate Nursing

Home Transition/ Money

Follows the Person

What is meant by “coordinate with the Transition Coordinator throughout the process, until the Applicant transitions into the community or until the application is closed?” Please provide as much detail about expectations as possible.

Refer to the answer to Q. 58. Coordination with the NHT coordinator includes verifying current discharge status at regular intervals and coordinating with Service Coordinator to ensure services are in place upon discharge. The Offeror is required to submit completed forms upon enrollment to the CAO and the appropriate Service Coordination Entity.


60 IV-4.L Waiting List When do participants come off the waiting list and how are they enrolled? There are currently no waiting lists for OLTL

waiver programs.


61 IV-4.M. Hearings

and Appeals

“The selected Offeror(s) is responsible for developing a strategy to track appeals and immediately notify OLTL of all appeals.” Please provide data on the number of appeals each year for the past 3 years, if possible separately for the Aging Waiver and each of the other waivers captured in this RFP? “The selected Offeror(s) shall prepare for and attend the hearing on behalf of the Department and provide any evidence deemed necessary to defend the appeal and support the selected Offeror(s) decision.” Since the Offeror will also assist in other appeals as necessary, please provide information about the number of appeals that required the current vendor to participate in the appeal process? How many of those resulted in the need to be present during a hearing? What is the requirement in staff hours and other related level of effort for these appeals?

There were a total of 207 non-financial determination related appeals during calendar year 2014 for which the selected Offeror(s) would likely be required to participate. The vast majority of hearings will take place over the phone.


62 IV-5.B Reports

Submission Chart

Please provide monthly call volumes by Lot. Please include abandonment rates and talk times.



63 IV-5.B Reports

Submission Chart

Please provide copies of recent reports. Current vendor reporting requirements do not necessarily conform to this RFP’s requirements and are not publically available.


64

IV-5. Reports and Project

Controls

The time frame to complete applications with clinical and program eligibility is stated as “within 15 calendar days” on page 48 and “within 30 days” on page 50. Which timeframe is correct (i.e., 15 vs. 30)?

The 30 calendar days timeframe is correct. There is an expectation that the eligibility determination will be concurrent with financial eligibility criteria.


65 IV-6 Performance

Standards

For purposes of performance standards, is the Contractor responsible for meeting timeframes in instances when the AAA or CAO fails to complete their responsibilities within their required timeframes?

No, however it is expected that the selected Offeror(s) will work with the AAA and CAOs to meet the timeframes. These efforts must be demonstrated and documented, as is indicated in Part IV-6 of the RFP.


66

IV-6 Performance Standards

In order to fully understand the basis for the Performance Standards and to further understand the duration of enrollment actions, please provide the current or most recent data on mean, median, and range of days for each of the following processes:

1) Days to complete applications for the Aging Waiver. 2) Days to transfer files for the Aging Waiver. 3) Days to complete applications for the Acquired Immune Deficiency

Syndrome (AIDS) Waiver; Attendant Care Act 150 Program; Attendant Care Waiver; Community Care (COMMCARE) Waiver; Independence Waiver; and Omnibus Budget Reconciliation Act (OBRA) Waiver.

4) Days to transfer files for the AIDS Waiver; Attendant Care Act 150 Program; Attendant Care Waiver; COMMCARE Waiver; Independence Waiver; and OBRA Waiver.

5) Days to complete the clinical and program eligibility for the Aging Waiver. 6) Days to complete the clinical and program eligibility for the AIDS Waiver;

Attendant Care Act 150 Program; Attendant Care Waiver; COMMCARE Waiver; Independence Waiver; and OBRA Waiver.

1), 2), 5), and 6) The Department does not currently track or maintain the requested information in a reportable format. 3) The Department does track the number of days to complete the entire enrollment process; however, it is estimated to be 72 days. 4) The current performance standard to transfer files is two days.


67 IV-6 Performance

Standards

Please identify the specific event associated with the start of the 30 day period for completion of the clinical and program eligibility for the Aging Waiver? Is this the date of application? Would this include the 45 day period allowable by the County Offices?

Refer to Part IV-3, J. 2. of the RFP. For all waivers, the enrollment process begins with the date the PA 600L is received by the Offeror or when a current MA recipient requests to apply for services. Yes. Yes.


