Texas Health and Human Services Commission HHSC

1
Texas Health and Human Services Commission (HHSC)

• Consulting Services to Provide Medical Checkup
  Completeness Study
• Request for Proposals 529-08-0170
• Vendor Conference August 5, 2008

2
Welcome

• Introductions
• Elizabeth Ward, Enterprise Contract and
  Procurement Services (ECPS)
• Jo Ann Roznovak, Medicaid/CHIP Division
• Sheila Keister, Office of General Counsel
• Carlos Balderas, HUB Program
• Housekeeping Items

3
HHSC Procurement Roles

• ECPS - Responsible for procurement activity
• Program - Responsible for project scope,
  requirements, performance, results, evaluation,
  and monitoring
• HUB Program Responsible for monitoring HUB
  activity
• Legal - Questions/answers and legal activity

4
Vendor Conference Overview

• Procurement Activities
• RFP Overview
• HUB Items
• Question Submittal
• Break
• Preliminary Responses to Questions
• Closing Comments

5
Procurement Activities

• Questions Answers
• Sole Contact, Elizabeth Ward
• Procurement Schedule
• Solicitation Access at http//www.hhsc.state.tx.us
  /about_hhsc/BusOpp/BO_opportunities.asp
• Submission Requirements
• Solicitation Changes
• Screening Evaluation
• Award Information

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Procurement Schedule

• RFP Release Date July 30
• Vendor Conference Aug 05
• Vendor Questions Due Aug 06
• HHSC Posts Responses Aug 18
• Proposals Due Aug 29
• Tentative Award Announcement Oct 21
• Anticipated Contract Start Date Nov 03

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RFP Overview

• Background
• Mission
• Objectives
• Contract Terms
• Eligible Respondents
• Scope of Work
• Performance Measures

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Background

• Frew v. Hawkins lawsuit
• Originally filed in September of 1993 and
  certified as a class action in 1994
• Challenges States provision of Early and
  Periodic Screening, Diagnosis, and Treatment
  (EPSDT) services to children on Medicaid birth
  through age 20
• Plaintiff class approximately 2.5 million
  children enrolled in Texas Medicaid
• Agreements reached
• Consent Decree (1996)
• Corrective Action Orders (2007)

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Mission

• In order to comply with the requirements of the
  Consent Decree and Check Ups Corrective Action
  Order entered in Frew v. Hawkins, HHSC seeks to
  procure the services of a Vendor to complete a
  study of Medicaid EPSDT medical checkup
  completeness.

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Objectives

• Procure the services of a Vendor to complete the
  required court-ordered study in accordance with
  the Corrective Action Order Checkups for an
  independent, unbiased, statistically valid, and
  timely assessment of EPSDT medical checkup
  completeness for Medicaid class members.
• Receive recommendations for Medicaid
  improvements, corrective action, strategic
  action, rewards, and/or sanctions based on the
  findings of the study and prevailing best
  practices.

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Contract Terms

• Initial contract period November 3, 2008
  August 31, 2009.
• HHSC reserves the option to amend the term of the
  contract for additional months and/or up to one
  year or as necessary to complete the mission of
  the procurement or to comply with Frew court
  orders.

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Eligible Respondents

• At a minimum, the Vendor, and/or its
  subcontractor, must have the following
  qualifications, demonstrated knowledge, and/or
  experience with the following
• Conducting evaluations and assessments focused on
  Medicaid or similar populations.
• Demonstrated experience with research design and
  analysis.
• Documented experience in data management and
  statistical analysis related to public insurance
  program enrollment files and health care claims
  and encounter data.

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Eligible Respondents

• Required qualifications continued
• Documented experience in using a range of data
  collection techniques, including the ability to
  conduct medical record reviews by experienced
  clinical personnel.
• Demonstrate sufficient infrastructure to conduct
  the proposed work, including an established
  research team, computing infrastructure, and data
  collection capabilities.

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Eligible Respondents

• Required qualifications continued
• Demonstrated expertise relevant to the particular
  area of study as evidenced by published studies
  in peer reviewed journals by the research teams,
  the organization, or the principal investigator
  of the Vendor.
• No personal or business interests that present a
  conflict of interest with respect to the RFP and
  resulting contract.

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Scope of Work - Medical Checkup Completeness Study

• The Vendor will independently review a
  statistically valid sample of class members
  medical records to
• Determine the percent of checkups that document
  the five federally mandated elements of an EPSDT
  checkup.
• Determine for checkups lacking documentation of
  one or more of these five elements, which of
  these elements are most commonly missed or not
  documented.

