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REQUEST FOR PROPOSAL (RFP)

Bid Event Number: EVT0004648

Requisition ID: 0000008652

Document Number: RFX0000831

Replaces Contract: New

Date Posted: September 30, 2016

Closing Date: December 9, 2016, 2:00 PM

Procurement Officer: Bonnie EdwardsTelephone: 785-296-3125E-Mail Address: [email protected] Address: http://admin.ks.gov/offices/procurement-and-contracts/

Agency: Kansas Department for Aging and Disability Services (KDADS)

Item: Vendor Fiscal/Employer Agent Financial Management Services

Period of Contract: Date of Award through June 30, 2019 (With the option to renew for two (2) one (1) year renewal periods)

Bid Guarantee: No monetary bid guarantee required.

This Bid Event was recently posted to the Procurement and Contracts Internet website. The document can be downloaded by going to the following website: http://admin.ks.gov/offices/procurement-and-contracts/ It shall be the bidder's responsibility to monitor this website on a regular basis for any

changes/amendments.

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http://admin.ks.gov/offices/procurement-and-contracts/

Event ID: EVT0004648

SIGNATURE SHEET

Item: Vendor Fiscal/Employer Agent Financial Management ServicesAgency: Kansas Department for Aging and Disability Services (KDADS)Closing Date: November 9, 2016, 2:00 PM

By submission of a bid and the signatures affixed thereto, the bidder certifies all products and services proposed in the bid meet or exceed all requirements of this specification as set forth in the request and that all exceptions are clearly identified.

Legal Name of Person, Firm or Corporation

Mailing Address City & State Zip

Toll Free Telephone Local

Cell Phone Fax Number Tax Number

CAUTION: If your tax number is the same as your Social Security Number (SSN), you must leave this line blank. DO NOT enter your SSN on this signature sheet. If your SSN is required to process a contract award, including any tax clearance requirements, you will be contacted by an authorized representative of the Office of Procurement and Contracts at a later date.

E-Mail

Signature Date

Typed Name Title

In the event the contact for the bidding process is different from above, indicate contact information below.

Bidding Process Contact Name



Cell Phone Fax Number

E-Mail

If awarded a contract and purchase orders are to be directed to an address other than above, indicate mailing address and telephone number below.

Award Contact Name



Cell Phone Fax Number

E-Mail

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CERTIFICATION REGARDINGIMMIGRATION REFORM & CONTROL

All Contractors are expected to comply with the Immigration and Reform Control Act of 1986 (IRCA), as may be amended from time to time. This Act, with certain limitations, requires the verification of the employment status of all individuals who were hired on or after November 6, 1986, by the Contractor as well as any subcontractor or sub-subcontractor. The usual method of verification is through the Employment Verification (I-9) Form. With the submission of this bid, the Contractor hereby certifies without exception that Contractor has complied with all federal and state laws relating to immigration and reform. Any misrepresentation in this regard or any employment of persons not authorized to work in the United States constitutes a material breach and, at the State’s option, may subject the contract to termination and any applicable damages.

Contractor certifies that, should it be awarded a contract by the State, Contractor will comply with all applicable federal and state laws, standards, orders and regulations affecting a person’s participation and eligibility in any program or activity undertaken by the Contractor pursuant to this contract. Contractor further certifies that it will remain in compliance throughout the term of the contract.

At the State’s request, Contractor is expected to produce to the State any documentation or other such evidence to verify Contractor’s compliance with any provision, duty, certification, or the like under the contract.

Contractor agrees to include this Certification in contracts between itself and any subcontractors in connection with the services performed under this contract.

____________________________________________ ______________________Signature, Title of Contractor date

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1. Bidding Instructions

1.1. Bid Event ID / Reference Number The Bid Event ID / RFP number, indicated in the header of this page, as well as on the first page of this proposal, has been assigned to this RFP and MUST be shown on all correspondence or other documents associated with this RFP and MUST be referred to in all verbal communications. All inquiries, written or verbal, shall be directed only to the procurement officer reflected on Page 1 of this proposal. There shall be no communication with any other State employee regarding this RFP except with designated state participants in attendance ONLY DURING:

Negotiations Contract Signing as otherwise specified in this RFP.

Violations of this provision by bidder or state agency personnel may result in the rejection of the proposal.

1.2. Questions/Addenda Questions requesting clarification of the bid event must be submitted in WRITING to the Procurement Officer prior to the close of business on October 14, 2016 to the following address:

Bonnie EdwardsTelephone: 785-296-3125Facsimile: 785-296-7240E-Mail Address: [email protected]

Kansas Department of AdministrationProcurement and Contracts900 SW Jackson, Suite 451-SouthTopeka, KS 66612-1286

Failure to notify the Procurement Officer of any conflicts or ambiguities in this bid event may result in items being resolved in the best interest of the State. Any modification to this bid event shall be made in writing by addendum and mailed to all vendors who received the original request. Only Written communications are binding.

Answers to questions will be available in the form of an addendum on the Procurement and Contracts' website, http://admin.ks.gov/offices/procurement-and-contracts.

It shall be the responsibility of all participating bidders to acquire any and all addenda and additional information as it is made available from the web site cited above. Vendors/Bidders not initially invited to participate in this Bid Event must notify the Procurement Officer (Event Contact) of their intent to bid at least 24 hours prior to the event's closing date/time. Bidders are required to check the website periodically for any additional information or instructions.

1.3. Pre-Bid Conference No pre-bid conference is scheduled for this bid event.

1.4. Negotiated Procurement This is a negotiated procurement pursuant to K.S.A. 75-37,102. Final evaluation and award will be made by the Procurement Negotiation Committee (PNC) consisting of the following entities (or their designees):

Secretary of Department of Administration; Director of Purchases, Department of Administration; and Head of Using Agency

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http://admin.ks.gov/offices/procurement-and-contracts


1.5. Appearance Before Committee Any, all or no bidders may be required to appear before the PNC to explain the bidder's understanding and approach to the project and/or respond to questions from the PNC concerning the proposal; or, the PNC may award without conducting negotiations, based on the initial proposal. The PNC reserves the right to request information from bidders as needed. If information is requested, the PNC is not required to request the information of all bidders.

Bidders selected to participate in negotiations may be given an opportunity to submit a revised technical and/or cost proposal/offer to the PNC, subject to a specified cut off time for submittal of revisions. Meetings before the PNC are not subject to the Open Meetings Act. Bidders are prohibited from electronically recording these meetings. All information received prior to the cut off time will be considered part of the bidder's revised offer.

No additional revisions shall be made after the specified cut off time unless requested by the PNC.

1.6. Notices All notices, demands, requests, approvals, reports, instructions, consents or other communications (collectively "notices") that may be required or desired to be given by either party to the other shall be IN WRITING and addressed as follows:

Kansas Department of AdministrationProcurement and Contracts900 SW Jackson, Suite 451-SouthTopeka, Kansas 66612-1286

RE: EVT0004648

or to any other persons or addresses as may be designated by notice from one party to the other.

1.7. Cost of Preparing Proposal The cost of developing and submitting the proposal is entirely the responsibility of the bidder. This includes costs to determine the nature of the engagement, preparation of the proposal, submitting the proposal, negotiating for the contract and other costs associated with this RFP.

1.8. Preparation of Proposal Prices are to be entered in spaces provided on the cost proposal form if provided herein. Computations and totals shall be indicated where required. In case of error in computations or totals, the unit price shall govern. The PNC has the right to rely on any prices provided by bidders. The bidder shall be responsible for any mathematical errors. The PNC reserves the right to reject proposals which contain errors.

All copies of cost proposals shall be submitted in a separate sealed envelope or container separate from the technical proposal. The outside shall be identified clearly as "Cost Proposal" or "Technical Proposal" with the Bid Event ID / RFP number and closing date.

A proposal shall not be considered for award if the price in the proposal was not arrived at independently and without collusion, consultation, communication or agreement as to any matter related to price with any other bidder, competitor or public officer/employee.

Technical proposals shall contain a concise description of bidder's capabilities to satisfy the requirements of this RFP with emphasis on completeness and clarity of content. Repetition of terms and conditions of the RFP without additional clarification shall not be considered responsive.

1.9. Signature of Proposals Each proposal shall give the complete legal name and mailing address of the bidder and be signed by an authorized representative by original signature with his or her name and legal title typed below the signature line. If the contract's contact will be a different entity, indicate that individual's contact information for communication purposes. Each proposal shall include the bidder's tax number.

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1.10. Acknowledgment of Amendments All bidders shall acknowledge receipt of any amendments to this bid event by returning a signed hard copy with the bid. Failure to acknowledge receipt of any amendments may render the proposal to be non-responsive. Changes to this bid event shall be issued only by the Office of Procurement and Contracts in writing.

1.11. Modification of Proposals A bidder may modify a proposal by letter or by FAX transmission at any time prior to the closing date and time for receipt of proposals.

1.12. Withdrawal of Proposals A proposal may be withdrawn on written request from the bidder to the Procurement Officer at the Office of Procurement and Contracts prior to the closing date.

1.13. Competition The purpose of this bid event is to seek competition. The bidder shall advise the Office of Procurement and Contracts if any specification, language or other requirement inadvertently restricts or limits bidding to a single source. Notification shall be in writing and must be received by the Office of Procurement and Contracts no later than five (5) business days prior to the bid closing date. The Director of Purchases reserves the right to waive minor deviations in the specifications which do not hinder the intent of this bid event.

1.14. Evaluation of Proposals Award shall be made in the best interest of the State as determined by the PNC or their designees. Although no weighted value is assigned, consideration may focus toward but is not limited to:

Cost. Bidders are not to inflate prices in the initial proposal as cost is a factor in determining who may receive an award or be invited to formal negotiations. The State reserves the right to award to the lowest responsive bid without conducting formal negotiations, if authorized by the PNC.

Adequacy and completeness of proposal Bidder's understanding of the project Compliance with the terms and conditions of the RFP Experience in providing like services Qualified staff Methodology to accomplish tasks Response format as required by this RFP

1.15. Acceptance or Rejection The Committee reserves the right to accept or reject any or all proposals or part of a proposal; to waive any informalities or technicalities; clarify any ambiguities in proposals; modify any criteria in this RFP; and unless otherwise specified, to accept any item in a proposal.

1.16. Proposal Disclosures At the time of closing, only the names of those who submitted proposals shall be made public information. No price information will be released. A List of Bidders may be obtained in the following manner:

1. Attending the public bid opening at the time and date noted on the Bid Event, OR2. Requesting a List of Bidders via E-mail to [email protected] or in writing to the following

address. Include the Bid Event number EVT0004648 in all requests.

Kansas Department of AdministrationProcurement and ContractsAttn: Bid Results900 SW Jackson, Suite 451-SouthTopeka, KS 66612-1286 All other documents pertaining to the bid (Tabsheets, individual bids, proposals, contract, etc.) are not available until the bid has been awarded, contract executed or all bids rejected.

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Once a bid file is available, a request for a cost estimate may be submitted to the e-mail or address noted above for the costs associated with the reproduction of bid documents. Procurement and Contracts will attempt to provide all Open Records requests with electronic copies when possible. Requests will not be fulfilled until payment has been received. Documents will be sent via First Class Mail. If requested, they may be sent via express mail services at the expense of the requester.

Any questions regarding Open Records requests for bid results should be directed to [email protected] or 785-296-0002.

1.17. Disclosure of Proposal Content and Proprietary Information All proposals become the property of the State of Kansas. The Open Records Act (K.S.A. 45-215 et seq) of the State of Kansas requires public information be placed in the public domain at the conclusion of the selection process, and be available for examination by all interested parties. (http://www.admin.ks.gov/offices/chief-counsel/kansas-open-records-act/kansas-open-records-act-procurement-and-contracts) No proposals shall be disclosed until after a contract award has been issued. The State reserves the right to destroy all proposals if the RFP is withdrawn, a contract award is withdrawn, or in accordance with Kansas law. Late Technical and/or Cost proposals will be retained unopened in the file and not receive consideration or may be returned to the bidder.

Trade secrets or proprietary information legally recognized as such and protected by law may be requested to be withheld if clearly labeled "Proprietary" on each individual page and provided as separate from the main proposal. Pricing information is not considered proprietary and the bidder's entire proposal response package will not be considered proprietary.

All information requested to be handled as "Proprietary" shall be submitted separately from the main proposal and clearly labeled, in a separate envelope or clipped apart from all other documentation. The bidder shall provide detailed written documentation justifying why this material should be considered "Proprietary". The Office of Procurement and Contracts reserves the right to accept, amend or deny such requests for maintaining information as proprietary in accordance with Kansas law.

The State of Kansas does not guarantee protection of any information which is not submitted as required.

1.18. Exceptions By submission of a response, the bidder acknowledges and accepts all terms and conditions of the RFP unless clearly avowed and wholly documented in a separate section of the Technical Proposal to be entitled: "Exceptions".

1.19. Notice of Award An award is made on execution of the written contract by all parties.

1.20. News Releases Only the State is authorized to issue news releases relating to this bid event, its evaluation, award and/or performance of the resulting contract.

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2. Proposal Response

2.1. Submission of Proposals Bidder's proposal shall consist of: One (1) original and three (3) copies of the Technical Proposal, including the signed Event

Details document, applicable literature and other supporting documents; One (1) original and three (3) copies of the cost proposal including the signed Event Details

document, Two (2) electronic / software version(s) of the technical and cost proposals are required. This

shall be provided on CD or flash drive, in Microsoft® Word, Excel or searchable PDF®. Technical and cost responses shall be submitted on separate media.

All copies of cost proposals shall be submitted in a separate sealed envelope or container separate from the technical proposal. The outside shall be identified clearly as "Cost Proposal" or "Technical Proposal" with the Bid Event ID number and closing date.

Bidder's proposal, sealed securely in an envelope or other container, shall be received no later than 2:00 p.m., Central Time, on the closing date, addressed as follows:

Kansas Department of AdministrationProcurement and ContractsProposal #: EVT0004648Closing Date: December 9, 2016900 SW Jackson Street, Suite 451-SouthTopeka, KS 66612-1286

It is the bidder's responsibility to ensure bids are received by the closing date and time. Delays in mail delivery or any other means of transmittal, including couriers or agents of the issuing entity shall not excuse late bid submissions.

Faxed, e-mailed or telephoned proposals are not acceptable unless otherwise specified.

Proposals received prior to the closing date shall be kept secured and sealed until closing. The State shall not be responsible for the premature opening of a proposal or for the rejection of a proposal that was not received prior to the closing date because it was not properly identified on the outside of the envelope or container. Late Technical and/or Cost proposals will be retained unopened in the file and not receive consideration or may be returned to the bidder.

2.2. Proposal Format Bidders are instructed to prepare their Technical Proposal following the same sequence as this RFP.

2.3. Transmittal Letter All bidders shall respond to the following statements:

(a) the bidder is the prime contractor and identifying all subcontractors;(b) the bidder is a corporation or other legal entity;(c) no attempt has been made or will be made to induce any other person or firm to submit or not to submit a proposal;(d) the bidder does not discriminate in employment practices with regard to race, color, religion, age (except as provided by law), sex, marital status, political affiliation, national origin or disability;(e) no cost or pricing information has been included in the transmittal letter or the Technical Proposal;(f) the bidder presently has no interest, direct or indirect, which would conflict with the performance of services under this contract and shall not employ, in the performance of this contract, any person having a conflict;(g) the person signing the proposal is authorized to make decisions as to pricing quoted and has not participated, and will not participate, in any action contrary to the above statements;(h) whether there is a reasonable probability that the bidder is or will be associated with any parent, affiliate or subsidiary organization, either formally or informally, in supplying any service or

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furnishing any supplies or equipment to the bidder which would relate to the performance of this contract. If the statement is in the affirmative, the bidder is required to submit with the proposal, written certification and authorization from the parent, affiliate or subsidiary organization granting the State and/or the federal government the right to examine any directly pertinent books, documents, papers and records involving such transactions related to the contract. Further, if at any time after a proposal is submitted, such an association arises, the bidder will obtain a similar certification and authorization and failure to do so will constitute grounds for termination for cause of the contract at the option of the State;(i) bidder agrees that any lost or reduced federal matching money resulting from unacceptable performance in a contractor task or responsibility defined in the RFP, contract or modification shall be accompanied by reductions in state payments to Contractor; and(j) the bidder has not been retained, nor has it retained a person to solicit or secure a state contract on an agreement or understanding for a commission, percentage, brokerage or contingent fee, except for retention of bona fide employees or bona fide established commercial selling agencies maintained by the bidder for the purpose of securing business.

For breach of this provision, the Committee shall have the right to reject the proposal, terminate the contract for cause and/or deduct from the contract price or otherwise recover the full amount of such commission, percentage, brokerage or contingent fee or other benefit.

2.4. Bidder Information The bidder must include a narrative of the bidder's corporation and each subcontractor if any. The narrative shall include the following:

(a) date established;(b) ownership (public, partnership, subsidiary, etc.);(c) number of personnel, full and part time, assigned to this project by function and job title;(d) resources assigned to this project and the extent they are dedicated to other matters;(e) organizational chart;(f) financial statement may be required.

2.5. Qualifications A description of the bidder's qualifications and experience providing the requested or similar service shall be submitted with the Technical Proposal. The bidder must be an established firm recognized for its capacity to perform. The bidder must have sufficient personnel to meet the deadlines specified in the bid event.

