RFP Template
Charles Smith, Executive CommissionerOpen Enrollment forPost-Acute Rehabilitation ServicesEnrollment Number: HHS0000023Enrollment Period Opens: October 20, 2016Enrollment Period Closes: August 31, 2019NIGP Class/Item Codes: 948-86 Therapy and Rehabilitation Services952-15 Case Management952-21 Counseling ServicesAddendum #1: 03/22/2018TABLE OF CONTENTS TOC \o "1-2" \h \z \u 1.GENERAL INFORMATION PAGEREF _Toc508099463 \h 31.1.Scope PAGEREF _Toc508099464 \h 31.2.Point of Contact PAGEREF _Toc508099465 \h 31.3.Procurement Schedule PAGEREF _Toc508099466 \h 41.4.Terms and Conditions PAGEREF _Toc508099467 \h 41.5.Background PAGEREF _Toc508099468 \h 41.6.Eligible Applicants PAGEREF _Toc508099469 \h 51.7.Strategic Elements and Special Terms and Conditions PAGEREF _Toc508099470 \h 61.8.Amendments and Announcements Regarding this Open Enrollment PAGEREF _Toc508099471 \h 71.9.Applicant Notifications and Questions PAGEREF _Toc508099472 \h 82.STATEMENT OF WORK PAGEREF _Toc508099473 \h 92.1.Program Purpose PAGEREF _Toc508099474 \h 92.2.Applicant/Contractor Requirements PAGEREF _Toc508099475 \h 92.3.Service Delivery Area(s) PAGEREF _Toc508099476 \h 92.4.Applicant’s Physical Address PAGEREF _Toc508099477 \h 92.5.Eligible Population PAGEREF _Toc508099478 \h 92.6.Consumer Characteristics PAGEREF _Toc508099479 \h 102.7.Minimum Qualifications PAGEREF _Toc508099480 \h 122.8.Goal and Performance Measures PAGEREF _Toc508099481 \h 133.UTILIZATION AND PAYMENT PAGEREF _Toc508099482 \h 153.1.Utilization PAGEREF _Toc508099483 \h 153.2.Payment PAGEREF _Toc508099484 \h 153.3.Invoicing Process PAGEREF _Toc508099485 \h 163.4.Utilization and Review PAGEREF _Toc508099486 \h RMATION AND SUBMISSION INSTRUCTIONS PAGEREF _Toc508099487 \h 174.1.Open Enrollment Cancellation/Partial Award/Non-Award PAGEREF _Toc508099488 \h 174.2.Right to Reject Applications or Portions of Applications PAGEREF _Toc508099489 \h 174.3.Joint Applications PAGEREF _Toc508099490 \h 174.4.Withdrawal of Applications PAGEREF _Toc508099491 \h 174.5.Costs Incurred PAGEREF _Toc508099492 \h 174.6.Application Submission Instructions PAGEREF _Toc508099493 \h 174.anization of Application and Required Documents PAGEREF _Toc508099494 \h 184.8.Alternate Delivery of Applications PAGEREF _Toc508099495 \h 194.9.Requirements for mailed or delivered applications PAGEREF _Toc508099496 \h 205.ELIGIBILITY DETERMINATION PAGEREF _Toc508099497 \h 215.1.Initial Compliance Screening PAGEREF _Toc508099498 \h 215.2.Unresponsive Applications PAGEREF _Toc508099499 \h 215.3.Corrections to Application PAGEREF _Toc508099500 \h 215.4.Review and Validation of Applications PAGEREF _Toc508099501 \h 225.5.Additional Information PAGEREF _Toc508099502 \h 225.6.Method of Allocation PAGEREF _Toc508099503 \h 225.7.Debriefing PAGEREF _Toc508099504 \h 225.8.Protest Procedures PAGEREF _Toc508099505 \h 226.GLOSSARY PAGEREF _Toc508099506 \h 23GENERAL INFORMATIONScopeThe State of Texas, by and through the Health and Human Services Commission (“HHSC”), seeks to contract Post-Acute Rehabilitation Services for people who have a traumatic brain injury“”, traumatic spinal cord injury“”, or both from vendors licensed by HHSC or Department of State Health Services (“DSHS”), as applicable, and operating as one of these facilities prior to contract execution: An Assisted Living Facility; A Home and Community Support Services Agency;A nursing facility;A general hospital; or A specialty hospital.In conjunction with appropriate licensing, each Applicant must have an accreditation, or obtain it no later than two years after contract execution, by the Commission on Accreditation of Rehabilitation Facilities (“CARF”) or Joint Commission on Accreditation of Healthcare Organizations (“JCAHO”) in accordance with the specifications contained in this open enrollment. Point of ContactThe HHSC Point of Contact for inquiries concerning this open enrollment until completion of the initial application screening is:Point of Contact:Blair Gossett, Project ManagerAddress:Health and Human Services CommissionOffice of Independence Services5806 34th StreetLubbock, Texas 79407Phone:806-791-7533Email:blair.gossett@hhsc.state.tx.us Office Hours:8:00 AM to 5:00 PM Monday through FridayApplicant must direct all procurement communications and questions relating to this open enrollment to HHSC Point of Contact named above, unless specifically instructed to an alternate Contact by HHSC.An alternate contact will be provided to Applicants by email upon completion of the initial screening conducted by the HHSC Project Manager.Procurement ScheduleAll dates are subject to change at HHSC's sole discretion. Applications must be received by the HHSC Point of Contact designated in Subsection 1.2, by the enrollment closing period provided in the Procurement Schedule below. Late applications will be deemed non-responsive and will not be considered.Procurement ScheduleOpen Enrollment Period OpensOctober 20,2016Open Enrollment Period Closes5:00 PM CSTAugust 31, 2019Anticipated Contract Start DateApproximately Thirty (30) days after all screening requirements are met.Adjustments to Closing DateHHSC may, at its sole discretion and without additional notice adjust the closing date for this entire open enrollment, a specific Region, or a specific service delivery area within a Region to meet the needs of HHSC. If an adjustment is made to the closing date specified in the table above, an amendment to this open enrollment will be posted.Re-Opening the Open EnrollmentHHSC may without additional notice close or re-open the enrollment period for this entire open enrollment, a specific Region, or for a specific service delivery