REQUEST FOR PROPOSAL:
Employee Assistance Program (EAP)
Diabetes Management Technology (DMT)
Expert Medical Opinion (EMO)
Neo-Natal Solutions Program
HOUSTON INDEPENDENT SCHOOL DISTRICT
THE HEALTH CARE PARTNERSHIP
PROJECT #: 14-04-02
APRIL 10, 2014
REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
HOUSTON INDEPENDENT SCHOOL DISTRICT
CONTENTS
I.
Instructions, Submission Requirements and Procedures .....................................................................3
1.1
General Information .................................................................................................................3
1.1.1 Code of Silence and Conflicts Of Interest ......................................................................3
II.
1.2
Definitions and Terms ..............................................................................................................4
1.3
Specifications...........................................................................................................................5
1.4
Proposal Information Required ................................................................................................5
1.5
Submission of Proposals .........................................................................................................6
1.6
Financial Information................................................................................................................7
1.7
Discussions / Negotiations .......................................................................................................7
1.8
Best and Final Offers ...............................................................................................................7
1.9
Modification or Withdrawal of Proposals ..................................................................................7
1.10
Opening Proposals ..................................................................................................................7
1.11
Schedule ..................................................................................................................................7
1.12
Retention of Proposal Documentation .....................................................................................8
1.13
Reservation of Rights...............................................................................................................9
1.14
Appeal Process ........................................................................................................................9
General Terms and Conditions ...........................................................................................................10
2.1
Agreement, Integration, Term & Transition, Purchase Order Requirements..........................10
2.2
Non-Assignment ....................................................................................................................11
2.3
Use of District Name or Logo(s).............................................................................................11
2.4
Authorization / Permits ...........................................................................................................11
2.5
Supplier Nationwide Criminal Background Checks ................................................................11
2.6
Supplier Document Audit and Inspection/Record Retention/Student Information ..................12
2.7
Confidential and Proprietary Information................................................................................12
2.8
Data and Proprietary Information ...........................................................................................13
2.9
Texas Public Information Act (TPIA) ......................................................................................13
2.10
Student Confidentiality ...........................................................................................................13
2.11
Insurance ...............................................................................................................................13
2.12
Taxes .....................................................................................................................................14
2.13
Invoices/Payment ..................................................................................................................14
2.14
Quantity .................................................................................................................................15
2.15
Bonding..................................................................................................................................15
2.16
Governing Law .......................................................................................................................15
MERCER
i
REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
III.
HOUSTON INDEPENDENT SCHOOL DISTRICT
2.17
Relationship of the Parties .....................................................................................................15
2.18
No Waiver of Immunity...........................................................................................................15
2.19
Indemnification .......................................................................................................................16
2.20
Notice.....................................................................................................................................16
2.21
Section Headings ...................................................................................................................16
2.22
Third Party Beneficiaries ........................................................................................................16
2.23
Dispute Resolution .................................................................................................................17
2.24
Termination ............................................................................................................................17
2.25
Defective / Non-Conforming Work .........................................................................................17
2.26
Default Conditions .................................................................................................................17
2.27
Warranties .............................................................................................................................18
2.28
Use by Other Government Entities ........................................................................................18
2.29
Third Parties ..........................................................................................................................18
2.30
Unenforceable Sections .........................................................................................................18
2.31
MWBE Participation Goal ......................................................................................................18
2.32
Subcontracting .......................................................................................................................18
2.33
Work Stopage ........................................................................................................................18
2.34
Hazardous Materials ..............................................................................................................18
2.35
Business Ethics .....................................................................................................................18
2.36
Business Certificates / HISD Taxes .......................................................................................19
2.37
Attorney Fees ........................................................................................................................19
Scope of Work and Specific Conditions ..............................................................................................20
3.1
Scope of Work .......................................................................................................................20
3.2
Specific Conditions ................................................................................................................20
3.3
Specifications.........................................................................................................................20
3.4
Cost .......................................................................................................................................20
3.5
Evaluation Factors .................................................................................................................20
IV.
Pricing Sheets Including Electronic Submittal Requirements .............................................................22
V.
Form A - Company Information:........................................................................................................23
5.1
Subsection I - Company Information: ...................................................................................24
5.2
Subsection II - Certification and Disclosure Statement: .......................................................29
5.3
Subsection III - Free of Indebtedness Statement: ................................................................30
5.4
Subsection IV - Certification Regarding Debarment and Suspension: .................................31
5.5
Subsection V - Statement of Non-Collusion: ........................................................................32
MERCER
ii
REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
VI.