2.6. Experience All bidders must have a minimum of five (5) years continuous active participation in the applicable industry, providing equipment/services comparable in size and complexity to those specified herein.

2.7. References Provide three (3) references that have purchased similar items or services from the bidder in the last five (5) year(s). References shall show firm name, contact person, address, e-mail address and phone number. Bidder's employees and the buying agency shall not be shown as references.

2.8. Bidder Contracts Bidders must include with their RFP response, a copy of any contracts, agreements, licenses, warranties, etc. that the bidder would propose to incorporate into the contract generated from this Bid Event. (State of Kansas form DA-146a remains a mandatory requirement in all contracts.)

2.9. Procurement Card (P-Card) Many State Agencies use a State of Kansas Procurement Card (currently Visa) in lieu of a state warrant to pay for certain purchases. No additional charges will be allowed for using the P-Card. Bidders shall indicate on the Event Details document if they will accept the Procurement Card for payment.

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3. Terms and Conditions

3.1. Contract The successful bidder will be required to enter into a written contract with the State. The contractor agrees to accept the provisions of Form DA 146a (Contractual Provisions Attachment), which is incorporated into all contracts with the State and is incorporated into this bid event.

3.2. Contract Documents This bid event, any amendments, the response and any response amendments of the Contractor, and the State of Kansas DA-146a (Contractual Provision Attachment) shall be incorporated into the written contract, which shall compose the complete understanding of the parties.

In the event of a conflict in terms of language among the documents, the following order of precedence shall govern:

Form DA 146a; written modifications to the executed contract; written contract signed by the parties; the Bid Event documents, including any and all amendments; and Contractor's written offer submitted in response to the Bid Event as finalized.

3.3. Captions The captions or headings in this contract are for reference only and do not define, describe, extend, or limit the scope or intent of this contract.

3.4. Definitions A glossary of common procurement terms is available at http://admin.ks.gov/offices/procurement-and-contracts, under the "Procurement Forms" link.

3.5. Contract Formation No contract shall be considered to have been entered into by the State until all statutorily required signatures and certifications have been rendered and a written contract has been signed by the contractor.

3.6. Statutes Each and every provision of law and clause required by law to be inserted in the contract shall be deemed to be inserted herein and the contract shall be read and enforced as though it were included herein. If through mistake or otherwise any such provision is not inserted, or is not correctly inserted, then on the application of either party the contract shall be amended to make such insertion or correction.

3.7. Governing Law This contract shall be governed by the laws of the State of Kansas and shall be deemed executed in Topeka, Shawnee County, Kansas.

3.8. Jurisdiction The parties shall bring any and all legal proceedings arising hereunder in the State of Kansas District Court of Shawnee County, unless otherwise specified and agreed upon by the State of Kansas. Contractor waives personal service of process, all defenses of lack of personal jurisdiction and forum non conveniens. The Eleventh Amendment of the United States Constitution is an inherent and incumbent protection with the State of Kansas and need not be reserved, but prudence requires the State to reiterate that nothing related to this Agreement shall be deemed a waiver of the Eleventh Amendment

3.9. Mandatory Provisions The provisions found in Contractual Provisions Attachment (DA 146a) are incorporated by reference and made a part of this contract.

3.10. Termination for Cause

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The Director of Purchases may terminate this contract, or any part of this contract, for cause under any one of the following circumstances:

the Contractor fails to make delivery of goods or services as specified in this contract; the Contractor provides substandard quality or workmanship; the Contractor fails to perform any of the provisions of this contract, or the Contractor fails to make progress as to endanger performance of this contract in

accordance with its terms.

The Director of Purchases shall provide Contractor with written notice of the conditions endangering performance. If the Contractor fails to remedy the conditions within ten (10) days from the receipt of the notice (or such longer period as State may authorize in writing), the Director of Purchases shall issue the Contractor an order to stop work immediately. Receipt of the notice shall be presumed to have occurred within three (3) days of the date of the notice.

3.11. Termination for Convenience The Director of Purchases may terminate performance of work under this contract in whole or in part whenever, for any reason, the Director of Purchases shall determine that the termination is in the best interest of the State of Kansas. In the event that the Director of Purchases elects to terminate this contract pursuant to this provision, it shall provide the Contractor written notice at least 30 days prior to the termination date. The termination shall be effective as of the date specified in the notice. The Contractor shall continue to perform any part of the work that may have not been terminated by the notice.

3.12. Rights and Remedies If this contract is terminated, the State, in addition to any other rights provided for in this contract, may require the Contractor to transfer title and deliver to the State in the manner and to the extent directed, any completed materials. The State shall be obligated only for those services and materials rendered and accepted prior to the date of termination.

In the event of termination, the Contractor shall receive payment prorated for that portion of the contract period services were provided to or goods were accepted by State subject to any offset by State for actual damages including loss of federal matching funds.

The rights and remedies of the State provided for in this contract shall not be exclusive and are in addition to any other rights and remedies provided by law.

3.13. Debarment of State Contractors Any Contractor who defaults on delivery or does not perform in a satisfactory manner as defined in this Contract may be barred for a period up to three (3) years, pursuant to KSA 75-37,103, or have their work evaluated for pre-qualification purposes pursuant to K.S.A. 75-37,104.

3.14. Antitrust If the Contractor elects not to proceed with performance under any such contract with the State, the Contractor assigns to the State all rights to and interests in any cause of action it has or may acquire under the anti-trust laws of the United States and the State of Kansas relating to the particular products or services purchased or acquired by the State pursuant to this contract.

3.15. Hold Harmless The Contractor shall indemnify the State against any and all loss or damage to the extent arising out of the Contractor's negligence in the performance of services under this contract and for infringement of any copyright or patent occurring in connection with or in any way incidental to or arising out of the occupancy, use, service, operations or performance of work under this contract.

The State shall not be precluded from receiving the benefits of any insurance the Contractor may carry which provides for indemnification for any loss or damage to property in the Contractor's custody and control, where such loss or destruction is to state property. The Contractor shall do nothing to prejudice the State's right to recover against third parties for any loss, destruction or damage to State property.

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3.16. Force Majeure The Contractor shall not be held liable if the failure to perform under this contract arises out of causes beyond the control of the Contractor. Causes may include, but are not limited to, acts of nature, fires, tornadoes, quarantine, strikes other than by Contractor's employees, and freight embargoes.

3.17. Assignment The Contractor shall not assign, convey, encumber, or otherwise transfer its rights or duties under this contract without the prior written consent of the State. State may reasonably withhold consent for any reason.

This contract may terminate for cause in the event of its assignment, conveyance, encumbrance or other transfer by the Contractor without the prior written consent of the State.

3.18. Third Party Beneficiaries This contract shall not be construed as providing an enforceable right to any third party.

3.19. Waiver Waiver of any breach of any provision in this contract shall not be a waiver of any prior or subsequent breach. Any waiver shall be in writing and any forbearance or indulgence in any other form or manner by State shall not constitute a waiver.

3.20. Injunctions Should Kansas be prevented or enjoined from proceeding with the acquisition before or after contract execution by reason of any litigation or other reason beyond the control of the State, Contractor shall not be entitled to make or assert claim for damage by reason of said delay.

3.21. Staff Qualifications The Contractor shall warrant that all persons assigned by it to the performance of this contract shall be employees of the Contractor (or specified Subcontractor) and shall be fully qualified to perform the work required. The Contractor shall include a similar provision in any contract with any Subcontractor selected to perform work under this contract.

Failure of the Contractor to provide qualified staffing at the level required by the contract specifications may result in termination of this contract or damages.

3.22. Subcontractors The Contractor shall be the sole source of contact for the contract. The State will not subcontract any work under the contract to any other firm and will not deal with any subcontractors. The Contractor is totally responsible for all actions and work performed by its subcontractors. All terms, conditions and requirements of the contract shall apply without qualification to any services performed or goods provided by any subcontractor.

3.23. Independent Contractor Both parties, in the performance of this contract, shall be acting in their individual capacity and not as agents, employees, partners, joint ventures or associates of one another. The employees or agents of one party shall not be construed to be the employees or agents of the other party for any purpose whatsoever.

The Contractor accepts full responsibility for payment of unemployment insurance, workers compensation, social security, income tax deductions and any other taxes or payroll deductions required by law for its employees engaged in work authorized by this contract.

3.24. Worker Misclassification The Contractor and all lower tiered subcontractors under the Contractor shall properly classify workers as employees rather than independent contractors and treat them accordingly for purposes of workers' compensation insurance coverage, unemployment taxes, social security taxes, and income tax withholding. Failure to do so may result in contract termination.

3.25. Immigration and Reform Control Act of 1986 (IRCA)

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All contractors are expected to comply with the Immigration and Reform Control Act of 1986 (IRCA), as may be amended from time to time. This Act, with certain limitations, requires the verification of the employment status of all individuals who were hired on or after November 6, 1986, by the Contractor as well as any subcontractor or sub-contractors. The usual method of verification is through the Employment Verification (I-9) Form.

With the submission of this bid, the Contractor hereby certifies without exception that such Contractor has complied with all federal and state laws relating to immigration and reform. Any misrepresentation in this regard or any employment of persons not authorized to work in the United States constitutes a material breach and, at the State's option, may subject the contract to termination for cause and any applicable damages.

Unless provided otherwise herein, all contractors are expected to be able to produce for the State any documentation or other such evidence to verify Contractor's IRCA compliance with any provision, duty, certification or like item under the contract.

Contractor will provide a copy of a signed Certification Regarding Immigration Reform and Control Form (See page three (3) of this document) with the technical proposal.

3.26. Proof of Insurance Upon request, the Contractor shall present an affidavit of Worker's Compensation, Public Liability, and Property Damage Insurance to Procurement and Contracts.

3.27. Conflict of Interest The Contractor shall not knowingly employ, during the period of this contract or any extensions to it, any professional personnel who are also in the employ of the State and providing services involving this contract or services similar in nature to the scope of this contract to the State. Furthermore, the Contractor shall not knowingly employ, during the period of this contract or any extensions to it, any state employee who has participated in the making of this contract until at least two years after his/her termination of employment with the State.

3.28. Nondiscrimination and Workplace Safety The Contractor agrees to abide by all federal, state and local laws, and rules and regulations prohibiting discrimination in employment and controlling workplace safety. Any violations of applicable laws or rules or regulations may result in termination of this contract.

3.29. Confidentiality The Contractor may have access to private or confidential data maintained by State to the extent necessary to carry out its responsibilities under this contract. Contractor must comply with all the requirements of the Kansas Open Records Act (K.S.A. 45-215 et seq.) in providing services under this contract. Contractor shall accept full responsibility for providing adequate supervision and training to its agents and employees to ensure compliance with the Act. No private or confidential data collected, maintained or used in the course of performance of this contract shall be disseminated by either party except as authorized by statute, either during the period of the contract or thereafter. Contractor agrees to return any or all data furnished by the State promptly at the request of State in whatever form it is maintained by Contractor. On the termination or expiration of this contract, Contractor shall not use any of such data or any material derived from the data for any purpose and, where so instructed by State, shall destroy or render it unreadable.

3.30. Environmental Protection The Contractor shall abide by all federal, state and local laws, and rules and regulations regarding the protection of the environment. The Contractor shall report any violations to the applicable governmental agency. A violation of applicable laws or rule or regulations may result in termination of this contract for cause.

3.31. Care of State Property The Contractor shall be responsible for the proper care and custody of any state owned personal tangible property and real property furnished for Contractor's use in connection with the performance of this contract. The Contractor shall reimburse the State for such property's loss or damage caused by the Contractor, except for normal wear and tear.

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3.32. Prohibition of Gratuities Neither the Contractor nor any person, firm or corporation employed by the Contractor in the performance of this contract shall offer or give any gift, money or anything of value or any promise for future reward or compensation to any State employee at any time.

3.33. Retention of Records Unless the State specifies in writing a different period of time, the Contractor agrees to preserve and make available at reasonable times all of its books, documents, papers, records and other evidence involving transactions related to this contract for a period of five (5) years from the date of the expiration or termination of this contract.

Matters involving litigation shall be kept for one (1) year following the termination of litigation, including all appeals, if the litigation exceeds five (5) years. The Contractor agrees that authorized federal and state representatives, including but not limited to, personnel of the using agency; independent auditors acting on behalf of state and/or federal agencies shall have access to and the right to examine records during the contract period and during the five (5) year post contract period. Delivery of and access to the records shall be within five (5) business days at no cost to the state.

3.34. Off-Shore Sourcing If, during the term of the contract, the Contractor or subcontractor plans to move work previously performed in the United States to a location outside of the United States, the Contractor shall immediately notify the Procurement and Contracts and the respective agency in writing, indicating the desired new location, the nature of the work to be moved and the percentage of work that would be relocated. The Director of Purchases, with the advice of the respective agency, must approve any changes prior to work being relocated. Failure to obtain the Director's approval may be grounds to terminate the contract for cause.

3.35. Indefinite Quantity Contract This is an open-ended contract between the Contractor and the State to furnish an undetermined quantity of a good or service in a given period of time. The quantities ordered will be those actually required during the contract period, and the Contractor will deliver only such quantities as may be ordered. No guarantee of volume is made. An estimated quantity based on past history or other means may be used as a guide.

3.36. Prices Prices shall remain firm for the entire contract period and subsequent renewals. Prices shall be net delivered, including all trade, quantity and cash discounts. Any price reductions available during the contract period shall be offered to the State of Kansas. Failure to provide available price reductions may result in termination of the contract for cause.

3.37. Payment Payment Terms are Net 30 days. Payment date and receipt of order date shall be based upon K.S.A. 75-6403(b). This Statute requires state agencies to pay the full amount due for goods or services on or before the 30th calendar day after the date the agency receives such goods or services or the bill for the goods and services, whichever is later, unless other provisions for payment are agreed to in writing by the Contractor and the state agency. NOTE: If the 30th calendar day noted above falls on a Saturday, Sunday, or legal holiday, the following workday will become the required payment date.

Payments shall not be made for costs or items not listed in this contract.

Payment schedule shall be on a frequency mutually agreed upon by both the agency and the Contractor.

3.38. Accounts Receivable Set-Off Program If, during the course of this contract the Contractor is found to owe a debt to the State of Kansas, a state agency, municipality, or the federal government, agency payments to the Contractor may be intercepted / setoff by the State of Kansas. Notice of the setoff action will be provided to the Contractor. Pursuant to K.S.A. 75-6201 et seq, Contractor shall have the opportunity to challenge

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the validity of the debt. The Contractor shall credit the account of the agency making the payment in an amount equal to the funds intercepted.

K.S.A. 75-6201 et seq. allows the Director of Accounts & Reports to setoff funds the State of Kansas owes Contractors against debts owed by the Contractors to the State of Kansas, state agencies, municipalities, or the federal government. Payments setoff in this manner constitute lawful payment for services or goods received. The Contractor benefits fully from the payment because its obligation is reduced by the amount subject to setoff.

3.39. Federal, State and Local Taxes Unless otherwise specified, the contracted price shall include all applicable federal, state and local taxes. The Contractor shall pay all taxes lawfully imposed on it with respect to any product or service delivered in accordance with this Contract. The State of Kansas is exempt from state sales or use taxes and federal excise taxes for direct purchases. These taxes shall not be included in the contracted price. Upon request, the State shall provide to the Contractor a certificate of tax exemption.

The State makes no representation as to the exemption from liability of any tax imposed by any governmental entity on the Contractor.

3.40. Debarment of State Contractors Any Contractor who defaults on delivery or does not perform in a satisfactory manner as defined in this Agreement may be barred for up to a period of three (3) years, pursuant to K.S.A. 75-37,103, or have its work evaluated for pre-qualification purposes. Contractor shall disclose any conviction or judgment for a criminal or civil offense of any employee, individual or entity which controls a company or organization or will perform work under this Agreement that indicates a lack of business integrity or business honesty. This includes (1) conviction of a criminal offense as an incident to obtaining or attempting to obtain a public or private contract or subcontract or in the performance of such contract or subcontract; (2) conviction under state or federal statutes of embezzlement, theft, forgery, bribery, falsification or destruction of records, receiving stolen property; (3) conviction under state or federal antitrust statutes; and (4) any other offense to be so serious and compelling as to affect responsibility as a state contractor. For the purpose of this section, an individual or entity shall be presumed to have control of a company or organization if the individual or entity directly or indirectly, or acting in concert with one or more individuals or entities, owns or controls 25 percent or more of its equity, or otherwise controls its management or policies. Failure to disclose an offense may result in the termination of the contract.

3.41. Materials and Workmanship The Contractor shall perform all work and furnish all supplies and materials, machinery, equipment, facilities, and means, necessary to complete all the work required by this Contract, within the time specified, in accordance with the provisions as specified.

The Contractor shall be responsible for all work put in under these specifications and shall make good, repair and/or replace, at the Contractor's own expense, as may be necessary, any defective work, material, etc., if in the opinion of agency and/or Procurement and Contracts said issue is due to imperfection in material, design, workmanship or Contractor fault.

3.42. Industry Standards If not otherwise provided, materials or work called for in this contract shall be furnished and performed in accordance with best established practice and standards recognized by the contracted industry and comply with all codes and regulations which shall apply.

3.43. Implied Requirements All products and services not specifically mentioned in this contract, but which are necessary to provide the functional capabilities described by the specifications, shall be included.

