Ryan White Part ARFP# RW0801

MECKLENBURGCOUNTY

HEALTH DEPARTMENT


Request for Proposal (RFP)

RFP# RW0801

FOR

THE PROVISION OF OUTPATIENT AND AMBULATORY

HEALTH AND SUPPORT SERVICES

FOR INDIVIDUALS WITH HIV DISEASE AND THEIR FAMILIES/CAREGIVERS

AS AUTHORIZED BY THE

RYAN WHITE TREATMENT MODERNIZATION ACT OF 2006

Mecklenburg County1

Ryan White Part ARFP# RW0801

TABLE OF CONTENTS

Section...... Page

A.Request for Proposal (RFP) Schedule ...... 1

B.Overview (including Provider Requirements)...... 2

C.Eligible Services...... 5

D.Submission Requirements and General Terms...... 7

E.Proposal Evaluation...... 9

F. Disqualification Criteria ...... 10

G.Content of Application Package...... 11

H.Agency Questionnaire...... 12

I.Agency Documentation Checklist...... 13

J.Exhibits...... 14

K.Attachments...... 28

MecklenburgCounty

Ryan White Part ARFP# RW0801

  1. Request for ProposalSchedule

Wednesday, December 12, 2007 / Request For Proposals (RFP) advertised and posted at
Friday, December 21, 2007 / RFPBidders Conference will be held to answer questions from those planning to submit proposals at:
10:00 A.M.
HalMarshallServicesCenter Auditorium 1 and 2
700 North Tryon Street
Charlotte, NC 28202
Friday, January 18, 2008 / Deadline for submitting proposalsto:
Mecklenburg County Health Department
Attn: Luis A. Cruz
618 N. College Street, Charlotte, NC28202Applications submitted after 5:00 p.m. will not be accepted.
Monday, January28, 2008 / Disqualified applicants notified.
Friday, February15, 2008 / Award notifications sent to recipients and posted at
Friday February 22, 2008 / Meeting with grant recipients and review of contract requirements.

Note: Any changes to this schedule will be posted at .

B.Overview (including Provider Requirements)

1.Introduction

MecklenburgCounty, a political subdivision of the State of North Carolina, hereafter referred to as COUNTY, is the grantee recipient of Part A Ryan White Treatment ModernizationAct federal grant funds. The Ryan White Program provides HIV-related health and support services within the service areas detailed below. This RFP is 100% federally funded under the Health Resources Services Administration (HRSA).

Part A’s Transitional Grant Area, hereafter referred to as TGA,is comprised of the following North Carolina counties: Mecklenburg, Gaston, Cabarrus, Union, Anson and York County, South Carolina. The Mecklenburg County Health Department, hereafter referred to as DEPARTMENT, is responsible for administering the Part AProgram for the COUNTY.

2.Statement of Purpose

The purpose of the Part A Program is to augment the health care systems currently bearing the burden of HIV-related care. The purpose of funds awarded under this RFP is to enhance available HIV-related health and support services by funding providers to increase these services. The COUNTY is issuing this RFP in order to select the applicantsbest qualified to deliver needed services to eligible individuals with HIV disease and families/caregivers within the six county area.

3.Organizations/Agencies Eligible to Apply

Organizations/Agencies meeting the following criteria are eligible to apply for funding under this RFP. For-profit agencies are eligible only in the absence of qualified nonprofit agencies able and willing to provide quality services.

  1. Public or nonprofit private entities include hospitals, community-based organizations, hospices, ambulatory care facilities, community health centers, migrant health centers, and homeless health centers.
  2. Private entities must be incorporated, or be authorized to do business in North or South Carolina, and have local offices, representatives and phone numbers.
  3. Organization/Agency must deliver services to residents of one or more of the following North Carolina counties: Mecklenburg, Gaston,Cabarrus,Union, Anson, and York County, SC.
  4. Organization/Agency must perform one or more of the eligible services listed in this RFP.
  5. Organization/Agency proposing Medicaid reimbursable services must show proof of being a Medicaid provider at the time of application.
  1. Client Eligibility

Client eligibility for services under this RFP and resulting HIV-Services Agreements shall be determined using the following criteria:

  1. Person with confirmed HIV infection
  2. Person with confirmed AIDS diagnosis
  3. Affected family member and/or caregiver of an HIV/AIDS infected personin limited situations
  4. Persons having an income below 300% offederal poverty level
  5. Persons having no other funding source for service received, i.e. Medicaid, private insurance

PROVIDERS contracted under this RFP must obtain and keep on file written documentation of seropositivity of HIV infected clients.PROVIDERS contracted under this RFP shall assume the financial risk for providing services to individuals not testing HIV positive; providing services to individuals who the PROVIDER has not documented as HIV positive; or providing services to individuals who have no HIV-positive family member. PROVIDERS shall also assume the financial risk for delivering services for which other sources of funding could reasonably have been anticipated or determined.Ryan White funding is the payor of last resort.