HOUSTON INDEPENDENT SCHOOL DISTRICT
5.6
Subsection VI - Subsection VI Antitrust Certification Statement: ......................................34
5.7
Subsection VII - Conflict of Interest Questionnaire Form: ..................................................35
Form B - M/WBE Instructions .............................................................................................................38
M/WBE Participation Requirements .......................................................................................40
M/WBE Participcation Report ................................................................................................41
M/WBE Outreach Example Letter ..........................................................................................52
M/WBE Subcontractor Change Request................................................................................53
Certifying Agencies ................................................................................................................54
M/WBE Business Organizations & Associations ....................................................................55
M/WBE Newspapers and Periodicals ....................................................................................57
VII.
Form C - Addendum for Agreement Funded by U.S. Federal Grant .................................................58
VIII.
Form D - Pricing and Service Affirmation..........................................................................................60
IX.
Form E - Exception Form ..................................................................................................................62
X.
Form F - (Price Schedule) ................................................................................................................63
XI.
Form G - Supplier Relations – CHE (Local) Questionaire:................................................................64
XII
Information (District Requirements) ....................................................................................................69
XIII
XIV
XV
12.1
Explanation to Proposers .......................................................................................................69
12.2
Expansion of Programs to Other Districts through Interlocal Agreements .............................72
General Information and Instructions (Subject Matter) .......................................................................73
13.1
General Information ...............................................................................................................73
13.2
Instructions ............................................................................................................................77
Minimum Business Requirements ......................................................................................................83
14.1
General Questions .................................................................................................................83
14.2
Company-Specific Information ...............................................................................................89
Expert Medical Opinion.......................................................................................................................92
15.1
MERCER
General Questions .................................................................................................................92
iii
REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
XVI
Employee Assistance Program (EAP) ..............................................................................................100
16.1
XVII
Technical Questionnaire ......................................................................................................100
Diabetes Technology ........................................................................................................................115
17.1
XVIII
HOUSTON INDEPENDENT SCHOOL DISTRICT
General Questions ...............................................................................................................115
Neonatal Solutions Program .............................................................................................................118
18.1
MERCER
General Questions ...............................................................................................................118
iv
REQUEST FOR PROPOSALS
RFP # 14-04-02
Employee Assistance Program (EAP),
Diabetes Management Technology (DMT),
Expert Medical Opinion (EMO), and NeoNatal Program (NNP)
The Houston Independent School District (“HISD” and/or the “District”) is soliciting proposals for
Total Health Management related programs, including Diabetes Management technology
solutions, Employee Assistance Program, Neo-Natal coordinator care for parents, and Expert
Medical Opinion services as more fully set out in the Scope of Work and Specific Conditions
and Specifications sections of this Request for Proposals (“RFP”). An original, three paper
copies of the original and one digitized copy in PDF format on CD or USB Travel Drive of the
proposal response must be submitted in accordance with the instructions set out herein to:
Houston Independent School District
Board Services - Room 1C03
Attn: William Struska
RFP/ 14-04-02 Project EAP, DMT, EMO, NNP
4400 West 18th Street
Houston, TX 77092
Each set of the proposal must be submitted in a binder. The original proposal must be labeled
“ORIGINAL” and contain original signatures. The copies of the original must be labeled
“COPY.”
Each binder and any container for the binder(s) must be labeled on the outside with the Proposer’s name, address,
the RFP number and the RFP name.
Proposals will be received at the above address until Friday May 2, 2014 3:00PM Central Standard Time. A preproposal conference will be held in conjunction with the RFP from 1:00PM-2:00PM on Thursday April, 17, 2014 in
Building A, Room PL-3, HISD’s Ryan Professional Development Center, 4001 Hardy Street Houston, TX 77009.
Submitting proposals prior to the pre-proposal conference is not recommended, and such proposals may be rejected
by HISD. A more detailed timeline is set out in the Instructions, Submission Requirements and Procedures section of
the RFP. Proposals will be reviewed as received in a manner that avoids disclosure to competing proposals.
Contents of proposals will remain confidential during the negotiations period. Only the proposal number and the
identity of the Proposer(s) submitting the proposal will be made available to the public before award of the RFP.
