€¦ · web viewamong this number, an estimated 2,900 are eligible for supplemental security...

**IMPORTANT NOTICE**

The format of this RFP has been simplified. Only the following pages require signatures:

1. Exhibit A – Bid Response Packet, Bidder Information and Acceptance pagea. Must be signed by Bidder

2. Exhibit A – Bid Response Packet, SLEB Partnering Information Sheeta. Must be signed by Bidder b. Must be signed by SLEB Partner if subcontracting

to a SLEB

Please read EXHIBIT A – Bid Response Packet carefully, INCOMPLETE BIDS WILL BE REJECTED. Alameda County will not accept submissions or documentation after the bid response due date.

ALAMEDA COUNTY I.HEALTH CARE SERVICES 1000 San Leandro Boulevard, Suite 300

San Leandro, CA 94577AGENCY Tel: (510) 618-3452

ALEX BRISCOE, Director Fax: (510) 351-1367

COUNTY OF ALAMEDAREQUEST FOR PROPOSAL No. 900386

forTRUST CLINIC: INTEGRATED PRIMARY CARE & BEHAVIORAL HEALTH SERVICES

NETWORKING/BIDDERS CONFERENCESat

Bidders Conference #1 10 am

January 7, 2014 at

1100 San Leandro Blvd, Red RoomSan Leandro, CA 94577

Bidders Conference #2 2 pm

January 8, 2014 at

1000 Broadway, Room 5000AOakland, CA 94607

Additional Information: Free parking is available at the San Leandro Bidders Conference. Please allow enough time for parking at metered street parking or public parking lot and entry into secure building at the Oakland

Bidders Conference.

For complete information regarding this project, see RFP posted at http://www.acgov.org/gsa_app/gsa/purchasing/bid_content/contractopportunities.jsp or

contact the County representative listed below. Thank you for your interest!Contact Person: Kristel AcacioPhone Number: (510) 618-1910E-mail Address: [email protected]

RESPONSE DUEby

2:00 pmon

February 19, 2014at

Alameda County, Health Care Services Agency1000 San Leandro Blvd., Suite 300

San Leandro, CA 94577Alameda County is committed to reducing environmental impacts across our entire supply chain.

http://www.acgov.org/gsa_app/gsa/purchasing/bid_content/contractopportunities.jsp

If printing this document, please print only what you need, print double-sided, and use recycled-content paper.

COUNTY OF ALAMEDAREQUEST FOR PROPOSAL No. 900386

SPECIFICATIONS, TERMS & CONDITIONSfor

TRUST CLINIC INTEGRATED PRIMARY CARE & BEHAVIORAL HEALTH SERVICES

TABLE OF CONTENTSPage

I. STATEMENT OF WORK 4A. INTENT...............................................................................................................................4B. BACKGROUND....................................................................................................................5C. SCOPE................................................................................................................................. 6D. BIDDER QUALIFICATIONS...................................................................................................9E. SPECIFIC REQUIREMENTS.................................................................................................10F. DELIVERABLES / REPORTS................................................................................................10

II. CALENDAR OF EVENTS 11G. NETWORKING / BIDDERS CONFERENCES.........................................................................11

III. COUNTY PROCEDURES, TERMS, AND CONDITIONS 12H. EVALUATION CRITERIA / SELECTION COMMITTEE...........................................................12I. CONTRACT EVALUATION AND ASSESSMENT....................................................................18J. NOTICE OF RECOMMENDATION TO AWARD...................................................................18K. TERM / TERMINATION / RENEWAL..................................................................................19L. AWARD.............................................................................................................................19M. BID PROCESS AND APPEALS.............................................................................................21N. INVOICING........................................................................................................................23O. ACCOUNT MANAGER / SUPPORT STAFF..........................................................................23

IV. INSTRUCTIONS TO BIDDERS 24P. COUNTY CONTACTS..........................................................................................................24Q. SUBMITTAL OF BIDS.........................................................................................................24R. RESPONSE FORMAT..........................................................................................................27

ATTACHMENTS

EXHIBIT A - BID RESPONSE PACKETEXHIBIT B - INSURANCE REQUIREMENTSEXHIBIT C - MINIMUM INSURANCE REQUIREMENTSEXHIBIT D - SAMPLE SUMMARY LETTERS DOCUMENTING DISABILITYEXHIBIT E - TRUST CLINIC CONSTRUCTION PLAN AND FIRST FLOOREXHIBIT F - TRUST CLINIC DATA REPORTEXHIBIT G - SAMHSA STANDARDS OF INTEGRATION

Specifications, Terms & Conditionsfor TRUST Clinic Integrated Primary Care and Behavioral Health Services

I. STATEMENT OF WORK

A. INTENT

It is the intent of these specifications, terms and conditions to describe the integrated primary care and behavioral health services being requested by the Alameda County Health Care Services Agency (hereafter, HCSA or the County). Specifically, HCSA seeks to award a contract to a qualified state licensed or exempt community clinic in Alameda County to establish and operate a financially sustainable and integrated primary care/behavioral health home clinic for publicly insured individuals with disabling health conditions, histories of homelessness, and participation in the County General Assistance Program.

The County is in the process of constructing a health and human services center for this target population in downtown Oakland, known as the TRUST Clinic. The name reflects the importance of trust-building among staff and clients and the concept of a revolving SSI trust account rather than an acronym. The TRUST Clinic is located at the corner of 14th and Franklin Streets and is anticipated to open in early 2014. The primary care and behavioral health home clinic operated by the selected awarded bidder will be located within the new TRUST Clinic site and will be integrated into a variety of service offerings available at the new facility. The space available for the primary care and behavioral health home clinic is approximately 5,112 sq ft, including six exam rooms, four counseling offices, a triage area, laboratory, multiple workstations, dispensary, and a room for group activities.

This project will be funded through multiple county funding sources, including local Mental Health Services Act funds (also known as MHSA or Proposition 63). To date, Alameda County has funded the site development and furniture for the entire facility. Schematic floor plans including wiring and cabling detail are included as an Exhibit to this RFP (see Exhibit E). A list of furnishings and photographs for this site are available to bidders upon request. Site visits may also be available depending on scheduled completion dates for construction at the site.

The County intends to award a three (3)-year Master Contract (with option to renew) to the bidder(s) selected as the most qualified bidder(s) whose response best conforms to the RFP and meets the County’s requirements. The terms and conditions of this RFP will become integral parts of the Master Contract. Bidders may request up to $2,700,000 in County funding over the three (3)-year term to fulfill the County’s requirements.

The actual amount of award will be determined by the development of the service delivery model and financing plan that will be negotiated and finalized by the County, in conjunction with the selected awarded bidder, during the contract period. Renewal of

RFP No. 900386Page 4


contract with the selected awarded bidder is contingent upon meeting performance measures and contract deliverables, as set forth by the County and subject to periodic review, and upon the availability of funding. HCSA may award the contract to a single or multiple vendors.

The County reserves the right to reject any or all offers and discontinue this RFP process without obligation or liability to any actual or potential bidder. Bidders may utilize a subcontractor to implement portions of the contract provided that the bidder has clearly articulated its leadership role and role(s) of the subcontractor.

It is the County’s intent to increase participation of certified small, local, and emerging businesses (SLEB). In order to participate herein, a business must satisfy the locality requirements and be certified by the County as a small local or emerging local business. Community-based organizations with a 501(c)(3) status serving Alameda County residents directly are exempt from the SLEB requirement.

B. BACKGROUND

HCSA is the Alameda County health authority that consists of four departments: Behavioral Health Care Services (BHCS), Public Health Department (PHD), Environmental Health Department (EHD) and Administration/Indigent Health Services (A/IHS). HCSA’s ultimate mission is to provide fully integrated health care services to Alameda County residents.

To better serve its mission, HCSA has adopted new policy strategies for administering its service delivery platform. One such approach is the practice of “convergence” or deliberate cross-departmental/cross-agency/CBO collaboration and coordination in the provision of services to Alameda County residents. The end goal of convergence is to produce better population outcomes by increasing access to an array of needed quality and non-cost prohibitive health care services to vulnerable clients, in this case, individuals awaiting federal disability determination and/or individuals with histories of homelessness. The TRUST Clinic is a center which will embody the practice of convergence and go beyond the provision of primary and behavioral health care services to include assistance with housing and other public benefits.

The mission of the TRUST Clinic is to improve the lives of clients by providing high-value care that addresses clients’ physical, mental, and social well-being in one location. This collaboration between multiple government agencies and non-profit organizations will promote dignity, respect, and compassion in all interactions among staff and clients. Participating organizations will collaborate closely to support clients to find and



maintain stable homes, to promote their overall health and well-being, and to develop or re-establish strong social support networks outside of the public services system.

According to a report released by the Economic Roundtable, an average of 8,000 individuals receive General Assistance in Alameda County in any given month. Among this number, an estimated 2,900 are eligible for Supplemental Security Income (SSI) but are not receiving it. These individuals face challenges in applying for Social Security benefits and obtaining the health assessments necessary to document their eligibility for the program. Due to their low incomes and lack of health insurance, many are often homeless or unstably housed, have poor health status and limited access to health care services. The health care services they do receive are often in emergency situations and involve acute care. This is because these individuals do not have a regular source of outpatient care that could reduce their need for higher cost, crisis-oriented services.

Alameda County can improve the health and well-being of an extremely low-income population by offering cost-effective, integrated healthcare and social services. The County can also help ensure that General Assistance recipients and homeless individuals obtain and maintain eligibility for federal cash assistance as well as federally-matched health insurance coverage.

For this project, Alameda County has prioritized the use of MHSA funding to increase care integration, to address homelessness and housing crises, and to provide assistance to individuals with serious behavioral health issues and who have been historically excluded from accessing services. Passed by California’s voters in November 2004, MHSA provides dedicated funding for services and programs that promote wellness, recovery, and resiliency for adults (including older adults) with severe mental illness, as well as for children and youth with serious emotional disturbances and their family members. MHSA will provide some grant funding to support the start-up costs and ongoing enhanced services at this new community clinic site.

C. SCOPE

1. Program Description

The selected awarded bidder will provide ongoing, integrated primary care and behavioral health services within the TRUST Clinic--Primary Care Program. The population served will include 1500 clients (at any given time) with no health insurance, HealthPAC, Medi-Cal, or Medicare/Medi-Cal health coverage, with an emphasis on serving those with Medi-Cal expansion coverage. In addition, members of the target population will fall into one or more of the following groups: 1) General Assistance recipients applying for federal disability benefits through the Social Security



Administration; 2) Clients with long or repeated histories of homelessness and disabling health conditions; and 3) clients with histories of serious mental health issues and unstable housing. Current data on a sample of this population demonstrate high behavioral health needs including 58% with post-traumatic stress disorder, more than 50% with substance use disorders, 90% with more than one behavioral health diagnosis, more than 90% ultimately eligible for SSI primarily on the basis of a mental health diagnosis, and nearly all meeting the Health Resources and Services Administration definition of homelessness (Exhibit F—TRUST Clinic Data Report).

Care within the TRUST Clinic—Primary Care Program will “fully integrate” behavioral health and primary care services according to Substance Abuse and Mental Health Services Administration (SAMHSA) standards (see Exhibit G). Integration will include a single health record, a single treatment plan, close communication, and joint decision-making among behavioral health and primary care clinicians. The behavioral health services in the Primary Care Program will focus on providing behavioral health services consistent with those required by the Medi-Cal managed care plans effective January 1, 2014 (http://www.dhcs.ca.gov/Pages/Medi-CalExpansionInformation.aspx). The Primary Care Program will serve patients with a range of behavioral health needs including those with mild to moderate conditions, those with more moderate to severe conditions that choose to receive care from their primary care provider, and individuals that currently receive or have received specialty behavioral health services.

