Coastal Plains Community Center Proposal Due Date: 4:00 P.M. CST, August 3, 2012
This RFP is issued by COASTAL PLAINS COMMUNITY CENTER (CPCC), a Community Mental Health and Mental Retardation Center and a governmental unit of the State of Texas under the provisions of Vernon’s Texas Codes Annotated, Health and Safety Code, Chapter 534, as amended, (the “Center”), for the purposes of providing mental health services to eligible residents of Aransas, Bee, Brooks, Duval, Jim Wells, Kenedy, Kleberg, Live Oak and San Patricio Counties in an effective, cost-efficient, and quality manner in accordance with State requirement and community standards. This RFP contains the requirements that all proposals must meet to be considered by CPCC for selection. Failure to conform to requirements of the RFP will result in rejection of the proposal without any further consideration. The offerer is solely responsible for the preparation and submission of a proposal in accordance with instructions contained in this RFP. Services to be Purchased:
Note: In order to provide services to consumers in all of our nine (9) counties it may be necessary to award a contract to more than one provider. If your laboratory is unable to cover all nine counties, please submit a proposal for the locations which you are able to cover.
Contact Person: All inquiries about this RFP should be directed to:
Theresa Guerra, Director of Authority Functions 200 Marriott Portland TX 78374 (361) 777-3991
Submission of Completed Application: As a condition of consideration, an ORIGINAL SEALED APPLICATION PLUS two (2) copies must be received by August 3, 2012 by no later than 4:00 p.m. CST in the office of the Director of Authority Functions. All applications must to be addressed to:
Theresa Guerra, Director of Authority Functions
INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED. ELECTRONICALLY SUBMITTED APPLICATIONS WILL NOT BE CONSIDERED. APPLICATIONS RECEIVED AFTER THE DUE DATE WILL NOT BE CONSIDERED. OFFERORS SHOULD CAREFULLY READ AND UNDERSTAND THIS RFP PRIOR TO SUBMISSION OF AN APPLICATION.
CLARIFICATION OR OBJECTION TO PROPOSAL SPECIFICATION: If any person contemplating submitting a proposal for this contract is in doubt as to the true meaning of the specifications or other documents or any part thereof, he/she may submit to the Director of Authority Functions on or before TEN DAYS PRIOR to scheduled opening of bids, a request for clarification. All such requests for information shall be made in writing and the person submitting the request will be responsible for its prompt delivery. Any interpretation of the RFP will be made only by RFP Amendment duly issued. A copy of such RFP Amendment will be mailed or delivered to each person receiving a solicitation. COVERED SERVICES: Laboratory services provided will include the following:
1) Clinical laboratory tests to be performed on blood, urine, and/or other body fluids in accordance with
physician’s order for consumers of CPCC.
2) All specimen containers and venipuncture equipment will be provided by contractor. 3) Contractor will provide services in accordance with the following :
STAT or emergency tests will be reported, by phone or fax, back to the clinic or physician within 2 hours of the arrival of specimen at the laboratory.
ii) Routine tests will be reported within forty-eighty (48) hours. iii) Results deemed as “critical value” will be phoned into the clinic immediately. iv)
Results deemed as “alert value” will be phoned into the clinic within twenty four (24) hours.
Contractor will have or develop mechanism to ensure confidentiality of consumer information in accordance with applicable State and Federal laws as well as Department of State Health Services (DSHS) standards.
Billing will be done on a monthly basis and will include the consumers’ names, test performed, and cost of the procedure.
CPCC is the payer of last resort. For all consumers with third party payers (Medicaid, CHIP, Private insurance), the laboratory is required to bill the third party payer first.
c) The following laboratory tests will be approved for reimbursement by the Center under this
Description of Service
COVERED INDIVIDUAL: Any Child, Adolescent, or adult (1) who meets the Texas DSHS priority population criteria; (2) who is a resident of Kleberg, Kenedy, Jim Wells, Duval, Brooks, Bee, Live Oak, Aransas and San Patricio counties; (3) for whom the prescription of medications has been authorized by the Center’s designee and (4) who does not have a third party or governmental payor for medical services. BILLING AND PAYMENT Monthly billing for services provided is preferred. Payment will be made within 30 days of receipt of bill. SPECIFIC PROPOSAL REQUIREMENTS To achieve a uniform review process and to obtain a maximum degree of comparability, CPCC requires that the proposal be submitted with a master (marked original) and two (2) copies. Each must include the following:
1) Title Page - must show the RFP subject; the offeror's name; the name, address, and telephone
number of a contact person; and the date of the proposal.
2) Transmittal Letter - Submit a signed letter briefly addressing the offeror's understanding of the work to
be done, the commitment to do the work detailed within this RFP and a statement explaining why the offeror believes itself to be best qualified to do the required work.
3) Signed Assurances and Certifications form (attachment #1) with Offeror Representative 4) Detailed Application –(attachment #2)
a. Demographic information b. Organizational structure c. Risk Profile
i. List any lawsuits or litigation involving yourself during the past five years. Provide details.