Proposals received after the Proposal due date and time will not be considered.
Faxed proposals will not be accepted. Proposals must be submitted in sufficient time to be
received and time-stamped at the above location on or before the proposal due date and time.
HISD will not be responsible for proposals delivered late by the United States Postal Service, or
NOTICE for RFP - PAGE 1
Revised 2/13/14 – Version 7.8
any other delivery or courier services. All proposals must remain open for one hundred twenty
(120) days from the proposal due date pending acceptance by HISD.
The District will award this RFP to a line item award, based upon the evaluation of all
proposals received. More details regarding evaluation of proposals are included in Section III,
which is the Scope of Work and Specific Conditions section of this RFP.
Gilberto A. Carles
April 10, 2014
________________________________________
Gilberto A. Carles, MBA
General Manager – Procurement Services
_________________________
NOTICE for RFP - PAGE 2
Date
Revised 2/13/14 – Version 7.8
RFP # 14-04-02 Employee Assistance Program (EAP), Diabetes Management
Technology (DMT), Expert Medical Opinion (EMO) and Neo-Natal Program (NNP)
I. INSTRUCTIONS, SUBMISSION REQUIREMENTS AND PROCEDURES
1.1 GENERAL INFORMATION: The following instructions by the District are intended to afford
Proposer(s) an equal opportunity to participate in the proposal process and provide a
predetermined set of criteria representing the District’s business and service requirements. This
proposal is governed by Texas Education Code (TEC), other applicable Texas state statutes,
and all local Board of Education (Board) policies.
1.1.1 CODE OF SILENCE AND CONFLICTS OF INTEREST: The Board of Education (Board) has
adopted a “Code of Silence” policy (ref. Board Policy CAA (Local)) and a “Conflict of Interest
Disclosures” policy (ref. Board Policy BBFA (Local))to enforce its commitment to ethical
contracting standards and improve accountability and public confidence. It is important to avoid
both the appearance of conflicts and actual conflicts of interest.
1.1.2
The Code of Silence" shall mean a prohibition on any communication regarding
any
RFP, bid, or other competitive solicitation between:
1. Any person who seeks an award from the District or its affiliated entities (including,
but not limited to, the HISD Foundation and the HISD Public Facility Corporation),
including a potential vendor or vendor's representative, and
2.
Board members, the Superintendent of Schools, senior staff members, principals,
department heads, directors, managers, or other District representatives who have
influence in the evaluation or selection process.
The “Code of Silence” time period shall begin when the Request for Proposal (RFP) is issued
and ends upon the execution of the contract. During the “Code of Silence”, campaign
contributions, gifts, donations, loans, and any other items of value are prohibited between these
parties, including candidates who have filed for election to the Board.
The “Conflicts of Interest Disclosures” requires a Board member to disclose and recuse himself
or herself from voting on any contract, agreement, or any other District transaction involving an
entity or related officer and/or key employee who has provided campaign contributions during
the preceding 12 month period in excess of $500.
Board Policy CAA (Local) pertaining to the “Code of Silence” and Board Policy BBFA (Local)
pertaining to “Conflicts of Interest Disclosures” are attached by URL link above and incorporated
by reference. Please review the policies carefully and ensure that the policies are followed in all
respects. Proposer(s) agree and understand that non-compliance with the “Code of Silence”
policy may result in disqualification. Furthermore, the failure of a Board member to disclose a
conflict of interest may result in the debarment of a vendor for 24 months.
1.1.3 By submitting a proposal, the Proposer agrees to provide the goods/services in full
accordance with the specifications and other contract documents notwithstanding existing
material and labor markets conditions.
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RFP # 14-04-02 Employee Assistance Program (EAP), Diabetes Management
Technology (DMT), Expert Medical Opinion (EMO) and Neo-Natal Program (NNP)
1.1.4
The designated project manager during the proposal process shall be William
Struska, Procurement Services, 4400 West 18th Street, Houston, Texas
77092,
wstruska@houstonisd.org. All communications pertaining to the RFP shall be addressed in
writing to the Project Manager, as indicated in the next paragraph.
1.1.5 Questions concerning the RFP will be answered only if sent to the Procurement
Services Department, in writing via email to wstruska@houstonisd.org, on or before 5:00 P.M.