area within a region to meet the needs of HHSC. If it becomes necessary to close or re-open this open enrollment outside of the dates specified in the table above, an amendment to this open enrollment will be posted.Terms and ConditionsThe terms and conditions outlined throughout this open enrollment govern the open enrollment and any resulting contract. Any Contract awarded under this open enrollment includes the following, found at the end of this document, Attachments:HHSC Vendor Uniform Contract Terms and Conditions Version 2.15HHSC Special Conditions Version 1.2HHSC CRS Supplemental Conditions Version 1.0 BackgroundOverview of HHSCSince 1991, HHSC has overseen and coordinated the planning and delivery of health and human service programs throughout Texas. HHSC is established in accordance with Texas Government Code Chapter 531 and is responsible for the oversight of all Texas Health and Human Service agencies (“HHS Agencies”). As a result of the consolidation pursuant to the 78th Texas Legislature, Regular Session (2003), House Bill 2292, some of the contracting and procurement activities for the HHS Agencies have been assigned to the Procurement and Contracting Services (“PCS”) Division of HHSC. As such, PCS will administer the initial stages of the procurement process, including enrollment announcement and publication. Project OverviewHHSC will work in collaboration with Contractors to provide an array of training and support services to consumers who have a traumatic brain injury (“TBI”) and/or traumatic spinal cord injury (“TSCI”) to function more independently in the home and community.Eligible ApplicantsTo be eligible to apply for a contract and receive an award through this open enrollment, Applicants must be qualified in all respects set forth in this open enrollment and shall:Submit the required and completed Application, supporting documentation, and forms.Be an entity free to participate in state contracts and not be debarred by the Texas Comptroller of Public Accounts: free to participate in federal contracts with the System of Award Management (SAM). Applicant is ineligible to apply for funds under this open enrollment if currently debarred, suspended, or otherwise excluded or ineligible for participation in Federal or State assistance programs. Search the federal excluded list at the following website: ; Be authorized as a public or private entity to do business in Texas with the Secretary of State: ; Be free of exclusions with the US Department of Health and Human Services, Office of Inspector General: free from negative reports in the Vendor Performance Tracking System on the Centralized Master Bidders List (CMBL): ; andHold one (1) of the following current and valid licenses or acceptance letters issued by HHSC or DSHS:An Assisted Living Facility license issued by HHSC Regulatory Services Division in one of the following subsets: (1) Type A Assisted Living Facility; or (2) Type B Assisted Living Facility; or A Home and Community Support Services Agency (“HCSSA”) license issued by HHSC Regulatory Services Division; orA nursing facility license issued by HHSC Regulatory Services Division; orA Hospital license issued by DSHS; orA chemical dependency treatment center license issued by DSHS; orAn acceptance letter from HHSC Regulatory Services Division or from DSHS stating that an application for the license or license subset identified in subsections 1.6.7.1 through 1.6.7.6. under which the Applicant is applying for a contract is complete and has been accepted by HHSC or DSHS, as applicable, prior to submission of an Application under this open enrollment; or Registration with the Executive Council of Physical Therapy and Occupational Therapy ().The license or acceptance letter, as applicable, must be valid. For the license or letter to be valid, it must be current and not have been withdrawn or denied. The license or acceptance letter, as applicable, must remain valid during the open enrollment Application review process and throughout the entire term of any resulting contract, including all periods of renewal, if any. Strategic Elements and Special Terms and ConditionsContract Type and TermHHSC will award one or more Contracts for Post-Acute Rehabilitation Services as described in Section 2. The initial resulting Contract term will be for two (2) years, unless renewed, extended, or terminated pursuant to the terms and conditions of the Contract. HHSC reserves the option to amend the term of the resulting Contract for a period or periods of time no greater than a cumulative total of five (5) years, which five-year period includes the original contract term.At the sole option of HHSC, any resulting Contract may also be extended beyond all exercised renewal periods? as necessary to complete the mission of this open enrollment, ensure continuity of service, or as otherwise determined by HHSC to serve the best interest of the state. Contract ElementsThe term “Contract” means any contract awarded as a result of this open enrollment and all exhibits, amendments or addenda to the Contract. At a minimum, the following documents will be incorporated into the Contract: any modifications, addenda, or amendments issued in conjunction with this open enrollment; applicable HHSC Uniform Terms and Conditions; HHSC Special Conditions; HHS CRS Supplemental Conditions; and the successful Applicant’s Application. However, any term, condition, or other part of Applicant's Application that has been rejected by HHSC that is not accepted in writing by HHSC, or that conflicts with applicable law, the Contract, this open enrollment solicitation, exhibits to this open