Immediately adjacent to the TRUST Clinic—Primary Care Program, HCSA will operate the TRUST Clinic--Specialty Mental Health Program, a specialty behavioral health program serving 200-250 clients at any given time, most of whom will also receive primary care from the selected awarded bidder. The TRUST Clinic—Special Mental Health Program will perform assessment and documentation of mental health disabilities, and specialty mental health services for TRUST Clinic clients with the most complex behavioral health needs, that are eligible for specialty mental health services. The Specialty Mental Health Program will also provide case management that includes housing navigation and care coordination to assist clients in establishing permanent housing with appropriate linkages and supports to enable them to maintain their housing and health.

The TRUST Clinic—Primary Care Program and Specialty Mental Health Program will be “Partly Integrated” according to SAMHSA standards (Exhibit G). The programs will collaborate in the care of the most complex clients through enhanced communication protocols, including shared access to patient records, secure and streamlined electronic messaging, and weekly multidisciplinary treatment planning conferences.

The TRUST Clinic--Specialty Mental Health Program will provide additional limited services to TRUST Clinic clients served by either or both programs. One HCSA staff will


http://www.dhcs.ca.gov/Pages/Medi-CalExpansionInformation.aspx


be onsite to help clients obtain and maintain health insurance coverage and other public benefits. HCSA will provide “Officer of the Day” services, assisting TRUST Clinic providers in both programs to assess and resolve urgent psychosocial needs, in addition to performing other case management duties.

The TRUST Clinic—Primary Care Program will collaborate with additional County-contracted and County-operated services located both on- and off-site. Homeless Action Center, a non-profit legal advocacy organization with a County contract for services, will be available on-site to help clients obtain public benefits for which they are eligible. Benefits advocacy for TRUST Clinic clients will also be provided by organizations located off-site including the SSI unit of the Alameda County Social Services Agency, and organizations such as Bay Area Legal Aid, the Mental Health Advocates Program of the Mental Health Association of Alameda County, and Building Opportunities for Self Sufficiency (BOSS). Other case management and specialty mental health programs located off-site may provide referrals to the TRUST Clinic—Primary Care Program as well as varying degrees of ongoing case management and housing navigation services to TRUST Clinic—Primary Care Program clients.

While the Specialty Mental Health Program and the Primary Care Program will continue to be governed by separate entities, a joint TRUST Clinic management team will be charged with ensuring effective collaboration in service of all TRUST Clinic clients. The team will include managers from both the Primary Care Program and the Specialty Mental Health Program. The selected awarded bidder will participate in the process of developing the structure, composition, and work-plan for the joint management team.

2. Objectives

The overall objectives of the health and human services center and the selected awarded bidder are to:

1. Improve access to health care and promote the health and well-being of the target population.

2. Provide integrated primary care and behavioral health services for the target population.

3. Assess and document disability for the target population.4. Reduce utilization of emergency, inpatient, and crisis health care services.5. Establish partnerships and collaborations with other social service organizations. 6. Develop and disseminate innovations in the care of homeless and disabled

clients.7. Develop financially sustainable, high-quality operations.



D. BIDDER QUALIFICATIONS

1. Bidder Minimum Qualifications

To be eligible to participate in this RFP, Bidder must be a community clinic licensed by the State of California (or exempt from licensure requirements) and must successfully demonstrate in their proposal how they meet the following Bidder Minimum Qualifications:

a. Bidder shall be regularly and continuously engaged in the business of providing primary care services for at least five (5) years and integrated primary care and behavioral health services for a minimum of two (2) years.

b. Bidder shall be a licensed or exempt community clinic based in Alameda County with capacity and willingness to establish and operate a collaborative clinic in downtown Oakland by June 1, 2014.

c. Bidder shall have demonstrated capacity to bill for medical and behavioral health services with multiple payors.

d. Bidder shall have existing contracts with Alameda Alliance for Health and Anthem Blue Cross Medi-Cal Managed Care plans, and the capacity and willingness to add this site to the scope of services covered under these contracts.

e. Bidder shall possess all permits, licenses and professional credentials necessary to perform services as specified under this RFP.

Proposals that exceed County funding amounts or are unreasonable and/or unrealistic in terms of budget, as solely determined by the County, shall be disqualified from moving forward in the evaluation process.

Bidders are eligible to participate in the RFP process if they meet the Bidder Minimum Qualifications. HCSA will disqualify proposals that do not demonstrate that Bidder meets the specified Bidder Minimum Qualifications, and these disqualified proposals will not be evaluated by the County Selection Committee (CSC)/Evaluation Panel and will not be eligible for contract award under this RFP.



E. SPECIFIC REQUIREMENTS

The selected awarded bidder(s) shall meet the abovementioned minimum qualifications but also be willing to perform the following activities during the contract term:

1. Contractor shall have specialty care networks with which to connect clients in the Oakland, California area.

2. Contractor shall establish and implement contracts (either new or existing) with pharmacies in Oakland that have experience working with disabled and homeless clients.

3. Contractor shall establish and implement lab contracts (either new or existing) and specimen pick-up in downtown Oakland.

4. Contractor shall have a mechanism (e.g. a volunteer credentialing program) for allowing one or more external health care providers, including physicians and behavioral health professionals employed by the County, to work in the new clinic.

5. Contractor shall implement an electronic health record for this site, including laboratory and pharmacy interfaces.

6. Contractor shall work, coordinate, and collaborate with service providers and other stakeholders at the request of HCSA and TRUST Clinic staff to design and/or implement clinical services and operations.

7. Contractor shall participate in negotiating additional items as well as amending details of the original, selected proposal for the Master Contract. Negotiated items may include but are not limited to program deliverables, financing, and space sharing agreements.

8. Contractor shall participate in designing the structure, composition, and work-plan for the TRUST Clinic management team.

F. DELIVERABLES / REPORTS

2. Contractor shall comply with any reporting and evaluation standards and agreements as set forth by HCSA and TRUST Clinic staff (see Exhibit A of the RFP- Bid Response Required Documentation and Submittals Item 10 below for details on Deliverables and Reports). In addition, methodology for reporting



performance standards may also include a Results Based Accountability (RBA)1 model. If required, County will provide technical training and support to the contractor.

II. CALENDAR OF EVENTS

EVENT DATE/LOCATIONRequest Issued December 16, 2013Written Questions Due by 5:00 p.m. on January 8, 2014Networking/Bidders Conference #1*Attendance at one of the bidders conferences is mandatory

January 7, 2014 @ 10 a.m. at: 1100 San Leandro Blvd, Red Room

San Leandro, CA 94577

Networking/Bidders Conference #2*Attendance at one of the bidders conferences is mandatory

January 8, 2014 @ 2 p.m. at: 1000 Broadway, Room 5000A

Oakland, CA 94607

Addendum Issued January 29, 2014Response Due February 19, 2014 by 2:00 p.m. Evaluation Period February 20-March 19, 2014Vendor Interviews March 10-14, 2014Board Letter Recommending Award Issued

May 13, 2014

Board Consideration Award Date

May 27, 2014

Contract Start Date June 1, 2014

Note: Award and start dates are approximate.

A. NETWORKING / BIDDERS CONFERENCES

Networking/bidders conferences will be held to:

1 The idea behind use of RBA methodology is to develop alongside the contractor, specified performance measures for improvement of the service program. For more information on Results Based Accountability, see Trying Hard is Not Good Enough: How to Produce Measurable Improvements for Customers and Communities by Mark Friedman (Trafford 205).



3. Provide an opportunity for bidders to ask specific questions about the project and request RFP clarification.

4. Provide the County with an opportunity to receive feedback regarding the project and RFP.

All questions will be addressed, and the list of attendees will be included, in an RFP Addendum following the networking/bidders conference(s).

Attendance at one of the scheduled networking/bidders conferences is mandatory to submit a bid response to this RFP. By attending one of the networking/bidders conference(s) potential bidders will have the opportunity to further facilitate subcontracting relationships. Vendors who attend a networking/bidders conference will be added to the Vendor Bid List.

III. COUNTY PROCEDURES, TERMS, AND CONDITIONS

A. EVALUATION CRITERIA / SELECTION COMMITTEE

All proposals that pass the initial Evaluation Criteria which are determined on a pass/fail basis (Completeness of Response, Financial Stability, and Debarment and Suspension) will be evaluated by a County Selection Committee (CSC). The County Selection Committee may be composed of County staff and other parties that may have expertise or experience in integrated primary and behavioral health care and related services. The CSC will score and recommend a Contractor in accordance with the evaluation criteria set forth in this RFP. Other than the initial pass/fail Evaluation Criteria, the evaluation of the proposals shall be within the sole judgment and discretion of the CSC.

All contact during the evaluation phase shall be through Kristel Acacio, Program Specialist, only. Bidders shall neither contact nor lobby evaluators during the evaluation process. Attempts by Bidder to contact and/or influence members of the CSC may result in disqualification of Bidder.

The CSC will evaluate each proposal meeting the qualification requirements set forth in this RFP. Bidders should bear in mind that any proposal that is unrealistic in terms of the technical or schedule commitments, or unrealistically high or low in cost, will be deemed reflective of an inherent lack of technical competence or indicative of a failure to comprehend the complexity and risk of the County’s requirements as set forth in this RFP.

Bidders are advised that in the evaluation of cost it will be assumed that the unit price quoted is correct in the case of a discrepancy between the unit price and an extension.



As a result of this RFP, the County intends to award a contract to the responsible bidder(s) whose response conforms to the RFP and whose bid presents the greatest value to the County, all evaluation criteria considered. The combined weight of the evaluation criteria is greater in importance than cost in determining the greatest value to the County. The goal is to award a contract to the bidder(s) that proposes the County the best quality as determined by the combined weight of the evaluation criteria. The County may award a contract of higher qualitative competence over the lowest priced response.

The basic information that each section should contain is specified below, these specifications should be considered as minimum requirements. Much of the material needed to present a comprehensive proposal can be placed into one of the sections listed. However, other criteria may be added to further support the evaluation process whenever such additional criteria are deemed appropriate in considering the nature of the goods and/or services being solicited.

Each of the Evaluation Criteria below will be used in ranking and determining the quality of bidders’ proposals. Proposals will be evaluated according to each Evaluation Criteria, and scored on the zero to five-point scale outlined below. The scores for all Evaluation Criteria will then be added, according to their assigned weight (below), to arrive at a weighted score for each proposal. A proposal with a high weighted total will be deemed of higher quality than a proposal with a lesser-weighted total. The final maximum score for any project is five hundred fifty (550) points, including the possible fifty (50) points for local and small, local and emerging, or local preference points (maximum 10% of final score).

The evaluation process may include a two-stage approach including an initial evaluation of the written proposal and preliminary scoring to develop a short list of bidders that will continue to the final stage of oral presentation and interview and reference checks. The preliminary scoring will be based on the total points, excluding points allocated to references, oral presentation and interview.

If the two-stage approach is used, the three (3) bidders receiving the highest preliminary scores and with at least 200 points will be invited to an oral presentation and interview. Only the bidders meeting the short list criteria will proceed to the next stage. All other bidders will be deemed eliminated from the process. All bidders will be notified of the short list participants; however, the preliminary scores at that time will not be communicated to bidders.

The zero to five-point scale range is defined as follows:

0 Not Acceptable Non-responsive, fails to meet RFP specification. The approach



has no probability of success. If a mandatory requirement this score will result in disqualification of proposal.

1 PoorBelow average, falls short of expectations, is substandard to that which is the average or expected norm, has a low probability of success in achieving objectives per RFP.

2 Fair Has a reasonable probability of success, however, some objectives may not be met.

3 Average

Acceptable, achieves all objectives in a reasonable fashion per RFP specification. This will be the baseline score for each item with adjustments based on interpretation of proposal by Evaluation Committee members.