Central Standard Time April, 23, 2014. If there is a pre-proposal conference, responses to
written questions submitted prior to the pre-proposal conference will be read at the pre-proposal
conference and included in the first addendum along with additional information including
questions and responses from the pre-proposal conference. All questions submitted in writing
to the Project Manager prior to the deadline will be answered in the form of addenda. All
addenda will be posted on the HISD Procurement website.
The Board of Education has approved a resolution establishing policy requiring Supplier(s) to
have paid all assessed taxes and be free of any indebtedness to the District before a project is
awarded.
Proposer(s) shall provide the District with a statement concerning any indebtedness, including
personal and real property taxes, when submitting responses.
1.1.6 In an effort to encourage minority and women owned businesses to participate in
HISD business and submit proposals based upon their capacity to perform and be successful,
this project may be awarded to more than one Proposer if it is in the best interest of the District
to do so. Interested Proposer(s) should obtain additional information concerning the District’s
location of schools and offices and consider submitting their proposal for any one or more
schools and/or departments, or the entire District.
1.1.7 All costs related to the preparation and submission of this proposal shall be paid by
the Proposer. Issuance of this RFP does not commit HISD, in any way, to pay any costs in the
preparation and submission of the proposal. Nor does the issuance of the RFP obligate HISD to
award, enter into an agreement, or purchase any goods and services stated in the RFP.
1.2 DEFINITIONS AND TERMS: In this RFP, terms are used as follows:
1.2.1 “Agreement” is defined in Section II, General Terms and Conditions.
1.2.2 “HISD, owner, district, and/or government entity” refers to Houston Independent
School District.
1.2.3 “Proposer” refers to the person/firm that submits the proposal to this RFP.
1.2.4 “Project” means the Scope of Work for furnishing goods and services.
1.2.5 “Proposal” refers to the document submitted by an entity that addresses the scope
and requirements of this RFP.
1.2.6 “RFP” refers to this Request for Proposal.
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Revised 2/13/14 – Version 7.8
RFP # 14-04-02 Employee Assistance Program (EAP), Diabetes Management
Technology (DMT), Expert Medical Opinion (EMO) and Neo-Natal Program (NNP)
1.2.7 “Scope of Work” is set forth in Section III. Scope of Work and Specific Conditions.
1.2.8 “Supplier” and/or “Vendor” refer to the person(s)/firm(s)/entity(ies) to whom a contract
is awarded pursuant to this RFP.
1.2.9 Singular terms shall include the plural and vice versa. A gender reference includes
both genders.
1.3 SPECIFICATIONS: Proposer(s) are expected to examine and be familiar with all requirements and obligations of this entire
RFP. Failure to do so will be at the Proposer(s) risk. The evaluation criteria for the award of this RFP are set forth in the Scope of
Work and Specific Conditions Section of this RFP at paragraph 3.5. All exceptions to the specifications and requirements of the
RFP must be noted in detail in the Proposal Exception Form (Form E hereto) and included in the proposal.
1.4 PROPOSAL INFORMATION REQUIRED:
1.4.1 To achieve a uniform review process and obtain the maximum degree of
comparability, it is required that proposals be organized in the manner specified.
The Proposal shall be submitted in a binder with tabs as set forth below:
Title Page
Show the RFP subject, the name of the Proposer’s firm, address, telephone number, name of contact
person, and date.

Tab 1 – Table of Contents
Clearly identify the materials by sections and page numbers.

Tab 2 – Proposal Submission Forms
Complete and return Forms A–G set forth in the last Section of this RFP. The set of forms submitted in the
proposal marked “ORIGINAL” requires original manual signatures. Copies of the forms bearing original
signatures should be included in each additional proposal.
The forms should be submitted in the following order:
1. FORM A: Company Information
2. FORM B: M/WBE Participation Report
3. FORM C: Addendum for Agreement Funded by U.S. Federal Grant (Non-Construction Contracts)
4. FORM D: Pricing and Service Affirmation
5. FORM E: Exception Form
6. FORM F: Price Schedule (if applicable) (should be placed in tab 7)
7. FORM G: CHE (Local) Questionnaire


Tab 3 – Profile of the Proposer
a. Indicate the number of people in your organization and their level of experience and qualifications and
the percentage of their time that will be dedicated to this project.
b. Provide a list of the Proposer’s top ten current and prior two years’ clients indicating the type of goods
and/or services your organization has provided and/or performed for each client.
