Personal Care Independent Assessment Services

Contract to a Wisconsin Business or Organization
to Qualify Individuals for Assistance with Daily Tasks

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Agency Type:

State

Funding Source:

Wisconsin Department of Health Services (DHS), Division of Health Care Access and Accountability (DHCAA), with the DHS Bureau of Strategic Sourcing (BSS)

Deadline Date:

10/23/15 3:00 PM CT

Description:

Request a Grant Writer

Contract to a qualified Wisconsin business or organization to determine eligibility of applicants for personal care assistance under their medical insurance plan. September 21 is the deadline for questions to be submitted. Applicants will conduct needs assessments for individuals to determine their need for assistance with activities of daily living, but will not oversee, manage, or participate in providing those services.

The DHCAA is seeking to contract with a vendor who can assist with the following goals and objectives that have been set forth:

• To ensure covered PCS services are medically necessary and provided in quantities appropriate to the member’s unmet need for covered services based on the severity of their medical condition, functional disability, or physical or cognitive impairment;
• To provide IA services in a manner that ensures that there are no actual or potential conflicts of interest with entities or individuals providing PCS;
• To promote consistent application of screening criteria and level of service determination;
• To ensure the validity and reliability of PCS assessments and procedures;
• To automate all business processes required to effectively and efficiently manage this process, including assessments, Physician Orders, member and Provider notifications, and process status reports;
• To automate the IA processes addressed in this RFP in a manner that will provide readily available data to the Department to monitor and manage costs, quality, utilization and compliance with federal and state statutes, rules, regulations, policies, and guidelines; and
• To develop and automate uniform reporting in a comprehensive interactive database.

Personal Care Services are a covered benefit under Wisconsin’s MA program. A PCS Provider under the written Orders of a physician performs Personal Care Services. Personal Care Services assist a member with Activities of Daily Living (ADLs) necessary to maintain the member in his or her place of residence in the community and include assistance with bathing, feeding, toileting, mobility, and other activities.

When appropriate, PCS may also include assistance with Medically Oriented Tasks (MOTs) that are supportive of nursing care and require special medical knowledge or skill. Personal Care Services may also include services Incidental to Activities of Daily Living (IADLs) such as laundering members’ personal clothing, light cleaning in essential areas of the residence during personal care activities, and meal preparation.

GrantWatch ID#:

GrantWatch ID#: 161946

Number of Grants:

Term of Contract:

Estimated Start date for performing assessments: 8/1/2016

The contract shall be effective on the date indicated on the purchase order or the contract execution date and shall run for three (3) years from that date, with an option by mutual agreement of the agency and contractor, to renew for two one-year extensions.

Eligibility:

Domestic public or private and non-profit entities
For profit organizations other than small businesses
Nonprofits having a 501(c)(3) status with the IRS
Open to all responsible sources
See RFP and/or Grant Guidelines for full eligibility
Small businesses

Additional Eligibility Criteria:

The vendor with whom the State contracts for this RFP will be precluded from providing PCS as an MA-enrolled provider and may not receive any direct or indirect financial gain from any organization that provides PCS.

In addition, the vendor must be able to provide assurance that the vendor and its employees, and Subcontractors, if applicable, performing services under this Contract:

1) Have no direct or indirect financial or other interest in a (WI MA enrolled) PCS provider that would cause, or reasonably appear to cause, any conflict of interest related to the services provided under this Contract;

2) Will not promote or steer members to select a particular PCS provider or PCS worker.

Pre-Application Information:

Written questions must be submitted before September 21, 2015. All questions are to be submitted in non-protected Microsoft Word format with the following subject line listed below: Question S-0426 DHCAA-15– Company Name

10/12/2015 (Estimated) Written inquiries answered: State will post answers to submitted written inquiries to VendorNet.

This RFP will be published to VendorNet and classified under the commodity/service codes below. Interested vendors should make certain that their VendorNet registration incorporates these codes in order to ensure their receipt of updates on this RFP. Commodity Codes:

91832 - Consulting Services (Not Otherwise Classified)
91875 - Management Consulting
91878 - Medical Consulting
91888 - Quality Assurance/Control Consulting
94807 - Administration Services, Health
94864 - Nursing Services
95208 - Assisted Living Services
95215 - Case Management
95226 - Day Care (Adult)
95240 - Elderly Assistance Services
95253 - Home Management
95268 - Personal Care Services
95816 - Business Management Services
95856 - Health Care Management Services (Including Managed Care Services)
95868 - Support Services, Management
94848 - Health Care Services (Not Otherwise Classified)
95274 - Referral Services
95285 - Support Services