Funds awarded under this RFP may only be used for services to affected individuals as outlined in HRSA policies (

  1. Provider Requirements

All service providers, hereafter referred to as PROVIDER(S) recommended for funding under this RFP shall be required to comply with terms and conditions of the contract between the COUNTY and the PROVIDER. At a minimum, PROVIDERS will be required to comply with the following contract terms:

  1. PROVIDERS of Case Management services will be required to participate in Case Management trainings sponsored by COUNTY or COUNTY designee.
  2. PROVIDERS must obtain proof of ambulatory/outpatient medical care annually on all clients served.
  3. PROVIDERS and staff must possess all required North Carolina or South Carolina licenses, where applicable, as well as appropriate County licenses, and shall comply with all laws, ordinances, and regulations applicable to the services for which it is contracting.
  4. PROVIDERS must send at least one representative to every PROVIDER meeting that is scheduled by the DEPARTMENT.
  5. PROVIDERS must submit audited financial statements by an independent certified public accountant for prior fiscal yearthat demonstrates financial responsibility tobe determined by the COUNTY FinanceDepartment.
  6. Prior to contract award, PROVIDERS will be required to submit a breakdown of administrative fees according to Attachments II and III. Costs can not exceed 10%.
  7. PROVIDERS must have Equal Opportunity Plan. (See Attachment I MecklenburgCounty Equal Opportunity Clause)
  8. PROVIDERS must have PC resources with the following minimum requirements: Hardware -128 MB RAM, 166mhz processor, 250mb of hard drive space, and display resolution 800X600. Software -Windows® 98 and up, Microsoft Access Components (MDAC) 2.6, and Microsoft .NET Framework. If PROVIDERS need to purchase PC hardware to complete the requirements of this contract, you must indicate this on Exhibit I of the Application Package.
  9. PROVIDER will report clinical and administrative activity to the DEPARTMENT on hard copy or direct entry on a monthly basis into CAREWare data management system as specified by the county in the contract. See for information on the CAREWare software.
  10. PROVIDERS agree to make all client and financial records available for on-site audits by the DEPARTMENT.
  11. PROVIDERS must have a Memorandum of Understanding with all points of entry.
  12. PROVIDERS agree to comply with any and all requests for information to ensure completion of federal and state reports and grant applications.
  13. PROVIDERS shall be required to comply with all current and subsequent HRSA policies at
  14. PROVIDERS must comply with HIPAA security rules.
  15. PROVIDERS must access the DEPARTMENT website at view this RFP, submit questions and clarifications, view answers to questions, view schedule updates, and view award information. To submit questions, click the “Feedback” link. To be notified when new Ryan White Grant information is posted, sign up by clicking the “Notify Me” icon.

6.Glossary

Service category definitions and unit of service definitions are included in Eligible Services, page6. Other terms are defined as follows:

  1. ALLOCATION: The total dollar amount that may be expended for a specific service category.
  2. BOCC:Mecklenburg CountyBoard of Commissioners.
  3. CLIENT: An individual determined eligible as described in the Ryan WhiteTreatmentModernization Act.
  4. CONTRACT PERIOD RYAN WHITE PART A: approximate March 1, 2008 – February 28, 2009.
  5. COUNTY: MecklenburgCounty.
  6. DEPARTMENT: Mecklenburg County Health Department.
  7. HRSA: Health Resources and Services Administration, the division of the Department of Health and Human Services responsible for the Ryan White Treatment Modernization Act.
  8. PAYOR:Funding Source.
  9. PROPOSAL: An agency’s plan/response for providing a proposed service.
  10. PROVIDER: Service provider.
  11. TGA: Transitional Grant Areathatincludes North Carolina counties of Mecklenburg, Gaston, Cabarrus, Union, and Anson, as well asYork County, South Carolina.

