FMS RFP directory form



Directory of Proposal RequirementsThe following twelve (12) responder qualifications and proposal requirements are minimum requirements of the proposal. DHS will evaluate the qualifications on a pass/fail basis. A responder will receive a failing score if the evaluation team determines the responder failed to submit the required documentation or verification for each qualification and proposal.The responder must use this directory in order to identify the location of each required proposal component listed under the responder qualifications and proposal requirements section of this RFP.If the responder fails to complete and submit this directory and all required documentation or verification, DHS may remove the responder from consideration. Instructions to submitOnce complete, attach this form to your RFP submission according to the direction on the RFP. Remainder of the page intentionally left blank.1. Readiness review for VF/EA financial management services QualificationBefore enrollment, the responder must have successfully completed a readiness review within the past five years of the date of this RFP. The responder will be required to participate in a performance review every three years after enrollment for Medicaid funded programs. If the responder’s readiness review was completed more than five (5) years ago, the responder must successfully complete an updated readiness review during the first twelve (12) months of FMS enrollment. To clarify, if you have ever had a readiness review completed, please submit the following information:The name of the entity who conducted the readiness review.The address of the entity who conducted the readiness review.The date the readiness review was completed.The contact information for the entity who completed the readiness review.A sworn statement from the responder that the entity that conducted the readiness review previously performed a VF/EA or Veteran’s FMS readiness review for a vendor that has an agreement (including sub-contract) with a governmental entity to provide services under a Medicaid or another federally funded health care program. In addition, if the readiness review was completed more than five (5) years ago, the responder must also submit a sworn statement that it will successfully complete an updated readiness review during the first twelve (12) months of FMS enrollment, and it will provide the State the same documentation required above upon completion.If you have never had a readiness review completed prior to the date of the RFP, you cannot pass this requirement and are unable to be considered under this RFP.Required documentation or verificationThe responder must provide documentation to verify their successful completion of a VF/EA FMS readiness review. The documentation required must contain: Table 1: Readiness review for VF/EA financial management services checklistRequired documentation or verificationIndicate location in proposal (section and page number[s])a. The name and address of the entity who conducted the readiness review; FORMTEXT ?????b. The date the readiness review was completed; FORMTEXT ?????c. Contact information for the entity who completed the readiness review; and FORMTEXT ?????d. A sworn statement from the responder that the entity that conducted the readiness review previously performed a VF/EA or Veteran’s FMS readiness review for a vendor that has an agreement (including sub-contract) with a governmental entity to provide services under a Medicaid or another federally funded health care program. FORMTEXT ?????If the responder’s readiness review was completed more than five (5) years ago, the responder provide a sworn statement that it will successfully complete an updated readiness review during the first twelve (12) months of FMS enrollment, and it will provide the state the same documentation required above upon completion. FORMTEXT ?????2. Required staffQualification The responder must have on staff:An information technology security officer andEither a certified payroll professional, a certified public accountant, or a person with a bachelor’s degree in accounting. Required documentation or verificationTable 2: Required staff checklistRequired documentation or verificationIndicate location in proposal (section and page number[s])a. The responder must provide the name(s), resumes, and job description for the organization’s information technology security officer; and FORMTEXT ?????b. The responder must provide the name(s), resumes, and job description for the organization’s: 1. Certified payroll professional, 2. Certified public accountant, or 3. Individual with a bachelor’s degree in accounting FORMTEXT ?????3. Electronic tracking, reporting and verification software productQualificationThe responder must have a detailed plan to acquire or develop an electronic tracking, reporting and verification software product for required controls and reports that rely on analyzing data on participants and support workers across FMS providers. Required documentation or verification The Responder must describe their organization’s electronic tracking, reporting and verification software product. The software product must have the minimum functionality listed below: Table 3: Electronic tracking, reporting and verification software product checklistRequired documentation or verificationIndicate location in proposal (section and page number[s])a. Track and report on individual worker training, hours worked, overtime, travel time, and paid time off across participants; FORMTEXT ?????b. Identify overlapping hours across workers providing service to participants served by the Responder; FORMTEXT ?????c. Send information to Service Employees International Union (SEIU) or a DHS contracted software contractor or their designees and receive information from other providers, managed care organizations, and the department; FORMTEXT ?????d. Produce data in a file format that is compatible with the data systems used by providers, managed care organizations, and the department; and FORMTEXT ?????e. Be configurable to accommodate future program changes, reporting requirements, or changes in policy, regulation or law. FORMTEXT ?????4. Requirements for VF/EA FMS under a collective bargaining contractQualificationThe responder must have the capacity to meet the requirements for VF/EA FMS under a collective bargaining contract. Required documentation or verification The Responder will describe their organizational