Certification of Insurance (Acord form).
Tab 4 – Scope Section
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RFP # 14-04-02 Employee Assistance Program (EAP), Diabetes Management
Technology (DMT), Expert Medical Opinion (EMO) and Neo-Natal Program (NNP)
Clearly describe the scope of the goods and /or services to be provided based upon the information in the
Scope of Work and Specific Conditions and Specification Sections stated in the RFP. Respond to each item
listed.

Tab 5 – Questionnaire Response — [If questionnaires are supplied and a response is required.]
Respond to any questionnaires included in the RFP. If no questionnaires are submitted, this section should
be left blank.

Tab 6 – Invoice Procedure
a. Describe the firm’s invoicing procedure.
b. Include documentation identifying all of the Proposer’s fees.
c. Payment terms. The District’s standard payment terms are 30 days after invoice is received. State any
payment discounts that your company offers, i.e., 2% 10 days – net 30; or 5% 7 days – net 30.

Tab 7 – Price
Any and all pricing information, including any alternate pricing proposals that may be acceptable for some
projects. Include a hard copy of Form F (Price Schedule) in this section, if applicable.

Tab 8 – Addenda
Insert all addenda under this section.
1.5 SUBMISSION OF PROPOSALS: The Proposer(s) should propose his/her lowest and best price,
(as applicable), on each good/service which is the subject of this RFP. Proposals shall be
submitted in strict compliance with the instructions set out in this RFP.
1.5.1 All prices shall be entered on the proposal in ink or typewritten. All required
signatures shall be original and in ink.
1.5.2 Proposed prices should be firm (fixed). If the Proposer(s), however, believes it
necessary to include in his/her price an economic price adjustment, such a proposal may be
considered, but only as an alternate proposal and should be noted in the Exception Form
(FORM E). The economic price adjustment should give the maximum price increase or
decrease (either % or $) and the date and/or event at which the increase would be effective.
Additionally, if a Proposer has reason to believe a better (more cost effective) method is
practical, then the Proposer may offer that better pricing option as an alternative.
1.5.3 All costs associated with the project must be enumerated in the proposal. Any
costs associated with the project not explicitly enumerated and discussed in the proposal will
not be honored. Proposer(s) shall provide information on their standard fee arrangement for any
goods and/or services proposed, and any discounts offered. Proposer(s) must include in the
cost proposal all travel and accommodation expenses associated with travel to perform this
project. Travel expenses associated with the project must conform to a “reasonableness” test
for travel expenditures associated with governmental travel and must be pre-approved by the
District before being incurred.
1.5.4 The District’s standard freight terms are F.O.B., destination, prepaid and allowed.
HISD may specify various and different locations within the District for “destination” during the
term of the Agreement, or extension of the term, and prices should include allowances for such
freight contingencies. No C.O.D. shipments will be accepted. If the goods are not shipped in
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Revised 2/13/14 – Version 7.8
RFP # 14-04-02 Employee Assistance Program (EAP), Diabetes Management
Technology (DMT), Expert Medical Opinion (EMO) and Neo-Natal Program (NNP)
accordance with HISD’s directions and the instructions set out in the Agreement, the Supplier
shall pay to HISD any excess cost incurred by District.
1.5.5 Proposer(s) are required to provide HISD with a menu of any optional services
offered. Each service must be priced separately and independent of any other services offered
or rendered.
1.5.6 HISD is exempt from and will not be responsible for payment of any taxes.
1.5.7 Failure to manually sign the required forms of this proposal may result in rejection of
the proposal.
1.5.8 A signed submitted proposal constitutes an offer to perform the work and/or deliver the
product(s) specified in this RFP.
1.6 FINANCIAL INFORMATION: Proposer(s) may be required to submit a current audited financial
statement. The Project Manager will determine the necessity of financial information. In the
event the Proposer(s) does not have an audited statement, other information such as an
unaudited statement or copies of the Proposer(s)’ federal income tax returns, with all
amendments, may be required.
1.7 DISCUSSIONS / NEGOTIATIONS: Discussions/negotiations may be conducted with Proposer(s)
who are deemed to be within the final competitive range; however, HISD reserves the right to
award a contract without discussions/negotiations. The competitive range will be determined by
HISD and will include only those initial proposals that HISD determines have a reasonable
chance of being awarded a contract. If discussions/negotiations are conducted, Proposer(s)
may be required to submit a best and final offer. The best and final offer may be required as
early as 24 hours after completion of negotiations/discussions.