68 IV-6 Performance

Standards

Performance Standards #1, #2 and #3 can be impacted by factors outside of the Offeror’s control. The RFP states “Further, if through no fault of the selected Offeror(s), and despite the demonstrated and documented best efforts of the selected Offeror(s), an application is not completed in 60 days, the sanction will not be imposed.” This seems to apply only to Performance Standard #1. Can DHS waive the penalties for such cases in #1, #2 and #3 that are delayed by factors that are outside of the Offeror’s control?

Performance Standards 1 and 3 will not result in sanctions if an application is not completed through no fault of the selected Offeror(s) provided these efforts are demonstrated and documented, as is indicated in Part IV-6 of the RFP. Performance Standard #2 is solely the responsibility of the selected Offeror(s) and will not be waived.


69 IV-6 Performance

Standards

The following maximum penalties are listed for Standards 1 through 3: Standard 1 – 20% of invoice amount to be deducted; Standard 2 – 5% of invoice amount to be deducted; and Standard 3 – 20% of invoice amount to be deducted. Are these penalties cumulative? That is, would a total of 45% of an invoice be deducted due to performance deficits?

The amounts referenced are the amounts that may be imposed at the discretion of the Department.


70 IV-6 Performance

Standards

May all of the Performance Standards and Non-Compliance Amounts Owed (penalties) be negotiated once an Offeror(s) has been selected for negotiation?

Offerors must submit proposals based on the requirements of the RFP. The Department, at its sole discretion, may negotiate these amounts with the selected Offeror(s).


71 IV-6 Performance

Standards

Can the Performance Standards and Amount Owed for non-compliance (penalties) be made discretionary, solely at the discretion of DHS, so they “may” be applied in the best interest of DHS as opposed to written in a way that they must be applied?

Offerors must submit proposals based on the requirements of the RFP. The Department, at its sole discretion, may negotiate these terms with the selected Offeror(s).


72 IV-6 Performance

Standards

Would the Commonwealth lower the performance standards for “Minimum Acceptable” to 95% for #1), #2) and #3)? Could the percentages be lowered to 3%, 6%, and 10% where now they are 10%, 15% and 20% respectively? Could a cap of no more than 15% of total invoice in any one month and a cap of no more than 8% of total amount invoiced annually be considered?



73 IV-6 Performance

Standards

Could the Performance Standards and thresholds be phased in over the first year of the contract to permit a smoother ramp up and assessment by the Commonwealth of the proposed Performance Standards? Could a provision for “notice of Non- Compliance” and a specified opportunity to cure before penalties are applied be considered?



74 IV-6 Performance

Standards

According to the 2012 Settlement Agreement between Mosley et al. and Alexander, eligibility determination should be issued within ninety (90) days of the application date. Since the performance standards in the RFP are based on sixty (60) days of the application date, can the Commonwealth provide information about the rationale used to determine the performance standards? This would include the shift from 90 to 60 days, as well as the minimal acceptable levels (i.e., 97-98%)?

The purpose of the Question and Answers process is to assist Offerors in responding to the solicitation requirements. Offerors must develop their proposals based on the requirements of this RFP and not on the current contract requirements.


75 IV-6 Performance

Standards

Will the selected Offeror(s) have the ability to contest a penalty? If so, what will that process be?

Refer to Appendix A, Section V32 Contract-024.1 Contract Controversies, of the RFP.


76 IV-6 Performance

Standards

Will the Commonwealth consider suggestions for alternate language in these sections?



77 Cost Proposal

Template

For both “Deliverables” labeled “Transition” and “Turnover,” is a single number entered for each cell acceptable? Is additional detail required? If so, in what format? Is a “cost verification” worksheet available or required for those cells?

Yes. No. N/A. The cost verification worksheet is only required for the total contract cost.


78 Cost Proposal

Template

The enrollment numbers on the Cost Proposal Template are not consistent with the numbers captured within the RFP (page 27) or in Appendix L. In addition, with only one template, the Offeror(s) will not be able to submit cost proposals for each of the four lots (i.e., regions). Will the Commonwealth provide updated cost submittal worksheets that include the correct number of enrollments detailed separately by region?

A revised Cost Submittal, providing for the four separate Lots, was issued as Addendum 1 of the RFP. Refer to the answer to Q. 16.