Provide consent to release information from past and present insurance carriers.
iii. History of validated client abuse, client neglect, or client rights violation claims in the past
iv. History of suspension or revocation of professional license.
d. Description of Quality Management and Quality Assurance program – procedures to insure
continuous improvement in the quality of services
e. Description of plan to provide the requested services with a proposed fee f.
5) Proof of Professional Liability Insurance, with a minimum coverage of $1,000,000 per claim and
AWARD CRITERIA Each application will be evaluated based on the identified award criteria. The maximum score for each
Background and experience as a provider (30 Points)
Cost effectiveness and best value of the proposed services (35 Points)
MONITORING CPCC will perform periodic on-site monitoring of Contractor’s compliance with the terms of this contract, and of the adequacy and timeliness of Contractor’s performance under this contract. After each monitoring visit, CPCC shall provide Contractor with a written report of the monitor's findings. If the report notes deficiencies in Contractor’s performances under the terms of this contract, it shall include requirements and deadlines for the correction of those deficiencies by Contractor. Contractor shall take action specified in the monitoring report prior to the deadlines specified. PART V - ASSURANCES AND CERTIFICATIONS
I understand that my organization, known collectively as “Offeror”, and I must comply with each of the assurances listed below if awarded a contract in response to this solicitation. I am legally authorized to bind my organization to the following assurances, as signified by my signature at the end of this section. I understand that my failure to sign this section and certify all of these assurances may result in disqualification of this application. 1. Offeror has made no attempt nor will make any attempt to induce any person or firm to submit or not submit
2. Offeror will comply with the requirements of the Immigration Reform and Control Act of 1986 and Immigration
Act of 1990 regarding employment verification and retention of verification forms for any individual(s) hired on or after November 6, 1986, described in this application who will perform any labor or services.
3. Offeror will comply with all federal statutes relating to nondiscrimination. These include but are not limited to
Title VI of the Civil Rights Act of 1964 (Public Law 88-352) which prohibits discrimination on the basis of race, color or national origin; Title IX of the Education Amendments of 1972, as amended (20 U.S.C. Sections 1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; Section 504 of the Rehabilitation Act of 1973 (Public Law 93-112), which prohibits discrimination on the basis of handicaps; the American with Disabilities Act of 1990 (Public Law 101-336); and all amendment to each, and all requirements imposed by the regulations issues pursuant to these acts, especially 45 CFR Part 80 (relating to race, color and national origin), 45 CFR Part 84 (relating to handicap), 45 CFR Part 86 (relating to sex), and 45 CFR Part 91 (relating to age).
4. Offeror has arrived at this application independently without consultation, communication, or agreement with
any other applicant or competitor for the purpose of restricting competition.
5. Offeror certifies that neither it nor its officers or employees is involved in other activities or relationships with
other persons that cause Offeror to be unable or potentially unable to render impartial assistance or advice to CPCC, or that impair or might impair the Offeror’s objectivity in performing work under the contract or that cause Offeror to have an unfair competitive advantage.
6. Offeror accepts the terms, conditions, criteria and requirements set forth in the RFP. 7. Offeror accepts CPCC’s sole right to award any application or reject any or all offers submitted at any time. 8. Offeror accepts CPCC’s sole right to cancel the RFP at any time CPCC so desires. 9. Offeror accepts CPCC’s sole right to alter the timetables for procurement as set forth in the RFP. 10. Offeror agrees that no claim will be made for payment to cover costs incurred in the preparation of the
submission of the application or any other associated costs.
11. Offeror owes no funds to CPCC or the State of Texas for unresolved audit exceptions. An unresolved audit
exception is an exception for which the Offeror has exhausted all administrative and/or judicial remedies and has failed to comply with any resulting demand for payment.
12. Offeror agrees that all processes and products resulting from this contract award will be the property of the
13. Offeror agrees to ensure that information about individuals served by CPCC will be kept confidential
according to federal and state laws and regulations.
14. Offeror certifies that neither it nor its principals are presently debarred, suspended, proposed for debarment,
declared ineligible, or voluntarily excluded from participation in this contract by any federal or state Agency or agency.
15. Offeror, if it is a corporation, is either not delinquent in its franchise tax payments to the State of Texas, or is
not otherwise subject to payment of franchise taxes to the State of Texas.
16. Neither Offeror nor any member of Offeror’s staff or governing authority has participated in the development
of specific evaluation criteria for award of this contract, nor will participate in the selection of the successful Offeror awarded this contract.
17. No principal of Offeror’s has worked as an employee for CPCC in the past year. 18. Offeror has not retained or promised to retain an entity or used or promised to use a consultant that has
participated in the development of the specific criteria for the award of this contract or that will participate in the selection of the successful Offeror awarded this contract.