1.8 BEST AND FINAL OFFERS: Best and final offers must be received by the date/time provided
during discussions/negotiations, or the originally submitted proposal will be used for further
evaluation and award recommendation.
1.9 MODIFICATION OR WITHDRAWAL OF PROPOSALS: Proposals may be modified or withdrawn by
written or electronic notice received by the Project Manager prior to the exact hour and date
specified for receipt of proposals. A proposal may also be withdrawn in person by a Proposer’s
authorized representative prior to the Proposal Due Date and time, provided the Proposer’s
identity is confirmed and Proposer’s representative signs a receipt for the proposal.
1.10 OPENING PROPOSALS: All proposals may be opened as soon as received. A formal public
"opening" will not be held. Trade secrets and confidential information contained in proposals
shall not generally be open for public inspection, but HISD’s records are subject to the State of
Texas Public Information Act requirements.
1.11 SCHEDULE: The following schedule and timelines apply to this RFP.
1.11.1 Proposal Schedule: HISD desires to complete the proposal process in
accordance with the following timeline which is subject to change at the District’s discretion:
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Revised 2/13/14 – Version 7.8
RFP # 14-04-02 Employee Assistance Program (EAP), Diabetes Management
Technology (DMT), Expert Medical Opinion (EMO) and Neo-Natal Program (NNP)
Timeline
Thursday, April 10, 2014
Thursday April, 17, 2014 from 1:00PM – 2:00pm in Building A,
Pre-Proposal Conference
Room PL-3, HISD’s Ryan Professional Development Center,
4001 Hardy Street Houston, TX 77009
Last date for questions:
Wednesday, April, 23, 2014 5:00 PM Central Standard Time
RFP Due
Friday, May 2, 2014 3:00 PM Central Standard Time
Evaluation Period
Friday, May 2, 2014 – Wednesday, May 28, 2014
Selected
Proposal(s) Next regularly scheduled Board meeting after interviews
Approved
and selection
Release RFP
1.11.2. Proposer(s) are strongly encouraged to attend the pre-proposal conference. The conference will
start promptly at the stated time and be moderated by a Procurement Department member. General rules of
business meeting protocol will be observed during the meeting. Admittance for individuals arriving late is at the
discretion of the moderator. In the event that an individual is admitted late, questions already discussed will not be
revisited during the remaining portion of the conference.
Individuals attending the pre-proposal conference will be required to sign an attendance roster. In addition to their
name and company name, each person will be asked to supply an email address, telephone number and a fax
number for facsimile transmissions, if needed. This attendance roster will be posted as an addendum on the
District’s website along with the RFP and other related documents.
1.11.3 At the District’s discretion, one or more Proposer(s) may be invited to
demonstrate their solution(s) and/or system(s) and interview, based on a District pre-defined
agenda and time line. Said Proposer(s) will be notified by e-mail if the District determines that
such demonstrations and interviews are needed. Proposer(s) shall demonstrate their
competence, qualifications and/or ability to satisfy the District’s RFP requirements.
1.11.4 Award of the Project to Proposer(s) will be confirmed by a fully executed Agreement,
an Agreement Letter and/or confirming Purchase Order.
1.11.5 Timelines set forth herein may be strictly enforced by the District. The District,
however, maintains sole discretion to adjust any deadline or timeline to suit the best interests of
the District.
1.11.6 Late Proposals: Responses submitted after the due date and time noted in this
RFP shall not be considered and shall be returned to the Proposer(s), unopened, by United
States Mail. The District is not responsible for lateness of U.S. Mail, Commercial (Professional)
Carrier, personal delivery, or any other delivery method. The time and date stamp clock in the
Houston ISD’s Board Services Department, Hattie Mae White Educational Support Center, 4400
West 18th Street, Houston, Texas 77092, shall be the official date and time of receipt. It shall be
the sole responsibility of the Proposer(s) to ensure that his or her bid is received at the
appropriate location by the specified deadline. There shall be no exceptions to these
requirements.
1.12 RETENTION OF PROPOSAL DOCUMENTATION: All proposal materials and supporting
documentation that are submitted in response to this proposal becomes the permanent property
of HISD.