4 Above Average / Good

Very good probability of success, better than that which is average or expected as the norm. Achieves all objectives per RFP requirements and expectations.

5 Excellent / Exceptional

Exceeds expectations, very innovative, clearly superior to that which is average or expected as the norm. Excellent probability of success and in achieving all objectives and meeting RFP specification.

The Evaluation Criteria and their respective weights are as follows:

Evaluation Criteria WeightA. Completeness of Response:

Responses to this RFP must be complete. Responses that do not include the proposal content requirements identified within this RFP and subsequent Addenda and do not address each of the items listed below will be considered incomplete, be rated a Fail in the Evaluation Criteria and will receive no further consideration.

Responses that are rated a Fail and are not considered may be picked up at the delivery location within 14 calendar days of contract award and/or the completion of the competitive process.

Pass/Fail

B. Financial Stability (See Exhibit A – Bid Response Packet)Bidder’s Dunn and Bradstreet Supplier Qualifier Report must be ranked a six or lower for HCSA to consider Bidder for contract award.

Pass/Fail

C. Debarment and Suspension: Pass/Fail



Bidders, its principal and named subcontractors are not identified on the list of Federally debarred, suspended or other excluded parties located at www.sam.gov.

D. Cost:The points for Cost will be computed by dividing the amount of the lowest responsive bid received by each bidder’s total proposed cost.

While not reflected in the Cost evaluation points, an evaluation may also be made of:1. Reasonableness (i.e., does the proposed pricing accurately

reflect the bidder’s effort to meet requirements and objectives?);

2. Realism (i.e., is the proposed cost appropriate to the nature of the products and services to be provided?); and

3. Affordability (i.e., the ability of the County to finance the services).

Consideration of price in terms of overall affordability may be controlling in circumstances where two or more proposals are otherwise adjudged to be equal, or when a superior proposal is at a price that the County cannot afford.

15 Points

E. Service Description:Proposals will be evaluated against the RFP specifications for each area and the questions below:1. Project Overview - How well does the proposed project fit

into Bidder’s organizational structure? How explicit is Bidder regarding providing culturally responsive services?

2. Target Population –How specific is the program design to the target population/ demographics described in the RFP?

3. Proposed Services – How well does the proposed plan address the following objectives: a) Improve access to health care and promote the health

and well-being of the target population. b) Provide integrated primary care & behavioral health

services for the target population.c) Assess and document disability for the target

population.d) Reduce utilization of emergency, inpatient, and crisis

health care services. e) Establish partnerships and collaborations with other

20Points


http://www.sam.gov/


social service organizations. f) Develop and disseminate innovations in the care of

homeless and disabled clients. 4. Staffing Plan -- How thoughtful and well-matched to the

RFP requirements is Bidder’s staffing plan? Are résumés complete and do they demonstrate backgrounds that would be desirable for individuals engaged in the work the project requires? Is there sufficient oversight to ensure success?

F. Relevant Experience: Proposals will be evaluated against the RFP specifications as listed below:1. Does bidder have comparable experience working on start-up projects where sustainability-level operations were reached? 2. How well does Bidder’s experience providing integrated primary care and behavioral health services support the objectives of the RFP? a) Does experience include co-location of services?b) Does experience include shared electronic health records containing both primary care and behavioral health information? c) Does experience include team meetings or regular communication about shared patients between primary care and behavioral health professionals? d) Does experience include treatment plans that include behavioral health and primary care issues being managed collaboratively between providers? e) Does experience include improving housing outcomes through supportive services and/or collaboration?

20Points

G. Implementation Schedule, and Sustainability Plan: Proposals will be evaluated based on the likelihood that Bidder’s implementation schedule and sustainability plan will meet the County’s requirements, and against the questions below:1. How thorough, thoughtful, and realistic is Bidder’s plan?2. How thorough, thoughtful, and realistic is Bidder’s

identification of challenges and barrier mitigation strategies?

3. How creative and solution-oriented are Bidder’s

20Points



strategies? 4. How well-matched is Bidder’s budget to the proposed

program?5. How well does the Bidder allocate staff and resources?6. How much value does the proposal add in considering the

cost of the program & proposed expected outcomes & the number served?

7. Is there a plan to leverage current resources?8. How well does the Bidder demonstrate the ability to

sustain the project beyond HCSA funding?

I. Deliverables & ReportsProposals will be evaluated based on ability to track data and outcomes. 1. How clear are Bidder’s measurable outcomes? 2. How thorough, thoughtful and relevant is Bidder’s plan to collect data to monitor the progress of the proposed project? 3. How well matched are Bidder’s proposed measures to the 7 key project objectives?

5Points

J. Oral Presentation & Interview:The oral presentation by each bidder shall not exceed 90 minutes in length. An oral interview will follow the presentation, and will consist of standard questions asked of each of the bidders, as well as specific questions regarding the specific proposal. The proposals may then be re-evaluated and re-scored based on the oral presentation and interview.

20Points

K. References (See Exhibit A – Bid Response Packet) Pass/Fail

SMALL LOCAL EMERGING BUSINESS PREFERENCE POINTS, IF APPLICABLE% of Subtotal of Points

Local Preference: Points equaling five percent (5%) of bidder’s total score, for the above Evaluation Criteria, will be added. This will be the bidder’s final score for purposes of award evaluation.

(5%)

Small and Local or Emerging and Local Preference: Points equaling five percent (5%) of bidder’s total score, for the above Evaluation Criteria, will be added. This will be the bidder’s final score for purposes of award evaluation.

(5%)



B. CONTRACT EVALUATION AND ASSESSMENT

During the initial sixty (60) day period of any contract, which may be awarded to Contractor, the CSC and/or other persons designated by the County will meet with the Contractor to evaluate the services performance and to identify any issues or potential problems.

The County reserves the right to determine, at its sole discretion, whether:

5. Contractor has complied with all terms of this RFP; and

6. Any problems or potential problems with the proposed services were evidenced which make it unlikely (even with possible modifications) that such services have met the County requirements.

If, as a result of such determination, the County concludes that it is not satisfied with Contractor, Contractor’s performance under any awarded contract and/or Contractor’s services as contracted for therein, the Contractor will be notified of contract termination effective forty-five (45) days following notice. The County will have the right to invite the next highest ranked bidder to enter into a contract. The County also reserves the right to re-bid this project if it is determined to be in its best interest to do so.

C. NOTICE OF RECOMMENDATION TO AWARD

7. At the conclusion of the RFP response evaluation process (“Evaluation Process”), all bidders will be notified in writing by e-mail or fax, and certified mail, of the contract award recommendation, if any. The document providing this notification is the Notice of Recommendation to Award.

The Notice of Recommendation to Award will provide the following information:

a. The name of the bidder being recommended for contract award; and

b. The names of all other parties that submitted proposals.

8. At the conclusion of the RFP process, debriefings for unsuccessful bidders will be scheduled and provided upon written request and will be restricted to discussion of the unsuccessful offeror’s bid.

a. Under no circumstances will any discussion be conducted with regard to contract negotiations with the successful bidder.



b. Debriefing may include review of successful bidder’s proposal with redactions as appropriate.

9. The submitted proposals shall be made available upon request no later than five (5) business days before approval of the award and contract is scheduled to be heard by the Board of Supervisors.

D. TERM / TERMINATION / RENEWAL

10. The term of the contract, which may be awarded pursuant to this RFP, will be thirty-six (36) months.

11. The County has and reserves the right to suspend, terminate or abandon the execution of any work by the Contractor without cause at any time upon giving to the Contractor prior written notice. In the event that the County should abandon, terminate or suspend the Contractor’s work, the Contractor shall be entitled to payment for services provided hereunder prior to the effective date of said suspension, termination or abandonment. The County may terminate the contract at any time without written notice upon a material breach of contract and substandard or unsatisfactory performance by the Contractor. In the event of termination with cause, the County reserves the right to seek any and all damages from the Contractor. In the event of such termination with or without cause, the County reserves the right to invite the next highest ranked bidder to enter into a contract or re-bid the project if it is determined to be in its best interest to do so.

12. The County may, at its sole option, terminate any contract that may be awarded as a result of this RFP at the end of any County Fiscal Year, for reason of non-appropriation of funds. In such event, the County will give Contractor at least thirty (30) days written notice that such function will not be funded for the next fiscal period. In such event, the County will return any associated equipment to the Contractor in good working order, reasonable wear and tear excepted.

13. By mutual agreement, any contract which may be awarded pursuant to this RFP, may be extended for an additional two-year term at agreed prices with all other terms and conditions remaining the same.

E. AWARD

14. Proposals will be evaluated by a committee and will be ranked in accordance with the RFP section entitled “Evaluation Criteria/Selection Committee.”



15. The committee will recommend award to the bidder who, in its opinion, has submitted the proposal that best serves the overall interests of the County and attains the highest overall point score. Award may not necessarily be made to the bidder with the lowest price.

16. Small and Emerging Locally Owned Business: The County is vitally interested in promoting the growth of small and emerging local businesses by means of increasing the participation of these businesses in the County’s purchase of goods and services.

As a result of the County’s commitment to advance the economic opportunities of these businesses, Bidders must meet the County’s Small and Emerging Locally Owned Business requirements in order to be considered for the contract award. These requirements can be found online at:

http://acgov.org/auditor/sleb/overview.htm

For purposes of this bid, applicable industries include, but are not limited to, the following NAICS Code(s): 621999 as having no more than $14,000,000 in average annual gross receipts over the last three (3) years.

An emerging business, as defined by the County, is one that has less than one-half (1/2) of the preceding amount and has been in business less than five (5) years.

17. The County reserves the right to reject any or all responses that materially differ from any terms contained in this RFP or from any Exhibits attached hereto, to waive informalities and minor irregularities in responses received, and to provide an opportunity for bidders to correct minor and immaterial errors contained in their submissions. The decision as to what constitutes a minor irregularity shall be made solely at the discretion of the County.

18. The County reserves the right to award to a single or multiple Contractors.

19. The County has the right to decline to award this contract or any part thereof for any reason.

20. County Board of Supervisors approval to award a contract is required.

21. A contract must be negotiated, finalized, and signed by the recommended awardee prior to Board approval.




22. Final Standard Agreement terms and conditions will be negotiated with the selected bidder. Bidder may access a copy of the Standard Services Agreement template online at:

http://www.acgov.org/gsa/purchasing/standardServicesAgreement.pdf

The template contains minimal Agreement boilerplate language only.

23. The RFP specifications, terms, conditions and Exhibits, RFP Addenda and Bidder’s proposal, may be incorporated into and made a part of any contract that may be awarded as a result of this RFP.

F. BID PROTEST/APPEALS PROCESS

24. HCSA prides itself on the establishment of fair and competitive contracting procedures and the commitment made to following those procedures. The following is provided in the event that bidders wish to protest the bid process or appeal the recommendation to award a contract for this project once the Notices of Intent to Award/Non-Award have been issued. Bid protests submitted prior to issuance of the Notices of Intent to Award/Non-Award will not be accepted by the County.

Any Bid protest by any Bidder regarding any other Bid must be submitted in writing to Rebecca Gebhart, Finance Director, 1000 San Leandro Blvd., Suite 300, San Leandro, CA 94577, Fax (510) 351-1367 before 5:00 pm of the FIFTH (5th) business day following the date of issuance of the Notice of Intent to Award, not the date received by the Bidder. A Bid protest received after 5:00 pm is considered received as of the next business day.

a. The Bid protest must contain a complete statement of the reasons and facts for the protest.

b. The protest must refer to the specific portions of all documents that form the basis for the protest.

c. The protest must include the name, address, email address, fax number and telephone number of the person representing the protesting party.

d. The County Agency/Department will transmit a copy of the bid protest to all bidders as soon as possible after receipt of the protest.