79 Cost Proposal

Template

During the first year it is projected that 7,659 people will be enrolled. While there appears to be a steady increase across the years, the reviews during the first year are based on a partial 9 month period. This will result in a proportionately higher number of enrollments projected during the first year of the contract. (7,659/9= 841/mo. x12= 10,092/yr.). Please confirm whether more enrollments are expected during the first year of the contract? If not, please explain the numbers provided. Will the current vendor continue to complete all enrollment activities during the 90 day transition period?

The data provided in Appendix L is based on 2014 data. We would anticipate more enrollments in subsequent years based on the aging population in the Commonwealth, however, a percentage or more accurate prediction cannot be ascertained. Refer to the answer to Q. 16.


80 Cost Proposal

Template

Given the increase in scope as well as volume as compared to the current IEB contract, can the Commonwealth provide an estimated or targeted budget by region or Statewide for this RFP’s scope of work?

No, the Offeror must propose pricing based on the RFP requirements.


81 Appendix L

The table provided refers to intakes as “Valid Intakes.” Please clarify what a “valid” intake means. Are these the number of intakes that result in an application and a need for eligibility determination? Are there invalid intakes? If so, how many?

The Department does not make a distinction between valid/invalid intakes for this RFP. Yes. No.


82 Appendix L

Based on the data provided for all waivers combined, there were 34,508 intakes that led to 13,646 enrollments. What are the reasons that an intake would not result in enrollment and can the Commonwealth provide data on the frequencies by reason?

An intake would not result in an enrollment if the applicant does not meet eligibility criteria, clinically, programmatically or financially, or the applicant chooses not to pursue the application.


83 Appendix N

There are elements of the form that would appear to be outside the Contractor’s scope (e.g., financial eligibility). Is the Contractor to obtain all the data in the form during the home visit or does some of the data come from other sources?

The required sections of the CMI will be identified during transition.


84 Appendix N If data for some of the questions comes from other sources, who does it come from and when does the Contractor receive it?

Unknown at this time, it will be determined during transition.


85 Appendix O

If the complete Individual Service Plan (ISP) is to be completed by the IEB vendor, what role does the Service Coordination Entity play during the initial plan development? In addition, where will the IEB vendor obtain the necessary information about total hours of each service, as well as the schedule for service delivery? Would the IEB vendor be required to obtain all of the required signatures that are part of the ISP (e.g. service coordinator, others who participated in developing the plan, etc.)?

The Service Coordinator has no role in initial plan development. Initial plan hours and services will be developed by the selected Offeror(s) utilizing the service plan development process that will be included in the OLTL training provided to the selected Offeror(s).


86 General Would the Department please provide the number of home visits per Lot per year? The Department does not currently track or

maintain the requested information in a reportable format.


87 General Does the Contractor have any responsibilities for redetermination? If so, what are they?

Annual redeterminations are not the responsibility of the selected Offeror(s). Denied applicants can re-apply at any time.


88

What are the quota requirements for hiring TANF individuals and can we provide our own training tailored to the requirements of the positions in addition to partnering with the workforce development system?

The CPP does not have a quota requirement for hiring TANF individuals. All Offerors are encouraged to review the services of the contract to identify areas where entry level workers could be beneficial to their company and/or their subcontracting companies. Offerors are encouraged to look outside the box when developing a plan to meet the CPP requirements. Yes, you can provide your own training tailored to the requirements of the position. Employment and Training programs have Federal and State requirements they must meet, so while some flexibility can be granted for Employer Specific training curriculum, there are some limits to what can be done. Larger CPP hiring numbers give

us more leverage to request exemptions to provide Employer Specific training curriculum.


89

Who qualifies for tax credits for hiring TANF recipients (what type of organization) and where is information on this located?

Information can be accessed on the Department of Labor & Industry’s website http://www.portal.state.pa.us/portal/server.pt/community/employment_tax_credits/10569


90

IF the prime contractor is a nonprofit, can they be eligible for the small business MWDE qualification, or does this only apply to for profit businesses?

Companies must be for profit in order to self-certify as a small business. If they do not meet the requirements as a small business they will not be unable to verify as a small

diverse business.


91

What are the current negotiated rates for the enrollment broker and the AAAs involved, per attempted enrollment?

The current contractor is not paid a fee for attempted enrollments. The current under-60 waiver enrollment broker is paid a fixed monthly fee and a per enrollment fee. The AAAs are paid a $95 per enrollment fee for the Aging Waiver enrollments.