systems in place to meet the requirements for fiscal intermediaries under a collective bargaining contract, including but not limited to: Table 4: Requirements for VF/EA FMS under a collective bargaining contract checklistRequired documentation or verificationIndicate location in proposal (section and page number[s])a. Managing paid time off accrual in accordance with the Collective Bargaining Agreement; FORMTEXT ?????b. Allowing the posting of collective bargaining notices on the FMS provider's premises and distributing membership materials to new workers; FORMTEXT ?????c. Complying with reporting requirements on worker data as established under the terms of the contract; FORMTEXT ?????d. Collecting and remitting voluntary membership dues; and FORMTEXT ?????e. Providing the option of direct deposit for all workers. FORMTEXT ?????5. HIPAA-compliant security plan QualificationThe responder must have a:Health Insurance Portability and Accountability Act (HIPAA)-compliant security planDisaster recovery procedures for both electronic and hard copy documents (including off-site back-up data storage) Continuity of operations plan for assuring internal controls and system capacity to:Secure private dataDetect and address data breachesIdentity theft or hacking attempts as soon as they are discovered.Required documentation or verificationThe responder must provide a description of their organization’s Health Insurance Portability and Accountability Act (HIPAA) compliant security plan and a continuity of operations plan for assuring internal controls and system capacity to: Table 5: HIPAA-compliant security plan checklistRequired documentation or verificationIndicate location in proposal (section and page number[s])a. Secure private data and detect and address data breaches FORMTEXT ?????b. Identity theft, or hacking attempts as soon as they are discovered; and FORMTEXT ?????c. Have disaster recovery procedures for both electronic and hard copy documents, including off-site back-up data storage. FORMTEXT ?????d. All electronic data must be encrypted at rest and in transit FORMTEXT ?????6. Customer service system QualificationThe responder must have an established customer service system with the components listed below. Required documentation or verificationThe responder must provide documentation that their organization has a customer service system that includes: Table 6: Customer service system checklistRequired documentation or verificationIndicate location in proposal (section and page number[s])a. A toll-free telephone; FORMTEXT ?????b. A business office with a physical location in Minnesota; FORMTEXT ?????c. A secure fax line; FORMTEXT ?????d. A public Web site; FORMTEXT ?????e. Trained staff available outside normal business hours with secure and alternative methods of timely communication with participants and support workers; FORMTEXT ?????f. The capacity to provide effective customer service to:1. Older adults; FORMTEXT ????? 2. Persons with disabilities; FORMTEXT ????? 3. Persons who are deaf or hard of hearing; and FORMTEXT ????? 4. Persons whose primary language is not English; FORMTEXT ????? g. Grievance procedure; and FORMTEXT ?????h. Method to track communication and time line for responding to customers’ grievances, questions and concerns. FORMTEXT ?????7. Quality assurance and program integrity system QualificationThe responder must have a quality assurance and program integrity system with the essential internal controls and monitoring required for the efficient and accurate delivery of services and the prevention, detection, and reporting of known or suspected fraud, abuse or errors. Required documentation or verificationThe responder must submit a proposed Quality Assurance (QA) work plan that describes all QA activities. The responder must identify how they will perform the quality assurance activities during the contract period.Table 7: Quality assurance and program integrity system checklistRequired documentation or verificationIndicate location in proposal (section and page number[s])a. The responder must include all QA activities that: 1. Strengthen internal controls; FORMTEXT ?????2. Promote efficient and accurate delivery of services; and FORMTEXT ?????3. Prevent, detect and report known or suspected fraud, abuse or errors. FORMTEXT ?????b. The responder must describe methods used to keep up to date on all of the following:1. Changes in policy; FORMTEXT ?????2. Changes made to regulation; and FORMTEXT ?????3. Changes made to law including those for tax, labor, immigration, workers’ compensation, and funding sources (e.g.: Medicare and Medical Assistance). FORMTEXT ?????8. Minnesota-specific VF/EA policies and procedures QualificationThe responder must have a Minnesota-specific policies and procedures manual for providing VF/EA FMS that minimally address the items listed below. Required documentation or verificationThe responder must submit their organization’s Minnesota-specific policies and procedures manual for providing vendor fiscal/employer agent financial management services. The policies and procedures must minimally address: Table 8: Minnesota-specific VF/EA policies and procedures checklistRequired documentation or verificationIndicate location in proposal (section and page number[s])a. Operating in compliance with IRS Revenue Procedure 2013-39 under Section 3504 of the Internal Revenue Code; FORMTEXT ?????b. Vendor fiscal/employer agent (VF/EA) duties and responsibilities for assisting participant employers with obtaining and retiring employer identification numbers; FORMTEXT ?????c. Payroll processing for household employers or Home Care Service recipients using a 3504 agent, filing payroll taxes and unemployment for household employers using an agent, and maintaining workers' compensation and liability coverage for household employers under Minnesota statute; FORMTEXT ?????d. Orientation of participant employers; FORMTEXT ?????e. Worker misconduct and communications with participant’s workers; FORMTEXT ?????f. Procedures for enrolling workers as employees of participant-employers; FORMTEXT ?????g. Individual budget tracking and reporting; FORMTEXT ?????h. Compliance with federal HIPAA and HITECH requirements; FORMTEXT ?????i. Customer service to participant-employers and workers; FORMTEXT ?????j. Allowing workers access to collective bargaining membership information; and FORMTEXT ?????k. A grievance procedure. FORMTEXT ?????9. Financial stability QualificationThe responder