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RFP # 14-04-02 Employee Assistance Program (EAP), Diabetes Management
Technology (DMT), Expert Medical Opinion (EMO) and Neo-Natal Program (NNP)
1.13 RESERVATION OF RIGHTS: The District reserves the right to reject any and all proposals. The
District reserves the right in its sole discretion to accept the proposal(s) it considers the best
value for the District, and the right to waive any and all minor irregularities in the proposal(s).
Additionally, the District reserves the right to waive any requirements of the RFP. The District
further reserves the right to reject all proposals and seek new proposals when such action
would be deemed in the best interests of the District.
1.14 APPEAL PROCESS: Any Proposer(s) that submitted a proposal may appeal the District’s
award, if the appeal is based on deviations from laws, rules, regulations, or Board of Education
policies. Board of Education GF Local applies to Proposer(s) wishing to appeal a proposal
and/or award of a contract: Proposer(s) shall submit appeals via U.S. mail or electronic-mail (email), utilizing the District Dispute Resolution Form, to the General Manager – Procurement
Services, and appeals must be received no later than 4:00 P.M. on or before the fifteenth (15th)
business day after Board Award. In the event that a Proposer is unsure about the Board Award,
it is the Proposer’s responsibility to contact Procurement Services on the next business day
after the Board Award is announced, and verify the specifics concerning the Award. Proposers
need to conduct whatever research is necessary to verify the Award, and, in the event that an
appeal is filed, must meet the fifteenth business day rule stated in GF Local. The 15 days
begins to run on the first business day after Board Award is announced.
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II. GENERAL TERMS AND CONDITIONS
The following terms and conditions are incorporated into this RFP and incorporated into any letter agreement or
formal written agreement between HISD and the successful Proposer(s).
2.1 AGREEMENT, INTEGRATION, TERM & TRANSITION, PURCHASE ORDER REQUIREMENTS:
2.1.1 The terms, conditions, specifications, stipulations and requirements stated in this
RFP, and any and all Addenda issued by HISD shall become part of the Agreement entered into
between the District and the Supplier, unless otherwise determined by the District per the
Agreement provisions. The Supplier, as determined by the District, may be required to execute
a written contract to furnish all goods and/or services and other deliverables required for
successful completion of the proposed project. No Supplier shall obtain any interest or rights
in any award until the District has executed the Agreement. The District reserves the right
to require any modification, or modifications to the Agreement terms if the modifications are
deemed to be in the best interest of the District and do not substantially change the scope of the
Board award.
2.1.2 The District does not sign Supplier contract forms. Supplier(s) should be familiar with
the District’s Agreement form, Agreement letter and/or purchase order and indicate in its
proposal that this type of project documentation is acceptable. This information should be
included in the transmittal letter. In the event that a project is awarded to a Supplier and the
Supplier requests changes to the District standard Agreement form, the District reserves the
right to cancel the award and re-award the project to an alternate Supplier(s).
2.1.3 In the event of a license agreement or other contract document requested by the Supplier for
execution, the District reserves the right to review and amend such document at the District’s discretion.
2.1.4 The Request for Proposals, with all Addenda, those provisions in the proposal that are satisfactory to
the District, and the District’s Agreement form(s), which may include, but are not limited to a written contract,
agreement letter or purchase order constitute the Agreement between the Supplier and the District (collectively, the,
“Agreement”). NOTWITHSTANDING ANYTHING TO THE CONTRARY IN ANY SUPPLIER FORM, PROPOSAL OR
DOCUMENTATION, THE TERMS AND CONDITIONS OF THE AGREEMENT AS INTEGRATED ABOVE SHALL BE
CONTROLLING IN ALL INSTANCES. To the extent there is any conflict between or among the documents
composing the Agreement, the following hierarchy (from most to least authoritative) shall prevail: (i) District’s
Agreement forms (written contract, agreement letter or purchase order as applicable), and (ii) RFP as provided by the
District all Addenda, and (iii) any Proposal provisions agreed to by the District.
2.1.5 Unless otherwise provided or required by the District, a standard agreement which results from this
RFP shall be for a period of one year from the effective date of the Agreement with an exclusive option by the District
to renew on an annual basis thereafter for four additional one-year terms, or as otherwise stated in the Agreement.