7.Funding

Funds for this project are made available through The Ryan White Treatment Modernization Act of 2006. Approval of proposals submitted for the 2008 Ryan White Part A funding will be contingent upon HRSA funding levels.

8. Restrictions

  1. Cash payments to clients by PROVIDERS are prohibited.
  2. Funds under this grant program shall be used only as a last resort for services not covered by other funding sources or programs, and cannot be used to replace local, state or federal funding for HIV health and support services.
  3. There shall be no advanced funding.

C.Eligible Services

1.Health Care Services

a.Ambulatory/Outpatient Medical Care
Professional diagnostic and therapeutic services rendered by a physician, physician’s assistant, clinical nurse specialist or nurse practitioner in an outpatient, community based and/or office-based setting. This includes diagnostic testing, early intervention and risk assessment, preventive care and screening, practitioner examination, medical history taking, diagnosis and treatment of common physical and mental conditions, prescribing and managing medication therapy, care of minor injuries, education and counseling on health and nutritional issues, minor surgery and assisting at surgery, well-baby care, continuing care and management of chronic conditions, and referral to and provision of specialty care.

b.Drug Reimbursement (Medications)

Approved pharmaceuticals or medications for persons with no other payment source. This is a local drug reimbursement program to expand the number of covered medications available to low-income patients and/or to broaden eligibility beyond that established by a State operated Part B or other State-funded Drug Reimbursement program.

c.Medical Case Management

A range of client-centered services that link clients with health care, psychosocial and other services to insure timely, coordinated access to medically appropriate levels of health and support services, continuity of care, on-going assessment of the client’s and other family members’ needs and personal support systems, and case management services that prevent unnecessary hospitalization or that expedite discharge, as medically appropriate, from inpatient facilities. Key activities include: initial comprehensive assessment of the client’s needs and personal support systems; development of a comprehensive, individualized service plan; coordination of the services required to implement the plan; client monitoring to assess the efficacy of the plan; and periodic re-evaluation and revision of the plan as necessary over the life of the client. May include client-specific advocacy and/or review of utilization of services.

d.Mental Health Services

Psychological and psychiatric treatment and counseling services, including individual and group counseling, provided by a mental health professional licensed or authorized within the State, including psychiatrists, psychologists, clinical nurse specialists, social workers, and counselors.

e.Oral Health Services

Diagnostic, prophylactic and therapeutic services rendered by dentists, dental hygienists and similar professional practitioners. A unit of dental service is defined as each dental service performed for dentistbilling by procedure code.For the purpose of reporting, the PROVIDER must also report the number of visits.

f.Health Insurance
Financial assistance for eligible individuals with HIV disease to maintain a continuity of health insurance or to receive medical benefits under a health insurance program.

g.Medical Nutrition Therapy
Nutritional education and/or counseling by a licensed/registered dietician outside of a primary care visit.

h.Early Intervention Services

Counseling, testing and referral services to PLWH who know their status but are not in primary medical care or who are recently diagnosed and are not in primary care for the purpose of facilitating access to HIV-related services.

i.Substance Abuse Services

Provision of treatment and/or counseling to address substance abuse problems (including alcohol, legal and illegal drugs), provided in an outpatient or residential health service setting.

2.Support Services

a.Food Bank/Home Delivered Meals/Nutritional Supplements

This includes the provision of actual food, meals, or nutritional supplements. It does not include finances to purchase food or meals. Includes vouchers to purchase food.

b.Emergency Housing Assistance

Short-term or emergency financial assistance to support temporary and/or transitional housing to enable the individual or affected family/caregiver to gain and/or maintain medical care. Use of Titles A,B and D funds for short-term or emergency housing must be linked to medical and/or health-care services, or be certified as essential to a client’s ability to gain or maintain access to HIV-related medical care or treatment.

c.Legal Service

Legal services directly necessitated by a person’s HIV status including: preparation of Powers of Attorney, Do Not Resuscitate Orders, wills, trusts, bankruptcy proceedings, and interventions necessary to ensure access to eligible benefits including discrimination or breach of confidentiality litigation as it relates to services eligible for funding under the Ryan White Treatment Modernization Act of 2006. It does not include any legal services that arrange for guardianship or adoption of children after the death of their normal caregiver.