92

Do the current negotiated rates differ between the four regions identified in the RFP?

No, currently there is one contractor who provides services state wide for the under-60 waiver enrollment services.


93

What is the current understanding of how a managed care transition would affect the future of the enrollment process? Is it expected that the enrollment process would remain independent of any identified MCO and constitute changes to the process only?

The Department continues to engage various stakeholders in an effort to rebalance the Long Term Care system, which may result in additional or different enrollment services. Those changes are unknown at this time.

http://www.portal.state.pa.us/portal/server.pt/community/employment_tax_credits/10569




94

The PA OLTL currently contracts with Public Partnership LLC a subsidiary of Public Consulting Group (PCG) to provide financial management services to participants who choose to direct their own services. PPL is a contracted administrative vendor, not a direct service provider. Please confirm that OLTL would not consider it a conflict of interest if PCG were to bid as a prime contractor or be named as a subcontractor to a prime contractor.

Although providers of administrative services are likely outside the scope of the RFP’s conflict of interest provisions, the Department cannot make any individual determinations until it has had the opportunity to review the Offeror’s proposal.


95

The RFP states “During the in-home visit, the selected Offeror will determine if the applicant meets programmatic eligibility for the specific program that best meets the applicant’s needs” Does the Commonwealth intend for the Offeror to determine program eligibility at the time of the in-home visit or will the Offeror submit the enrollment into HCSIS/SAMS for OLTL to make the programmatic determination?

The selected Offeror(s) will determine program eligibility.


96 Appendix L reflects statistical data on the number of valid intakes for the under 60 and Aging waivers. Please explain the sources for the data.

The data was derived from the Departments IT systems and the incumbent vendor.


97 Part I-I.3-Scope-

Page 1

Should the award from this request for proposal result in contracts with multiple offerors, how will the Commonwealth specifically assure that all residents of the Commonwealth experience a consistent and similar enrollment experience across all communities of the State?

The Department will work with, and monitor the performance of the selected Offeror(s) to ensure that all RFP requirements and performance measures are met.


98 Part I-I-3.Scope-

Note- Page1

In what detailed ways will the Commonwealth hold a selected offeror or offerors

accountable for meeting other changes that will be realized through the State’s

long –term care system rebalancing efforts?

The selected Offeror(s) will be required to adhere to the RFP requirements. Significant future program changes, if any, will be accomplished via contract amendments or subsequent procurements.


99 Part I-I-16-Alternate

Proposals-Page5

Please explain how the “creativity” encouraged for the development of proposals

will be objectively considered and uniformly evaluated during the proposal review

and selection process?

The RFP evaluation criterion is contained in Part III.


100

II-5.6-Personnel-

Page 15

What is the rationale for including enrollment brokers under the definition of key

personnel since typically that definition is restricted to those personnel performing

supervisory service functions?

This requirement has been removed; Enrollment Brokers will not be considered Key Personnel.


101

Part IV-IV-4.A. Transition-

Page34

In what manner and for how long will current HCBS waiver enrollment providers be

compensated for supporting and effecting system transitions to a new waiver

enrollment broker(s)?

This has yet to be determined. At some time in the future, the Department will determine when HCBS waiver enrollment providers will stop taking new Applicants.


102 Part IV-IV-

4.A.Transition-Page 34

In what defined ways (other than general oversight) will the Commonwealth ensure

that the proposed transition plans for new enrollment providers are being carried

out with the highest degree of efficiency and effectiveness, according to all plan

objectives?

The Department will work with, and monitor the performance of the selected Offeror(s) to ensure that RFP requirements regarding Transition are met prior to the selected Offeror(s) providing enrollment services.


103 Part IV-IV-

4.A.Transition-Page34

What action will the Commonwealth take if the transition to a new vendor takes

longer than the prescribed maximum 90 day period?

The Department will take whatever steps are necessary to effectuate a smooth transition of services.


104 Part IV-B-Intake -

Page 38

How will the Commonwealth work to ensure that there is effective interface/

coordination among the intake processes for non-enrollment community agencies

and the intake process of the independent enrollment broker(s)?

The Department will work with the selected Offeror(s) during the transition phase and monitor the performance of the selected Offeror(s) to ensure that RFP requirements are met and that the program functions efficiently and effectively for program applicants.