3.44. Submission of the Bid Submission of the bid will be considered presumptive evidence that the bidder is conversant with local facilities and difficulties, the requirements of the documents and of pertinent State and/or local codes, state of labor and material markets, and has made due allowances in the proposal for all contingencies. Later claims for labor, work, materials, equipment, and tax liability required

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for any difficulties encountered which could have been foreseen will not be recognized and all such difficulties shall be properly taken care of by Contractor at no additional cost to the State of Kansas.

3.45. Inspection The State reserves the right to reject, on arrival at destination, any items which do not conform to specification of the Contract.

3.46. Acceptance No contract provision or use of items by the State shall constitute acceptance or relieve the Contractor of liability in respect to any expressed or implied warranties.

3.47. Ownership All data, forms, procedures, software, manuals, system descriptions and work flows developed or accumulated by the Contractor under this contract shall be owned by the using agency. The Contractor may not release any materials without the written approval of the using agency.

3.48. Information/Data Any and all information/data required to be provided at any time during the contract term shall be made available in a format as requested and/or approved by the State.

3.49. Certification of Materials Submitted The Bid document, together with the specifications set forth herein and all data submitted by the Contractor to support their response including brochures, manuals, and descriptions covering the operating characteristics of the item(s) proposed, shall become a part of the contract between the Contractor and the State of Kansas. Any written representation covering such matters as reliability of the item(s), the experience of other users, or warranties of performance shall be incorporated by reference into the contract.

3.50. Transition Assistance In the event of contract termination or expiration, Contractor shall provide all reasonable and necessary assistance to State to allow for a functional transition to another vendor.

3.51. Integration This contract, in its final composite form, shall represent the entire agreement between the parties and shall supersede all prior negotiations, representations or agreements, either written or oral, between the parties relating to the subject matter hereof. This Agreement between the parties shall be independent of and have no effect on any other contracts of either party.

3.52. Modification This contract shall be modified only by the written agreement and approval of the parties. No alteration or variation of the terms and conditions of the contract shall be valid unless made in writing and signed by the parties. Every amendment shall specify the date on which its provisions shall be effective.

3.53. Severability If any provision of this contract is determined by a court of competent jurisdiction to be invalid or unenforceable to any extent, the remainder of this contract shall not be affected and each provision of this contract shall be enforced to the fullest extent permitted by law.

3.54. Award Award will be by line item or group total, whichever is in the best interest of the State of Kansas.

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4. SPECIFICATIONS

With this Request for Proposal, the Kansas Department of Aging and Disability Services (KDADS) is seeking interested vendors to prepare and submit proposals for consideration for fulfilling the need for a statewide Vendor Fiscal/Employer Agent (VF/EA) Financial Management Services (FMS). The selected organization(s) will provide fiscal support to individuals participating in Participant-Directed Services and will be identified as a “VF/EA FMS organization(s)”.

KDADS seeks to ensure that FMS is provided consistently across all Home and Community-Based Services (HCBS) waiver programs. This project will provide information and assistance to self-directing participants and ensure all required withholdings are consistent with federal, state, and local regulations. The project will secure up to four entities with the capacity to provide FMS across Kansas or on a regional basis. KDADS intends to achieve cost savings and efficiencies through the regionalization of the VF/EA FMS Services while enhancing services to eligible participants.

KDADS is seeking contractors to provide FMS services in the following regions:

Region 1: Northwest RegionRegion 2: Northeast RegionRegion 3: Southwest RegionRegion 4: Southeast Region

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Region 1 .

BartonCheyenneClayCloudDecaturDickinsonEllisEllsworthGearyGoveGrahamGreeleyJewellLaneLincolnLoganMarshallMitchellNessNortonOsborne

Northwest Region

OttawaPhillipsPottawatomieRawlinsRepublicRiceRileyRooksRushRussellSalineScottSheridanShermanSmithThomasTregoWabaunseeWallaceWashingtonWichita

Region 2 . Northeast Region

AtchisonBrownDoniphanDouglasJacksonJeffersonJohnsonLeavenworthNemahaShawneeWyandotte

Region 3 .

BarberClarkComancheEdwardsFinneyFordGrantGrayHamiltonHarperHaskellHodgemanKearny

Southwest Region

KingmanKiowaMeadeMortonPawneePrattRenoSedgwickSewardStaffordStantonStevensSumner

Region 4 .

AllenAndersonBourbonButlerChaseChautauquaCherokeeCoffeyCowleyCrawfordElkFranklinGreenwood

Southeast Region

HarveyLabetteLinnLyonMarionMcPhersonMiamiMontgomeryMorrisNeoshoOsageWilsonWoodson

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4.1 Background:

Federal Medicaid law prohibits an individual or representative from receiving Medicaid funds directly. Federal Medicaid law requires only Medicaid providers may receive Medicaid funds directly. Due to this requirement, the Selected Vendor(s) must perform payment-related employer responsibilities on behalf of individuals or representatives who exercise employer over personal care workers. One such type of entity that performs this service is a Vendor Fiscal/Employer Agent (VF/EA) Financial Management Services (FMS) organization. VF/EA FMS are available to participants who receive participant directed services through the Kansas Medicaid §1915(c) HCBS waiver programs.

A VF/EA FMS organization acts as the employer agent to the common law employer (individuals receiving waiver services and their representatives) in accordance with Section 3504 of the IRS code, IRS Revenue Procedure 70-6, IRS Proposed Notice 2003-70 and REG-137036-08, as applicable. In Kansas, the fiscal support services provided by a VF/EA FMS organization include, but are not limited to:

1. Ensuring qualified PCS workers are paid in accordance with federal, state and local tax, labor and unemployment insurance laws, as applicable;

2. Preparing and distributing qualified PCS workers’ payroll including the management of federal and state income tax withholding and employment taxes;

3. Verifying prospective PCS workers’ citizenship and alien status and ensuring that PCS workers meet the qualifications for the services they are providing as per state requirements;

4. Brokering worker’s compensation insurance policies and renewals and paying premiums for individuals and representatives who are common law employers;

5. Preparing and distributing financial reports to: common law employers, federal and state taxing authorities, and any other federal or state agencies as required; and

6. Providing orientation and skills training to individuals and representative acting as common law employers.

The table below provides historical data for the provision of FMS services in Kansas.

New Clients

Since 01/01/2016 10,333 30 587 2015 10,916 43 1,202 2014 11,193 54 1,108

Number of Self-Directed Clients

Number of FMS Providers

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The following tables provide a current breakdown of self-directed clients served by county and region.

Region 1 Northwest Region Total 949

County County CountyBarton 82 Lincoln 5 Rooks 14Cheyenne 3 Logan 9 Rush 4Clay 22 Marshall 21 Russell 20Cloud 42 Mitchell 13 Saline 223Decatur 3 Ness 5 Scott 14Dickinson 49 Norton 5 Sheridan 3Ellis 72 Osborne 10 Sherman 11Ellsworth 17 Ottawa 18 Smith 7Geary 44 Phillips 10 Thomas 12Gove 4 Pottawatomie 58 Trego 7Graham 4 Rawlins 4 Wabaunsee 13Greeley 2 Republic 8 Wallace 2Jewell 6 Rice 23 Washington 7

Region 2 Northeast Region Total 3034

County CountyAtchison 69 Johnson 1000Brown 53 Leavenworth 125Doniphan 32 Nemaha 23Douglas 223 Shawnee 784Jackson 43 Wyandotte 634Jefferson 48

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Region 3 Southwest Region Total

County CountyBarber 15 Harper


Region 4 Southeast Region Total 2771

County County CountyAllen 102 Crawford 314 McPherson 55Anderson 45 Elk 20 Miami 94Bourbon 89 Franklin 149 Montgomery 364Butler 149 Greenwood 56 Morris 12Chase 10 Harvey 85 Neosho 129Chautauqua 27 Labette 260 Osage 82Cherokee 262 Linn 53 Wilson 85Coffey 42 Lyon 115 Woodson 36

4.2 Scope of Work

KDADS seeks to ensure that VF/EA FMS are provided consistently to eligible individuals who wish to use participant directed services in Kansas. The VF/EA FMS model has been implemented to support the delivery of participant directed services by performing the following primary functions:

1. Reduce the individual’s and/or representative’s employer-related burden associated with participant directed services and enhances the individual’s and/or representative’s choice and control through the provision of appropriate fiscal, payroll and supportive services.

2. Ensure KDADS that the provision of participant directed services is in compliance with federal, state and local tax and labor and state worker’s compensation insurance rules and requirements related to the employment of qualified Personal Care Services (PCS) workers.

3. KDADS is seeking to achieve cost savings and efficiencies through the regionalization of the VF/EA FMS Services while enhancing services to those utilizing participant directed services.

KDADS will secure up to four vendors with the capacity to provide VF/EA FMS to the waiver programs included in this project and described below:

Frail Elderly (FE) Waiver Program

The Home and Community Based Services Frail Elderly (FE) program provides an option for Kansas seniors who receive Medicaid and qualify functionally to receive community based services as an alternative to nursing facility care. The program promotes independence within the community and helps to offer residency in the most integrated environment.

Intellectual/Developmentally Disabled (I/DD)Waiver Program

The Home and Community Based Services Intellectual/Developmentally Disabled (I/DD) program serves individuals age five and older who meet the definition of intellectual disability, having a developmental disability or are eligible for care in an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF-IID).

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Physically Disabled (PD) Waiver Program

The Physical Disabilities Program serves individuals age 16 to 65 years of age who meet the criteria for nursing facility placement due to their physical disability, who are determined disabled by social security standards, and who are Medicaid eligible.

Technology Assisted (TA) Waiver Program

The TA Program serves individuals ages 0 through 21 years who are chronically ill or medically fragile and dependent upon a ventilator or medical device to compensate for the loss of vital bodily function(s). Eligible participants must also require the following:

Substantial and ongoing daily care by a nurse comparable to the level of care provided at a hospital setting;

Substantial and ongoing daily care by other qualified caregiver(s) under the supervision of a nurse to the level of care provided at a hospital setting;

For individuals whose illness or disability, in the absence of home care services, would require admission to a hospital.

Traumatic Brain Injury (TBI) Waiver Program

The HCBS/TBI program is for individuals who have sustained a traumatic brain injury and provides the services needed after injury to ensure that individuals can stay in their homes and be as independent as possible in a safe, healthy environment. The HCBS/TBI program serves individuals 16 to 65 years of age who would otherwise require institutionalization in a TBI Rehabilitation Facility.

The TBI Program is not considered a long-term care program and is designed to be a rehabilitative program for consumers to receive therapies and services that enable them to rely less on supports as the consumer's independence increases.

4.3 General Requirements

The Selected Vendor(s) must meet the general requirements prior to serving individuals enrolled in the waiver who wish to use participant directed services.

1. Prime Contractor Responsibilities. The Agreement will require the Selected Vendor(s) to assume responsibility for all services offered in its proposal whether it produces them itself or by subcontract. KDADS will consider the Selected Vendor(s) to be the sole point of contact with regard to contractual and operational matters.

2. Subcontracting. Any use of subcontractors by the Selected Vendor(s) must be identified in the proposal and approved by KDADS. During the Project period, use of any subcontractors by the Selected Vendor(s) not previously identified in the proposal must be approved in writing by KDADS prior to the start of the work effort. Subcontractors are required to meet the same work skill qualification as the prospective Selected Vendor(s) as identified in this RFP.

3. Subcontracting with a Reporting Agent. The Selected Vendor(s) may not subcontract with and delegate VF/EA FMS tasks to a reporting agent.

4. Performance and Payment Bonds. The Agreement will require the Selected Vendor(s) to deliver to KDADS executed performance and payment bonds, each in the sum of six

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months of estimated annual Agreement amount, with KDADS as the oblige. The surety will be a surety company or companies listed in the Federal Registry of Surety Companies and approved by the State Corporation Commission to transact business in the State of Kansas. No payment will be due and payable to the Selected Vendor(s), even if the Agreement has been performed in whole or in part, until the bonds have been delivered and approved. The payment bond will be used to cover delinquent payments to qualified PCS workers and federal state and local tax and worker’s compensation insurance premium payments up to the maximum of the value of the full value of the bond in the event that the Selected Vendor(s) is unable to properly, promptly and efficiently perform the Agreement and/or the Agreement is terminated by default or bankruptcy.

5. As a VF/EA FMS organization, the Selected Vendor(s) must operate in accordance with §3504 of the Internal Revenue Service (IRS) Code, Revenue Procedure 70-6, 1970-1 C.B. 420, as modified by IRS Proposed Notice 2003-70 and,

6. IRS REG-137036-08 and any other future revenue procedures, notices or publication promulgated by the IRS. The Selected Vendor(s) also must operate in compliance with state and local tax laws, federal and state labor laws and state workers’ compensation insurance laws.

7. The Selected Vendor(s) must file for and obtain a separate Federal Employer Identification Number (FEIN) in addition to its corporate FEIN for the sole purpose of filing certain federal forms and income tax withholding and employment taxes and depositing these taxes on behalf of the individuals and representatives the Selected Vendor(s) represents as employer agent. Since the Selected Vendor(s) is required to have three (3) years of experience providing VF/EA FMS to publicly-funded participant directed services programs, it should have a separate FEIN and must show evidence of this.

8. The Selected Vendor(s) must have a working knowledge of the Medicaid target population (individuals with developmental disabilities, over the age of 60, and physical disabilities), participant directed services and how participant direction relates to the provision of VF/EA FMS and providing VF/EA FMS in accordance with federal, state and local tax, labor, worker’s compensation insurance and program rules and regulations, as applicable.

9. The Selected Vendor(s) must comply with the contracted Managed Care Organizations (MCOs) credentialing and contracting requirements.

10. The Selected Vendor(s) must comply with existing or new applicable regulations, requirements, standards, directives, statutes, etc. issued by the State of Kansas and/or Federal and local governments that take effect during the Agreement period.

4.3.1 Conflict Free Requirements.

The Selected Vendor(s) must be free of any conflict of interest with any existing or future waiver/program providers. To ensure an objective, unbiased process, the Selected Vendor(s) and any subcontractors must be free of real or perceived conflicts of interest:

Requirements:

1. The Selected Vendor(s) and its subcontractors shall not be a part of or affiliated and must remain independent from any provider of home and community based waiver services. Neither the governing body of the selected vendor(s) nor individual members of the governing body may be affiliated with any provider of home or community based waiver services. Nor may the selected vendor(s) or its subcontractors be affiliated with or a subsidiary of any existing provider of home and community based waiver services.

2. No personnel assigned to the project may work for any provider of home and community based waiver services. However, personnel assigned to the project may receive direct

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services or supports from such provider as long as the services are purchased at fair rates (either private pay, through an HCBS program, or through another third party program).

3. The Selected Vendor(s) shall not be a provider of HCBS services within the State of Kansas. However, if the selected vendor(s) merely is related to or otherwise affiliated with a Medicaid service provider, the Selected Vendor(s) must disclose this relationship in its Technical Proposal and provide a detailed written description of the nature of its relationship with the related provider, including, but not limited to, detailed information on the ownership of the company that contains the names and percent of ownership, ownership structure, as well as another current contracting or subcontracting relationships that may result in a conflict of interest with the requirements of this solicitation.

4. The Selected Vendor(s) also must abide by the conflict of interest standards identified in the Standard Terms and Conditions for Services.

5. In addition, KDADS reserves the right to not accept a proposal from a v endor that has been determined to have a conflict of interest based on the language above. As part of the Transmittal Letter the Vendor must submit complete organizational information that includes an organization chart listing all subsidiaries; a listing of all Agreements that the Vendor has within Kansas; a listing of any Agreements of its subsidiaries associated with any home and community based services in Kansas.

4.3.2 In-state Office Requirement

Selected Vendor(s) must establish at least one brick and mortar office in Kansas regardless of the number of regions awarded. All sites within Kansas must be accessible and meet the Americans with Disabilities Act (ADA) standards. The physical site of the Selected Vendor(s)’s administrative functions, all satellite offices, and any worksites cannot be co-located with any existing provider.

4.3.3 Regional Presence

Selected Vendor(s) must establish a presence in each region and must have the capability to conduct in-person meetings with individuals, families, and representatives in each region. In addition, the Selected Vendor(s) must establish regional teams, which can provide expertise on local tax issues and other related topics. Regional teams need not be regionally located. Teleconferencing and tele-video conferencing may be utilized in order to comply with this requirement.

4.3.4 Resource Requirements

Selected Vendor(s) must have a physical plant and the equipment that is appropriate and supports the provision of VF/EA FMS. The Selected Vendor(s) must supply meeting rooms and normal office space for personnel, including equipment, Microsoft® Office Software, network connectivity, supplies, clerical assistance, and administrative support needed to perform this engagement at its headquarters and any satellite offices.

4.3.5 Service Capacity

The Selected Vendor(s) must have the capacity to serve individuals and representatives located in each of the State of Kansas regions in the state (see regional map included above) and to conduct in-person meetings with individuals located in each region.

4.3.6 Secretary of State

Selected Vendor(s) must be qualified and registered with the Kansas Secretary of State to do business in Kansas. The Selected Vendor(s) shall remain in good standing at all times during the term of this agreement.

4.3.7 Financial Viability

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Secure a surety bond equal to or greater than the total cost of VF/EA FMS and related services for the VF/EA for one month. The Selected Vendor(s) must have a sound financial and reporting structure to efficiently serve participants.