  1. Psychosocial Support

Individual and/or group counseling services other than mental health counseling, which is provided to clients, affected family and/or caregivers by non-licensed counselors. May include psychosocial providers, peer counseling/support group services, care giver support/bereavement counseling, drop-in counseling, benefits counseling, and/or nutritional counseling or education.

e. Medical Transportation

Conveyance services to a client in order to access primary medical care or psychosocial support services. May be provided routinely or on an emergency basis.

f.Outreach

Programs which have as their principle purpose identifying people with HIV disease so that they may become aware of and may be enrolled in care and treatment services. Outreach services do not include HIV counseling and testing, or HIV prevention education.

g.Emergency Financial Assistance

Provision of short-term payments to agencies, or establishment of voucher programs, to assist with emergency expenses related to food, housing, rent, utilities, medications or other critical needs.

D.Submission Requirements and General Terms

1. MecklenburgCounty will conduct onebidder’sconference concerning this RFP at the following place and time:

HalMarshallServicesCenter Auditorium 1 and 2

700 North Tryon Street

Charlotte, NC 28202

Friday, December21, 2007 at 10:00 a.m.

2.PROVIDERS seeking a contract under this RFP are required to submit proposals as follows:

  1. One (1) original proposaland 1 copy in a sealed envelope with the PROVIDER’S name. The envelope must be marked:SEALED RESPONSE FOR RYAN WHITE GRANT.The original signature of the PROVIDER’S authorized official must appear on the original application package.

In order to be considered, applications must be received before the deadline of 5:00 p.m., Friday, January 18, 2008, at the following location:

Mecklenburg County Health Department

618 N. College Street

Charlotte, NC 28202

Attn: Luis A. Cruz

b.In addition, an electronic copy of the applicationmay be submittedat .

c.Applications must include all items listed on the Agency Documentation Checklist shown in the Application Package and be type written on the forms provided.

d.Applicationswill not be accepted after the deadline.PROVIDERS may not withdraw or modify a response after the deadline.

3. The PROVIDER agrees to execute a contract with the COUNTY if the PROVIDER is awarded a contract. Approval of proposals submitted for the 2008 Ryan White Part A funding will be contingent upon HRSA funding levels.

4.Due to funding,the COUNTY may at its sole discretion negotiate with the PROVIDER regarding the funding, services, units of services and any other requirements deemed necessary by the COUNTY.However, all other terms included in this RFP are not subject to negotiations. The COUNTY may at its sole discretion add additional terms and requirements to the termsin this RFP based on new or additional requirements from the HRSA.

5.Failure to negotiate in good faith or to perform after the contract is awarded may result in debarment from future contracts with the COUNTY.

6.Any request for interpretation must be submitted through the DEPARTMENT website at All questions will be answered on the website for view by all PROVIDERS.

7.No successful PROVIDER may make any assignment of duties, in whole or in part, to any third party under the resulting contractual agreement between the parties without the prior written authorization of the DEPARTMENT.

8.The cost of preparing a response to this RFP shall be borne entirely by the PROVIDER.

9.The COUNTY hereby notifies all PROVIDERS that: Disadvantaged Minority Business Enterprises (DMBE's) and Disadvantaged Women Business Enterprises (DWBE's) will be afforded a full opportunity to participate in any award made by the COUNTY pursuant to this RFP and will not be subjected to discrimination on the basis of race, color, sex, religion, sexual orientation, age, handicap, marital status, or national origin. The COUNTY prohibits any person involved in Mecklenburg County contracting and procurement activities to discriminate on the basis of race, color, religion, sex, sexual orientation, national origin, age, handicap, or marital status.

10.All requirements, terms, and attachments contained in this RFP document are incorporated into any resulting contract with the COUNTY by this reference.

11.The award of this proposal and continuation of resulting contract will be contingent upon the availability of funds to the COUNTY.

12.The COUNTY reserves the right to reject any or all proposals; to re-advertise this RFP, in whole or in part; to postpone or cancel this process; to waive irregularities in the RFP process; and to change or modify the proposal schedule at any time.

13.Where proposals have erasuresor corrections, the PROVIDER must initial each erasure or correction in ink. In case of unit price contracts, if an error is committed in the extension of an item, the unit price as shown in the Pricing Schedule will govern.