105

Part IV-IV-4.G-Provide Education,

Outreach, and Community

Awareness- Page 41

How will the Commonwealth support and assist a selected offeror or offerors in

executing their education, outreach, and community plans for the community?

The Department will work with the selected Offeror(s) during the transition phase to establish a management and monitoring plan for their community outreach and education plans.


106

Part IV-IV-3.K. Addressing

Immediate Need-Page 42

The RFP encourages potential offers to propose an expedited process for HCBS waivers, in coordination with Protective Service and the Office of Long Term Living. What standards/expectations will the Commonwealth utilize for determining if a proposed expedited process is acceptable?

The RFP evaluation criterion is defined in Part III-4.


107 Part IV.IV-M.

Appeals- Page 43

A selected offer will be responsible to developing a strategy for tracking consumer

appeals. What are the basic core data elements the Commonwealth will require for

approving the implementation of such a tracking system?

Refer to Part IV-6 of the RFP. Factors include: enrollment denials, number of enrollment denial appeals, reason and outcome for appeals, as well as other information the Department may request (p. 43). The selected Offeror(s) are required to notify the Department of scheduled appeal hearings.


108 Part IV.IV-M.

Appeals- Page 43

Since a selected offeror is required to provide some assistance to an alleged

aggrieved consumer during the appeals process, what (if any) is the offerors

obligation to a consumer who requests the assistance of legal counsel to defend an

appeal?

The selected Offeror(s) will be required to defend its decision that led to the appeal. The Department does not require the selected Offeror(s) to provide legal counsel for the applicant. Refer to Part IV-4, M. of the RFP.


109 General

How will the Commonwealth structure a system of oversight and monitoring so

that all terms, conditions, policies and practices and performance expectations are

met by the selected offeror or offerors at all times?

The Department will assign a Contract Administrator to administer and monitor the contract(s). Contract reporting and monitoring activities will be ongoing to ensure adherence to the contract requirements.


110 General

What is the anticipated time frame for reviewing proposals and selecting an offeror

or offerers, in response to this RFP?

There is currently no anticipated timeframe. However, the prompt and careful review of proposals is a priority.


111

Can the state clearly define that a proposed vendor must demonstrate actual experience where they have provided enrollment broker services in the past?

An Offeror must provide information in response to the Corporate Prior Experience as defined in Part II-4 and Personnel experience as defined II-5. As indicated in Part III-4 of the RFP, Offeror Qualifications are an evaluation factor.


112 II-4 A. Corporate

Background

Can DHS further define conflicts of interest and clearly state whether a health care provider or health plan can under any circumstance be the enrollment broker for requested services under this RFP and still be compliant with CMS regulations?

The Department cannot make any individual determinations until it has had the opportunity to review the Offeror’s proposal. The Department will evaluate Offerors responses to Part IV-3, C. to determine if any conflicts exist.


113

Can the Commonwealth confirm that the Mosley requirements, as outlined in Exhibit C of the Mosley v. Alexander Settlement, are no longer requirements of the scope of work?

All applicable requirements for this project are specified and included within the RFP.


114 Appendix L

Why is the monthly total for the PDA waiver always 39% for each Lot for each month. Is there a limit to the number of applicants who can come into the Aging waiver per month?

These values are estimated. No.


115 Appendix L

Is there a waiting list for PDA waiver? No.


116 Appendix L

Does the intake data in Appendix L represent individuals or total applications received, including multiple applications filed by one applicant? What percentage of people re-apply within a 12 month period?

The intake data represents total applications received. The Department does not currently track or maintain the requested information in a reportable format.


117 I-19.C

The Public disclosure section of the RFP refers to Appendix F of the RFP for a Trade Secret Form that may be used as the signed written statement. However, Appendix F is the domestic workforce utilization certification. Can DHS please clarify that they intended to refer to Appendix E, Trade Secret/Confidential Proprietary Information Notice?

The reference should be for Appendix E.


118

I-24;

Appendix A V.3

The RFP states that the Department may renew the contract(s) on the same terms and conditions for up to three (3) additional one-year periods. In Appendix A, it states that the Contract may be renewed for a maximum of 2 additional 1 year term(s). Will the Commonwealth please advise if bidders are to submit proposals with two (2) or three (3) priced option periods?

As indicated in Part I-24 and the revised Cost Submittal provided in Addendum 1, the term of the contract is for a period of two (2) years; the Department may renew the contract(s) for up to three (3) additional one-year periods.