19. Offeror agrees to provide CPCC with information necessary to validate any statements made in this
application, as requested by CPCC, including but not limited to, allowing access for on-site observation, granting permission for CPCC to verify information with third parties, and allowing inspection of Offeror’s records. Offeror understands that failure to substantiate any statements made in the application as requested by CPCC may result in disqualification of the offer.
20. As provided by Texas Family Code, Section 231.006, a child support obligor who is more than 30-days
delinquent in paying child support and a business entity in which the obligor is a sole proprietor, partner, shareholder, or owner with an ownership interest of at least 25% is not eligible to receive payments from state
funds under a contract to provide property, materials, or services or receive a state-funded grant or loan. Offeror certifies that it is not ineligible to receive the payments under this contract and acknowledges that this contract may be terminated and payment may be withheld if this certification is inaccurate.
21. Offeror certifies that any Health and Human Services agency or Public Safety and Criminal Justice agency
has not revoked its license, permit, or certificate.
22. Neither Offeror nor its officers and employees have given, offered to give, or intend to give any economic
opportunity, future employment, gift, loan, gratuity, special discount, trip, favor, or service to a public employee in connection with the submitted offer.
23. Confidential information, as defined in the RFP, will be used only to assist the successful Offeror in
performing services pursuant to its contract with CPCC.
24. Offeror will use at least the same standard of care in the protection of confidential information as it uses to
protect its own confidential or proprietary information.
25. All confidential materials made available to the successful Offeror, including copies thereof, shall be returned
to CPCC upon completion of the project or request by CPCC.
26. Offeror certifies that none of the funds paid by CPCC pursuant to any contract resulting from this RFP will be
used to pay any person for influencing or attempting to influence an officer or employee of any agency, a member, officer or employee of Congress or the state legislature or for obtaining any federal or state contract.
27. Offeror certifies that it has not filed for protection under any state or federal bankruptcy law. 28. Offeror certifies that none of Offeror’s property, plant or equipment has been subject to foreclosure or
repossession within the preceding 10-year period.
29. Offeror certifies that it has not had any debt declared in default and accelerated to maturity within the
Person to contact regarding inquiries: (Offeror Representative) Name
LABORATORY SERVICE APPLICATION
Agency: __________________________________________ Owner: __________________________________________ SSN#/TIN: _______________________________________ Years of operation: __________________________________ Address: ____________________________________ City: ____________________ Zip: _________ Phone: ___________________________________ Fax: ____________________________ Certification # if a Historically Underutilized Business: ___________________________________________ Billing Manager: ___________________________________________________________________________ Phone Number: ______________________________ Fax number:_________________________________ Other Business Locations in this Market Area:
1. _____________________________________________________________________________________ 2. _____________________________________________________________________________________ Organization Structure: Name of Director/President/CEO, include a list of the names and titles of the organizations key personnel, attach a copy of organizational chart if necessary.
1. ____________________________________ ___________
2. ____________________________________ ___________
Describe your background experience as a provider of laboratory services. Include your history of working with persons with major mental illness.
Are you able to deploy staff to our clinics to draw blood/urine samples?____________________________ What additional fee would be required for this service?__________________________________________ Describe your staff’s experience in working with various cultures.
Description of your Quality Management and Quality Assurance efforts to insure continuous improvement in the quality of laboratory services. (Any process you have to discover and track errors, to receive communication from clients with respect to satisfaction with service and resolution of complaints, documentation of any accreditation/licensing evaluations completed in the past 24 months).
Describe the financial stability of your company, including the resources necessary to guarantee your ability to deliver the proposed services at the proposed fees. __________________________________________________________________________________________
1) Do you or anyone working in your organization who are providing services have any felony convictions?
2) Have you or any of your employees (or subcontracted employees) had any validated client abuse, client
neglect, or client rights violation claims in the past five years.
3) Have you or any of your employees had a professional license suspended or revoked?
4) Have you or any of your employees had Medicaid or Medicare sanctions?
5) Has the organization/partnership/business been placed on vender hold within the past five (5) years by any
6) Are you, or any of your employees, currently on the Texas or U.S. Office of the Inspector General’s exclusion
7) Have you ever been dropped from a managed care network?
8) For any answers “yes” to questions 1 through 6, please, attach a detailed explanation.
9) Are your laboratories CLIA certified?
10) Attach proof of liability insurance, minimum $1,000,000 per claim and $3,000,000 annual aggregate.
11) List any lawsuits or litigation involving your organization during the past five years. Provide details.
Attach a plan to deliver the covered Laboratory Services to Coastal Plains Community Center’s consumers including
a description how services will be provided in our 9 county service area, specifically listing service locations
any ancillary or additional services that you will provide at no cost, if any
a proposal of fees for the following individual laboratory tests
Description of Service
Note to applicant: Coastal Plains MHMR completes a credentialing process and will verify any certifications and /or accreditations prior to completing a contract. You have the right to review this information. You also have the right to correct any erroneous information that the Center receives for the purposes of Credentialing. _______________________________________________
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