enrollment or the Contract, or applicable terms and conditions will not constitute part of the Contract.Any term, condition, or other part of Applicant's Application that has been rejected by HHSC, that is not accepted in writing by HHSC, or that conflicts with applicable law, the Contract, this open enrollment, exhibits to this open enrollment or the Contract, or applicable terms and conditions will not constitute part of the Contract. HYPERLINK InsuranceUnless otherwise specified in this Contract, Applicant will acquire and maintain, prior to contract execution and for the duration of this Contract, insurance coverage necessary to ensure proper fulfillment of this Contract and potential liabilities thereunder with financially sound and reputable insurers licensed by the Texas Department of Insurance. All required insurance coverage must be issued from a company or companies that have both: (1) a Financial Strength Rating of "A" or better from A.M. Best Company, Inc.; and (2) a Financial Size Category Class of "VII" or better from A.M. Best Company, Inc. Upon request by HHSC,Contractor will provide evidence of insurance as required under this Contract, including a schedule of coverage or underwriter’s schedules establishing to the satisfaction of HHSC the nature and extent of coverage granted by each such policy. In the event that any policy is determined by HHSC to be deficient to comply with the terms of this Contract, Contractor will secure such additional policies or coverage as HHSC may request or that are required by law or regulation. If coverage expires during the term of this Contract, Contractor must produce renewal certificates for each type of coverage.These and all other insurance requirements under the Contract apply to both Contractor and its Subcontractors, if any. Contractor is responsible for ensuring its Subcontractors' compliance with all requirements. All insurance contracts must:(1) be written on a primary and non-contributory basis with any other insurance coverages the Applicant currently has in place; and(2) include a waiver of subrogation. Applicant must ensure that all insurance policies and certificates of insurance for required coverage are written to include all services and locations related to Applicant's performance under the Contract.All certificates of insurance for required coverage other than workers compensation and professional liability must name the State of Texas and its officers, directors, and employees as additional insureds.Amendments and Announcements Regarding this Open EnrollmentHHSC will post all official communication regarding this open enrollment on the HHS Open Enrollment Opportunities web page located at: reserves the right to revise this open enrollment at any time. It is the responsibility of each Applicant to comply with any changes, amendments, or clarifications posted to the HHS Open Enrollment Opportunities web page. Applicant must check the HHS Open Enrollment Opportunities web page frequently for changes and notices of matters affecting this open enrollment.An Applicant’s failure to check the HHS Open Enrollment Opportunities web page will in no way release the Applicant from the requirements of any revisions, addenda, or additional information. All questions and comments regarding this open enrollment should be sent to the HHSC Point of Contact designated in Subsection 1.2. Questions must reference the appropriate page and section number. HHSC will post answers to questions to the HHS Open Enrollment Opportunities web page as deemed appropriate at the sole discretion of HHSC. HHSC reserves the right to amend answers prior to the open enrollment closing date.Applicants should notify HHSC Point of Contact (designated in Subsection 1.2 of this open enrollment) in writing of any ambiguity, conflict, discrepancy, exclusionary specification, omission, or error in this open enrollment prior to submitting an Application. If an Applicant fails to timely notify HHSC of such issues, Applicant submits its Application at its own risk and, if awarded a contract, Applicant: (1) shall have waived any claim of error or ambiguity in the open enrollment or resulting contract, (2) shall not contest HHSC’s interpretation of such provision(s), and (3) shall not be entitled to additional compensation, relief, or time by reason of, or later correction of, the ambiguity, conflict, discrepancy, exclusionary specification, omission, or error. Applicant Notifications and QuestionsAny notification or questions by the Applicant regarding this open enrollment must be submitted in writing to the HHSC Point of Contact designated in Subsection 1.2 of this open enrollment, unless otherwise specified. At all times, Applicant will maintain and monitor at least one active email address for the receipt of Application-related communications from HHSC. It is the Applicant’s responsibility to monitor this email address for Application-related information.