119 II,C.a Can we submit 11” x 17” paper folded to 8.5” x 11” size (such as for a Gantt Chart)? Yes.


120 II,C.b

For presentation purposes, is it permissible to use a font smaller than 12 in exhibits, graphics, charts, screen shots, Gantt chart, tables, and other types of exhibit as long as they are clearly legible?

Yes.


121 II, C

The RFP requires for materials provided in any Appendix to be referenced by page number(s) in the body of the proposal. Appendices are normally a complete submission and do not require a specific page reference. Would the Commonwealth consider striking out the requirement to reference the page number?

No.


122 II-4; III-4

RFP Commonwealths that, “a significant subcontractor is defined as an organization undertaking more than ten (10%) (on a total cost basis) of the work associated with this RFP” on p 15, but then references that, “a significant subcontracting commitment is a minimum of five percent (5%) of the total contract value” on p. 23. Will the Commonwealth please clarify what constitutes a “significant subcontractor”?

The purposes of providing similar background information in Part II-2, it is 10%. For the purpose of evaluating SDB, it is 5%. They are separate and distinct purposes.


123 II-5

For the purpose of a cleaner presentation, is it permissible to illustrate the number of hours per week each staff member is projected to work on a table that accompanies the organizational chart rather than on the organizational chart itself?

Yes.


124 II-5. Tab 6 – Personnel

The RFP requests organizational charts and "similar information for any subcontractors that are proposed." Can the bidder include subcontractors in the same project organizational chart?

Yes, but subcontractors must be indicated as such.


125

IV-2

Can DHS anticipate the estimated call and document processing volumes for the under 60 and for the over 60 populations during the upcoming contract term?



126 IV-2

Can the Commonwealth estimate the number of calls per participant? The Department does not currently track or maintain the requested information in a reportable format. The incumbent contractor has provided the following data; however, the Department has not attempted to independently verify its accuracy. In 2014, the incumbent received 84,543 calls for all 4 lots from the under 60 population. The average handle time per call in 2014 was roughly 5 minutes and 30 seconds. The Department has no similar information in its possession relating to the Aging Waiver.


127 IV-2

Can the Commonwealth release historical call center and document processing volumes to potential Offeror(s)?

The Department does not currently track or maintain the requested information in a reportable format. The incumbent provided the following data; however, the Department has not attempted to independently verify its accuracy. In 2014, the incumbent sent/received 8,181 documents for all 4 lots from the under 60

population. In 2014, the incumbent data entered 7,136 cases into HCSIS for all 4 lots from the under 60 population. The average time it took to data enter information into HCSIS is roughly 60 minutes per case. Refer also to the answer to Q. 126.


128 IV-2

Can the Commonwealth confirm that for each intake, as outlined in Appendix L, the Offeror will need to conduct document processing tasks, including but not limited to sending out and receiving/processing the PA 600, the Level of Care Determination, the Physician Certification, CAO 1768/PA 162, as well as sending enrollment information documentation to the Service Coordination Provider and the Applicant?

No, based on the applicant’s MA status and interest in continuing in the process, not all steps may be required.


129 IV-2

Can the Commonwealth confirm that Offerors will be required to data enter case information into HCSIS/SAMS following the LCD and the in-home assessment to submit to OLTL?

The selected Offeror(s) will be required to enter enrollment data into HCSIS and SAMS for each eligible enrollment.


130 IV-2

Can the Commonwealth confirm that it takes 60 minutes on average to data enter case information into HCSIS/SAMS?

The Department does not currently track or maintain the requested information in a reportable format. Refer to the answer to Q. 127.


131 IV-2

How long will the in-home assessment take in minutes, including the Individual Service Plan development?

The Department does not currently track or maintain the requested information in a reportable format. The length of in- home assessments will vary by person.


132 IV-3 F.2.a Can the Commonwealth clarify the role and responsibility of the Registered Nurse? The Registered Nurse will provide Clinical

consultation.


133 IV-3.D In what capacity will the Offeror use the PROMISe system? Refer to the answer to Q. 21.


134 IV-3 E

Can the Commonwealth confirm that “functional website” refers the web-based tracking system used internally to track case status? If not, does the Commonwealth require a public-facing informational website for Participants to submit applications?