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Scope of Work - Medical Checkup Completeness Study

• Study requirements continued
• Assess reasons that checkup elements are most
  commonly missed or not documented.
• Provide statistically valid comparisons among
  various Medicaid delivery models and the various
  HMOs, including PCCM in each service delivery
  area.

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Performance Measures

• Performance monitored by HHSC.
• All services and deliverables under the contract
  shall be provided at an acceptable quality level
  and in a manner consistent with acceptable
  industry standard, custom, and practice.
• See Attachment B Performance Measures and
  Liquidated Damages Matrix.

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HUB Subcontracting Plan(HSP) Requirements
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Agenda Topics

• RFP Section 4.0 Historically Underutilized
  Business
• Participation Requirements
• HUB Subcontracting Plan for the RFP is required
• Self Performance HSP
• HSP Prime Contractor Progress Assessment Report

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RFP Section 4.0 - Historically Underutilized
Business Participation Requirements

• HUB Participation Goals
• Potential Subcontracting Opportunities
• Vendor Intends to Subcontract
• Minority or Women Trade Organizations
• Self Performance
• HSP Changes After Contract Award
• Reporting and Compliance with the HSP

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If HSP is inadequate, response will be rejected
HSP Information Page
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HUB GOALS
HSP Information Page
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HSP Information Page
Special reminders and instructions
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HSP Information Page
Section 1 Company Information
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HSP Information Page
Section 2 Subcontracting Declaration
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HSP Information Page
Section 2 Enter subcontracting opportunities
If more than 20 subcontracting opportunities,
click the link provided to continue adding
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One page for each area subcontracted (listed on
page 1)
HSP Information Page
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Section 3 List Line and Subcontracting
Opportunity
HSP Information Page
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HSP Information Page
Section 4 Protégé performing the work
Section 8 Skip to Sections 8 and 10
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HSP Information Page
Section 5 Professional Services Category
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HSP Information Page
Section 6(a) Good Faith Efforts to find/include
Texas Certified HUB Vendors
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HSP Information Page
Section 6(b) Contact HUB Trade Organization
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HSP Information Page
Section 6(c) Written Notification Requirements
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HSP Information Page
Section 7 List 3 HUBs Contacted for this
Subcontracting Opportunity
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HSP Information Page
Section 8 List Subs Selected (HUBs Non-HUBs)
for this Subcontracting Opportunity
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HSP Information Page
Section 8 Reason why HUB was not selected for
this Subcontracting Opportunity
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Section 9 Self Performance Explanation
HSP Information Page
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HSP Information Page
Section 10 Signature Affirms that True and
Correct Information is Provided
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HSP Prime Contractor Progress Assessment Report
ATTACHMENT E

• Required with
• ALL Pay Requests

• List ALL Sub payments
• (HUBs Non-HUBs)

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HSP ASSISTANCE FROM TPASS
HUB Subcontracting Plan (HSP) Forms Step-by-step
instructions and an audio on How to Complete an
HSP is located on the Comptroller of Public
Accounts (CPA) Texas
Procurement and Support Services (TPASS) website
at http//www.cpa.state.tx.us/procurement/prog/
hub/hub-forms/ HUB Subcontracting Plan
Instructional Video Play Windows Media Version
(7.7 MB download) Play Quicktime (mp4) version
(24 MB download) Play Macromedia Flash version
(10.8 MB download) Read Video Transcript (.rtf
file) (160 K download)
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Administrative Services Development HUB Program
Office

• Robert L. Hall, C.P.M.
• Director of Administrative Services
  Development
• - [phone]
• - robert.hall_at_hhsc.state.tx.us
• Carlos A. Balderas
• ASD HUB Administrator
• - [phone]
• - carlos.balderas_at_hhsc.state.tx.us
• Sherice Williams-Patty
• ASD HUB Administrator
• - [phone]
• - sherice.williams-patty_at_hhsc.state.tx.us
• Segundo Sanchez
• ASD Procurement/HUB Team Lead
• - [phone]
• - segundo.sanchez_at_hhsc.state.tx.us

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Texas Health and Human Services Commission (HHSC)

• Question Submittal
• Followed by Break

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Tentative Responses to Vendor Questions

• Non-binding verbal answers to vendor questions
  may be provided.
• Binding written responses will be posted on the
  procurement website on August 18, 2008.

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Closing Comments