2. Upon receipt of written protest, HCSA Finance Director, or designee will review and evaluate the protest and issue a written decision. The HCSA Finance Director, may, at his or her discretion, investigate the protest, obtain additional


http://www.acgov.org/gsa/purchasing/standardServicesAgreement.pdf


information, provide an opportunity to settle the protest by mutual agreement, and/or schedule a meeting(s) with the protesting Bidder and others (as appropriate) to discuss the protest. The decision on the bid protest will be issued at least ten (10) business days prior to the Board hearing or HCSA award date.

The decision will be communicated by e-mail or fax, and certified mail, and will inform the bidder whether or not the recommendation to the Board of Supervisors or HCSA in the Notice of Intent to Award is going to change. A copy of the decision will be furnished to all Bidders affected by the decision. As used in this paragraph, a Bidder is affected by the decision on a Bid protest if a decision on the protest could have resulted in the Bidder not being the apparent successful Bidder on the Bid.

3. The decision of the HCSA Finance Director on the bid protest may be appealed to the Auditor- Controller’s Office of Contract Compliance (OCC) located at 1221 Oak St., Room 249, Oakland, CA 94612, Fax: (510) 272-6502. The Bidder whose Bid is the subject of the protest, all Bidders affected by the HCSA Finance Director’s decision on the protest, and the protestor have the right to appeal if not satisfied with the HCSA Finance Director’s decision. All appeals to the Auditor-Controller’s OCC shall be in writing and submitted within five (5) business days following the issuance of the decision by the HCSA Finance Director, not the date received by the Bidder. An appeal received after 5:00 p.m. is considered received as of the next business day.

a. The appeal shall specify the decision being appealed and all the facts and circumstances relied upon in support of the appeal.

b. In reviewing protest appeals, the OCC will not re-judge the proposal(s). The appeal to the OCC shall be limited to review of the procurement process to determine if the contracting department materially erred in following the Bid or, where appropriate, County contracting policies or other laws and regulations.

c. The appeal to the OCC also shall be limited to the grounds raised in the original protest and the decision by the HCSA Finance Director. As such, a Bidder is prohibited from stating new grounds for a Bid protest in its appeal.

d. The decision of the Auditor-Controller’s OCC is the final step of the appeal process. A copy of the decision of the Auditor-Controller’s OCC will be furnished to the protestor, the Bidder whose Bid is the subject of the Bid protest, and all Bidders affected by the decision.



4. The County will complete the Bid protest/appeal procedures set forth in this paragraph before a recommendation to award the Contract is considered by the Board of Supervisor or HCSA.

5. The procedures and time limits set forth in this paragraph are mandatory and are each Bidder's sole and exclusive remedy in the event of Bid Protest. A Bidder’s failure to timely complete both the Bid protest and appeal procedures shall be deemed a failure to exhaust administrative remedies. Failure to exhaust administrative remedies, or failure to comply otherwise with these procedures, shall constitute a waiver of any right to further pursue the Bid protest, including filing a Government Code Claim or legal proceedings

G. INVOICING

25. Contractor shall invoice the requesting department, unless otherwise advised, upon satisfactory receipt of product and/or performance of services.

26. Payment will be made within thirty (30) days following receipt of invoice and upon complete satisfactory receipt of product and performance of services.

27. County shall notify Contractor of any adjustments required to invoice.

28. Invoices shall contain invoice number, vendor tax identification number, remit to address and itemized products and/or services description and price as quoted and shall be accompanied by acceptable proof of delivery.

29. Contractor shall utilize standardized invoice upon request.

30. Invoices shall only be issued by the Contractor who is awarded a contract.

31. Payments will be issued to and invoices must be received from the same Contractor whose name is specified on the POs.

32. The County will pay Contractor monthly or as agreed upon, not to exceed the total RFP quoted in the bid response.

H. ACCOUNT MANAGER / SUPPORT STAFF

33. Contractor shall provide a dedicated competent account manager who shall be responsible for the County account/contract. The account manager shall receive all orders from the County and shall be the primary contact for all issues regarding Bidder’s response to this RFP and any contract which may arise pursuant to this RFP.



34. Contractor shall also provide adequate, competent support staff that shall be able to service the County during normal working hours, Monday through Friday. Such representative(s) shall be knowledgeable about the contract, products offered and able to identify and resolve quickly any issues including but not limited to order and invoicing problems.

35. Contractor account manager shall be familiar with County requirements and standards and work with the ACPHD to ensure that established standards are adhered to.

IV. INSTRUCTIONS TO BIDDERS

A. COUNTY CONTACTS

All contact during the competitive process is to be through Kristel Acacio, Program Specialist, only. Contact information is provided in Section O below. All questions regarding these specifications, terms and conditions are to be submitted in writing, preferably via e-mail to Kristel Acacio by the specified date on the Calendar of Events.

The evaluation phase of the competitive process shall begin upon receipt of sealed bids until a contract has been awarded. Bidders shall not contact or lobby evaluators during the evaluation process. Attempts by Bidder to contact evaluators may result in disqualification of bidder.

The GSA Contracting Opportunities website will be the official notification posting place of all Requests for Interest, Proposals, Quotes and Addenda. Go to http://www.acgov.org/gsa_app/gsa/purchasing/bid_content/contractopportunities.jsp to view current contracting opportunities.

B. SUBMITTAL OF BIDS

36. All bids must be SEALED and must be received at the Health Care Services Agency of Alameda County BY 2:00 p.m. on the due date specified in the Calendar of Events.

NOTE: LATE AND/OR UNSEALED BIDS CANNOT BE ACCEPTED. IF HAND DELIVERING BIDS PLEASE ALLOW TIME FOR METERED STREET PARKING OR PARKING IN AREA PUBLIC PARKING LOTS AND ENTRY INTO SECURE BUILDING.

Bids will be received only at the address shown below, and by the time indicated in the Calendar of Events. Any bid received after said time and/or date or at a place other than the stated address cannot be considered and will be returned to the bidder unopened.


http://www.acgov.org/gsa_app/gsa/purchasing/bid_content/contractopportunities.jsp


All bids, whether delivered by an employee of Bidder, U.S. Postal Service, courier or package delivery service, must be received and time stamped at the stated address prior to the time designated. HCSA's timestamp shall be considered the official timepiece for the purpose of establishing the actual receipt of bids.

37. Bids are to be addressed and delivered as follows:

TRUST Clinic Integrated Primary Care ServicesRFP Number 900386Kristel Acacio, Program SpecialistAlameda County Health Care Services Agency1000 San Leandro Blvd. Suite 300San Leandro, CA 94577

For questions:E-Mail: [email protected]: (510) 618-1910

Bidder's name, return address, and the RFP number and title must also appear on the mailing or delivered package.

*PLEASE NOTE that on the bid due date, a bid reception desk will be open between 10:00 a.m. – 2:00 p.m. and will be located on the third floor at 1000 San Leandro Blvd, Suite 300.

38. Bidders are to submit one (1) original hardcopy bid (Exhibit A – Bid Response Packet, including additional required documentation), with original ink signatures, plus five (5) copies of their proposal. Original proposal is to be clearly marked “ORIGINAL” with copies to be marked “COPY”. All submittals should be printed on plain white paper, and must be either loose leaf or in a 3-ring binder (NOT bound). It is preferred that all proposals submitted shall be printed double-sided and on minimum 30% post-consumer recycled content paper. Inability to comply with the 30% post-consumer recycled content recommendation will have no impact on the evaluation and scoring of the proposal.

Bidders must also submit an electronic copy of their proposal. The electronic copy must be in a single file (PDF with OCR preferred), and shall be an exact scanned image of the original hard copy Exhibit A – Bid Response Packet, including additional required documentation. The file must be on disk or USB flash drive and enclosed with the sealed original hardcopy of the bid.

39. BIDDERS SHALL NOT MODIFY BID FORM(S) OR QUALIFY THEIR BIDS. BIDDERS SHALL NOT SUBMIT TO THE COUNTY A SCANNED, RE-TYPED, WORD-PROCESSED,



OR OTHERWISE RECREATED VERSION OF THE BID FORM(S) OR ANY OTHER COUNTY-PROVIDED DOCUMENT.

40. No email (electronic) or facsimile bids will be considered.

41. All costs required for the preparation and submission of a bid shall be borne by Bidder.

42. Only one bid response will be accepted from any one person, partnership, corporation, or other entity for each distinctly different neighborhood/ region; however, several alternatives may be included in one response. For purposes of this requirement, “partnership” shall mean, and is limited to, a legal partnership formed under one or more of the provisions of the California or other state’s Corporations Code or an equivalent statute. An organization may submit more than one bid proposal if each application is for a distinctly different neighborhood/ region. It is emphasized that separate bids must be submitted for each neighborhood/ region.

43. All other information regarding the bid responses will be held as confidential until such time as the County Selection Committee has completed its evaluation, and recommended award has been made by the County Selection Committee, and the contract has been fully negotiated with the recommended awardee named in the recommendation to award/non-award notification(s). The submitted proposals shall be made available upon request no later than five (5) business days before the recommendation to award and enter into contract is scheduled to be heard by the Board of Supervisors. All parties submitting proposals, either qualified or unqualified, will receive mailed recommendation to award/non-award notification(s), which will include the name of the bidder to be recommended for award of this project. In addition, award information will be posted on the County’s “Contracting Opportunities” website, mentioned above.

44. Each bid received, with the name of the bidder, shall be entered on a record, and each record with the successful bid indicated thereon shall, after the award of the order or contract, be open to public inspection.

45. California Government Code Section 4552: In submitting a bid to a public purchasing body, the bidder offers and agrees that if the bid is accepted, it will assign to the purchasing body all rights, title, and interest in and to all causes of action it may have under Section 4 of the Clayton Act (15 U.S.C. Sec. 15) or under the Cartwright Act (Chapter 2, commencing with Section 16700, of Part 2 of Division 7 of the Business and Professions Code), arising from purchases of goods, materials, or services by the bidder for sale to the purchasing body pursuant to



the bid. Such assignment shall be made and become effective at the time the purchasing body tenders final payment to the bidder.

46. Bidder expressly acknowledges that it is aware that if a false claim is knowingly submitted (as the terms “claim” and “knowingly” are defined in the California False Claims Act, Cal. Gov. Code, §12650 et seq.), County will be entitled to civil remedies set forth in the California False Claim Act. It may also be considered fraud and the Contractor may be subject to criminal prosecution.

47. The undersigned Bidder certifies that it is, at the time of bidding, and shall be throughout the period of the contract, licensed by the State of California to do the type of work required under the terms of the Contract Documents. Bidder further certifies that it is regularly engaged in the general class and type of work called for in the Bid Documents.

48. The undersigned Bidder certifies that it is not, at the time of bidding, on the California Department of General Services (DGS) list of persons determined to be engaged in investment activities in Iran or otherwise in violation of the Iran Contracting Act of 2010 (Public Contract Code Section 2200-2208).

49. It is understood that County reserves the right to reject this bid and that the bid shall remain open to acceptance and is irrevocable for a period of one hundred eighty (180) days, unless otherwise specified in the Bid Documents.

C. RESPONSE FORMAT

50. Bid responses are to be straightforward, clear, concise and specific to the information requested.

51. In order for bids to be considered complete, Bidder must provide responses to all information requested. See Exhibit A – Bid Response Packet.