4.3.8 Medicaid Enrolled Provider

The Selected Vendor(s) must be an enrolled provider in g o o d s t a n d i n g w i t h the Kansas Medical Assistance Program and under contract with each of the MCOs providing services in Kansas.

4.3.9 Background Check Requirements.

The Selected Vendor(s) must maintain documentation to support its compliance with these requirements.

1. The Selected Vendor(s) must arrange for, at its own expense, criminal background clearances from the Kansas Bureau of Investigation for all staff that perform work related to this RFP. K.S.A. 65-6205 authorizes community service providers, mental health centers, and independent living agencies to request information for background checks on applicants and employees regarding abuse, neglect and exploitations. Providers or employers not listed in K.S.A. 65-6205 shall have the applicant or employee sign a Kansas Department for Children and Families (DCF) release of information form. Other required clearances include:

a. DCF Adult Abuse, Neglect and Exploitation (ANE) Central Registry;

b. DCF maintains a statewide registry identifying, after due process, persons substantiated for the abuse, neglect, exploitation or fiduciary abuse of vulnerable adults;

c. Requests for adult registry checks shall be submitted to DCF for the applicant or

employee using the required request for information form currently found at:

http://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_10000_Forms/PPS10400.pdf.

i) A screen shot of the results shall be maintained in the applicant’s file.

d. DCF Child Abuse and Neglect Central Registry

i) DCF maintains a statewide registry identifying, after due process, persons substantiated for the abuse or neglect for children.

ii) Requests for children registry checks shall be submitted to DCF for the applicant

or employee using the required request for information form currently found at:


iii) A screen shot of the results shall be maintained in the applicant’s file.

e. If staff that perform work related to this RFP has not been a Kansas resident for the previous two (2) years, the Selected Vendor(s) must obtain a Federal Criminal History Record from the Federal Bureau of Investigation (FBI), in addition to the Kansas Bureau of Investigation (KBI) for criminal history record information (CHRI).

2. The Selected Vendor(s) must, at its expense, arrange for criminal background clearances from the Kansas Bureau of Investigation and obtain written results for each of its employees, as well as the employees of any of its subcontractors, who will have access to the State of Kansas IT service programs, either through on-site access or through remote access. The criminal background checks must be conducted prior to initial access and on an annual basis thereafter.

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http://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_1000_Forms/PPS1011.pdf





Before the State of Kansas will permit access to the Selected Vendor(s), the Selected Vendor(s) must provide written confirmation that the background checks have been conducted. If, at any time, it is discovered that a Selected Vendor(s) employee has a criminal record that includes a felony or misdemeanor involving terroristic behavior, violence, use of a lethal weapon, or breach of trust/fiduciary responsibility or which raises concern about building, system or personal security or is otherwise job-related, the Selected Vendor(s) shall not assign that employee to any Kansas service program, shall remove any access privileges already given to the employee and shall not permit that employee remote access unless the agency consents to the access, in writing, prior to access. The State of Kansas may withhold its consent in its complete discretion. Failure of the Selected Vendor(s) to comply with the terms of this paragraph may result in default of the Selected Vendor(s) under its Agreement.

3. The Selected Vendor(s) must arrange for, at its own expense, criminal background clearances from the Kansas Bureau of Investigation for all PCS workers employed by the common law employer as a condition of becoming qualified and prior to providing waiver services. K.S.A. 65-6205 authorizes community service providers, mental health centers, and independent living agencies to request information for background checks on applicants and employees regarding abuse, neglect and exploitations. Providers or employers not listed in K.S.A. 65-6205 shall have the applicant or employee sign a DCF release of information form. Required clearances shall include performance of all background checks in accordance with KDADS policy, including, but not limited to the following:

a. DCF Adult Abuse, Neglect and Exploitation (ANE) Central Registry

i) DCF maintains a statewide registry identifying, after due process, persons substantiated for the abuse, neglect, exploitation or fiduciary abuse of vulnerable adults.

ii) Requests for adult registry checks shall be submitted to DCF for the applicant or employee using the required request for information form currently found at: http://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_10000_Forms/PPS10400.pdf.

iii) A screen shot of the results shall be maintained in the applicant’s file.

iv) DCF Child Abuse and Neglect Central Registry

v) DCF maintains a statewide registry identifying, after due process, persons substantiated for the abuse or neglect for children.

vi) Requests for children registry checks shall be submitted to DCF for the applicant or employee using the required request for information form currently found at:


vii) A screen shot of the results shall be maintained in the applicant’s file.

b. If a PCS worker employed by the common law employer as a condition of becoming qualified and prior to providing waiver services has not been a Kansas resident for the previous two (2) years, the Selected Vendor(s) must obtain the following:

i) Federal Criminal History Record from the Federal Bureau of Investigation (FBI), ii) Kansas Bureau of Investigation (KBI) for criminal history record information

(CHRI).

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4 . 3 . 1 0 Information Handling.

The Selected Vendor(s) must abide by the specific regulations and requirements of the State of Kansas and provisions of the Health Insurance Portability and Accountability Act (HIPAA) and the Health Information Technology for Economic and Clinical Health Act (HITECH), all as amended, and all regulations implementing the same. The Selected Vendor (s), at the direction of the KDADS, shall sign a Business Associates Agreement ("BA Agreement"). The failure of the successful vendor(s) to timely execute a BA Agreement in the from presented by KDADS shall, at the option of the KDADS, be deemed a material breach of the Agreement and the Standard Terms and Conditions as detailed in this RFP. The Selected Vendor(s) must protect the confidentiality of all information possessed by the State of Kansas and KDADS. The Selected Vendor(s) agrees that any breach of this provision may, at the discretion of the State of Kansas and/or KDADS result in termination of the Agreement.

The nature of VF/EA FMS requires the handling of sensitive information. All personnel and/or sub-Selected Vendor(s) assigned to the provision of VF/EA FMS by the Selected Vendor(s) must comply with applicable federal and state laws, regulations, and rules regarding the security and confidentiality of information on individuals receiving Medicaid waiver services.

Compliance will include:1. All personnel and/or sub-Selected Vendor(s) of the Selected Vendor(s) and its reporting agent,

as applicable must comply with the Health Insurance Portability and Accountability Act (HIPAA) and the Health Information Technology for Economic and Clinical Health Act (HITECH);

2. All personnel and/or sub-Selected Vendor(s) of the Selected Vendor(s) and its reporting agent, as applicable, must receive training in confidentiality regulations, including HIPAA Privacy, and the Health Information Technology for Economic and Clinical Health Act (HITECH), and Security training and Medicaid confidentiality requirements;

a. All training shall be submitted to KDADS for review and approval prior to implementation of the transition resulting from the award of the contract.

b. Training developed shall include training provided to new staff and annual refresher training for existing staff.

3. All personnel and/or sub-Selected Vendor(s) of the Selected Vendor(s) must sign a confidentiality agreement. Personnel policies must address disciplinary procedures relevant to violation of the signed confidentiality agreement; and

4. Both confidential and sensitive information are not to be used by the Selected Vendor(s) or sub-Selected Vendor(s) or given to another agency other than for the purpose of carrying out obligations of the Agreement.

The Selected Vendor(s) is responsible for ensuring that adequate measures are in place to prohibit unauthorized access, copying, and distribution of information during work on this project. The Selected Vendor(s) is responsible for proper disposal of both hard and electronic working copies of information during work on this Project, as well as any remaining information upon the completion of the project.

Sensitive information may need to be transferred from other agencies or shared with the State of Kansas during the course of the Agreement, and/or transitioned to another vendor at the conclusion of this Agreement. The Selected Vendor(s) will follow State of Kansas procedures for information handling and sharing. The Selected Vendor(s) will ensure that all records are properly retained for six (6) years after becoming fully inactive or until the disposition of court hearings, audits and appeals are complete. The Selected Vendor(s) is responsible for following record retention procedures for all applicable federal, state and local government agencies.

4.3.11 Current, Comprehensive, Kansas-specific VF/EA FMS Organization Procedures Manual.

The Selected Vendor(s) must prepare and maintain a Kansas-specific VF/EA FMS Organization Procedures Manual (“Manual‟). This manual must include procedures and internal controls for all VF/EA FMS organization tasks and requirements outlined in this RFP. The Manual must be submitted to KDADS during the VF/EA FMS Organization Readiness Review for review and approval. The Manual should be updated at least annually or more frequently, as necessary and all updates must be reviewed and approved by KDADS. The manual shall be available and submitted to KDADS in an

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electronic format. The VF/EA FMS Organization Procedures Manual shall include, but not be limited to the following sections:

Introduction Participant-Direction Qualified Selected Vendor(s) Requirements General FMS Duties Administrative Support for Participant-Direction Information, Referral, and Assistance for Participant-Direction Billing and Claims Quality Assurance and Program Integrity Forms and Resources

4 . 3 . 1 2 Archived Files.

The Selected Vendor(s) must establish and maintain all archived files in an accurate, secure and confidential manner and for the required period of time as mandated by applicable federal, state and local rules and regulations.

4.3.13 Implementation Plan.

The Selected Vendor(s) must provide KDADS with a full implementation plan along with their bid. The implementation plan shall detail how each phase of the implementation will occur. It is the expectation that a complete project plan and timeline will be included. The plan shall include:

1. A current, comprehensive and Kansas-specific VF/EA FMS Organization Procedures Manual addressing all required functions and tasks found in this RFP;

2. A copy of the Contractor’s organizational chart;3. A copy of the Contractor’s IRS Form SS-4, Application for Employer Identification Number

(application for separate FEIN);4. A copy of the Contractor’s IRS document providing the separate FEIN;5. A copy of the IRS document providing the corporate Selected Vendor(s)’s FEIN;6. A copy of the IRS Form 940, Employer’s Annual Federal Unemployment (FUTA) Report;

Schedule R, Allocation Schedule for Form 940 Filers; and Schedule A, Multi-State Employer and Credit Reduction Information, as appropriate. These documents should reflect the most recent tax year;

7. A copy of deposit documentation showing the electronic (EFT) filing made for FUTA;8. A copy of the IRS Form 941, Employer’s Quarterly Federal Tax Report, along with IRS Forms

941 Schedule R, Allocation for Aggregate Form 941 Filers and Schedule B, Report of Tax Liability for Semi-Annual Schedule Depositors, as appropriate. These documents should reflect the most recent tax year;

9. A copy of deposit documentation showing the electronic (EFT) filing made for FIT/FICA;

4.3.14 VF/EA FMS Organization Readiness Review.

In advance of the transition of common law employers, the Selected Vendor(s) shall participate in the VF/EA FMS Organization Readiness Review (“Readiness Review”) process which will be conducted by KDADS. The purpose of the Readiness Review is to assess and document the status of the Selected Vendor(s) readiness with respect to meeting the requirements outlined in the RFP and Agreement. The Selected Vendor(s) will not be permitted to begin serving Kansas waiver participants if it does not show acceptable evidence of readiness relative to each requirement during the KDADS-conducted Readiness Review. Readiness Reviews include Selected Vendor(s)-provided detailed descriptions of how the Selected Vendor(s) will comply with the VF/EA FMS Agreement requirements during an onsite visit with KDADS staff. The Readiness Review must include:

1. Timeframe for preparing enrollment and employment packets and distributing them to new and current individuals and representatives who will become common law employers;

2. Current database modification to meet all requirements of this RFP and the Agreement;3. Staff recruitment and training process and timeline;4. Modifications to a current call center;

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5. Modifications to a current website;6. Recommended modifications to the current processes used by KDADS for VF/EA FMS

organizations;7. Timeframe for computer networks to be installed and tested;8. Timeframe for Medicaid billing systems to be implemented and tested;

9. Timeframe for Reporting system and reports to be tested and validated by VF/EA FMS organization and KDADS prior to implementation;

10. Timeframe for enrolling existing common law employers with the Selected Vendor(s); and11. Develop a quality management system to monitor the requirements of this RFP and the

Agreement.

KDADS reserves the right to continue development of elements and forms to be used for the Readiness Review process. The date will be determined by KDADS.

Selected Vendor(s) will be expected to provide sufficient staff to facilitate the Readiness Review process. More specifically, the Selected Vendor(s) must have sufficient corporate staff devoted to the Readiness Review process. Selected Vendor(s) staff will be expected to play an active role in the Readiness Review and demonstrate progress in an ongoing manner. Once the Readiness Review is completed and the findings presented to the Selected Vendor(s) by KDADS, the Selected Vendor(s) will prepare a corrective action plan (“CAP”) and address all outstanding issues identified during the Readiness Review prior to providing VF/EA FMS effective January 1, 2017. During the implementation of the CAP, the Selected Vendor(s) will have regular status meetings with the KDADS Readiness Review Team. These meetings could occur either face-to-face or via conference call. The VF/EA FMS Organization Readiness Review is not a paid task.

4.3.15 VF/EA FMS Organization Performance R e v i e w .

accordance with a schedule implemented by KDADS, the Selected Vendor(s) shall participate in a VF/EA FMS Organization Performance Review (“Performance Review”) conducted by KDADS. The purpose of the Performance Review is to assess and document the Selected Vendor(s)’s ability to perform as a VF/EA FMS organization in accordance with federal, state and local rules and regulations. Based on the results of the Performance Review, a corrective action plan shall be instituted in order to address any deficiencies identified through the performance review. The KDADS prescribed process shall be followed in correcting any and all identified deficiencies.

Selected Vendor(s) will be expected to provide sufficient staff to facilitate the Performance Review process. Selected Vendor(s) staff will be expected to play an active role in the Performance Review and demonstrate progress in an ongoing manner. Once the Performance Review is completed and the findings presented to the Selected Vendor(s) by KDADS, the Selected Vendor(s) will prepare a corrective action plan (“CAP”) and address all outstanding issues identified during the Performance Review. During the implementation of the CAP, the Selected Vendor(s) will have regular status meetings with the KDADS Performance Review Team.

4.3.16 The Selected Vendor(s) must be capable of accessing KDADS systems, including but not limited the following:

1. The Authenticare system is the State of Kansas’ claims processing and management information system.

2. The Kansas Aging Management Information System (KAMIS) - the information system is a web-based application used to collect and report data for waiver programs (Intellectual/ Developmentally Disability, Physical Disability, Severe Emotional Disorder, Traumatic Brain Injury, Technology Assisted, Frail/Elderly and Autism.

3. Additional software packages as applicable.

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Workspace must meet all KDADS IT requirements including, but not limited to, hardware, Website, telecommunications, and network. Desktop computers must comply with the State of Kansas Desktop standards to include Virus Protection and Security Software.

The Selected Vendor(s) must have (or show a work plan for implementation of) a functional Website that meets the RFP requirements and meets Section 508 requirements and Kansas Information Technology Policy 1210. Section 508 and KIT policy 1210 refer to a statutory section in the Rehabilitation Act of 1973 (found at 29 U.S.C. § 794d). The primary purpose is to provide access to and use of federal executive agencies’ electronic and information technology (EIT) by individuals with disabilities. Additional information can be found at:

www.section508.gov and https://oits.ks.gov/kito/itec/itec-policies/itec-policy-1210 .

4.3.17 Emergency Preparedness.

To support continuity of operations during an emergency, including a pandemic, the State of Kansas requires a strategy for maintaining operations for an extended period of time. One part of this strategy is to ensure that essential Agreements that provide critical business services to the State of Kansas have planned for such an emergency and put contingencies in place to provide needed goods and services.

1. Describe how the Selected Vendor(s) anticipates such a crisis will impact its’ operations;2. Describe the Selected Vendor(s)’s emergency response continuity of operations plan. Please

attach a copy of the Selected Vendor(s)’s plan, or at a minimum, summarize how the Selected Vendor(s)’s plan addresses the following aspects of pandemic preparedness:a. Employee training (describe the Selected Vendor(s)’s training plan, and how frequently

its plan will be shared with employees);b. Identified essential business functions and key employees (within the Selected

Vendor(s)’s organization) necessary to carry them out;3. Describe the Selected Vendor(s)’s contingency plans for:

a. How the Selected Vendor(s)‟s organization will handle staffing issues when a portion of key employees are incapacitated due to illness;

b. How employees in the Selected Vendor(s)’s organization will carry out the essential functions if contagion control measures prevent them from coming to the primary workplace.

4. How the Selected Vendor(s)‟s organization will communicate with staff and suppliers when primary communications systems are overloaded or otherwise fail, including key contacts, chain of communications (including suppliers), etc.; and

5. How and when the Selected Vendor(s)’s emergency plan will be tested, and if the plan will be tested by a third-party.

4.3.18 Disaster Recovery Plan.

Selected Vendor(s) must develop and document a disaster recovery plan for electronic records and files. The disaster recovery plan must address:

1. The rapid return to limited operation;2. The accuracy of software and data at return to operation; and3. The ability to return to full capacity as soon as possible.