(The remainder of this page is intentionally left blank.)STATEMENT OF WORKProgram PurposeThe purpose of the Comprehensive Rehabilitation Services (“CRS”) program is to help eligible consumers who have a TBI and/or TSCI to improve their ability to function independently in the home and the community. The program focuses on mobility, self-care, and communication, and it sponsors three (3) core services to address functional ability.Applicant/Contractor RequirementsContractors must:Meet the requirements of, and provide all of the services in, an executed Post-Acute Rehabilitation Contract resulting from this open enrollment; andProvide all services in accordance with the standards for providers and the standards for providers outlines requirements to which Post-Acute rehabilitation contractors must agree and adhere. Review the standards that are applicable to the service(s) you are interested in providing in the CRS Standards Provider Manual that is currently available online and can be accessed at: Delivery Area(s)The geographic service area for the CRS program is state-wide, but specific provider services area(s) within the state are individually approved by HHSC. Applicant’s Physical Address The Applicant’s physical address, as shown on the Application, must be identical to the address on the applicable license.Eligible Population Consumer eligibility is determined by applicable law.For the CRS Program, basic requirements for consumer eligibility are set forth in 40 Texas Administrative Code (“TAC”) §107.707. To meet the current basic eligibility criteria for the CRS Program, there must a reasonable expectation that services will benefit the person by improving his or her ability to function within the home environment or within the community, and the person must:Have a traumatic brain injury or traumatic spinal cord injury that constitutes or results in a substantial impediment to the person's ability to function within the home environment or the community; Be at least fifteen (15) years of age; Be a U.S. citizen or lawful permanent resident, and a Texas resident (as defined by applicable rule); Not be participating in, or be eligible for and able to access, another rehabilitation program offering similar rehabilitation treatment or therapy services; however, the person may participate in rehabilitation programs that offer complementary rehabilitation services; Be willing to participate in services; andBe medically stable, including no progression of deficits, no deterioration of physical and cognitive status, or both; andnot be in imminent need of any acute care; and be functioning at a Level IV of the Rancho Los Amigos Levels of Cognitive Functioning Scale or equivalent.Consumer Characteristics Contractor must be prepared to serve individuals with characteristics including, but not limited to:Cognitive deficitsAttentionConcentrationDistractibilityMemorySpeed of ProcessingConfusionPerseverationImpulsivenessLanguage ProcessingExecutive functionsSpeech and Language deficitsNot understanding the spoken word (receptive aphasia)Difficulty speaking and being understood (expressive aphasia)Slurred speechSpeaking very fast or very slowProblems readingProblems writingSensory deficitsDifficulties with interpretation of touch, temperature, movement, limb position and fine discrimination. Perceptual deficitsDifficulty with the integration or patterning of sensory impressions into psychologically meaningful data.Vision deficitsPartial or total loss of visionWeakness of eye muscles and double vision (diplopia)Blurred visionProblems judging distanceInvoluntary eye movements (nystagmus)Intolerance of light (photophobia)Hearing deficitsDecrease or loss of hearingRinging in the ears (tinnitus)Increased sensitivity to soundsSmell deficitsLoss or diminished sense of smell (anosmia)Taste deficitsLoss or diminished sense of tasteSeizuresThe convulsions associated with epilepsy that can be several types and can involve disruption in consciousness, sensory perception, or motor movements.Physical ChangesPhysical paralysis/spasticityChronic painControl of bowel and bladderSleep disordersLoss of staminaAppetite changesRegulation of body temperatureMenstrual difficultiesSocial-Emotional deficitsDependent behaviorsEmotional abilityLack of motivationIrritabilityAggressionDepressionDisinhibitionDenial / lack of awarenessMinimum QualificationsMinimum Organizational QualificationsAll Applicants must:Have at least three (3) years’ experience providing the rehabilitation services for which the Applicant is applying through this open enrollment (e.g., traumatic brain injury, traumatic spinal cord injury, or both); andAdhere to the standards for providers (see, Subsection 2.2.1 of this open enrollment).Each Contractor must: Have an accreditation, or obtain it no later than two (2) years after contract execution, by the Commission on Accreditation of Rehabilitation Facilities (CARF) or Joint Commission on Accreditation of Healthcare Organizations (JCAHO) in accordance with the specifications contained in this open enrollment. Have and maintain a current and valid Certificate of Occupancy for the location at which services are to be provided.Hold one (1) of the following current and valid licenses or acceptance letter issued by HHSC or DSHS, or:An Assisted Living Facility (ALF) license issued by HHSC Regulatory Services Division in one of the following subsets: (1) Type A Assisted Living Facility; or (2) Type B Assisted Living Facility; or A Home and Community Support Services Agency (HCSSA) license issued by HHSC Regulatory Services Division; orNursing facility license issued by HHSC Regulatory Services Division; orA Hospital or Specialty Hospital license by DSHS; orA chemical dependency treatment center license issued by DSHS; orAn acceptance letter from HHSC Regulatory Services Division or from DSHS stating that an application for the license or license subset identified in sections 2.7.1.2.3.7 through 2.7.1.2.3.7.2 under which the Applicant is applying for a contract is complete and has been accepted by HHSC or DSHS, as applicable, prior to submission of an Application under this open enrollment.? All non-residential post-acute rehabilitation facilities that do business with CRS and are not licensed by HHSC as an ALF or as a nursing facility, or by DSHS as a hospital or chemical dependency