52. Bid responses, in whole or in part, are NOT to be marked confidential or proprietary. County may refuse to consider any bid response or part thereof so marked. Bid responses submitted in response to this RFP may be subject to public disclosure. County shall not be liable in any way for disclosure of any such records. Please refer to the County’s website at: http://www.acgov.org/gsa/departments/purchasing/policy/proprietary.htm for more information regarding Proprietary and Confidential Information policies.


http://www.acgov.org/gsa/departments/purchasing/policy/proprietary.htm

EXHIBIT ABID RESPONSE PACKET

RFP No. 900386 – TRUST Clinic Integrated Primary Care Services

To: The County of Alameda

From: (Official Name of Bidder)

AS DESCRIBED IN THE SUBMITTAL OF BIDS SECTION OF THIS RFP, BIDDERS ARE TO SUBMIT ONE (1) ORIGINAL HARDCOPY BID (EXHIBIT A – BID RESPONSE PACKET), INCLUDING ADDITIONAL REQUIRED DOCUMENTATION), WITH ORIGINAL INK SIGNATURES, PLUS FIVE (5) COPIES AND ONE (1) ELECTRONIC COPY OF THE BID IN PDF (with OCR preferred)

ALL PAGES OF THE BID RESPONSE PACKET (EXHIBIT A) MUST BE SUBMITTED IN TOTAL WITH ALL REQUIRED DOCUMENTS ATTACHED THERETO; ALL INFORMATION REQUESTED MUST BE SUPPLIED; ANY PAGES OF EXHIBIT A (OR ITEMS THEREIN) NOT APPLICABLE TO THE BIDDER MUST STILL BE SUBMITTED AS PART OF A COMPLETE BID RESPONSE, WITH SUCH PAGES OR ITEMS CLEARLY MARKED “N/A”

BIDDERS SHALL NOT SUBMIT TO THE COUNTY A RE-TYPED, WORD-PROCESSED, OR OTHERWISE RECREATED VERSION OF EXHIBIT A – BID RESPONSE PACKET OR ANY OTHER COUNTY-PROVIDED DOCUMENT

ALL PRICES AND NOTATIONS MUST BE PRINTED IN INK OR TYPEWRITTEN; NO ERASURES ARE PERMITTED; ERRORS MAY BE CROSSED OUT AND CORRECTIONS PRINTED IN INK OR TYPEWRITTEN ADJACENT, AND MUST BE INITIALED IN INK BY PERSON SIGNING BID

BIDDER MUST QUOTE PRICE(S) AS SPECIFIED IN RFP.

BIDDERS THAT DO NOT COMPLY WITH THE REQUIREMENTS, AND/OR SUBMIT INCOMPLETE BID PACKAGES, SHALL BE SUBJECT TO DISQUALIFICATION AND THEIR BIDS REJECTED IN TOTAL

IF BIDDERS ARE MAKING ANY CLARIFICATIONS AND/OR AMENDMENTS, OR TAKING EXCEPTION TO POLICIES OR SPECIFICATIONS OF THIS RFP, INCLUDING THOSE TO THE COUNTY SLEB POLICY, THESE MUST BE SUBMITTED IN THE EXCEPTIONS, CLARIFICATIONS, AMENDMENTS SECTION OF THIS EXHIBIT A – BID RESPONSE PACKET IN ORDER FOR THE BID RESPONSE TO BE CONSIDERED COMPLETE

Exhibit A – RFP No. 900386Page 1

BIDDER INFORMATION AND ACCEPTANCE

1. The undersigned declares that the Bid Documents, including, without limitation, the RFP, Addenda, and Exhibits have been read.

2. The undersigned is authorized, offers, and agrees to furnish the articles and/or services specified in accordance with the Specifications, Terms & Conditions of the Bid Documents of RFP No. 900386 – TRUST Clinic Integrated Primary Care Services.

3. The undersigned has reviewed the Bid Documents and fully understands the requirements in this Bid including, but not limited to, the requirements under the County Provisions, and that each Bidder who is awarded a contract shall be, in fact, a prime Contractor, not a subcontractor, to County, and agrees that its Bid, if accepted by County, will be the basis for the Bidder to enter into a contract with County in accordance with the intent of the Bid Documents.

4. The undersigned acknowledges receipt and acceptance of all addenda.

5. The undersigned agrees to the following terms, conditions, certifications, and requirements found on the County’s website

Debarment / Suspension Policy[http://www.acgov.org/gsa/departments/purchasing/policy/debar.htm]

Iran Contracting Act (ICA) of 2010[http://www.acgov.org/gsa/departments/purchasing/policy/ica.htm]

General Environmental Requirements[http://www.acgov.org/gsa/departments/purchasing/policy/environ.htm]

Small Local Emerging Business Program[http://acgov.org/auditor/sleb/overview.htm]

First Source [http://acgov.org/auditor/sleb/sourceprogram.htm]

Online Contract Compliance System[http://acgov.org/auditor/sleb/elation.htm]

General Requirements [http://www.acgov.org/gsa/departments/purchasing/policy/genreqs.htm]

Proprietary and Confidential Information[http://www.acgov.org/gsa/departments/purchasing/policy/proprietary.htm]




http://www.acgov.org/gsa/departments/purchasing/policy/genreqs.htm

http://www.acgov.org/gsa/departments/purchasing/policy/genreqs.htm

http://acgov.org/auditor/sleb/elation.htm

http://www.acgov.org/gsa/departments/purchasing/policy/compliance.htm

http://acgov.org/auditor/sleb/sourceprogram.htm

http://www.acgov.org/gsa/departments/purchasing/policy/first.htm


http://www.acgov.org/gsa/departments/purchasing/policy/environ.htm

http://www.acgov.org/gsa/departments/purchasing/policy/environ.htm

http://www.acgov.org/gsa/departments/purchasing/policy/ica.htm

http://www.acgov.org/gsa/departments/purchasing/policy/ica.htm

http://www.acgov.org/gsa/departments/purchasing/policy/debar.htm

http://www.acgov.org/gsa/departments/purchasing/policy/debar.htm

6. The undersigned acknowledges that Bidder will be in good standing in the State of California, with all the necessary licenses, permits, certifications, approvals, and authorizations necessary to perform all obligations in connection with this RFP and associated Bid Documents.

7. It is the responsibility of each bidder to be familiar with all of the specifications, terms and conditions and, if applicable, the site condition. By the submission of a Bid, the Bidder certifies that if awarded a contract they will make no claim against the County based upon ignorance of conditions or misunderstanding of the specifications.

8. Patent indemnity: Vendors who do business with the County shall hold the County of Alameda, its officers, agents and employees, harmless from liability of an nature or kind, including cost and expenses, for infringement or use of any patent, copyright or other proprietary right, secret process, patented or unpatented invention, article or appliance furnished or used in connection with the contract or purchase order.

9. Insurance certificates are not required at the time of submission. However, by signing Exhibit A – Bid Response Packet, the Contractor agrees to meet the minimum insurance requirements stated in the RFP. This documentation must be provided to the County, prior to award, and shall include an insurance certificate and additional insured certificate, naming the County of Alameda, which meets the minimum insurance requirements, as stated in the RFP.

10. The undersigned acknowledges ONE of the following (please check only one box):

Bidder is not local to Alameda County and is ineligible for any bid preference; OR

Bidder is a certified SLEB and is requesting 10% bid preference; (Bidder must check the first box and provide its SLEB Certification Number in the SLEB PARTNERING INFORMATION SHEET); OR

Bidder is LOCAL to Alameda County and is requesting 5% bid preference, and has attached the following documentation to this Exhibit:

Copy of a verifiable business license, issued by the County of Alameda or a City within the County; and

Proof of six (6) months business residency, identifying the name of the vendor and the local address. Utility bills, deed of trusts or lease agreements, etc., are acceptable verification documents to prove residency.


Official Name of Bidder:

Street Address Line 1:

Street Address Line 2:

City: State: Zip Code:

Webpage:

Type of Entity / Organizational Structure (check one):

Corporation Joint Venture

Limited Liability Partnership Partnership

Limited Liability Corporation Non-Profit / Church

Other:

Jurisdiction of Organization Structure:

Date of Organization Structure:

Federal Tax Identification Number:

Primary Contact Information:

Name / Title:

Telephone Number: Fax Number:

E-mail Address:

SIGNATURE:

Name and Title of Signer:

Dated this day of 20


BID FORM(S)

The cost quoted below shall include all taxes and all other charges, including travel expenses if applicable, and is the cost the County will pay for the three-year term of any contract that is a result of this bid.

Bidder hereby certifies to County that all representations, certifications, and statements made by Bidder, as set forth in this Bid Form and attachments are true and correct and are made under penalty of perjury pursuant to the laws of California.

SAMPLE TEMPLATE INCLUDED HERE IS AN EXAMPLE BUDGET. BIDDERS MUST PROVIDE THEIR OWN COMPREHENSIVE BUDGET BASED ON A 3 YEAR OPERATING COST PROJECTION

AND ONE-TIME START UP COST.

Pro-forma budget for TRUST Clinic Integrated Primary CareFor years 1, 2, and 3

Revenue Year 1 Year 2 Year 3

Alameda County (Start-up)Alameda County Program Income

Total

ExpensesSalaries and Wages Fringe Benefits

Total Salaries and Fringe Benefits

Consultants (if applicable)Total

Facility CostsTotal

Other Expenses

Total

Total Operating Expenses

Net Income (Loss)


START UP BUDGET (ONE TIME)Unit Cost Units Total

Next Gen BundleServerDesktops / Thin ClientsMonitorsLaserJet PrintersWindows/Office/AntivirusScannerLabel printerUSB Link print serverSwitchesWireless routerSignature epadsOthers expenses, shipping taxes…Fire Department Clearance and licensesMedical equipment (weighing scale, blood pressure kits,ADA compliant bed….)

Computers. Furniture and Equipment, Licenses….. Total


REQUIRED DOCUMENTATION AND SUBMITTALS

All of the specific documentation listed below is required to be submitted with the Exhibit A – Bid Response Packet in order for a bid to be deemed complete. Bidders shall submit all documentation, in the order listed below and clearly label each section with the appropriate title (i.e. Table of Contents, Letter of Transmittal, Key Personnel, etc.).

1. Title Page: Bid responses shall include a title page showing RFP number and title, your organization’s name and address, name of the contact person (for all matters regarding the RFP response), telephone number and proposal date.

2. Table of Contents: Bid responses shall include a table of contents listing the individual sections of the proposal and their corresponding page numbers. Tabs should separate each of the individual sections.

3. Exhibit A – Bid Response Packet: Every bidder must fill out and submit the complete Exhibit A – Bid Response Packet.

(a) Bidder Information and Acceptance:

(1) Every Bidder must select one choice under Item 10 of page 3 of Exhibit A and must fill out, submit a signed page 4 of Exhibit A.

(b) SLEB Partnering Information Sheet:

(1) Every bidder must fill out and submit a signed SLEB Partnering Information Sheet, (found on page 16 of Exhibit A) indicating their SLEB certification status. If bidder is not certified, the name, identification information, and goods/services to be provided by the named CERTIFIED SLEB partner(s) with whom the bidder will subcontract to meet the County SLEB participation requirement must be stated. Any CERTIFIED SLEB subcontractor(s) named, the Exhibit must be signed by the CERTIFIED SLEB(s) according to the instructions. All named SLEB subcontractor(s) must be certified by the time of bid submittal.

(c) References:

(1) Bidders must use the templates on pages 17-18 of this Exhibit A – Bid Response Packet to provide references.

(2) Bidders are to provide a list of four (4) current and four (4) former references. References must be satisfactory as deemed solely by County. References should have similar scope, volume and requirements to those outlined in these specifications, terms and conditions.

Bidders must verify the contact information for all references provided is current and valid.


Bidders are strongly encouraged to notify all references that the County may be contacting them to obtain a reference.

(3) The County may contact some or all of the references provided in order to determine Bidder’s performance record on work similar to that described in this request. The County reserves the right to contact references other than those provided in the Response and to use the information gained from them in the evaluation process.