Selected Vendor(s)’s disaster recovery plan must include, at a minimum:

1. A complete backup of all non-software data sets at the end of each production day;2. The resultant tapes/disks will be removed to an external secure site. These back-up

tapes/disks must be cycled on a weekly basis;

3. Upon the installation of any software (new or upgraded) a complete backup (copy) of the software must be made with the resultant tapes/disks removed to an external secure site. The backups must be retained in the grandfather, father, son scheme;

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4. The server must be designed to employ a method of redundancy for operational integrity and production;

5. All workstations attached to the network must have sufficient processing capability to be used interchangeably and must be able to backup one another until repair or replacement can be affected;

6. The server must be connected to an Uninterrupted Power Supply (UPS) system, which will condition incoming power to the server and provide sufficient processing time for the server to be correctly shutdown in the event of a power failure;

7. In the event of damage of a sufficient magnitude to the primary operational site, a second company location must be able to be modified to accommodate the system;

8. There must be a description of the change of communication and command, by level, in the case of a systems or power failure; and

9. There must be a Continuity of Operations (COOP) to maintain business operations via a semi-automated and/or manual mode to mitigate complete disruption of services until systems have been restored to normal operating capacities.

10. The Selected Vendor(s) must describe how, by whom, and when its disaster recovery plan will be tested.

4.3.19 Other Duties As Assigned

Selected Vendor(s) will be responsible for other tasks or deliverables requested by the KDADS Project Manager that are not outside the scope of this RFP. All such requests will be made in a formal, written manner by the manager. The Selected Vendor(s) should not commence with additional work without receiving the written request. These tasks may include but not limited to:

1. It is mandatory for the Selected Vendor(s) to supply monthly status reports to KDADS that are broken down by deliverable;

2. The Selected Vendor(s) and all subcontractors are required to complete HIPAA Privacy and Security training and sign a KDADS Business Associate Agreement prior to performing any work;

3. The majority of services provided by the Selected Vendor(s) will be provided during business hours of 8:00 am and 5:00 pm CST/CDT Monday through Friday, except on state and federal holidays;

4. The Selected Vendor(s) must supply support staff dedicated to this Project;5. Prior to the implementation of the Agreement, the Selected Vendor(s) will be required to

successfully complete a VF/EA FMS Readiness Review (“Readiness Review”) conducted by KDADS. Successful completion of the Readiness Review includes preparing and implementing a Plan of Correction based on the findings of the Review and having a current Kansas-specific VF/EA FMS Procedures Manual (“Manual”) in place and available for inspection by KDADS staff. This Manual must include procedures and internal controls for all VF/EA FMS organization tasks and requirements included in this RFP. The Manual must be updated by the Selected Vendor(s) annually and more frequently, as necessary;

6. Staff of the Selected Vendor(s) assigned to this Project must be able to work cooperatively with KDADS staff and their designees, including any or all other VF/EA FMS organization during all phases of the Project;

7. Staff of the Selected Vendor(s) assigned to this Project must be able to coordinate and receive direction from designated KDADS staff during all phases of this Project; and

8. Staff of the Selected Vendor(s) assigned to this Project must be able to deliver work that is not in conflict with the priorities and hardware/software choices and limitations as established by the State of Kansas and KDADS.

4.3.20 VF/EA FMS TASKS AND FUNCTIONS

For all the tasks and functions listed below the selected vendors must:

1. Have written policies and procedures related to the required tasks 2. Have written internal controls, including segregation of duties, related to the required tasks

A. Billing for Services Rendered

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1. Determine and incorporate all KDADS program rules and requirements for payroll payment and develop a rules-based system for billing;

2. Identify the process of submitting Medicaid claims through the State of Kansas’s Authenticare system for payments made for qualified services provided by PCS workers in accordance with waiver participants’ ISPs and KDADS billing and Agreement requirements;

3. Process Medicaid claims through Authenticare for the VF/EA FMS per member per month administrative fee established by KDADS in accordance with KDADS billing requirements;

4. Have a process for determining when a participant is admitted to a nursing facility or hospital and the length of stay;

5. Have a process for reconciling hours of services billed and paid;6. Have a process of ensuring accountability by identifying hours billed in error and documenting

required adjustments;7. Have a process for billing the common law employer directly for services provided not in

accordance with the individual’s approved ISP or when any established service limit is exceeded;

8. Have a process for monitoring and billing the FUTA/SUTA paid for each PCS worker and when applicable thresholds are met, reduce the rate billed;

9. Pay overtime in accordance with Department of Labor and Industry policy; and10. Have a process for reimbursing the State of Kansas for any unused payroll funds remaining at

the end of the state fiscal year.

B. Managing Public Funds

1. Have written policies and procedures related to the completion of the tasks listed below;2 . Have w r i t t e n internal c o n t r o l s , including segregation o f duties, related t o t h e

completion o f t h e tasks listed below;3. Establish and maintain an accounting and information system for receiving and disbursing

Medicaid funds and for tracking all transactions and balances;

a. Funds for the PCS worker Reimbursement Rate are earmarked solely for the specific common law employer to use in paying PCS workers employed by the common law employer and in paying workers’ compensation premiums and federal and state taxes associated with the employment of such common law employer’s PCS workers and cannot, under any circumstance, be used by the Selected Vendor(s) for administration expenditures, PCS workers employed by other common law employers, working capital, recruiting, or other day-to-day business uses.

b. Such Reimbursement Rate fund shall be deposited by the Selected Vendor(s) in an account in which such deposits may be traced to and accounted for each respective common law employer. The PCS worker rate/funds is subject to Medicaid rules and regulations and therefore, no portion can be utilized without the express direction of the respective common law employer. The Selected Vendor(s) shall not determine the use of such funds.

c. Funds paid for each PCS worker’s wages and benefits shall be tracked and accounted for individually with the ability to produce at any time a detailed accounting of funds paid for each individual PCS worker.

4. Establish a bank account for the purposes of receiving payment of the per member monthly administrative fee;

5. Establish a separate bank account for the purposes of managing participant directed funds into which all payments received from Medicaid and the State must be immediately deposited and must submit to the KDADS written evidence that the bank has established said account as set forth below.

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The VF/EA FMS organization must complete all forms as specified by the KDADS and the bank to establish electronic fund transfers from Medicaid and the State to the bank account.

a. Prohibit the withdrawal of funds except for payment for services provided to the consumer including all taxes, insurances, and fees; and

b. Maintain, to the extent legally permissible, in a manner that prevents creditors of the VF/EA FMS organization from in any way encumbering or acquiring funds in the bank account.

6. Any bank charges (i.e., stop payment fees) must be absorbed by the VF/EA and not reduce the balance of the bank account;

7. Ensure that funds deposited into the bank account are not used by the VF/EA FMS organization or by any other agent or third party to satisfy, temporarily or otherwise, any VF/EA FMS organization liability or for any other purpose, except as provided under this RFP;

8. Maintain a report on bank account activity in accordance with the reporting requirements established by the KDADS. These requirements should include monthly reporting of bank account activity, including a summary of the month’s bank activity, reconciliation of the bank balance to the General Ledger, and reconciliation of any amounts advanced from KDADS; and

9. Do not co-mingle other funds with Medicaid funds in the separate bank account.

C. Receiving Federal and State Authority to Act as a VF/EA FMS Organization

1. Apply for (through the completion and submission of the IRS Form SS-4 Application for Employer Identification Number) and obtain a separate Federal Employer Identification Number (EIN) for the sole purpose of purpose of filing and paying federal employment taxes and insurances and other required IRS forms on behalf of common law employers it represents as agent. (Note: the VF/EA FMS organization may already have a separate Federal EIN and should be able to demonstrate that it is separate and distinct from the organization’s corporate Federal EIN);

2. Maintain a copy of the completed IRS Form SS-4, separate FEIN and related correspondence with IRS in the VF/EA FMS organization’s file;

3. Apply for (through the completion and submission of the IRS Form SS-4, Application for Employer Identification Number), and obtain a Federal Employer Identification Number (EIN) for each newly enrolled common law employer it represents as employer agent;

4. Maintain a copy of the completed IRS Form SS-4 and Notice of FEIN in each common law employer’s file;

5. Apply for IRS agent authorization by completing and submitting an IRS Form 2678, Employer/Payer Appointment of Agent to the IRS per IRS Form instructions for each common law employer it represents as agent;

6. Maintain a copy of the completed IRS Form 2678 in each common law employer’s file;7. Receive written agent authorization from the IRS through the receipt of an IRS LTR 1997C,

Notice of Appointment, for each common law employer it represents as agent;8. Maintain the IRS LTR 1997C, Notice of Appointment in each common law employer’s file;9. Execute and submit an IRS Form 8821, Tax Information Authorization with each common law

employer it represents as agent;10. Maintain a copy of the executed Form 8821 in each common law employer’s file;11. Renew the executed IRS Forms 8821 with common law employers on a periodic basis per

Form instructions;12. Maintain a copy of any IRS Form 8821 renewals in each common law employer’s file;13. Obtain a signed Kansas Department of Labor Form K-CNS 032, Unemployment Power of

Attorney from each common law employer it represents as agent and file with the Kansas Department of Labor when registering a waiver participant or representative as the common law employer for state unemployment insurance filing and depositing purposes;

14. Maintain a copy of the executed Kansas Department of Labor Unemployment registration in each common law employer’s file;

15. When a common law employer ceases using the VF/EA FMS organization for any reason, the Selected Vendor(s) must notify the Kansas Department of Labor of the change by executing the Employer Account Record Change Form K-CNS 0103; and

16. When a common law employer ceases using the VF/EA FMS organization for any reason, the Selected Vendor(s) must maintain a copy of the Kansas Department of Labor Employer

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Account Record Change Form K-CNS 0103 and all communications in each common law employer’s file.

D. Providing Customer Service

1. Implement customer service policies and procedures that reflect the principals of self-determination;

2. Implement customer service policies and procedures that are culturally sensitive in business practices in order to communicate effectively with a diverse population of participants of all ages and with a variety of chronic conditions;

3. Implement and maintain mandatory staffing of the toll-free telephone system for an eight hour period between the hours of 8:00 AM – 5:00 PM CST/CDT, Monday through Friday, except on state and federal holidays with a voicemail box activated for after hours;

4. Respond to all participant calls (inquires, issues and complaints) within one business day of receipt of the call;

5. Have a fax;6. Have an operational TTY/TDD line;7. Have internet e-mail capacity;

8. Have a web site and provide access to waiver participants and representatives to view up-to-date information and have internal controls documented to monitor the accuracy of the materials included on the website and the effectiveness of the system;

9. Have written internal controls to monitor the accuracy of the materials included on the website and the effectiveness of the system;

10. Have the ability to provide translation and interpreter services (i.e., American Sign, and services for persons with Limited English Proficiency);

11. Have the ability to provide materials in alternate print (i.e., large print and Braille) and languages other than English;

12. Implement and maintain a system for receiving, responding and tracking all communications from any source (including complaints) and maintain a log that addresses:

a. Who made the call;b. Who received the call;c. The reason for the call;d. Any action taken;e. If any mandatory reporting that occurred; andf. Final resolution.

13. Implement and maintain a system for reporting incidents as defined by the K D A D S program office;

14. Respond to all waiver participant and representative communications of any source within one (1) business day from receipt of call;

15. Have and maintain a complaint and grievance procedure that includes:a. An Advisory/Grievance Committee that includes common law employers, and waiver

or state funded program participants and representatives, and meets either in person or via telephone or video conference at least quarterly to discuss the provision of VF/EA FMS and to evaluate any grievances filed or feedback provided by common law employers, waiver participants or representatives;

b. Responding to complaints from common law employers, waiver participants or representatives within two (2) business days;

c. Tracking activities related to the receipt of complaints;d. Resolving VF/EA FMS related complaints and grievances within five (5) business days

of receipt; ande. Providing monthly reports to KDADS outlining complaints received and resolutions

achieved;f. Conduct a Common Law Employer Satisfaction Survey using the tool developed by

the Vendor(s) and approved by KDADS. The survey must be implemented sixty (60) days after enrollment and annually thereafter. Survey data must be collected and analyzed. A report to KDADS must be prepared and submitted based on specifications determined by KDADS; and

g. Develop and implement a corrective action plan based on the results of the annual Common Law Employer Satisfaction Survey.

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E. Coordinating and Communicating with KDADS, Kansas Department of Health and Environment (KDHE), and Managed Care Organizations (MCO)

1. Coordinate its activities and communicate effectively with KDADS, KDHE, and MCOs;2. Provide orientation and training at a minimum on a semi-annual basis to MCOs regarding the role and

responsibility of the VF/EA FMS organization;3. Reports overuse of PCS worker hours to the (MCO) responsible for authorizing the services in the ISP in

accordance with the policy developed by KDADS;4. Informs the entity responsible for authorizing the services in the ISP of any common law employer who

does not submit timesheets or invoices to the Contractor for two or more consecutive payroll periods (one month or more); and

5. Complaints or grievances submitted to the VF/EA by CM/SC are responded to by VF/EA staff within two (2) business days.

6. Submit the following to KDADS for review and approval prior to dissemination, communication, and/or implementation:

a. Information bulletins distributed to participants, stakeholders, etc.;b. Policy revisions;c. Presentations, communications, training materials, formal responses to inquiries,

F. Providing Common Law Employer Orientation and Skills Training

1. Have a common law employer orientation process that uses a standard curriculum and materials that are pre-approved by the KDADS;

2. Common law employers receive orientation based on the standard curriculum developed for KDADS, prior to employing qualified employees. Common law orientation should include a review of the documents including a review of the information and forms contained in the Common Law Employer and Qualified PCS Worker Employment Enrollment Packets and how they should be completed. Also describe process used to notify common law employers of IRS/State/DOL updates impacting the common law employer;

3. Provide documentation and review with common law employer:a. Role and responsibilities of the common law employer using a VF/EA FMS organization;b. Role and responsibilities of the VF/EA FMS organization including level of interaction with

qualified employees, vendors and small unlicensed providers and support coordinators and the incident reporting system;

c. Services provided by the VF/EA FMS organization;d. Hours of operation;e. Key contacts at the VF/EA FMS organization;f. Toll free telephone, TTY and fax numbers;g. Participant Bill of Rights;h. VF/EA FMS Employer Handbook;i. Time frame and process for returning voice mail calls from common law employers,

participants and representatives;j. Process for receipt and processing of timesheets and processing of qualified employee payroll

checks including schedule for submitting timesheets and paydays;k. Process for purchasing approved goods and services from vendors, small unlicensed

providers, and independent contractors and submitting invoices for payment including schedule for submitting invoices and payment schedule;

l. Process for resolving issues and complaints;m. Effective practices for hiring, establishing work schedules, training, supervising, creating job

descriptions, completing and submitting time sheets and discharging qualified employees;n. Process for reviewing workplace safety issues and strategies for effective management of

workplace injuries;o. Informing qualified PCS workers of their right to file unemployment and workers’ compensation

insurance claims, when appropriate;p. Facilitate the process for completing and submitting the Worker Termination Form to the VF/EA

FMS organization within twenty-four (24) hours of when a qualified PCS worker ceases working for the common law employer; and

q. Process and timeline for completing the common law employer satisfaction surveys.

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r. Develop a process for providing ongoing employer skills training to common law employers using a standard curriculum and materials that are pre-approved by the KDADS Contract Administrator;

s. Identify common law employers who may need and/or desire additional employer skills training.

G. Enrolling Individuals and Representatives with the VF/EA FMS Organization as the Common Law Employer

1. Prepare a Common Law Employer Enrollment Packet, and receive approval from the KDADS Contract Administrator. In order for the common law employer to better understand and assist in completion of required documentation, the Packet should contain all required information and forms and be well organized and user friendly. The packet, and any revisions, must be submitted for approval to KDADS thirty (30) days prior to making any changes. At a minimum the information in the packet should include:

a. Cover letter or brochure that includes the VF/EA FMS organization’s staff contact information, days and hours of operations, toll-free number and TTY/TDD number, availability of VF/EA FMS materials in alternate print, roles and responsibilities of the VF/EA FMS organization, common law employer, waiver/program participant and representative, qualified employee and vendor/small unlicensed provider, as applicable;

b. Good to Go Process – this is the process for letting the employer know that their staff are enrolled and qualified to provide support;

c. Employment change in status/termination of the qualified employee, vendor and small unlicensed provider;

d. Authorized Representative Designation Form and Instructions;e. Common Law Employer Agreement Form and Instructions;f. Employee Qualification Form and Instructions;g. Common Law Employer Monthly Progress Notes Form and Instructions;h. Semi-completed Form SS-4, Application for Employer Identification Number and

instructions;i. Semi-completed Form 2678, Employer/Payer Appointment of Agent and instructions;j. Semi-completed Form 8821, Tax Information Authorization and instructions;k. Semi-completed Form K-CNS 032 Kansas Department of Labor Power of Attorney and

instructions;

l. Semi-completed Form CR-16, Kansas Business Tax Application and instructions for registering participant as an employer for state income tax withholding tax filing and payment purposes;

m. Kansas New Hire Report (form K-CNS 032) and instructions or generic form to collect the required information for electronic filing by the VF/EA FMS organization;

n. Process for qualified employee employment status change;o. Qualified Employee Termination Form;p. Appropriate paperwork for obtaining workers’ compensation insurance policy;q. FMS Individual Termination Form;r. Workplace safety information including but not limited to:

i. Participant site and home safety check list;ii. Procedures for identifying and reporting on qualified employees injuries for

workers’ compensation insurance purposes;iii. Procedures for addressing emergencies;iv. List of emergency contacts and telephone numbers; and

s. Universal precautions procedures, safe lifting techniques and body mechanics.t. Qualified PCS Worker Timesheet and instructions;u. Due date and payment schedule for Qualified PCS Worker Timesheets;v. Common Law Employer Enrollment Forms Check List; andw. Self-addressed stamped envelope.