center, must be:Registered with the Executive Council of Physical Therapy and Occupational Therapy (); or Licensed by HHSC as a home and community services agency ().Minimum Personnel QualificationsContractor’s staff, including Contractor’s department directors, or equivalent positions, providing services that by law require a professional license or certification to provide services, must hold a current, valid, and applicable Texas license and/or certification in good standing to do so. Department directors or equivalent positions, are responsible for ensuring that the Contractor's staff providing services, that by law require a professional license or certification to provide services, must hold a current, valid, and applicable Texas license and/or certification in good standing and must provide copies to HHSC of said licenses and/or certifications at HHSC’s request.Goal and Performance MeasuresContractor performance evaluation is based on assessment of the output and outcome measures outlined below and in compliance with the terms and conditions of the Contract, as indicated by HHSC contract management and contract monitoring performed by HHSC staff. GoalGoal of the Contract: The goal of the Post-Acute Rehabilitation Services contract is to ensure that consumers who have a traumatic brain injury or traumatic spinal cord injury, or both, receive individualized rehabilitation services to aid in attaining independence in the home and community. Performance Measures In addition to the Contractor's compliance with all of its obligations and duties under the Contract resulting from this open enrollment, HHSC will evaluate the performance of the Contractor on the basis of the following performance measures: Performance MeasuresGoal of the Contract: To provide individualized rehabilitation services to eligible consumers, which aid in achieving independence in the home and community.Outcome #1: Consumer is discharged to a home and community setting.Outcome Performance Period: Contractor performance for this outcome is determined on a case by case basis, as a consumer discharges from the facility.Outcome Indicator: Percent of consumers in the discharged to home and community settings compared to admissions.Outcome Target: 100%Purpose: To ensure consumers are provided rehabilitation services that aid in achieving independence in the home and community.Data Source: RehabWorksMethodology: The facility must report discharge location to HHSC counselor upon discharge from the facility.(The remainder of this page is intentionally left blank.)UTILIZATION AND PAYMENT UtilizationAn indicator of the level of need for this service is historical utilization data. However, no level of service is guaranteed by this procurement or constitutes any promise or guarantee of service utilization on the part of HHSC. The methodology to determine a per diem state-wide rate includes a base rate, evaluation rate, and a core rate for residential services and base rate and billed services for non-residential services. Residential RatesRegarding residential rates, the base rate will cover room and board, administration, paraprofessional services, medical (physician and nursing services), dietary/nutritional services, case management, and facility and operations costs. The evaluation per diem is based on providing an average of one evaluation each month. The tier rate for core service rate is calculated by reviewing the reimbursement for core services and determining a hourly proxy rate for those Core services. The hourly rate is applied to the tiered rate structure at the prescribed hourly increment for each tier, see chart below. Core services include physical therapy, occupational therapy, speech therapy, neuropsychological services, neuropsychiatric services, aquatic therapy, art therapy, behavioral management, chemical dependency, cognitive rehabilitation therapy, family therapy, massage therapy, mental restoration, music therapy, and recreational therapy. Ancillary services will continue to be paid as fee-for-service and based on current HHSC rates. Non-Residential Rates Regarding non-residential rates, a statewide base rate will cover the coordination of services by the Interdisciplinary Team, appropriate administration, facility and operations costs. HHSC will also pay on a fee-for-service basis for core and ancillary services that have been pre-approved by the Comprehensive Rehabilitation Services Counselor, documented in the consumer’s program plan and received by the consumer. Detailed service delivery data will be collected to evaluate the per diem state-wide rate based on data.Adopted Rates Adopted rates for the Comprehensive Services Program will be effective on September 1, 2016, with the published rates being currently available online and can be accessed at: . PaymentMethod of PaymentThe Contract resulting from this open enrollment will be paid on a combination of fee-for-service, and per diem reimbursement methods funded by state, or state and federal, money based on services provided. Total funding for these services is projected at $12,000,000.00 annually.HHSC is the payor of last resort; therefore, all comparable benefits must be exhausted prior to payment of services. HHSC will pay for services in accordance with Current Procedural Terminology (CPT) codes and HHSC rates for Non-Residential services and via the Tiered rate structure for Residential services.If the Contractor is providing services for a CRS consumer, then the Contractor must follow the CRS Standards for Providers, which are accessible at the following link: will not be paid for services provided:If a comparable benefit