As indicated in IV-3, E. 1, the functional website must allow applicants to apply for services and to track their application status.


135 IV-4, C Pages 38 –

39

Please confirm that a received PA 600 is considered complete when it includes a name and signature. Please confirm that the Offeror will forward this form to the CAO for processing and eligibility determination.

Yes, it is considered complete. Yes, the selected Offeror(s) will forward the PA600 to the CAO.


136 IV-4.C.3.b

Can applicants complete a PA 600 on Compass? If yes, how will the Offeror receive the 600 completed on Compass?

Yes, for general Medicaid eligibility. The selected Offeror(s) must access CIS to receive MA eligibility notifications based on submission of the PA 600.


137 IV-4.E. What screens/fields need to be completed in HCSIS/SAMS for the service plan and PAS provider selection?

This will be determined during transition.


138 IV-4.E.5

Is it acceptable to electronically maintain forms signed by applicant during the home visit? Or is it a requirement that we maintain the paper form?

Yes, as long as they are maintained in accordance with Part I-30 and IV-3, I. of the RFP. Paper forms are not required to be maintained.


139 IV-4.E.

Will OLTL still have final programmatic determination in waiver eligibility? Is the Offeror making the final programmatic waiver determination during the home visit?

No. The selected Offeror(s) will make the programmatic waiver determination.


140 IV-4.E. Is the Offeror completing the first page of the ISP as indicated in Appendix O? Or is the Offeror completing the entire 5-page ISP that is currently used by SCEs?

No. Yes, it is provided with this Addendum.


141 IV-4.E.

Can the Commonwealth provide bidders with a copy of the consent form the Offeror will need to complete for Money Follows the Person?

Yes, refer to the document provided with this Addendum.


142 IV-4.E. 9

The RFP states: “During the in-home visit, the selected Offeror will determine if the applicant meets programmatic eligibility for the specific program that best meets the applicant’s needs.” Does the Commonwealth intend for the Offeror to determine program eligibility at the time of the in-home visit or will the Offeror submit the enrollment into HCSIS/SAMs for OLTL to make the determination?

Yes, the selected Offeror(s) must determine program eligibility, but Offerors must determine when that will occur. The selected Offeror(s) will not submit the enrollment for OLTL to make the determination.


143 IV-4.E. 9

Does DHS intend for the Offeror to leave a copy of the 1768 indicating the Offerors programmatic decision with the applicant during the in home visit?

Refer to Part IV-4, E of the RFP. The selected Offeror(s) may provide preliminary results to the applicant during the in-home visit but a final decision cannot be made until financial eligibility is determined. There is no requirement that a copy of the form be left with the applicant during the in-home visit.


144 IV-4.E.

If applicants are deemed programmatically eligible during the in home visit, when would the Offeror enter that application into HCSIS/SAMS? Additionally, would the Offeror be required to data enter the application into HCSIS/SAMS if it is determined that the applicant is programmatically ineligible during the home visit?

Prior to completing the enrollment. No.


145 IV-4.E. Will Offeror render the decision of programmatic eligibility and inform the applicant of that decision during the in home visit?

Refer to Part IV-4, E and F. of the RFP.


146 IV-4.E.

How will the Offeror render a programmatic decision if there is no physician’s certification (MA-51) at the time of the in home visit?

The selected Offeror(s) cannot make the determination without the physician’s certification. PC/MA-51 is part of the Clinical Eligibility Determination process. Refer to Part IV-4, D.1. of the RFP.


147 IV-4.E. 9

Can the Commonwealth confirm that there will only be one review by OLTL for programmatic eligibility Please confirm that OLTL does not review a 2nd time to confirm financial eligibility, following the CAO determination.?

OLTL will not review program eligibility. OLTL will not confirm the financial eligibility.


148 IV-4 F

What is the timeframe for OLTL to complete their programmatic eligibility review? N/A. Refer to the answer to Q. 147.


149 IV-4 F

RFP section IV-4 F Commonwealths that “copies of all required information materials and the approved ISP will be sent to the participant.” Can the Commonwealth confirm that the Offeror will be the party sending these materials to the participant?

The selected Offeror(s) is responsible for sending the materials to the applicant.


150 1-3, IV-4 L

Can the Commonwealth confirm that any new applicants for the Options program be screened for the PDA waiver first? If so, are the applicants in the Options program included in the intake numbers provided in Appendix L?