must be a financially solvent organization with minimal cash reserve and a line of credit equal to at least three (3) payrolls of your current business that are available to cover shortages or delays in receipt of revenue. The responder must provide documents sufficient to substantiate financial solvency. If Responder is either substantially or wholly owned by another corporate entity, information about the parent organization must be provided at the time of enrollment. Required documentation or verificationThe responder must submit financial information that includes the following: Table 9: Financial stability checklistRequired documentation or verificationIndicate location in proposal (section and page number[s])a. A current financial statement; FORMTEXT ?????b. A copy of an independent audit conducted within the last year; and FORMTEXT ?????c. Other documents sufficient to substantiate responsible fiscal management FORMTEXT ?????d. Evidence of being a financially solvent organization with minimal cash reserves and a line of credit equal to at least three payrolls of the organization’s current business that are available to cover shortages or delays in receipt of revenue; and FORMTEXT ?????e. Sufficient financial documentation to verify their organization’s financial stability detailed below. FORMTEXT ?????In the event a responder is either substantially or wholly owned by another corporate entity, the proposal also must include:The most recent detailed financial report of the parent organizationA written guarantee by the parent organization that it will unconditionally guarantee performance by the responder in each and every term, covenant and condition of such contract as may be executed by the parties.10. Past or pending complaints or litigation QualificationThe responder must disclose information about any past or pending complaints or litigation relating to the provision of services by Responder. Required documentation or verificationTable10: Past or pending complaints or litigation checklistRequired documentation or verificationIndicate location in proposal (section and page number[s])The responder must provide information concerning any complaints filed with or by professional and state or federal licensing/regulatory organizations within the past six years against your organization or its employees relating to the provision of services. If such complaints exist, you must include the date of the complaint(s), the nature of the complaint(s), and the resolution/status of the complaint(s), including any disciplinary actions taken. FORMTEXT ?????All proposals must also include information about civil or criminal litigation pending or resolved within the past five (5) years that relates to the provision of services by your organization or its employees. If such litigation exists, please include the date of the lawsuit, nature of the lawsuit, and the dollar amount being requested as damages, and if resolved, what the resolution was (e.g. settled, dismissed, withdrawn by plaintiff, verdict for plaintiff with $ x damages awarded, verdict for Responder, etc.). FORMTEXT ?????The responder must disclose information about any action or sanction taken by any government agency against the following individuals: a. The responder; b. Any parent or subsidiary of the responder; and c. Any owner with more than 5% interest in the responder’s organization who either individually or wholly had any action taken against any prior company where they were an owner of more than 5%. FORMTEXT ?????11. Capacity to provide VF/EA financial management servicesQualificationThe responder must have the capacity to provide VF/EA FMS statewide during normal business hours. Required documentation or verificationThe responder must describe the following:Table 11: Capacity to provide VF/EA financial management services checklistRequired documentation or verificationIndicate location in proposal (section and page number[s])a. Program(s) the responder wishes to serve; FORMTEXT ?????b. Responder’s capacity to serve participants under each program identified in paragraph a of this section; FORMTEXT ?????c. Responder’s capacity to provide services statewide or a plan to ensure statewide capacity within 12 months of the start of contract in accordance with this RFP and contract requirements to participant employers, regardless of the geographical area in which the participant reside; and FORMTEXT ?????d. Describe how participants whose primary language is not English, or who are deaf or hard of hearing, or who have other communication needs will be served. FORMTEXT ?????12. Cost proposal General informationSuccessful responders will bill for each participant through MMIS or the managed care organization (MCOs) claim processing system according to the terms of the contract. Payment fees will be reviewed upon renewal of the contract. The fees must be on a fee-for-service basis other than a percentage of the participants’ service budget, and may not include set up fees or base rates or other similar charges. The responder must establish two separate service fees:One for employment-related tasks and goods as outlined under Section II, BOne for a service fee for participants who use goods only (non-routine, non-payroll transactions). Successful responder must also bill separately for criminal background studies which is not included in the service fee. Required documentation or verificationThe responder must describe and identify the proposed service fees they will charge to provide the required tasks and deliverables, as outlined under Section II, B. The responder must include a detailed description of the VF/EA FMS tasks included in the service fee and other charge or fees (if applicable). Table 12: Cost proposal checklistRequired documentation or verificationIndicate location in proposal (section and page number[s])The responder must include a detailed description of the VF/EA FMS tasks included in the service fee and other charge or fees (if applicable). a. The cost must include the responder’s service fee(s) and b. Other charges or fees (if applicable) billed to the participant’s budget. FORMTEXT ?????c. The responder must identify their proposed percentage of employer-related costs such as worker’s compensation and employee benefits and FORMTEXT ?????d. The responder’s proposed percentage must include an itemized breakdown of each employer-related component. FORMTEXT ????? ................
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