(d) Exceptions, Clarifications, Amendments:

(1) This shall include clarifications, exceptions and amendments, if any, to the RFP and associated Bid Documents, and shall be submitted with your bid response using the template on page 19 of this Exhibit A – Bid Response Packet.

(2) THE COUNTY IS UNDER NO OBLIGATION TO ACCEPT ANY EXCEPTIONS, AND SUCH EXCEPTIONS MAY BE A BASIS FOR BID DISQUALIFICATION.

4. Project Overview (Limit: 3 Pages): Bid responses shall include a description of Bidder’s capabilities and approach in providing its services to the County, and provide a brief synopsis of how the Bidder meets the Minimum Qualifications as outlined in Section I.D, pages 8-9 of the RFP, the highlights of the Proposal, and overall benefits of the Proposal to the County. Bidder should also describe how this project will fit with existing programs within the Bidder’s organization. This synopsis should not exceed three (3) pages in length and should be easily understood.

Bidder must describe its capacity to deliver services in a culturally responsive manner, including ability to treat patients in the four Medi-Cal threshold languages in Alameda County—Spanish, Vietnamese, Cantonese, and Mandarin. Bidder must also have the capacity to adopt strategies and design program features that value the cultural diversity of Alameda County.

5. Target Population (Limit: 1 Page): The County intends for TRUST Clinic services to be available to a target population with no health insurance, HealthPAC, Medi-Cal, or Medicare/Medi-Cal health coverage with an emphasis on serving those with Medi-Cal expansion coverage. In addition, members of the target population will fall into one or more of the following groups: 1) General Assistance recipients applying for federal disability benefits through the Social Security Administration; 2) Clients with long or repeated histories of homelessness and disabling health conditions; and 3) clients with histories of serious mental health issues and unstable housing.


To ensure that this resource-intensive care is provided to those who need it most, the County will maintain a referral list of members of the target population.2 The selected awarded bidder must serve the 1500 individuals referred by the County at any point in time (refer also to Section I.C, pages 6-7 of the RFP and Exhibit F for additional population description).

Bidder must describe how it will ensure access for the clients most in need of this service. Bidder must include examples of other initiatives/programs which the Bidder currently operates that preserve access for specific target populations. Bidder should specifically describe mechanisms for preserving timely access to face-to-face provider appointments and removal of cost barriers such as co-pays for visits or other services.

6. Description of the Proposed Services (Limit 12 pages): Bidder must describe how it will provide each of the following required services and related items listed under the major objectives. Each description should include staffing, information systems, and service models (up to 10 pages of sample protocols or visual overviews such as flow charts can be attached as an Appendix).

Finally, the description must: (1) specify how the services in the bid response will meet or exceed the requirements of the County; (2) explain any special resources, procedures or approaches that make the services of Bidder particularly advantageous to the County; and (3) identify any limitations or restrictions of Bidder in providing the services that the County should be aware of in evaluating its Response to this RFP.

Objective 1: Improve access to health care and promote the health and well-being of the target population.

● Registration and appointment scheduling processes that eliminate or minimize barriers for patients experiencing homelessness and patients with disabilities

● Telephone triage● Same-day visits for psychiatric and behavioral health services● Management of “open-access” (AKA “advanced access”) scheduling● Extended-hours, beyond 40 hours per week, including at least 4 hours of face-to-face

provider visits during nights and/or weekends for urgent care services● 24-hour telephone access to an on-call provider

Objective 2: Provide integrated primary care and behavioral health services for the target population.

● Assignment of patients to a primary care provider and/or team● Face-to-face primary care visits to provide comprehensive acute and chronic disease

care

2 The County’s referral list shall include referrals from Home Stretch, a project of EveryOne Home and community partners, which aims to accelerate progress toward ending homelessness. Home Stretch prioritizes people with long histories on the streets and multiple barriers to housing.


● Care coordination and referrals to specialty care, neuropsych/psychological testing, and substance use programs (please name and describe current and planned referral resources)

● On-site management of antipsychotic and mood stabilizer medications by a qualified clinician

● Medication-assisted treatment of substance use disorders● Behavioral health programming including psychiatric diagnostic evaluation; non-

specialty, individual, group, and family psychotherapy; health and behavior assessment and intervention; alcohol and substance abuse structured screening and brief intervention

● Program activities consistent with standards set by the Health Program of Alameda County (HealthPAC) and Alameda County Behavioral Health Care Services, in particular—

○ Using assessment instruments and protocols to guide treatment decisions, monitor patient outcomes, and make changes in treatment for patients who are not improving.

○ Integration of behavioral health professional(s) within the clinic as part of the primary care team.

○ Inclusion of the behavioral health professional in the practice management system with administrative support for appointment scheduling and schedule management.

○ Inclusion of the behavioral health professional in the EMR/EHR system.○ Leveraging the behavioral health professional’s skills and role as effectively

as possible, e.g., medical assistant or other administrative support is available for some paperwork and case management functions.

Objective 3: Assess and document disability for the target population.

High quality documentation of disabling conditions and associated functional impairments in the medical record

Draft and/or revise summary letters to be used as evidence in federal disability determination proceedings in partnership with advocacy organizations (examples attached as Exhibit D)

Dedicated time for doctoral-level providers and therapists (i.e. MDs and PsyDs, if relevant) to participate in disability documentation

Objective 4: Reduce utilization of emergency, inpatient, and crisis health care services.

● On-site medical management of chronic disease exacerbations (should specifically include intoxication, suicidal ideation, chronic pain exacerbations in patients treated with opiates, hyperglycemia, and hypertensive urgency) that minimizes the need for referral to acute settings when possible


● Engagement approaches for influencing and changing health care access patterns and retaining patients in primary care

Objective 5: Establish partnerships and collaborations with other social service organizations.

● Consent forms that allow for cross-agency sharing of protected health information● Mechanism for sharing TRUST Clinic—Primary Care and Specialty Mental Health

Program electronic health record data● Secure and streamlined electronic messaging among medical providers, therapists,

and case managers in both TRUST Clinic programs● Face-to-face meetings including staff/providers from both TRUST Clinic programs

and staff of collaborating case management programs for no less than two hours per week for multidisciplinary treatment planning

● Attendance at regular TRUST Clinic management meetings by a single manager representing the TRUST Clinic—Primary Care Program (initially weekly, with decreasing frequency over the contract period)

Objective 6: Develop and disseminate innovations in the care of homeless and disabled clients.

● Plan for dissemination of lessons learned including conferences, articles, and

participation in County forums such as Safety Net Council and HealthPAC Clinical Implementation Work Group

● Plan to seek out and successfully apply for compatible funding opportunities

Objective 7: Develop financially sustainable high-quality operations. Note: This objective will be addressed in Item 9 Implementation Schedule, and Finance Sustainability Plan below and will not require a separate description.

7. Staffing Plan (Limit 3 Pages): Bidder must propose a staffing structure that is consistent with functions outlined in the description of services above and that optimizes the available space as described in Section I.A, page 4 of the RFP and Exhibit E. Note: Resumes will not be counted toward maximum page limit for this section.

Identify the designated project director who will serve as the main point of contact. Provide professional resumes (as attachments) for the project director and other key project staff. Describe the qualifications and anticipated roles of key staff members involved in the project, including disciplines and degrees. Describe training and experience of existing staff to ensure project outcomes are achieved. Specifically, describe any experience with advocacy and program development for chronically homeless and/or disabled populations. Also describe planned physician staff qualifications and experience with medication assisted treatment of substance use disorders, including prescribing buprenorphine.


For key positions that will not be occupied by existing staff, describe any recruitment strategies and hiring plans as well as the Bidder’s prior experience in hiring staff for similar projects. The description should include strategies for hiring and retaining staff members with a broad vision of health and experience and who work effectively in team-based care.

8. Relevant Experience (Limit 2 Pages): Bidder should describe any previous experience working on start-up clinics or similar projects where rapid achievement of sustainability-level operations was a key outcome. Provide an evaluation of this experience, including successes and limitations, and include any partnerships with external agencies.

Bidder must also describe specific experience providing integrated primary care and behavioral health services for at least two years. Bidder should highlight any co-location of a behavioral health professional in a primary care practice OR a primary care professional in a behavioral health practice; shared electronic or paper health records that include behavioral health and primary care information; evidence of team meetings or regular communication about shared patients between primary care and behavioral health professionals; evidence of treatment plans that include behavioral health and primary care issues being managed collaboratively between providers; and evidence of improving housing outcomes through supportive services and/or collaborations.

9. Implementation Schedule, and Finance Sustainability Plan (Limit 5 Pages): The County intends to maintain a long-term relationship with the selected Bidder, subject to County re-bid requirements. The ongoing financial relationship will be dependent on availability of County funding, the selected Bidder’s operational costs, models for revenue generation, and the identification of other funding sources.

Bidder should describe an implementation plan to develop services during an initial ramp-up period within the first 3-6 months of operation, and a fully-operational integrated primary care and behavioral health clinic within the first year. Include projected timelines for clinic licensing in the plan for ramp-up. The description should also include a financial analysis of projected service needs, possible funding sources, potential revenue generation, including visit projections by provider, and operational budgets to ensure sustainability of the service delivery model over a potential 5-year contract period. Budgets should clearly state the total cost proposed to the county over the initial 3-year contract term, and should be accompanied by a budget narrative to aid the reader in evaluating the budget. Note: Budget attachments, including budget narrative, will not be counted toward the maximum page requirement. Bidder should also identify and describe strategies for mitigation of risks and barriers, which may adversely affect plans for long-term sustainability of the clinic site.

The County shall provide an amount not to exceed $2,700,000 during the initial 3-year contract term, subject to documented, allowable or approved costs incurred by the contractor. Any difference in costs not covered by County funds or Medi-Cal revenue


will be the responsibility of the bidder. It is expected that ongoing (past the initial 3-year contract term and subject to County re-bid requirements) the County will provide a minimum subsidy to cover costs for providing care to uninsured clients and other non-reimbursable activities required by the contract. Distribution of revenue received by the contractor in excess of costs shall be by mutual agreement between County and contractor.

Bidder should assume a rate of new referrals of approximately 250 unique individuals per month during a ramp-up phase, for a total of approximately 1500 clients once the clinic is in full operation, using an initial no-show rate of 30%. Bidder should also assume 85-90% of clients will be Medi-Cal eligible under the expansion, with the remaining 10-15% uninsured. It is expected that sustainable services would include a minimum annual primary care visit total of at least 8,000 primary care visits, a minimum of 4,000 behavioral health visits including those by psychiatrists, therapists, and social workers, but it is acknowledged that these visit totals will vary depending upon proposals for staffing structure.

One-time/start-up costs assumed by the Bidder shall include all medical equipment and supplies; office supplies; computers (including 2 patient portals in the waiting area for reading educational materials, taking tests, filling out forms, etc.), communications, and other office equipment, including installation; and should be included in a pro forma budget, in addition to other identified operational expenses. The County will provide all office, exam, and waiting room furniture (specific list available upon request), as well as initial communications wiring. Ongoing costs to the Bidder will include monthly communication fees and the rental lease which includes janitorial services, and utilities, including high-speed internet. The bidder’s portion of rent is based on 40% of total clinic space (i.e. 40% of 12,879 sq ft), and is estimated to be $106,638 in year one. With annual increases of .05 cents per square foot, year 2 is estimated at $109,729, and so on.

Additional Requirements for Federally Qualified Health Centers (FQHCs)Bidder should propose Prospective Payment System (PPS) rate-setting strategies for inclusion in the financial model. If a cost-based rate setting methodology is proposed, please include the proposed rate, final settlement rate, and an explanation of any differences for the three most recent submitted cost reports. The County reserves the right to restrict the method of rate-setting for the selected bidder. Beyond the initial contract term, and subject to County re-bid requirements, it is anticipated that if the selected bidder proposes a cost-report method of rate-setting, any reconciliation payment made to the selected bidder from the Department of Health Care Services (DHCS) upon reconciling a higher final PPS rate will be applied toward offsetting ongoing subsidies paid by the County.

