APPLICATION INSTRUCTIONS
Direct Service Purchase (DSP)
3-Year Bid Agreement to provide services
General Instructions:
· This application is only for agencies interested in providing the following services:
Community Living Program Services (CLPS) ▪ Homemaking ▪ In-Home Respite ▪ Medication Management ▪ Personal Emergency Response Systems (PERS) ▪ Personal Care ▪ Private Duty Nursing (PDN)
· Prior to submitting an application, all agencies must review the AAA 1-B Operating & Services standards, including the newly added Section G to ensure their ability to comply with the vendor expectations and standards. See Section G for additional service bid agreement requirements for Training and Community Living (CLS) Services.
· Applications must be typed; hand-written applications will not be accepted.
· Applications must be submitted electronically to . Additionally, three hard copies, including at least one with original signatures, must be mailed or delivered to the AAA 1-B office at 29100 Northwestern Hwy, Suite 400, Southfield, MI 48034, attention: Dana Daunter.
· All electronic and hard copy applications must be submitted by 4:30 pm on Thursday, December 1, 2011. Incomplete applications will not be considered.
· Applications will be reviewed by a multi-disciplinary AAA 1-B staff team as well as some members of the AAA 1-B Advisory Council and Board of Directors. Applications will be reviewed individually by a weighted application tool. A draft of the tool, with rating criteria, is available with the applications materials on the AAA 1-B website. Note that some criteria will be weighted as a positive and others as a negative to the overall application score.
· All applicants will receive notification of their selection decision by the first week of February, 2012.
· Applicants selected for approval will be required to sign a 3-year bid agreement for the awarded services. This 3-year bid agreement will be effective for Fiscal Years (FY) 2013 – 2015 (October 1, 2012 through September 30, 2015).
· Upon notification, approved applicants will be required to submit the following documentation to finalize the application process:
o Completed and signed bid agreements for their approved services. Bid agreements will be mailed to the selected applicants along with the selection notification.
o All Policies & Procedures and other additional documents required for vendors as outlined in the AAA 1-B DSP Manual, Section B.
o Other required documentation including: Articles of Incorporation, Required Insurance documentation, all Assurances and other documentation as outlined in the AAA 1-B DSP Manual, Section B.
o Harmony license fee of $200 per year for 2 user accounts
NOTE: Agencies selected to participate in the pool that are found to not have the necessary insurance, policies and procedures and/or other required documentation may delay or prevent the AAA 1-B signature and approval of the bid agreement, or disqualify their agency from participating in the vendor pool.
I. AGENCY INFORMATION
· Enter all agency contact information contained on the form.
· Enter the number of years your agency has been in business.
· Check yes for “current AAA 1-B vendor” if your agency has an active bid agreement with the AAA 1-B as of October 14, 2011.
· Check the box that correctly describes the agency’s corporate status.
· Check that box that indicates the agency’s minority status and if yes, an estimate of the percentage of staff that are minority.*
o Non-Profit Organizations - There is at least 50% minority representation on the organization’s Board of Directors and on the organization’s staff.
o For-Profit Organizations - The organization is owned or controlled by a majority of minority individuals.
· Check the box if your agency is owned by a woman.*
· Check the box if your agency is owned by a person with a disability.*
*Note: The Michigan Department of Community Health requires the AAA 1-B to track and report items E-G. An agency may check more than one of these items, as appropriate.
· Enter the name of the person completing the application.
· Once completed, the agency owner or CEO must sign and date the application prior to submission to the AAA 1-B.
II. SERVICE & TERRITORY BID PROPOSAL
· To better meet the needs of our participants and ensure consistency of service delivery, AAA 1-B has grouped applicable services together into three service groups. Agencies can apply for just one service group, or they may apply for multiple service groups if they can meet the appropriate service standards. Agencies must bid for all services within each group for which they choose to apply.