The Department cannot confirm at this time.


151 IV-4. M

Can DHS verify that the Offeror will have to follow Title 55 of the Pennsylvania Code 275.4 regarding the appeal process?

Yes.


152 IV-4. M

Can DHS verify that the Offeror is required to notify DHS of appeals related to doctor’s decisions on MA-51s, NFI LCD’s, missing documentation, decisions made at home visit, decisions by OLTL and financial determinations by CAO?

The selected Offeror(s) will be required to maintain documentation of appeals relating to program determinations and level of care determinations. The selected Offeror(s) is not required to notify or provide data to the Department for appeals of financial determinations.


153 IV-4. M

In order to provide all bidders with the same handle time information for appeals, the current incumbent has requests confirmation from DHS on the following appeal handle times:

1. Can DHS verify that each appeal requires approximately 1 hour in preparation prior to the hearing for appeal to send required documents to applicant, applicant’s representative, BHA, OLTL, CAO, and AAA office as needed?

2. Can DHS verify each phone or in person (conducted in a regional office) hearing for an appeal is an average of 1 hour in length?

3. Can DHS verify that each appeal requires approximately ½ hour for required follow up for appeal to send required documents to applicant, applicant’s legal representative, and BHA

The Department cannot verify this information. The Department does not currently track or maintain the requested information in a reportable format.


154 IV-4. M

What was the number of cases appealed for applicants over and under 60 in 2014? Does DHS expect that number to be similar?

In 2014, non-financial determination appeals were as follows: -165 for under-60 waivers -42 for the Aging waiver In future years, DHS has no expectation regarding the anticipated number of appeals.


155 IV-4. M

Can DHS confirm that BHA is going to continue to use block scheduling when scheduling appeals. The current blocks are 3 hours in length, and a staff member from the Offeror has to be available for this block of time.

Yes, BHA will continue to use 3 hour “block” scheduling.


156 IV-5,B The incumbent’s Average Speed to Answer SLA is set at 60 seconds. Is it OLTL’s intention to reduce the ASA to 40 seconds, and thereby increase staff?

Offerors must propose how they intend to meet the requirements and Performance Measures of the RFP.


157

IV-5,B

In alignment with Performance Measure #3, can the Commonwealth confirm that the performance requirement on page 48 should read “the number and applications with clinical and program eligibility complete within 30 days?” (Rather than 15 days).

Refer to the answer to Q.64.


158

IV-5.E

On pg 49, under Section E. Final Reports, the RFP states that “The final report will be due at the end of the three year Contract period…” Can DHS please clarify that this should read “at the end of the two year Contract period”?

The Final Report will be due at the end of the two year Contract period, or at the end of any renewal year if a renewal option is exercised.


159

IV-6

What constitutes “clinical and eligibility complete within 30 days?” Is this when the Offeror submits the case to DHS via HCSIS/SAMS following the LCD and the in-home assessment?

Clinical and program eligibility determination is described in Parts IV – 4. Tasks – D. Eligibility Determination and E. In-Home Visit, of the RFP. These tasks - obtaining the physician certification, obtaining the level of care determination, and completing an in-home visit with the participant – make up the tasks of completing clinical and program eligibility.


160

SAP Form for Contractual Agreements

Re: “SAP Form For Contractual Agreements (Funds Commitment/Funds Reservation, SAP# 4000015039) between vendor Maximus Health Services and the Department of Public Welfare with an effective date of January 1, 2014 and a termination date of August 31, 2014. This document states “Effective for the remainder of the current renewal period January 1, 2014 through August 31, 2014, and any subsequent renewal periods, the Monthly Flat Fee will be $447,722 for all utilization bands.” Does the term “utilization bands” refer to line items or some kind of break out of the “Monthly Flat Fee?” If so, please provide those line items. If not, please explain the term “utilization bands” and provide any detail you can associated with the “utilization bands” referenced. Additionally, please provide a sampling of last year’s invoices submitted by Maximus Health Services to the Commonwealth pursuant to this contract.

This question is not relevant to submitting a proposal for this procurement. The current contract, as amended, includes different requirements and is structured and priced differently than what is required by this RFP. Offerors must develop their proposals based on the requirements of this RFP and not on the current contract requirements. Anyone may request access to public records via a Right to Know Request submitted to [email protected]

mailto:[email protected]

mailto:[email protected]

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