10. Deliverables and Reports (Limit 3 Pages): Bidder selected and awarded will submit regular performance reports related to project objectives throughout the contract


period. The specific measures and frequency of reports will be jointly developed with the County. HCSA and Contractor will agree on specific administrative data to be extracted monthly from operational and panel management data sets and delivered electronically to HCSA.

Bidder should describe the databases, data collection systems, and quality improvement processes that will address the key anticipated measures for each objective listed below. For each objective, the Bidder may propose and justify alternative measures that better fit their proposed implementation plan.

Objective 1: Improve access to health care and promote the health and well-being of the target population.

Measures will include the distribution of wait times for initial and follow-up visits for primary care and behavioral health, and telephone wait times.

Objective 2: Provide integrated primary care and behavioral health services for the target population.

Measures will include health status data from a chronic disease registry for at least 3 chronic diseases, at least one of which is a behavioral health disorder, data on visit frequency and no-show rates to assess engagement and retention in care, and data from regularly collected patient experience surveys, including specific questions with regard to continuity and integration of behavioral health and physical health services, and transitions of care.

Objective 3: Assess and document disability for the target population.

The measurement process will include peer review of documentation of functional status, and feedback from collaborating organizations on the quality of documentation, including summary letters, and the clinic’s responsiveness to records requests.

Objective 4: Reduce utilization of emergency, inpatient, and crisis health care services.

Acute care episodes should be documented and rated with regard to preventability and/or appropriateness. Reduction of acute care utilization will be included in the quality improvement program.

Objective 5: Establish partnerships and collaborations with other social service organizations.

Measurements will include survey data from collaborating organizations on effectiveness of multi-disciplinary conferences and other inter-agency communication.


Objective 6: Develop and disseminate innovations in the care of homeless and disabled clients.

Notification of presentations, articles, and applications for outside funding will be included in regular reports.

Objective 7: Financially sustain high-quality operations.

Regular reports will be accompanied by periodic encounter data and include budgeted and actual revenue and expenditures by category, narrative discussion of variances, and updates on significant events (such as changes in payer contracts).

11. Financial Statements

(a) Most recent Dun & Bradstreet Supplier Qualifier Report. For information on how to obtain a Supplier Qualifier Report, contact Dun & Bradstreet at 1-800-424-2495 or http://www.dnb.com/government/contractor-management-portal.html; OR

(b) Audited financial statements for the past three (3) years


http://www.dnb.com/government/contractor-management-portal.html

SMALL LOCAL EMERGING BUSINESS (SLEB)PARTNERING INFORMATION SHEET

RFP No. 900386 – TRUST Clinic Integrated Primary Care and Behavioral Health Services

In order to meet the Small Local Emerging Business (SLEB) requirements of this RFP, all bidders must complete this form as required below.

Bidders not meeting the definition of a SLEB (http://acgov.org/auditor/sleb/overview.htm) are required to subcontract with a SLEB for at least twenty percent (20%) of the total estimated bid amount in order to be considered for contract award. SLEB subcontractors must be independently owned and operated from the prime Contractor with no employees of either entity working for the other. This form must be submitted for each business that bidders will work with, as evidence of a firm contractual commitment to meeting the SLEB participation goal. (Copy this form as needed.)

Bidders are encouraged to form a partnership with a SLEB that can participate directly with this contract. One of the benefits of the partnership will be economic, but this partnership will also assist the SLEB to grow and build the capacity to eventually bid as a prime on their own.

Once a contract has been awarded, bidders will not be able to substitute named subcontractors without prior written approval from the Auditor-Controller, Office of Contract Compliance (OCC).

County departments and the OCC will use the web-based Elation Systems to monitor contract compliance with the SLEB program (Elation Systems: http://www.elationsys.com/elationsys/index.htm).

BIDDER IS A CERTIFIED SLEB (sign at bottom of page)

SLEB BIDDER Business Name:

SLEB Certification #: SLEB Certification Expiration Date:

NAICS Codes Included in Certification:

BIDDER IS NOT A CERTIFIED SLEB AND WILL SUBCONTRACT % WITH THE SLEB NAMED BELOW FOR THE FOLLOWING GOODS/SERVICES:

SLEB Subcontractor Business Name:

SLEB Certification #: SLEB Certification Expiration Date:

SLEB Certification Status: Small / Emerging

NAICS Codes Included in Certification:

SLEB Subcontractor Principal Name:

SLEB Subcontractor Principal Signature: Date:

Upon award, prime Contractor and all SLEB subcontractors that receive contracts as a result of this bid process agree to register and use the secure web-based ELATION SYSTEMS. ELATION SYSTEMS will be used to submit SLEB subcontractor participation including, but not limited to, subcontractor contract amounts, payments made, and confirmation of payments received.

Bidder Printed Name/Title:____________________________________________________________________________Street Address: _____________________________________________City_____________State______ Zip Code______Bidder Signature: Date:


http://www.elationsys.com/elationsys/index.htm



CURRENT REFERENCES


Bidder Name:

Company Name: Contact Person: Address: Telephone Number: City, State, Zip: E-mail Address: Services Provided / Date(s) of Service:






FORMER REFERENCES


Bidder Name:







EXCEPTIONS, CLARIFICATIONS, AMENDMENTS


Bidder Name:

List below requests for clarifications, exceptions and amendments, if any, to the RFP and associated Bid Documents, and submit with your bid response.

The County is under no obligation to accept any exceptions and such exceptions may be a basis for bid disqualification.Reference to: Description

Page No. Section Item No.p. 23 D 1.c. Vendor takes exception to…

*Print additional pages as necessary


EXHIBIT BINSURANCE REQUIREMENTS

Insurance certificates are not required at the time of submission; however, by signing Exhibit A – Bid Packet, the bidder agrees to meet the minimum insurance requirements stated in the RFP, prior to award. This documentation must be provided to the County, prior to award, and shall include an insurance certificate and additional insured certificate, naming the County of Alameda, which meets the minimum insurance requirements, as stated in this Exhibit B – Insurance Requirements.

The following page contains the minimum insurance limits, required by the County of Alameda, to be held by the Contractor performing on this RFP:

*** SEE NEXT PAGE FOR COUNTY OF ALAMEDA MINIMUM INSURANCE REQUIREMENTS ***

Exhibit B – RFP No. 900386Page 1

EXHIBIT CCOUNTY OF ALAMEDA MINIMUM INSURANCE REQUIREMENTS

Without limiting any other obligation or liability under this Agreement, the Contractor, at its sole cost and expense, shall secure and keep in force during the entire term of the Agreement or longer, as may be specified below, the following insurance coverage, limits and endorsements:

TYPE OF INSURANCE COVERAGES MINIMUM LIMITSA Commercial General Liability

Premises Liability; Products and Completed Operations; Contractual Liability; Personal Injury and Advertising Liability

$1,000,000 per occurrence (CSL)Bodily Injury and Property Damage

B Commercial or Business Automobile LiabilityAll owned vehicles, hired or leased vehicles, non-owned, borrowed and permissive uses. Personal Automobile Liability is acceptable for individual contractors with no transportation or hauling related activities

$1,000,000 per occurrence (CSL)Any AutoBodily Injury and Property Damage

C Workers’ Compensation (WC) and Employers Liability (EL)Required for all contractors with employees

WC: Statutory LimitsEL: $100,000 per accident for bodily injury or disease

D Endorsements and Conditions : 1. ADDITIONAL INSURED: All insurance required above with the exception of Personal Automobile Liability, Workers’

Compensation and Employers Liability, shall be endorsed to name as additional insured: County of Alameda, its Board of Supervisors, the individual members thereof, and all County officers, agents, employees and representatives.

2. DURATION OF COVERAGE: All required insurance shall be maintained during the entire term of the Agreement with the following exception: Insurance policies and coverage(s) written on a claims-made basis shall be maintained during the entire term of the Agreement and until 3 years following termination and acceptance of all work provided under the Agreement, with the retroactive date of said insurance (as may be applicable) concurrent with the commencement of activities pursuant to this Agreement.

3. REDUCTION OR LIMIT OF OBLIGATION: All insurance policies shall be primary insurance to any insurance available to the Indemnified Parties and Additional Insured(s). Pursuant to the provisions of this Agreement, insurance effected or procured by the Contractor shall not reduce or limit Contractor’s contractual obligation to indemnify and defend the Indemnified Parties.

4. INSURER FINANCIAL RATING: Insurance shall be maintained through an insurer with a A.M. Best Rating of no less than A:VII or equivalent, shall be admitted to the State of California unless otherwise waived by Risk Management, and with deductible amounts acceptable to the County. Acceptance of Contractor’s insurance by County shall not relieve or decrease the liability of Contractor hereunder. Any deductible or self-insured retention amount or other similar obligation under the policies shall be the sole responsibility of the Contractor.

5. SUBCONTRACTORS: Contractor shall include all subcontractors as an insured (covered party) under its policies or shall furnish separate certificates and endorsements for each subcontractor. All coverages for subcontractors shall be subject to all of the requirements stated herein.

6. JOINT VENTURES: If Contractor is an association, partnership or other joint business venture, required insurance shall be provided by any one of the following methods:– Separate insurance policies issued for each individual entity, with each entity included as a “Named Insured (covered party),

or at minimum named as an “Additional Insured” on the other’s policies.– Joint insurance program with the association, partnership or other joint business venture included as a “Named Insured.

7. CANCELLATION OF INSURANCE: All required insurance shall be endorsed to provide thirty (30) days advance written notice to the County of cancellation.

8. CERTIFICATE OF INSURANCE: Before commencing operations under this Agreement, Contractor shall provide Certificate(s) of Insurance and applicable insurance endorsements, in form and satisfactory to County, evidencing that all required insurance coverage is in effect. The County reserves the rights to require the Contractor to provide complete, certified copies of all required insurance policies. The require certificate(s) and endorsements must be sent to:

- Department/Agency issuing the contract- With a copy to Risk Management Unit (125 – 12th Street, 3rd Floor, Oakland, CA 94607)

Certificate C-1 Page 1 of 1 Form 2001-1 (Rev. 03/15/06)

Exhibit C – RFP No. 900386Page 1

EXHIBIT DSAMPLE SUMMARY LETTERS DOCUMENTING DISABILITY

Documenting Disability: Simple Strategies for Medical Providers47 HCH Clinicians’ Network

LETTER 1November 12, 2004Re: L JSS# xxx-xx-xxxx

To Whom It May Concern:

I am writing this letter on behalf of L J, a patient of mine at the Austin Cook County Health Center, in support of her claim for disability. She has been a patient at our health center since 5/99 and my patient since 11/00. She has been seen in the clinic an average of 5 times a year during that time period.

Ms. J had a central nervous system cerebro-vascular accident on July 6, 2004 which has left her with significant persistent deficits in right arm and right leg. Her impairments include the following:

Gait and Right lower extremity: She has an unsteady gait that has made her unable to walk safely at a constant rate on a treadmill with the physical therapists. Her therapy goal was to walk on a level treadmill at three miles per hour for 10 minutes. She could not keep herself centered on the treadmill and would have fallen repeatedly had she not been supported by the hand rails. She was unable to walk for more than two minutes at a time. Her right hip flexion strength is 3/5. She steps to the right when trying to walk with her feet in tandem.

Right upper extremity: Ms. J is right handed. She carries her right arm in a flexed posture when walking. Her right upper extremity strength is 3/5 in flexion and extension at the elbow, and 3/5 in shoulder abduction. She has mildly reduced rapid alternating movements with her right hand and severely reduced ability to write or sign her name. She also has subjective numbness throughout her right arm and moderately reduced ability to identify objects placed in her right hand. She can not carry anything of significant weight (over 2 pounds) in her right hand.