· Agencies should also apply for the county(ies) they wish to serve for each service group. For each county selected, agencies are required to provide service to the entire county, unless service is restricted to a specific region within a county due to franchise agreements or other specific legal arrangements. Any requests to serve a portion of a county must be reviewed and approved by the AAA 1-B.
· Agencies will be allowed to bid on the unit rate for services, as long as their bid is equal to or below the AAA 1-B cap rate. Enter a unit rate that is appropriate for the needs and demands of your agency. The unit rate alone will not determine what applicants are awarded the bid. All factors of the application will be taken into consideration, including areas served, staffing, agency experience, business practices, standards of quality and other information identified in the Narrative portion of the application.
NOTE: A travel premium of $10.00 per visit, in addition to the approved unit rate, will be paid when services are authorized in the determined AAA 1-B hard to serve areas. These premiums apply only to services in service group #1 and Private Duty Nursing services. See DSP Manual Section G Guidelines for details.
Service Group #1 (Homecare services): Community Living Program Services (CLPS), Homemaking, Personal Care and In-Home Respite.
· Check the box indicating your wish to provide services under Service Group #1.
· Check the box(es) indicating the county(ies) in which you wish to provide service.
· Enter your proposed unit rate for service group #1. A unit is equal to 15 minutes of service. The cap rate for service group #1 is $4.20 per unit. You may bid at a rate equal to or below $4.20 per unit.
Service Group #2 (Private Duty Nursing): Private Duty Nursing and Medication Management
· Check the box indicating your wish to provide services under Service Group #2.
· Check the box(es) indicating the county(ies) in which you wish to provide service.
· Enter your proposed unit rate for RN and/or LPN. A unit is equal to 15 minutes of service. The cap rate for an RN is $11.00. The cap rate for an LPN is $10.00. You may bid at a rate equal to or below each cap rate.
· If your agency only has RNs, you can bid on just one type of licensed nurse. An agency must have at least one RN to be eligible to apply.
· Enter your proposed unit rate for medication management. Medication management includes set up and monitoring of medications by a nurse. See service standards for specific requirements. The medication management unit applicable to monitoring is equal to 15 minutes. The cap rate is $11 per unit.
Service Group #3 (Monitoring Equipment): Personal Emergency Response System (PERS) and Medication Dispensers.
NOTE: Agencies bidding for medication dispensers must adhere to the applicable requirements of the “medication management” and the “specialized medical equipment and supplies” service standards/definitions.
· Check the box indicating your wish to provide services under Service Group #3.
· Check the box(es) indicating the county(ies) in which you wish to provide service.
· Enter the items and rates for each device for which your agency wishes to provide to our participants. There is no cap rate for PERS and Medication Dispensers devices.
· For each device, enter the rate for installation or monitoring, if applicable. Indicate if it is an installation or monitoring fee. If there is no installation or monitoring rate, leave those rows blank.
III. NARRATIVE
· Complete a narrative, no more than the space indicated per section, which addresses all of the components on the application under each of the sections. Complete the appropriate sections for the services for which you are applying. Be sure to write in a manner that the reviewer can clearly understand all aspects of your descriptions. Identify your answers with the corresponding letter for each question.
A. Narrative for all applicants
· Includes agency history and experience, business practices, program implementation, quality assurance and staffing components.
· Additional allowable attachments to this section may include: Proof of accreditation, certification or licenses held by the agency (not by staff), documentation of measures used to assess participant and/or caregiver satisfaction, including results.
B. Narrative for Service Groups # 1 & 2
· Be as clear and specific as possible when providing staffing information.
· Additional attachments to this section may include an organizational chart.
C. Narrative for Service Group # 3
· Describe your devices/items clearly
· Additional attachments to this section may include a brochure or product sheet.
NOTE: The applicant should not include multiple additional attachments to their application, other than the materials noted above. Excessive additional attachments may result in a decrease in the application rating score.
For technical assistance or general questions with the 3-Year Bid Agreement Application, please email or contact Sandra Carter (Program Manager, DSP) at 248-262-1295.
5