is available to fund services;Without a Service Authorization from HHSC; Outside the date range authorized in the Service Authorization; or Without a denial of benefits and explanation of benefits, as applicable. Invoicing ProcessThe Contractor will submit to HHSC a total bill each month in the format prescribed by HHSC, and will accept as payment in full the Contracted unit rate. Refer to the CRS Provider Standard Manual. Contractors that provide both Residential and Non-Residential services for consumers who have a Traumatic Brain Injury are required to upload supporting billing detailed service records information by the 10th of each month for all services provided in the previous month into a repository data base.Failure to submit invoices on time may be considered a Contract compliance issue and be used in evaluating whether to renew or terminate the Contract.Utilization and ReviewThe use of utilization and review activities will ensure program fiscal integrity, address the state mandate requiring program funds be spent only as allowed under state laws and regulations, and to ensure that services are based on medical necessity and efficacy of services provided. Consumer records may be chosen for review through a random sample, or if billing issues are noted by CRS field staff. Review of consumer records, services and billing can occur from the point of entry into the CRS program until after the consumer ends/concludes treatment and may include prospective, concurrent, and retrospective review activities.(The remainder of this page is intentionally left blank.)INFORMATION AND SUBMISSION INSTRUCTIONSOpen Enrollment Cancellation/Partial Award/Non-AwardAt its sole discretion, HHSC may cancel this open enrollment, make partial award, or no awards.Right to Reject Applications or Portions of ApplicationsAt its sole discretion, HHSC may reject any and all Applications or portions thereof.Joint ApplicationsHHSC will not consider joint or collaborative Applications that require it to contract with more than one Applicant.Withdrawal of ApplicationsApplicants have the right to withdraw their Applications from consideration at any time prior to Contract award, by submitting a written request for withdrawal to the HHSC Point of Contact, as designated in Subsection 1.2.Costs IncurredIssuance of this open enrollment in no way constitutes a commitment by HHSC to award a Contract or to pay any costs incurred by an Applicant in the preparation of an Application in response to this open enrollment. HHSC is not liable for any costs incurred by an Applicant prior to issuance of, or entering into a formal agreement, Contract, or purchase order. Costs of developing Applications, preparing for or participating in oral presentations and site visits, or any other similar expenses incurred by an Applicant are entirely the responsibility of the Applicant, and will not be reimbursed in any manner by the State of Texas.Application Submission InstructionsApplicants or interested parties are responsible to periodically check the HHS Enrollment Opportunities website for updates to the procurement prior to submitting an application. An Applicant's failure to periodically check HHS Enrollment Opportunities will in no way release the Applicant from "addenda or additional information" resulting in additional costs to meet the requirements of the open enrollment.Applications should be submitted either by email, regular mail, or delivery service. DO NOT submit an Application by more than one submittal option as referenced above.4.6.1 Electronic Submission Applicant may submit application packet by email to: blair.gossett@hhsc.state.tx.us 4.6.2. Regular Mail SubmissionApplicant must submit two (2) electronic copies of all required documents as scanned versions (.pdf) on separate portable media devices, such as flash drives. 4.6.2.1. These devices and their content must be compatible with Microsoft Office 2010. Applicants must ensure there are no encryptions on these devices that would prevent HHSC from opening the documents. The electronic Application submission must be organized as directed in Subsection 4.7 of this open enrollment. If Applicant is having difficulty providing an electronic Application submission, contact the HHSC Point of Contact identified in Subsection 1.2 of this open enrollment for hard copy submittal accommodations. 4.6.2.2. It is the Applicant’s responsibility to appropriately mark and deliver the Application and related materials in response to this open enrollment by the Application due date.4.6.2.3. Submission of an Application does not execute a anization of Application and Required DocumentsApplicant must organize its scanned and signed Application packets in the following order and format. Each (Select acceptable form of submission: flash drive, compact disc, E-mail or paper) submission of the Application packet must include the documents listed below. The documents must be in the appropriate order, numbered, and labeled accordingly.File Folder 1: ApplicationPackage A: ApplicationPackage B: HHSC Uniform Contract Terms and Conditions Version 2.15Package C: HHSC Special Conditions Version 1.2Package D: HHSC CRS Supplemental Conditions Version 1.0File Folder 2: Required Forms Package 1: Affirmation and Solicitation AcceptancePackage 2: Work ExperiencePackage 3: Application for Texas Identification NumberPackage 4: Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion for Covered ContractsPackage 5: Direct Deposit AuthorizationPackage 6: Respondent Information and DisclosuresFile Folder 3: Supporting DocumentationAssumed Name Certificate (If applicable); LLC Articles of