2. Distribute Common Law Employer Enrollment Packets to designated participant/representative within three (3) business days of receipt of a call from a MCO informing the VF/EA FMS organization that a participant wishes to enroll with the VF/EA FMS organization;

3. Collect and process completed documents and forms included in the Common Law Employer Enrollment Packet and review for completeness;

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4. Apply for (through the completion and submission of the IRS Form SS-4, Application for Employer Identification Number), and obtain a Federal Employer Identification Number (Federal EIN) for each common law employer it represents as agent;

5. Maintain a copy of the completed IRS Form SS-4 and Notice of Federal EIN in each common law employer’s file;

6. Register each common law employer as an employer for state income withholding taxes with the Kansas Department of Revenue using the Form CR-16, Kansas Business Tax Application;

7. Obtain a Kansas Employer Withholding Account Identification Number for each participant it represents as employer agent for state income tax (SIT) withholding purposes;

8. Maintain a copy of the Form CR-16 and the Kansas Employer Withholding Account Identification Number in each common law employer’s file;

9. Complete the on-line registration for each common law employer as an employer for state unemployment insurance (SUI) taxes with the Kansas Department of Labor;

10. Obtain a Kansas Employer UC Account Identification Number for SUI purposes for each common law employer; and

11. Maintain a copy of the Kansas Employer UC Account Identification Number in each common law employer’s file.

H . Processing a Common L a w Employer’s Disenrollment f r o m a VF/EA FMS Organization

1. Revoke the IRS Form 2678 with the common law employer, when appropriate;2. Maintain a copy of the revoked Form 2678 and the IRS revocation confirmation letter (LTR 4228C)

in the common law employer's archived file;

3. Revoke the IRS Form 8821 with the common law employer, when appropriate;4. Maintain a copy of the revoked Form 8821in the common law employer's archived file;5. Retire the common law employer’s FEIN, when appropriate;6. Maintain a copy of the documentation of the FEIN retirement in the common law employer’s

archived file;7. Revoke the Form K-CNS 032 Kansas Department of Labor Power of Attorney with the common law

employer, when appropriate;8. Maintain a copy of the revoked Form K-CNS 032 Kansas Department of Labor Power of Attorney in

the common law employer’s archived file;9. Close the common law employer’s Kansas Department of Revenue state withholding tax account

number, when appropriate, by filing the CR-108, Notice of Business Closure Form;10. Maintain a copy of the CR-108, Notice of Business Closure Form in the common law employer’s

archived file;11. Close the common law employer’s Kansas Department of Labor state unemployment insurance tax

employer tax account number when appropriate, by using the Kansas form K-CNS 0103, Employer Account Record Change;

12. Maintain a copy of the Kansas form K-CNS 0103, Employer Account Record Change in the common law employer’s archived file;

13. Compute, withhold and file final state withholding tax reports (even when the final filing is zero wages);

14. Deposit final state income tax (even when the final filing is zero wages);15. Maintain a copy of the final state income tax filing and deposit and related c orrespondence in the

common law employer’s archived file;16. Compute, withhold and file final state unemployment taxes (even when the final filing is zero

wages);17. Deposit final state unemployment taxes (even when the final filing is zero wages);18. Maintain copies of the documentation of the filing and payment of the common law employer's final

state income tax and unemployment taxes in the common law employer’s archived file;19. Terminate the common law employer’s workers’ compensation insurance policy, when appropriate

and submit any premium refund to KDADS (i.e., via offset of future payment); and20. Maintain documentation related to terminating the common law employer's workers' compensation

insurance policy in the common law employer's archived file.

I. Processing and Distributing Qualified PCS Worker Payroll and Related Taxes and Insurances

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1. Determine if the qualified PCS worker is a family member who is exempt from paying into FICA and/or FUTA and SUTA and process payroll and related federal taxes accordingly;

2. Maintain documentation on relationship of common law employer to the qualified PCS worker in the worker’s file;

3. Determine if a qualified PCS worker is a non-resident of Kansas and the appropriate method to be used for state income tax withholding;

4. Maintain documentation on the qualified PCS worker’s Kansas non-resident status in the worker’s file;

5. Verify qualified PCS worker hourly wage is in compliance with federal, state, and Kansas Department of Labor wage and hour rules;

6. Develop and produce timesheets and instructions in use of Authenticare for qualified PCS workers;7. Collect, verify and process qualified PCS workers time sheets per Federal and State reporting

requirements;8. Maintain copies of time sheets in qualified PCS worker’s file;9. If the VF/EA FMS organization receives a qualified PCS worker’s timesheet with more hours than

approved in the common law employer’s service plan, the VF/EA FMS organization must address the issue immediately by:

a. Contacting and informing the common law employer or representative of the overage;b. The common law employer must adjust his or her qualified PCS worker’s time accordingly

on the next time sheet;c. Contacting and informing the MCO of the overage;

i. The MCO should develop a strategy with the common law employer to stay within the service plan;

ii. The MCO should determine if a change in the common law employer’s medical or social situation has occurred. If so, the service plan should be revised to reflect those changes; and

iii. If the common law employer authorized a qualified PCS worker to work hours above and beyond those approved in the service plan and the additional hours cannot be covered by a modified service plan, the VF/EA FMS organization will collect from the common law employer the total cost of those hours in excess of those approved in the service plan. Total cost that must be collected from the common law employer includes the sum of gross wages plus the sum of employer taxes due on such wages, including Social Security, Medicare, State Unemployment and Federal Unemployment taxes;

iv. The VF/EA FMS organization must notify the MCO of any such overages within five (5) business days of receipt of the involved time sheet.

10. Compute, withhold, file, and track quarterly federal income tax withholding in the aggregate using the VF/EA FMS organization’s separate FEIN and using the IRS Form 941, Employer’s Quarterly Federal Tax Report and IRS Form 941 Schedule R, Allocation for Aggregate Form 941 Filers and Schedule B, Report of Tax Liability for Semi-Annual Schedule Depositors, as appropriate;

11. Compute, withhold, file and track quarterly Medicare and Social Security taxes (FICA) in the aggregate using the VF/EA FMS organization’s separate FEIN, using the IRS Form 941, Employer’s Quarterly Federal Tax Report, along with IRS Forms 941 Schedule R, Allocation for Aggregate Form 941 Filers and Schedule B, Report of Tax Liability for Semi-Annual Schedule Depositors, as appropriate;

12. Maintain copies of the filed IRS Forms 941, Schedule R and Schedule B and related correspondence in VF/EA FMS organization’s file;

13. Deposit federal income tax withholding electronically (EFTS filing) in the aggregate using the VF/EA FMS organization’s separate FEIN per IRS depositing rules;

14. Maintain copies of federal income tax withholding deposit documentation in the VF/EA FMS organization’s file;

15. Deposit FICA in the aggregate electronically (EFTS filing) using the VF/EA FMS organization’s separate FEIN per IRS depositing rules;

16. Maintain copies of FICA deposit documentation in the VF/EA FMS organization file;17. Compute, withhold and file annual FUTA in the aggregate using the VF/EA FMS organization’s

separate FEIN and the IRS Form 940, Employer’s Annual Federal Unemployment (FUTA) Report, Schedule R, Allocation Schedule for Form 940 Filers and Schedule A, Multi-State Employer and Credit Reduction Information, as appropriate;

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18. Maintain copies of filed Form 940, Schedules A and R, as appropriate, and related documentation in the VF/EA FMS organization’s files;

19. Deposit FUTA in the aggregate electronically (EFTS filing) using the VF/EA FMS organization’s separate FEIN per IRS depositing rules;

20. Maintain copies of FUTA deposit documentation in the VF/EA FMS organization’s file;21. Create a UserID/Password and register the Kansas Employer Withholding Account Identification

Number to electronically file returns and payments when using KSWebTax Internet Filing System at:

https://www.kdor.ks.gov/Apps/kcsc/login.aspx?ReturnUrl=%2fApps%2fKCSC%2fsecure%2fdefault.aspx

22. Maintain copies of all documentation related to KSWebTax Internet Filing System’s authorization for state income tax withholding in the VF/EA FMS organization’s file;

23. Compute and withhold, at the current Kansas State Income tax rate, state income tax withholding for each common law employer’s qualified PCS worker (resident or nonresident);

24. Deposit state income tax withholding for each common law employer’s qualified PCS worker (resident or nonresident) electronically using the KSWebTax Internet Filing System based on the payment filing frequency determined by the Kansas Department of Revenue (semi-monthly, monthly, quarterly, or annual);

25. Maintain copies of state income tax withholding deposits and related correspondence in each common law employer’s file;

26. File an annual reconciliation (along with the accompanying individual wage statements) for each common law employer (resident or nonresident) electronically using the KSWebTax Internet Filing System;

27. Maintain copies of the annual reconciliation (Form KW-3 and/or other appropriate documentation) and related correspondence in each common law employer’s file;

28. File for and receive authorization from the Kansas Department of Labor to file state unemployment taxes electronically through the Kansas Employer Unemployment Insurance Tax system)at: https://www.kansasemployer.gov/uitax/account/login.aspx

29. Maintain copies documentation for state unemployment insurance taxes in the VF/EA FMS organization’s file;

30. Determine if any common law employer’s qualified PCS workers are family employees that are exempt from filing and paying state unemployment insurance taxes and process accordingly;

31. Compute, withhold and file state unemployment insurance tax quarterly for each common law employer (even when zero wages are reported) using the Kansas Employer Unemployment Insurance Tax system;

32. Maintain a report of wages paid and correspondence in calendar year for each common law employer’s qualified PCS worker who are currently non-liable, in each common law employer’s file;

33. Deposit state unemployment insurance tax quarterly for each common law employer (including last filing even when zero wages are reported) using the Kansas Employer Unemployment Insurance Tax system;

34. Maintain copies of state unemployment insurance deposits and correspondence in each common law employer’s file;

35. Process all judgments, garnishments, tax levies or other related holds on qualified PCS workers’ pay as may be required by federal or state governments;

36. Maintain copies of judgments, garnishments, tax levies, and other related hold documentation in qualified PCS workers files;

37. Generate and disburse payroll checks to all common law employers’ qualified PCS workers within the time period required for each pay period (two consecutive work weeks);

38. Process direct deposit of qualified PCS workers payroll checks as requested;39. Maintain copies of direct deposit documentation in qualified PCS workers files;40. Develop a system for managing improperly cashed or issued payroll checks, stop payment on

checks, and for the re-issuance of lost, stolen or improperly issued checks including:a. Maintenance of a log of voided and reissued checks, including all pertinent information;b. Proper authorization of all stop payments and re-issuances; andc. Timeframe for re-issuance of checks (i.e., within five (5) business days of notification of

lost/stolen check) and issuance of stop payment request.41. Research and resolve any tax notices received from the IRS, Kansas Department of Revenue and

Kansas Department of Labor regarding PCS worker tax liabilities/liens, including all pertinent information and step to resolution;

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https://www.kansasemployer.gov/uitax/account/login.aspx

https://www.kdor.ks.gov/Apps/kcsc/login.aspx?ReturnUrl=%2FApps%2FKCSC%2Fsecure%2Fdefault.aspx


42. Maintain a spreadsheet of all tax notices received from the IRS, Kansas Department of Revenue and Kansas Department of Labor regarding PCS worker liabilities/liens including all pertinent information and step to resolution;

J. End of Year Tax and Other Activities1. Update common law employer and qualified PCS worker address or phone number changes prior

to mailing out tax information in January of each year;2. Process refunds of over collected FICA for eligible common law employer (to KDADS) and

qualified PCS worker in accordance with IRS and KDADS directive;3. Maintain documentation related to FICA refunding in each applicable common law employer and

qualified PCS worker file;4. Process, file and distribute IRS Forms W-2, Wage and Tax Statement for all qualified PCS workers

and in accordance with IRS instructions for agents. As part of this process, the total gross payroll per the Form W-2 should be reconciled to the calendar year’s total gross payroll;

5. Verify that each qualified PCS workers social security number matches the name and date of birth information obtained from SSA’s Business Services Online prior to submitting IRS Forms W-2 to SSA each calendar year;

6. Maintain copies of the federal copy of Forms W-2 and related documentation in each qualified PCS workers file;

7. Process and file IRS Form W-3, Transmittal of Wage and Tax Statement, as appropriate (Note: If IRS Forms W-2 are filed electronically the IRS Form W- 3 is not necessary);

8. Maintain copies of IRS Form W-3, as appropriate, in the VF/EA FMS organization’s file;9. Process any returned qualified PCS worker payroll checks in accordance with Kansas Unclaimed

Property Laws; and10. Maintain copies of Kansas Unclaimed Property-related documentation in the qualified PCS

worker’s file.

K. Establishing and Maintaining Files and Documentation

1. Establish and maintain current common law employer files in an accurate, complete, secure and confidential manner and for the required period of time as mandated by applicable federal, state and local rules and regulations. The files should include, but not be limited to the following documents:

C o m m o n Law Employer File a. Common Law Employer’s name;b. Common Law Employer’s address;c. Common Law Employer’s phone number;d. Name, address and phone number of individual if he/she is not the common

law employer;e. Participant’s Medicaid Identification (MCI) Number;f. Participant’s emergency contact person;g. Name, address and phone number for representative if he/she is not the common law

employer;h. Completed Common Law Employer Enrollment Packet forms;i. Completed Qualified PCS worker Employment and Vendor and Small Unlicensed Provider

Enrollment Packet forms;j. ISP and updates;k. Copy revoked IRS Form 2678, IRS confirmation of IRS Form 2678 revocation and any

related correspondence from the IRS, as applicable;l. Copy of letter retiring common law employer’s FEIN, when applicable;m. Copy of IRS Form 8821 renewal (as applicable) and any related correspondence from the

IRS, as applicable;n. Copy of IRS Form 8821 revocation (as applicable) and any related correspondence with the

IRS, as applicable;o. Copy of Kansas form K-CNS 0103, Employer Account Record Change, revoking individuals

SUTA account number and Power of Attorney, when appropriate;

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p. Copy of the Kansas Department of Revenue Form CR-108, Notice of Business Closure, when appropriate;

q. Copies of all Kansas Department of Revenue Form KW-5, Withholding Tax Deposit Reports (for remittance monthly, semi-monthly, quarterly, or annual) including final return filed (even if its zero reporting) or copies of proof of filing if return filed electronically;

r. Copies of all Forms KW-3 Annual Withholding Tax Return and state copies of W-2s, (Annual Reconciliation) or copies of proof of filing if return filed electronically;

s. SIT and SUI account numbers;t. Copies of documentation of all payments of state income tax withholding or payment of

receipt if payments are made electronically;u. Copies of filing and payments of income tax withholding for Kansas non-resident

employees, as applicable;v. Copy of Form K-CNS 010, Kansas Department of Labor Status Report (provides the UC

account number assigned as well as other UC tax information);w. Copies of Form K-CNS 404 , Kansas Department of Labor Experience Rating Notice;x. Copies of quarterly Form K-CNS 100, Kansas Department of Labor Quarterly Wage Report

and Unemployment Tax Return or copy of proof or filing if return filed electronically;y. Copies of proof of payment of UC taxes for individual or payment receipt if payment is

made electronically;z. Copies of all individual-specific state unemployment insurance benefits payments;aa. Copies of the Kansas Department of Labor Form K-CNS 0103, Employer Account Record

Change, when appropriate.bb. Copies of documentation related to any FICA refunding (employee portion) process and

returned to eligible, qualified PCS worker;cc. Copies of documentation related to any FICA refunding (employer portion) processed and

returned to the Kansas State Treasurer;dd. Copies of workers’ compensation insurance policies, premium invoices and documentation

of payments, refunds and all notices and correspondence;ee. Copies of completed workers’ compensation audit reports, as applicable;ff. Copies of Qualified Person Care Services Worker Termination Form;gg. Documentation for transitioning the individual from their current VF/EA FMS organization to

a new VF/EA FMS organization, when appropriate.

2. Establish and maintain current PCS Workers’ files in an accurate, complete, secure and confidential manner and for the required period of time as mandated by applicable federal, state and local rules and regulations. They shall include, but not be limited to the following documents:

Qualified PCS Worker Filea. Common Law Employer’s name;b. Common Law Employer’s address;c. Common Law Employer’s phone number;d. Name, address and phone number of individual if he/she is not the common law employer;e. Participant’s Medicaid Identification (MCI) Number;f. Participant’s emergency contact person;g. Name, address and phone number for representative if he/she is not the common law

employer;h. Copy of the Qualified PCS Worker Employment Enrollment Packet forms;i. Copies of documentation verifying the employee’s social security number matches the

name and date of birth information provided obtained through the Social Security Administration’s Business Service Online;

j. Dates of employment for each qualified Person Care Services Worker;k. Copies of qualified personal care worker background check clearances as required by

KDADS policy.

l. Determination of qualified PCS Worker’s state of residence;42


m. Copies of filings and payments of out-of-state income tax withholding, when applicable;n. Determination if the qualified PCS worker is a paid family member who is exempt from

paying into FICA and/or FUTA per IRS Publication 15 and SUTA and documentation that applicable taxes have not been withheld and deposited;

o. Copies of PCS worker’s time sheets, and any time sheet corrections or adjustments verified by the common law employer;

p. Copy of completed Kansas Department of Labor New Hire Report K-CNS 436;q. Copies of documentation regarding any judgments, garnishments and tax levies or any

related holds on the PCS worker pay as may be required by federal or state government;r. Copies of completed IRS Forms W-2 and W-2(c), as applicable;s. Copies of documentation regarding any FICA refunds processed (employee portion) and

copies of cancelled refund checks;t. Copies of documentation of requests for verification of PCS worker wages requested by

federal and state agencies, as applicable;u. Copies of documentation of any workers‟ compensation insurance claims filed by PCS

worker or documentation that the VF/EA FMS made every attempt to obtain the documentation;

v. Copies of documentation of submission of PCS worker returned/not cancelled payroll checks, FICA refund checks or any other payments due to the Kansas State Treasurer, Unclaimed Property Division;

w. Copy of Qualified PCS worker Termination Form; andx. Copy of completed Kansas Department of Labor Employer Notice K-BEN 44/45.