In my opinion, L J is permanently disabled as a result of her stroke. She meets Social Security listing 11.04 as described in the online Blue Book. She has significant and persistent (over 3 months) disorganization of motor function in 2 extremities (right arm and right leg) resulting in sustained disturbance of gross (inability to carry objects) and dexterous (inability to write) movements or gait and station (her gait is abnormal and unsteady).

L J also meets the functional requirements for a musculoskeletal listing described at section 1.00 of the listings. She requires a walker for distances as short as a single block and cannot sustain effective ambulation. Her use of the right arm is so restricted that she cannot prepare a simple meal or feed herself without assistance.

During an eight-hour work day, L J could stand or walk no more than one hour. She can sit without limitation. She is not limited in the ability to lift with her left arm, but she can lift no more than two pounds with her right arm.

L J has not had a mental evaluation since her stroke, but she has complained of memory loss and an inability to concentrate. If her disability claim cannot be favorably resolved based upon her physical limitations, I would recommend that a neuropsychological evaluation be obtained.

If you have any additional specific questions about her condition, please let me know. I am enclosing copies of my relevant treatment records.

Sincerely,

Exhibit D – RFP No. 900386Page 1

David Buchanan, MDAttending PhysicianJohn Stroger Hospital of Cook CountyBoard Certified in Internal MedicineAssistant Professor, Rush University

11.04 Central nervous system vascular accident. With oneof the following more than 3 months post-vascular accident:A. Sensory or motor aphasia resulting in ineffective speech orcommunication; orB. Significant and persistent disorganization of motor function intwo extremities, resulting in sustained disturbance of gross anddexterous movements, or gait and station (see 11.00C).Listing of Impairment cited in the preceding letterSource: 2006 SSA Blue Book

Documenting Disability: Simple Strategies for Medical ProvidersHCH Clinicians’ Network 48

LETTER 2February 22, 2006To Whom It May Concern:

I am writing this letter in regards to Mr. J. S., Case # 1111111 and SS# 111-11-1111. This letter is intended to give the Social Security Administration information regarding Mr. S’s current status as it relates to his application for SSI. I am currently Mr. S’s Treating Source. We have had an ongoing treatment relationship since February 2005. I have also consulted on this case with Mr. S’s former therapist George Gilman, LCSW and his Case Manager, Jennifer Alfredson, APSW. Mr. Smith was admitted into the Health Care for the Homeless Case Management Program in August 2005.

Mr. S. is not currently engaging in any Substantial Gainful Activity.

Mr. S. was diagnosed with Bipolar Disorder Type 1 by myself, Dr. Steven Ortell, in February 2005. Prior to February 2005, Mr. S’s mental impairments were undocumented. Mr. S. had been living in the woods, outdoors, since 2002 and was not seeking any treatment for what he described as problems with his thinking. He was engaged by the Health Care for the Homeless – Street Outreach. He agreed to begin seeing a psychiatrist at Health Care for the Homeless’ Recovery Behavioral Health Clinic. He also agreed to begin working with the Red Cross Outreach Nurse and was referred to a Safe Haven Shelter.

Mr. S’s impairments became clearer once he was staying at Safe Haven, where they have only 8 residents and staff present 24 hours a day. Ms. Alfredson was able to inform this writer about the occurrences at Safe Haven. Mr. S. did not respond appropriately to the supervision at Safe Haven. He did not get along with other residents or the staff and mostly stayed to himself. He had trouble understanding that his situation differed from the other residents. He would become very irritable when comparing his situation to others and would ask why he can’t get a bus pass or other things that residents with income had access to. He expressed paranoia about the other residents and the staff. He demonstrated an irritable and labile mood that inhibited his ability meet the expectations of staff in the area of household chores and/or keeping his room in order. Mr. S. demonstrated poor judgment when he had trouble following the rules and was eventually asked to move out due to his chronic non-compliance with the curfew of 10 PM. When Mr. S. left the Safe Haven in September 2005, he went back to living in the woods, outdoors. He was quite upset about the consequence of his poor judgment. I think that Mr. S. does demonstrate a severe impairment.

I think that Mr. S. does meet the criteria listed in the Social Security Blue Book, section 12.04 for Affective Disorders. Mr. S. does have a disturbance of mood, accompanied by partial manic and depressive symptoms. Mr. S. meets the criteria of 12.04 (A) in the following way: Mr. S. has depressive symptoms that were first assessed and documented in February 2005. Mr. S. reported a loss of interest in all activities, a


sleep disturbance, feelings of guilt and worthlessness, difficulty concentrating and feeling very paranoid. Mr. S. avoids public transportation due to paranoia and is extremely guarded with Outreach Workers and most other staff that he has come into contact with since being engaged by the Outreach Worker. Mr. S. has also experienced symptoms of mania. Mr. S. has been observed to have pressured speech, flight of ideas, and he is easily distracted. He also gets involved in activities that have negative consequences, such as fighting with people on the streets have led to both injury and incarceration. Again, Mr. S. reports feeling very paranoid. As a result of the previously described impairments, Mr. S. was diagnosed with Bipolar Disorder and has had periods manifested by the full symptomatic picture and currently is characterized by both depressive and manic symptoms.

And, Mr. S. meets the criteria of 12.04 (B) in the following way: Mr. S. evidences a marked restriction of activities of daily living. Most notably, Mr. S. has been unable to maintain a residence since 2002. Since that time, he has been living outdoors in a wooded area on the East side of Milwaukee. Mr. S. does not appropriately care for his personal grooming and hygiene. His appearance is usually odorous, his clothing dirty, and his hair appears dirty and unruly. Mr. S. has not had the opportunity to demonstrate the ability to pay bills, cook, or shop due to his having no income and living outdoors. When Mr. S. was living at Safe Haven from July until September 2005, his grooming and hygiene did improve somewhat. At the Safe Haven, he still did not have the opportunity to cook or shop. Mr. S. also avoids public transportation due to his paranoia, which then causes anxiety.

Mr. S. has marked difficulties in maintaining social functioning. Mr. S. has demonstrated that he is unable to interact appropriately with other individuals. Mr. S. does not have any relationships with any of his family, which includes his father and six living siblings. Mr. S. has referred to working for temp agencies where he would only work for a short time and he asked to not return. Mr. S. often refers to arguing with others and specifically, he is not welcome to visit his girlfriend because the people she stays with will not allow him to come to their home. When Mr. S. has staying at Safe Haven, he did not get along with the other residents and complained constantly about their behaviors. It was explained to him that all residents have mental health issues, but Mr. S. continued to not get along with and often argue with the other residents. Mr. S. did attend a Health Care for the Homeless sponsored picnic. He sat by himself and when others went and sat by him, he did not talk with them at all. Mr. S. is often uncooperative with this writer, the Therapist, and the Case Manager. He will attend appointments and then yell at the staff. Mr. S.’s strength is that although he discontinued therapy, he does continue to meet with Case Management staff and the Psychiatrist.

Mr. S. has marked difficulties in maintaining concentration. This writer does not have any observance of Mr. S. in a work setting. Ms. Alfredson was able to report that in the setting of case management, they had great difficulty completing the assessment and initial care plan. Mr. S. cannot concentrate on the task at hand and when asked a question, he begins to answer it, but then gets lost on a long tangent. He is difficult to re-direct. The therapist, Mr. Gilman, noted that he could not assess tasks of short-term memory due to tangents and paranoid thinking that the therapist was actually playing a trick on him. I think that Mr. S’s inability to complete a basic mental status exam is indication that when under the stress of employment, he would not be able to maintain concentration, persistence, or pace.

Mr. S. has also had repeated episodes of decompensation. He was in a decompensated state when first engaged by the Outreach Worker in February 2005. He agreed to treatment by a psychiatrist and after beginning medications, he did demonstrate some improvement. In April 2005, Mr. S. had a Lithium level tested at the lab and the result was slightly below therapeutic level. By May 2005, the Lithium level was within therapeutic level and Mr. S. was reporting to be feeling better. In August 2005, Mr. S. reported to the psychiatrist that he did not take medications for one week and was feeling the effects of mood instability.

In September 2005, Mr. S. again reported to the psychiatrist that he was not taking his medications and his mood was quite irritable. He had also suffered the consequence of getting discharged from the Safe Haven shelter due to noncompliance with rules in September 2005. He continued to report not taking meds and struggling with his moods in October 2005. In November 2005, the consumer reported to be taking his medications again and Case Management was monitoring his medications by only giving him one week at a time. Again, his mood improved, he became more cooperative, and he was granted re-admission to Safe Haven. Also at this time, his psychotropic medication was changed. Mr. S. reported feeling to “up” and agitated from the new medication. By January 2006 he was again asked to leave Safe Haven due to non-compliance with rules. Since that time, he has again been observed to be in a decompensated state. His


activities of daily living have diminished, his social functioning markedly impaired, and his concentration again observed to be very low.

In conclusion, it is my opinion that Mr. S. has a severe impairment and meets the criteria listed in section 12.04 of the Social Security Blue Book for Affective Disorder.

Steven Ortell, MD Date

George Gilman, LCSW Date

Jennifer G. Alfredson, APSW Date

Health Care for the Homeless of Milwaukee, Inc.

12.04 Affective disorders: Characterized by a disturbance of mood, accompanied by a full orpartial manic or depressive syndrome. Mood refers to a prolonged emotion that colors the wholepsychic life; it generally involves either depression or elation.

The required level of severity for these disorders is met when the requirements in both A and Bare satisfied, or when the requirements in C are satisfied.

A. Medically documented persistence, either continuous or intermittent, of one of the following:1. Depressive syndrome characterized by at least four of the following:

a. Anhedonia or pervasive loss of interest in almost all activities; orb. Appetite disturbance with change in weight; orc. Sleep disturbance; ord. Psychomotor agitation or retardation; ore. Decreased energy; orf. Feelings of guilt or worthlessness; org. Difficulty concentrating or thinking; orh. Thoughts of suicide; ori. Hallucinations, delusions, or paranoid thinking; or

2. Manic syndrome characterized by at least three of the following:a. Hyperactivity; orb. Pressure of speech; orc. Flight of ideas; ord. Inflated self-esteem; ore. Decreased need for sleep; orf. Easy distractibility; org. Involvement in activities that have a high probability of painful consequences which are not recognized; orh. Hallucinations, delusions or paranoid thinking; or

3. Bipolar syndrome with a history of episodic periods manifested by the full symptomatic pictureof both manic and depressive syndromes (and currently characterized by either or both syndromes);

AND

B. Resulting in at least two of the following:1. Marked restriction of activities of daily living; or2. Marked difficulties in maintaining social functioning; or3. Marked difficulties in maintaining concentration, persistence, or pace; or4. Repeated episodes of decompensation, each of extended duration;

OR

C. Medically documented history of a chronic affective disorder of at least 2 years' duration that has caused more than a minimal limitation of ability to do basic work activities, with symptoms or signs currently attenuated by medication or psychosocial support, and one of the following:

1. Repeated episodes of decompensation, each of extended duration; or2. A residual disease process that has resulted in such marginal adjustment that even a minimal increase in mental demands or change in the environment would be predicted to cause the individual to decompensate; or


3. Current history of 1 or more years' inability to function outside a highly supportive living arrangement, with an indication of continued need for such an arrangement.

Listing of Impairment specified in the preceding letterSource: June 2006 SSA Blue Book


EXHIBIT ETRUST Clinic Construction Plan and First Floor

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EXHIBIT FTRUST CLINIC DATA REPORT

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EXHIBIT GSAMHSA STANDARDS OF INTEGRATION

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