Formation (If applicable); Certificate of Incorporation (If applicable); or Copy of Partnership Agreement and Signatory Assignment (If applicable).Proof of Insurance, if Applicant already has required insurance, that meets insurance requirements in Subsection 1.7.3.A copy of the Applicant’s current and valid: License issued by HHSC as a:Assisted Living Facility (“ALF”);A Home and Community Support Services Agency (“HCSSA”);Nursing facility; orLicense issued by DSHS as a:A Hospital;A chemical dependency treatment center; or For non-residential post-acute rehabilitation facilities not licensed by HHSC as an ALF or nursing facility, or by DSHS as a hospital or chemical dependency center must submit a copy of the Applicant’s current and valid:Registration with the Executive Council of Physical Therapy and Occupational Therapy (); or License issued by HHSC as a home and community services agency (); A copy of the Applicant’s CARF Accreditation, as applicable;A copy of the Applicant’s JCAHO Accreditation, as applicable;A copy of valid, current Certificate of Occupancy ;Copies of applicable professional licenses of the director, or equivalent position, of each department for services provided that has licensed and/or certified staff (see, Subsection 2.7.1.2 of this open enrollment) that will be providing direct services/therapies to consumers. If the director, or equivalent position, does not have an applicable professional license, submit written documentation attesting to that fact;All CMS 2567, HHSC 3724 deficiency reports, and Statements of Deficiencies for up to and including the two (2) calendar years preceding the date of Application submittal; or if Applicant has no CMS 2567, HHSC 3724 deficiency reports, or Statements of Deficiencies for up to and including the two (2) calendar years preceding the date of Application submittal, a statement from Applicant attesting to that fact;Narrative of Work experience, available in Form 2 of this Enrollment’s main mage, describing the organization's three (3) years of experience working with people who have a traumatic brain injury, traumatic spinal cord injury, or both including dates of service, positions held and place of employment;and Investigation reports for the two (2) calendar years preceding the date of Application submittal; or if Applicant has no investigation reports for the two calendar years preceding the date of Application submittal, a statement from Applicant attesting to that fact.Alternate Delivery of ApplicationsIf Applicant cannot submit their application and required documents by email, the documents may be delivered by mail, courier, or delivery service.DO NOT submit an Application by both email and regular mail or delivery service.Submit all copies of the Application to HHSC at the address provided below. All required documents must be received by HHSC by the due date and time listed in the Procurement Schedule in Subsection 1.3. of this open enrollment. Delivery OptionPhysical Address for delivery(Operating Hours – 8:00 A.M. to 5:00 P.M.)Health and Human Services CommissionAttn: Blair Gossett5806 34th StreetLubbock, Texas 79407HHSC will date and time-stamp all submissions when received. The clock in the HHSC office is the official timepiece for determining compliance with the deadlines in this procurement. HHSC reserves the right to reject late submissions. It is the Applicant’s responsibility to appropriately mark and deliver the Application to HHSC by the specified time and date.All Applications become the property of HHSC after submission.Requirements for Mailed or Delivered ApplicationsSubmit one original set of all required documents and an electronic media device (flash drive or compact disc) containing the required documents. Documents and electronic media device must be placed in a sealed package and correctly identified with the Procurment Number of this open enrollment and in the order listed in Section 4.7. It is the Applicant’s responsibility to appropriately mark and deliver the application and related materials in response to this Enrollment.Each flash drive or compact disc must be in a sealed envelope and labeled as follows:Full Legal Name of the Organization; Organization’s point of contact;Organization’s point of contact’s job title;Organization’s point of contact’s telephone number and Email address; HHSC procurement number of this open enrollment; andDate of submission. (The remainder of this page is intentionally left blank.)ELIGIBILITY DETERMINATIONInitial Compliance ScreeningHHSC will perform an initial screening of all Applications received. Unsigned Applications and Applications that do not include all required forms and sections are subject to rejection without further screening and application consideration. HHSC will review applications and assess for systemic programmatic issues, such as the severity of past deficiencies and pattern of repeated deficiencies. Decisions regarding selection of Applicants could take up to sixty (60) days. If a Applicant’s Application for enrollment is approved by HHSC, the Applicant must initiate licensure and certification action, if applicable, with the HHSC Regulatory Services Division within thirty (30) days of HHSC notification to the Applicant. After licensed by the HHSC Regulatory Services Division, HHSC will contact the Applicant to execute a contract. If no Applications are received, or if no provider Applicant meets the requirements to receive a contract, HHSC will close the procurement.Unresponsive ApplicationsUnless Applicant has taken action to withdraw the Application for this open enrollment, an Application will be considered