L. Processing a Common Law Employer’s Change in VF/EA FMS Organization

Selected V e n d o r ( s ) m u s t facilitate a n y n e c e s s a r y changes i n a c o m m o n l a w employer’s VF/EA FMS organization per K D A D S requirements.

M. Preparing and Submitting Required Reports

1. Prepare and distribute monthly, quarterly and annual reports to KDADS as specified by KDADS;2. Deliver KDADS reports via a secure electronic file transfer process;3. Report overuse of PCS worker hours to MCO in accordance with process developed by the

VF/EA and the MCO. This is evidenced by KDADS review of process and sample documentation provided to the MCO and results of KDADS survey of the MCO entity;

4. Inform the MCO of any participant who does not submit timesheets or invoices to the VF/EA for two or more consecutive payroll periods (one month or more) as evidenced by the VF/EA’s documentation and results of KDADS survey of MCO;

N. Brokering Worker’s Compensation Insurance for Common Law Employers

1. Manage t h e initial application and receipt of individual workers’ compensation insurance policies for each common law employer required by law to provide workers’ compensation coverage for employees or for common law employer’s not required by law to provide coverage, but who choose to do so (K.S.A. 44-505);

2. Manage the renewal of individual worker’s compensation insurance policies for each common law employer;

3. Manage the payment of each common law employer’s individual worker’s compensation insurance premium;

4. Provide wage information to workers’ compensation insurer(s) to determine qualified PCS workers benefits, when requested;

5. Facilitate the workers’ compensation insurer’s annual audit process, including hosting insurer staff on site, providing necessary documentation; and

6. Maintain the following information related to worker’s compensation insurance in the common law 43


employer’s file:

a. Worker’s compensation insurance application and renewal documentation for each common law employer;

b. Worker’s compensation insurance policies for each common law employer;c. Worker’s compensation premium documentation for each common law employer;d. Qualified PCS workers wage documentation for determining worker’s compensation

insurance benefits; ande. Relevant worker’s compensation insurance audit related documentation for each common

law employer.

O. Physical Plant, Equipment, Technology and Development, Implementation and Maintenance of Communications and Information Systems

1. Have the physical plant location, size and equipment (i.e., including computer hardware and software) that is adequate to effectively operate as a VF/EA FMS organization;

2. Have the necessary technologies and accommodations in place adequate to effectively operate as a VF/EA FMS organization;

3. Have a website that meets current website accessibility standards and contains current and accurate information related to the VF/EA FMS function;

4. Maintain a current operations computer database that ensures timeliness and accuracy of data entry and storage, and meets the needs of Participant Directed Services and VF/EA FMS.

4.3 Deliverables and Reporting:

4.3.1 Knowledge Receipt and Transition Plan. The Selected Vendor(s) must submit a current, detailed transition plan to the State of Kansas and KDADS within five (5) business days of the start of the VF/EA FMS Organization Readiness Review period or as required by State of Kansas and/or KDADS. At a minimum, the transition plan must include a detailed plan for moving all waiver and state funded program participants currently using VF/EA FMS from the current VF/EA FMS organization to the Selected Vendor(s) effective April 1, 2017.

4.3.2 Agreement Transition a n d Turnover. U p o n expiration o r termination of the Agreement by the selected Vendor or by the State of Kansas, the selected Vendor shall provide for a smooth and timely transition of its services to the State of Kansas and its contractors, as applicable. In addition, the selected Vendor(s) must:

a. Provide a final detailed description of the transition plan for approval by the State of Kansas and KDADS, and initiated four (4) months prior to the last day of the Agreement.

b. Cooperate with the State of Kansas and supply the State of Kansas and/or its contractor with all information required by the State of Kansas and/or its contractor during the transition process.

c. Pay all costs related to the transfer of materials and responsibilities as a normal part of doing business with the State of Kansas.

4.3.3 Transitioning VF/EA FMS Organization. At the expiration or termination of the Agreement by the selected Vendor(s) or by the State of Kansas and KDADS, or if at any time the State of Kansas and KDADS desires a transition of all or any part of the duties and obligations of the Selected Vendor(s) to the State of Kansas and KDADS or to another VF/EA FMS organization after termination or expiration of the Agreement, the State of Kansas and KDADS shall notify the Selected Vendor(s) of the need for transition. Such notice shall be provided at least ninety calendar days prior to the date of the Agreement will expire or will be deemed given as of the date the State of Kansas and KDADS provides notice of termination to the Selected Vendor(s). The transition process will commence immediately upon such notification and shall, at no additional cost the State of Kansas and KDADS, continue past the date of the termination or expiration, if, due to the actions or inactions of the Selected Vendor(s), the transition process is not completed before that date. In the event that a subsequent VF/EA FMS organization is unable to assume operations on the planned

44


date for transfer, the Selected Vendor(s) will continue to perform VF/EA FMS on a month-to-month basis for up to six months beyond the planned transition date. The State of Kansas and KDADS will withhold final payment to the Selected Vendor(s) until the transition to the new VF/EA FMS organization is complete. If delays in the transition process are due solely to the actions or inactions of the State of Kansas and KDADS and or the State of Kansas and KDADS’ newly designated VF/EA FMS organization, the State of Kansas, KDADS and the Selected Vendor(s) will negotiate in good faith an Agreement for the conduct of and compensation for transition of activities after the termination or expiration of the Agreement. The Selected Vendor(s) shall be liable for all payroll claims and VF/EA FMS responsibilities incurred up to the date of termination.

The Selected Vendor(s) will perform the tasks associated with the transitioning to a new VF/EA FMS organization as outlined in the State of Kansas and KDADS approved transition plan.

T h e State of Kansas and KDADS will review the transition plan, and the Selected Vendor(s) will revise it accordingly and resubmit updated versions to the State of Kansas and KDADS within five (5) business days from the request.

4.4.1 Reports a n d Project Control. Report formats and data sources must be approved by the KDADS Contract Administrator during the VF/EA FMS Readiness Review period. KDADS reserves the right to access pertinent data sources and generate ad hoc data reports. KDADS must have read only access to the accounting and information systems for validation of KDADS all data contained on KDADS reports and to perform ad hoc data queries. The VF/EA FMS organization must supply the Selected Vendor(s) Relationship Diagram to the KDADS Contract Administrator for facilitation of ad hoc reporting. If more than one Selected Vendor(s) is selected, the KDADS Contract Administrator will specify the data elements that the Selected Vendor(s) must have in their system for consistency in data and reporting.

a. Quarterly and Annual Status Reports. The VF/EA FMS organization must submit quarterly status reports covering activities and issues encountered during the reporting period. The fourth quarterly report must be an annual progress report covering activities and issues of the past full Agreement year as well as recommendations for the next Agreement year. All figures should be presented by month, regional office, county, waiver or state funded program, and in the aggregate; additional categories apply for some statistics and are listed individually. Quarterly status reports must include:

i. The number of Education and Outreach activities performed;ii. The number of referrals received, also presented by referral source;

iii. The number of individuals receiving VF/EA FMS during the reporting period. These figures must match the figures reported on service plan reports pulled from KDADS systems;

iv. The number of new individuals who received VF/EA FMS, also presented by service coordination provider. This number must match figures reported on service plan reports pulled from KDADS systems;

v. The number of individuals who stopped receiving VF/EA FMS from the VF/EA FMS organization. This number must also be presented by reason for termination;

vi. The number of individuals who previously stopped receiving VF/EA FMS from the VF/EA FMS organization, but then resumed services during the reporting period;

vii. The average number of staff resource hours per individual, also presented by county, service coordination agency and waiver or program;

viii. Explanation of any outliers or changes that are reflected in the numbers;ix. A description of issues identified by the VF/EA FMS organization which pose or

may pose unnecessary barriers to or delays in the provision of VF/EA FMS. These issues may be systemic or specific to the business processes within one region or county;

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x. Updates on all work plans that are active during the reporting period;xi. The fourth quarter (annual) report also must contain:

1. Identification of any trends in the provision of FMS and an explanation of how both best practices and lessons learned will be acted upon;

2. A summary of training opportunities offered to employees during the reporting period by the VF/EA FMS organization or third party training opportunities and the level of employee participation; and

b. Monthly Reports. The VF/EA must provide accurate and timely reports monthly to common law employers, MCOs, and KDADS. All figures should be presented by month, county, waiver or state funded program, and in the aggregate; additional categories apply for some elements and are listed individually.

i. Prepare and distribute monthly utilization reports to common law employers and MCOs as specified by KDADS;

ii. Report overuse of PCS worker hours to MCOs in accordance with the process developed by the VF/EA and the MCO. This is evidenced by KDADS review of process and sample documentation provided to the MCO and results of KDADS survey of the MCO entity;

iii. Inform the MCO of any common law employer who does not submit timesheets or invoices to the VF/EA for two or more consecutive payroll periods (one month or more) as evidenced by the VF/EA’s documentation and results of KDADS survey of MCO;

iv. Common law employers, MCOs, and KDADS are provided written notification of overutilization when utilization exceeds the monthly budget by 10% or more for two or more consecutive months. One letter is sent each month. This is evidenced by VF/EA documentation and KDADS review of sample of common law employer files;

v. Common law employers, MCOs, and KDADS are provided written notification of underutilization when utilization is 80% or less for two or more consecutive months. One letter is sent each month. This is evidenced by VF/EA documentation and KDADS review of sample of participant files;

vi. Monthly budget reports are distributed to Common Law employers and MCO within 5 business days after the second semi-monthly payroll period and must include;

1. Name of the consumer;2. Name and address of the common law employer;3. The activity period;4. The program;5. The procedure code for each service;6. Total authorized units and dollars of service by fiscal year;7. Utilization to date of authorized units and dollars of service;8. Remaining balance of authorized units and dollars of service;9. The SUTA rate;

10. Name, status, date of hire, and date qualified of each PCS worker;11. Pay type of each PCS worker;12. Payroll summary year-to-date for each PCS worker;13. The rate of pay of each PCS worker for each service rendered; and14. A legend that explains the procedure code, service name, and unit

description.

vii. The VF/EA provides Common Law employer, PCS worker or VF/EA related information, records, and statistics to KDADS within 10 business days of request;

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viii. The PCS worker s that are qualified to render services and the date of the last qualification determination;

ix. The consumers that have active authorizations for services;

x. Each PCS worker s hourly rate;xi. Common Law employer relationship to PCS worker report;xii. PCS workers that have worker for 16 hour or more in a single shift;xiii. Each common law employers SUTA rate;xiv. Each PCS worker that is tax exempt;xv. PCS workers that are employed by more than one common law employer and

have overlapping time submitted;xvi. Outstanding payments or reimbursements from Authenicare to any PCS

worker or vendor and the reason for the outstanding payment and the reason for not being reimbursed;

xvii. Requests for program exceptions based on established limits; andxviii. For KDADS only, the common law employers that have paid overtime, the

associated consumer, the amount of overtime paid, and the PCS worker that received the overtime payment.

c. Problem Identification Report. An “as required” report, identifying problem areas. The report should describe the problem and its impact on the overall project and on each affected task. It should list possible courses of action with advantages and disadvantages of each, and include Vendor recommendations with supporting rationale.

d. Final Report. The Vendor VF/EA FMS must submit draft copies of the final report prior to submission of the actual report. The final report will be due either at the end of the three year Agreement period, or at the end of any renewal year if a renewal option is exercised. The final report must include:

i. An abstract or summary of the VF/EA FMS activity during the Agreement period in terminology that will be meaningful to management and others generally familiar with the subject areas.

ii. A description of data collection and analysis and other techniques used during the Agreement period.

iii. A summary of findings, conclusions and recommendations for improving the VF/EA FMS activities.

iv. All supporting documentation; e.g., flow-charts, forms, questionnaires, etc.v. A time-phased work plan for implementing the recommendations.

e. Within six (6) months following the end of the initial Agreement term and every year thereafter, the Selected Vendor(s) shall submit to KDADS a Generally Accepted Accounting Principles (GAAP) audit. If, however, the Selected Vendor(s) is not on a calendar accounting year, the audit dates above shall be six (6) months following the end of the Provider’s respective fiscal year.

f. Audit upon Termination. In the event this Agreement is terminated, voluntarily or involuntarily, the Provider shall have a GAAP audit. Such audit shall be provided to KDADS within one hundred (120) calendar days following such termination. If the Provider believes additional time is required, the Provider shall request an extension from the Secretary. Such audit shall be at the Provider’s expense.

If, however, and for whatever reason, KDADS does not timely receive the audit, KDADS may audit the Provider and may charge the expense(s) for such audit to the Provider. If this provision is invoked, Provider agrees to timely reimburse KDADS for the expense(s) of such audit.

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4.4 GENERAL CONTRACT TERMS (NOT EXHAUSTIVE)

4.4.1 Term of the Contract:

The term of this contract shall be effective as of the date of the award and shall end on 06/30/2019. Upon mutual consent and the contractor successfully meeting all expected outcomes and deliverables there is an option to renew this Agreement for two (2) additional one (1) year periods. Notice of intent to exercise the option to renew for the period beginning July 1, 2019 shall be initiated by KDADS on or before April 30, 2019 and on or before April 20, 2020 for the period beginning July 1, 2020.

4.4.2 Cost and Payment:

The total cost and payment terms are to be agreed upon through the RFP negotiation process. Costs shall be based on an administrative fee assessed by the FMS contractor(s) per member served. It is KDADS’ business practice that prior to making payment, KDADS must receive and approve a monthly invoice.

4.4.3 State Responsibilities

KDADS shall monitor compliance and implementation by:

Reviewing for accuracy and completeness all required reports and other deliverables; Providing direction to the FMS contractor(s) regarding required functions under the agreement

between KDADS and the FMS contractor(s); Providing ongoing quality review/assurance and quarterly quality review of work required in this RFP

or as adjusted to comply with state and federal programs, as well as regulatory, or statutory changes; Providing technical assistance and tools, including required forms and reports, related to the FMS

contractor(s)’ functions; Assisting the FMS contractor(s) to achieve required functions through coordination with other state

agencies and follow through on all initiatives; and Assisting in the dispute and conflict resolution process among the various partner agencies involved

in the project.

4.4.4 Quality Assurance and Recoupment:

Should the FMS contractor(s) fail to comply with any deadline contracted herein, time being of the essence, the KDADS may recoup from the contractor(s)’ monthly administrative fee based on the alleged non-compliance. Recoupments will be calculated at a rate of $500.00 per occurrence of non-compliance.

4.4.5 Liquidated Damages

The purpose of liquidated damages is to ensure compliance with Contract requirements. No punitive intention is inherent. It is agreed by the State and the Contractor that, in the event of a failure to meet one of the Performance Requirements listed below, damage shall be sustained by the State, and that it is and shall be impractical and extremely difficult to ascertain and determine the actual damages that the State shall sustain in the event of, and by reason of, such failure; and it is therefore agreed that the Contractor shall pay the State for such failures at the sole discretion of the State according to the following subsections. The imposition of liquidated damages is strictly between the contracting parties, is governed only by the terms of their agreement, is not subject to any further review or appeal, and is not in lieu of any other remedy available to the State. The purpose of using liquidated damages in this way is to ensure that there are immediate course-correction remedies available to KDADS, to help the parties attend to the infrastructure of the substance abuse system involved in their contract, to ensure ongoing responsiveness of the contractor, and to ultimately support the success of an ongoing relationship between the parties. These provisions relate to core performance expectations that must be consistently addressed, and the measured use of liquidated damages will be a mechanism to support consistent performance.

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Damage assessments are linked to performance of system implementation or operational responsibilities. Where an assessment is defined as an "up to" amount, the dollar value shall be set at the discretion of KDADS.

Written notification of each failure to meet a Performance Requirement shall be given to the Contractor prior to assessing liquidated damages. The Contractor shall have five business days from the date of receipt of written notification of a failure to perform to specifications to cure the failure. Additional days can be approved by KDADS if deemed necessary. If the failure is not resolved within the cure period, liquidated damages may be imposed retroactively to the date of the failure to perform.

If the State elects not to impose a sanction in a particular instance, including Liquidated Damages, this decision shall not be construed as a waiver of the State's rights to pursue future assessment of damages associated with the Performance Requirement.

a. Network Performance RequirementContractor shall have a network in place, sufficient in size and composition to meet the service requirements of the RFP. The

required attestation of network sufficiency shall be submitted at that time of award.

DamagesOne hundred dollars ($100.00) shall be assessed, at KDADS’ discretion, per business day for each day that the network is not

adequate to meet the service needs of the covered populations.

b. Network Access RequirementContractor shall assure that Members access to the network.

DamagesOne thousand dollars ($1,000.00) per month shall be assessed, at KDADS’ discretion, for each standard that is not met at least 95 percent of the time for the preceding month.

c. Timely Reports and Data Delivery Performance RequirementThis Performance Requirement applies to all reports and data, including encounter data, to be delivered to KDADS or

designee as defined in the RFP or by KDADS. Reports and data shall be timely and produced in the format and media approved by KDADS.

Confidential data shall be provided in HIPAA required formats (see the 837 Institutional Claim and Encounter Transactions and the 837 Professional Services Claim and Encounter Transactions companion guides, and NCPDP.) These requirements can be found under Publications, HIPAA Companion Guides, on the website at https://www.kmap-state-ks.us/

DamagesOne hundred dollars ($100.00) shall be assessed for each business day, at KDADS’s discretion, that each report or data

delivery is late, includes less than the required copies, or is not in the approved format.

d. Accuracy of Reports and Data Performance RequirementThe Contractor shall be responsible for the accuracy of all reports, including calculations and completeness of data, including

encounter data, used as input.

DamagesIf the report is not corrected within five business days of the notice of failure to meet the reporting accuracy requirements, then

one hundred dollars ($100) per day shall be, at KDADS’s discretion, assessed for each report that has been

identified as inaccurate from the date of notification until the date the KDADS-approved corrected report is delivered.

e. Personnel Performance Requirement The Contractor shall meet all requirements specified in the Performance Requirement section of this RFP.

Damages

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One thousand dollars ($1,000.00) per day per position shall be assessed, at KDADS’s discretion, for each day after the thirty allowed calendar days for which a Key Position remains unfilled by a qualified person approved by KDADS. Key Positions include:

Chief Executive Officer of the Kansas Project; and Chief Financial Officer of the Kansas Project;

f. Timely Payroll Payment Performance RequirementOne hundred (100) percent of all payroll and related taxes and benefits, including adjustments, shall be processed and paid or

processed by the due date for each.

DamagesOne dollar ($1.00) per business day, at KDADS’s discretion, shall be assessed for each claim that is not processed within the

required time frame.

4.4.6 KDADS Ability to Modify, Correct, Supplement or Withdraw:

KDADS, in its sole discretion reserves the right to modify, correct, supplement or withdraw this RFP at any time prior to the execution of a contract agreement.

4.4.7 Exceptions:

The failure of the Department of Administration and/or the KDADS to agree to a bidder’s requested exception(s) is not an appealable event, and as such denial of an exemption request is within the sole discretion of the Department of Administration and the KDADS.

4.4.8 Miscellaneous Provisions

Readiness Review: Prior to being considered a fully functioning FMS provider, Selected Vendor(s) awarded a contract must be available for a readiness review as described previously in the RFP. Readiness reviews will include, but are not limited to: onsite visits, policy and procedure reviews, technology reviews and/or trainings.

4.4.9 Confidentiality .

In accordance with U. S. Department of Health & Human Services, Centers for Medicare and Medicaid Services Medicaid regulations, 42 C.F.R. 431.300 et seq., Contractor shall maintain the confidentiality of information about individuals learned in performing the duties required by this Agreement, including the individual’s name; address; telephone number; past or present receipt of any state or federal program services; family, social, or economic circumstances; medical data, including diagnoses and past history of disease, impairment, or disability; income and other financial information; State agency evaluation of personal or medical information; program eligibility; or third-party liability for payment for program services to any person or entity. Contractor shall not prepare and publish, or permit the preparation and publication of, any electronic or written report disclosing confidential information about any individual in a manner which permits the identification of that individual. Contractor shall not disclose or permit the disclosure of any confidential information about any individual without the prior informed consent of the individual or of the individual’s representative, unless the disclosure is required by court order, to enable the delivery of services for which the individual or the individual’s representative has requested or applied, for Medicaid program administration, or by this Agreement. Contractor shall comply with the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”). Contractor shall further develop and maintain policies and procedures, which protect the confidentiality of and guard against the unauthorized disclosure of confidential information about individuals obtained through the performance of this Agreement. Contractor's policies and procedures shall be binding on their employees, agents, and independent Contractors and describe the penalties and sanctions imposed for violations of those policies and procedures.

4.4.10 Health Insurance Portability and Accountability Act-Business Associates Agreement.

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KDADS and various state entities are parties to a Business Associates Agreement (“BA AGT”). On January 25, 2013, HHS promulgated new and final rules implementing the HI TECH Act effective on or about September 23, 2013. A copy of KDADS’ revised BA AGT addressing the new rules may be found at: http://www.kdads.ks.gov/provider-home/forms. Prior to any payment being issued, under the Agreement, and regardless of whether the Contractor was a party to an existing BA AGT, contractor shall complete the form, print, sign and mail the BA AGT to KDADS “Legal Division.” Thereafter, a fully executed document will then be forwarded electronically to the Contractor. In the event that Contractor receives protected health information, it shall comply with the terms of the BA AGT, as it presently exists or as modified/amended, as if the same were set forth in full herein. Notwithstanding such BA AGT, Contractor shall at all times comply with HIPAA and the HI TECH ACT, as amended.

Capacity for technology of the bidding organization to conduct standard operations will be considered during the RFP evaluation. Encryption software must be standard on all lap tops, smart phones, computers, and other equipment used to complete FMS functions and standard operations. Any hardware and/or software used by the FMS will not be provided by KDADS and shall be the sole responsibility of the FMS contractor(s). All bids must include the technology capacity of the contractor(s) that will be used to the meet goals and outcomes of the FMS. The Selected Vendor(s) shall strictly comply with applicable confidentiality and privacy laws and regulations, state or federal, and shall further comply with the provisions of the Health Insurance Portability and Accountability Act (HIPAA) and the Health Information Technology for Economic and Clinical Health Act (HITECH), all as amended, and all regulations implementing the same. The Selected Vendor (s), at the direction of the KDADS, sign a Business Associates Agreement ("BA Agreement"). The failure of the Selected Vendor (s) to timely execute a BA Agreement in the from presented by KDADS shall, at the option of the KDADS, be deemed a material breach of the Agreement.

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http://www.kdads.ks.gov/provider-home/forms

http://www.kdads.ks.gov/provider-home/forms


Glossary of Terms and Definitions:

Managed Care Organization (MCO) is the entity that is responsible for authorizing the services on the ISP.

Employer is, under common law rules, an individual or organization that has the right to direct and control how a person (engaged by an individual/organization) performs the services provided. This control refers not only to the result to be accomplished (outcome) by the work but also the means and details by which that result are accomplished, even if the employer gives the person he/she engages freedom of action.

Kansas Department for Aging and Disability Services (KDADS) is the State of Kansas’ department that administers a variety of home and community-based programs.

Personal Care Service Worker (PCS Worker) is an individual who meets the requirements as described in the waiver or program standards and is employed by the participant or his/her representative to provide assistance and support to the participant in accordance with the participant’s service plan.

Taxes are taxes imposed on employees and employers by the Federal Insurance Contribution Act (FICA), sections 3101 and 3111 of the Code, the tax imposed on employers by the Federal Unemployment Tax Act (FUTA), section 3301 of the Code and Federal income tax withholding, section 3402 of the Code.

under common law rules, anyone who performs services for a person or organization where the person/organization has the right to direct and control what will be done and how it will be done. This control refers not only to the result to be accomplished (outcome) by the work but also the means and details by which that result is accomplished, even if the person/organization gives the individual they engaged freedom of action.

Employer Authority is when participants exercise the full range of decision-making authority over their direct care workers and the full array of support is available to participants. Under the Employer Authority, the participant exercises choice and control over workers who furnish waiver services to which this authority applies (e.g., personal assistance, attendant services). The

principal defining characteristic of this authority is that the participant functions as the employer of workers. Functions included under Employer Authority include:

1. Verifying workers’ citizenship status;2. Collecting and processing PCS workers’ timesheets; and3. Processing payroll including the management of federal, state, and local employment-related taxes and

insurances.4. Executing and maintaining KanCare provider agreements, i.e. PCS Worker Agreements asauthorized under

a written agreement with KDADS; and5. Receiving and disbursing funds for the payment of participant-directed services under an agreement with

the Department.

Vendor Fiscal/ Employer Agent that is awarded the contract.

Management Services (FMS) provide payroll, invoice processing and payment, fiscal reporting services, employer orientation, and skills

training, and other fiscal-related services to s e l f - d i r e c t e d w a i v e r participants their representatives choosing to exercise employer authority. The FMS services provided reduce the employer-related burden for participants while making sure Medicaid funds are used to pay for services and supports as outlined in the participant’s Individual Service Plan are managed and disbursed appropriately as authorized. The Selected Vendor(s) must operate as a Vendor Fiscal/Employer Agent (F/EA), in accordance with §3504 of the IRS code and Revenue

respectively, as modified by IRS Proposed Notice 2003-70. The F/EA must have an FMS Policies and Procedures Manual, developed for the specific type of F/EA employed, that includes the policies, procedures and internal controls that describe the proper operation of the F/EA, that are in accordance with federal, state and local tax, labor, workers’

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compensation and State of Kansas and KDADS program rules and regulations. The FMS Policies and Procedures Manual shall include, but not be limited to the following sections:

Introduction Participant-Direction Qualified Selected Vendor(s) Requirements General FMS Duties Administrative Support for Participant-Direction Information, Referral, and Assistance for Particpant-Direction Billing and Claims Quality Assurance and Program Integrity Forms and Resources

Service Plan (ISP) is the plan that includes the assessed need for a good or service. The plan will include authorized services including the frequency and duration of the services.

person determined by the State of Kansas to be eligible and is receiving self-directed Medicaid home and community-based waiver services or state funded program services.

Month (PM/PM) is a payment method established through the RFP negotiation that reimburses a VF/EA FMS for services rendered based on a flat rate of payment for each participant it serves as employer agent each month it provides services and processes claims for PCS workers payments for each participant.

is a family member, friend or other person who is close to and chosen by the participant who shares the authority, with the participant, for managing the participant’s services and supports and the direct care workers who provide them. This authority must reflect the desires and preferences of the participant and may include being the common law employer of the participants’ direct care workers when appropriate. A participant’s representative cannot also be his/her direct care worker but may be the employer of a participant’s direct care worker(s) when appropriate.

a service model where participants have the right to exercise decision making authority over some or all of the services they need to live in their community and accept the responsibility for taking a direct role in managing these services. It is an alternative to provider management of services and promotes personal choice and control over their services and how they are delivered. Some self-directing program participants share authority with or delegate authority to a representative (i.e., a family member, friend or other person close to the participant). The designation of a representative enables adults with cognitive impairments to participate in self-direction programs.

Fiscal/Employer Agent (VF/EA) is a vendor entity that applies for and receives approval from the Internal Revenue Service (IRS) to be an employer agent, in accordance with §3504 of the IRS code, Revenue Procedure 70-6, 1970-1 C.B. 420, as modified by Proposed Notice 2003-70, on behalf of participants/representatives/surrogates performing all that is required of an employer for wages paid on their behalf and all that is required of the payer for the requirements of back-up withholding, as applicable. The VF/EA FMS performs other fiscal and reporting tasks as required by OLTL/ODP and as described in this RFA.

all 1915c Home and Community based waivers that allow for participant directed services. For Kansas these include the following waiver programs: Autism, Frail Elderly, Intellectual/Developmentally Disabled, Physical Disability, Serious Emotional Disturbance, Technology Assisted, and Traumatic Brain Injury.

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5. COST SHEET

Please see excel spreadsheet attached as Exhibit 1 – Cost Sheet. Please type directly into the document and return with your bid response.

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6. Contractual Provisions Attachment DA-146a Rev. 06/12

6.1. Terms Herein Controlling Provisions It is expressly agreed that the terms of each and every provision in this attachment shall prevail and control over the terms of any other conflicting provision in any other document relating to and a part of the contract in which this attachment is incorporated. Any terms that conflict or could be interpreted to conflict with this attachment are nullified.

6.2. Kansas Law and Venue This contract shall be subject to, governed by, and construed according to the laws of the State of Kansas, and jurisdiction and venue of any suit in connection with this contract shall reside only in courts located in the State of Kansas.

6.3. Termination Due To Lack Of Funding Appropriation If, in the judgment of the Director of Accounts and Reports, Department of Administration, sufficient funds are not appropriated to continue the function performed in this agreement and for the payment of the charges hereunder, State may terminate this agreement at the end of its current fiscal year. State agrees to give written notice of termination to contractor at least 30 days prior to the end of its current fiscal year, and shall give such notice for a greater period prior to the end of such fiscal year as may be provided in this contract, except that such notice shall not be required prior to 90 days before the end of such fiscal year. Contractor shall have the right, at the end of such fiscal year, to take possession of any equipment provided State under the contract. State will pay to the contractor all regular contractual payments incurred through the end of such fiscal year, plus contractual charges incidental to the return of any such equipment. Upon termination of the agreement by State, title to any such equipment shall revert to contractor at the end of the State's current fiscal year. The termination of the contract pursuant to this paragraph shall not cause any penalty to be charged to the agency or the contractor.

6.4. Disclaimer Of Liability No provision of this contract will be given effect that attempts to require the State of Kansas or its agencies to defend, hold harmless, or indemnify any contractor or third party for any acts or omissions. The liability of the State of Kansas is defined under the Kansas Tort Claims Act (K.S.A. 75-6101 et seq.).

6.5. Anti-Discrimination Clause The contractor agrees: (a) to comply with the Kansas Act Against Discrimination (K.S.A. 44-1001 et seq.) and the Kansas Age Discrimination in Employment Act (K.S.A. 44-1111 et seq.) and the applicable provisions of the Americans With Disabilities Act (42 U.S.C. 12101 et seq.) (ADA) and to not discriminate against any person because of race, religion, color, sex, disability, national origin or ancestry, or age in the admission or access to, or treatment or employment in, its programs or activities; (b) to include in all solicitations or advertisements for employees, the phrase ""equal opportunity employer""; (c) to comply with the reporting requirements set out at K.S.A. 44-1031 and K.S.A. 44-1116; (d) to include those provisions in every subcontract or purchase order so that they are binding upon such subcontractor or vendor; (e) that a failure to comply with the reporting requirements of (c) above or if the contractor is found guilty of any violation of such acts by the Kansas Human Rights Commission, such violation shall constitute a breach of contract and the contract may be cancelled, terminated or suspended, in whole or in part, by the contracting state agency or the Kansas Department of Administration; (f) if it is determined that the contractor has violated applicable provisions of ADA, such violation shall constitute a breach of contract and the contract may be cancelled, terminated or suspended, in whole or in part, by the contracting state agency or the Kansas Department of Administration.

Contractor agrees to comply with all applicable state and federal anti-discrimination laws.

The provisions of this paragraph number 5 (with the exception of those provisions relating to the ADA) are not applicable to a contractor who employs fewer than four employees during the term of such contract or whose contracts with the contracting State agency cumulatively total $5,000 or less during the fiscal year of such agency.

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6.6. Acceptance Of Contract This contract shall not be considered accepted, approved or otherwise effective until the statutorily required approvals and certifications have been given.

6.7. Arbitration, Damages, Warranties Notwithstanding any language to the contrary, no interpretation of this contract shall find that the State or its agencies have agreed to binding arbitration, or the payment of damages or penalties. Further, the State of Kansas and its agencies do not agree to pay attorney fees, costs, or late payment charges beyond those available under the Kansas Prompt Payment Act (K.S.A. 75-6403), and no provision will be given effect that attempts to exclude, modify, disclaim or otherwise attempt to limit any damages available to the State of Kansas or its agencies at law, including but not limited to the implied warranties of merchantability and fitness for a particular purpose.

6.8. Representative's Authority To Contract By signing this contract, the representative of the contractor thereby represents that such person is duly authorized by the contractor to execute this contract on behalf of the contractor and that the contractor agrees to be bound by the provisions thereof.

6.9. Responsibility For Taxes The State of Kansas and its agencies shall not be responsible for, nor indemnify a contractor for, any federal, state or local taxes which may be imposed or levied upon the subject matter of this contract.

6.10. Insurance The State of Kansas and its agencies shall not be required to purchase any insurance against loss or damage to property or any other subject matter relating to this contract, nor shall this contract require them to establish a "self-insurance" fund to protect against any such loss or damage. Subject to the provisions of the Kansas Tort Claims Act (K.S.A. 75-6101 et seq.), the contractor shall bear the risk of any loss or damage to any property in which the contractor holds title.

6.11. Information No provision of this contract shall be construed as limiting the Legislative Division of Post Audit from having access to information pursuant to K.S.A. 46-1101 et seq.

6.12. The Eleventh Amendment "The Eleventh Amendment is an inherent and incumbent protection with the State of Kansas and need not be reserved, but prudence requires the State to reiterate that nothing related to this contract shall be deemed a waiver of the Eleventh Amendment."

6.13. Campaign Contributions / Lobbying Funds provided through a grant award or contract shall not be given or received in exchange for the making of a campaign contribution. No part of the funds provided through this contract shall be used to influence or attempt to influence an officer or employee of any State of Kansas agency or a member of the Legislature regarding any pending legislation or the awarding, extension, continuation, renewal, amendment or modification of any government contract, grant, loan, or cooperative agreement.

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