unresponsive and will not be considered further when any of the following conditions occurs:The Applicant fails to meet major open enrollment specifications, including:The Applicant fails to submit the required Application, supporting documentation, or forms.The Applicant is not eligible under Subsection 1.5 of this open enrollment.The Applicant does not accept the payment rate established in this open enrollment.The Application is not signed.The Applicant’s Application is not clearly legible. Typewritten is preferred.The Application is not received by the closing of the open enrollment period provided in Subsection 1.3 of this open enrollment.Corrections to ApplicationApplicants have the right to amend their Application at any time prior to the completion of HHSC's initial screening and prior to sending the Application to HHSC for further screening (see, Subsection 5.2., Unresponsive Applications). To make corrections, Applicant must submit a written amendment to the HHSC Point of Contact, as designated in Subsection 1.2.Review and Validation of ApplicationsThe Applicant must provide full, accurate, and complete information as required by this open enrollment.Additional InformationBy submitting an Application, the Applicant grants HHSC the right to obtain detailed information, including but not limited to the following, from any lawful source regarding the Applicant’s, its directors’, its officers’, and its employees’:Past business history, practices, and conduct;Prior regulatory compliance with federal and state statutes and rules;Ability to supply the goods and services; andAbility to comply with Contract requirements.By submitting an Application, an Applicant generally releases from liability and waives all claims against any party providing HHSC information about either the Applicant or about the accuracy or veracity of information provided in the Application. HHSC may take such information into consideration in screening or validating information in Applications or supporting documentation.Method of AllocationMethod of allocation is based on a per diem state-wide rate that includes a base rate and a core rate for services the Contractor will provide consumers (residential or non-residential services) and the established CRS rates. The residential rate and non-residential rate will differ, as described in Section 3.1.Because services provided are contingent upon the CRS consumer, any successful Applicant will be awarded a contract to provide services; however, there is no guarantee that any successful Applicant will receive any consumers for residential or non-residential services as a result of any awarded contract.DebriefingAny Applicant who is not awarded a Contract may request a debriefing by submitting a written request to the HHSC Point of Contact as designated in Subsection 1.2. of this open enrollment. The debriefing provides information to the Applicant on the strengths and weaknesses of its Application.Protest ProceduresThe protest procedure for an Applicant who is not awarded a Contract to protest an award or tentative award made by any HHS agency, is allowed for competitive Procurements. This Procurement is non-competitive and cannot be protested as provided in 1 TAC §391.403.GLOSSARYTERMDEFINITIONApplicantAny individual or entity that submits an Application for enrollment pursuant to this open enrollment.ApplicationAn Application submitted by an Applicant in response to this open enrollment.ConsumerPerson receiving services who has a traumatic brain injury, traumatic spinal cord injury, or both.ExpectationApplicant’s perception of satisfaction as indicated by responses made to the items on the Applicant Satisfaction Survey Questionnaire.Fiscal Year (State of Texas)The period beginning September 1 and ending August 31 of each year.InvoiceA contractor’s bill or written request for payment under the contract for services performed.Licensed ProfessionalA person who has completed a prescribed program of study in a health field and who has obtained a license indicating his or her competence to practice in that field in Texas. Examples of licensed professionals include a physician, registered nurse, occupational therapist, physical therapist, licensed professional counselor, or social worker.Post-Acute Brain Injury Services (PABI)Services provided as recommended by an interdisciplinary team to address deficits in functional and cognitive skills based on individualized assessed needs. Services may include behavior management, the development of coping skills, and compensatory strategies. These services may be provided on a residential or non-residential basis.Post-Acute Rehabilitation ServicesPost-Acute Brain Injury services and Post-Acute Spinal Cord Injury services.Post-Acute Spinal Cord Injury ServicesServices provided as recommended by an interdisciplinary team to address deficits in functional skills based on individualized assessed needs. These services are provided in the home and in the community (non-residential settings). ProcurementThe acquisition of goods or services.SolicitationA document requesting submittal of an application to provide goods or services in accordance with the advertised specifications.SpecificationsA description of what the purchaser requires and what an applicant must offer. The written statement or description and enumeration of particulars of goods to be purchased or services to be performed.StateThe State of Texas.State AgencyAgency of the State of Texas as defined in Texas Government Code 2056.001.(The remainder of this page is intentionally left blank.) ................
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