Alternately, the District may approve longer or shorter terms of agreement upon the mutual consent of the parties. At
the District’s option, there may be an additional 90-day transitional period added to the end of the initial term or any
renewal term. The Agreement prices, terms and conditions are to remain in force during the transitional period.
Should the Agreement with the Supplier terminate during the initial or any renewal term for any
reason, the District reserves the right to have the same transitional period, prices, terms and
conditions as if the Agreement terminated at the expiration of that term.
2.1.6 At the discretion of the District, purchases may require the issuance of an official
HISD purchase order from the District’s Procurement Services Department. If so required, then
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all goods provided without a purchase order will be returned at Supplier’s expense. All services
provided without a purchase order may be considered a contribution to the District.
2.1.6.1 HISD reserves the right to make changes to a purchase order (e.g.,
increase/decrease quantities, change delivery date, delivery address). Any changes to a
purchase order shall be communicated to the awarded supplier by the issuance of a formal
change purchase order. Only an HISD procurement staff member may make a change to the
purchase order by issuing and sending a formal change purchase order to the awarded
supplier.
2.1.7 Once the performance of the Agreement has begun, any change orders or
requests will be made in accordance with Texas Education Code Section 44.0411 and
applicable HISD procedures and policies. If Supplier acts on the direction of a District employee
that is not authorized to make changes, Supplier does so at his or her own risk or peril and risks
termination of the Agreement for cause. Also, if a Supplier attempts, or receives, a
modification/amendment from a District employee that is not authorized to make changes, the
Supplier does this at his or her own risk or peril and risks termination of the Agreement for
cause.
2.2 NON-ASSIGNMENT: The Supplier may not assign, sell, or otherwise transfer its interest in the
Agreement award or any part thereof, without prior written consent from the District. The
Supplier shall have full responsibility for the completion and performance of all services and the
delivery of all goods awarded to Supplier pursuant to this RFP.
2.3 USE OF DISTRICT NAME OR LOGO(S): Supplier may not use the District’s official name or logo, or
any phrase associated with the District, without the written permission from the Board of
Education, the Superintendent of Schools, or their designee.
2.4 AUTHORIZATION / PERMITS: The Supplier must have current licenses, permits, fees and
similar authorizations required by the City of Houston, Harris Country, and the State of Texas to
conduct business and provide awarded goods and/or services to the District and, upon the
request of the District, must provide copies of all licenses, permits and fees as being paid and
current that are required to do business by the city, county and State for the type of business
they are seeking to provide to the District. Supplier will maintain all such licenses, permits, fees
and similar authorizations current for the duration of the Agreement term.
2.5 SUPPLIER NATIONWIDE CRIMINAL BACKGROUND CHECKS:
Pursuant to Sections
22.085 and 22.0834 of the Texas Education Code, Supplier hereby certifies that all employees, subcontractors and
volunteers of the Supplier who are hired by Supplier on or after January 1, 2008, and who have continuing duties
related to the contracted services; and who have or will have direct contact with students have passed a national
criminal history background record information review as required by those sections.
Supplier shall send or ensure that the employee or applicant sends to the Texas Department of Public Safety (“DPS”)
information that is required by the DPS for obtaining national criminal history record information, which may include
fingerprints and photographs. DPS shall obtain the person’s national criminal history record information and report
the results through the criminal history clearinghouse as provided by Section 411.0845, Government Code.
Supplier must also obtain certifications from all subcontractors that their employees to whom Section 22.0834 applies
have also passed a national criminal history background record information review.
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Supplier must also provide assurances that all of its employees, subcontractors and volunteers, including those hired
before January 1, 2008, who have contact with students have passed a criminal history background check current
within the last year. If an employee, subcontractor or volunteer of the Supplier has a criminal conviction or has
received deferred adjudication for a felony offense or a misdemeanor involving moral turpitude, the District may elect
not to enter into this contract, or cancel the contract.
WARNING: Section 44.034 of the Texas Education Code requires that a person or business entity that enters into a
contract with a school district must give advance notice to the district if the person or an owner or operator of the
business entity has been convicted of a felony. The notice must include a general description of the conduct
resulting in the conviction of a felony.
The district may terminate this contract if the district determines that the person or business entity failed to give notice
as required by Section 44.034 (a) or misrepresented the conduct resulting in the conviction. The district will
compensate the person or business entity for services performed before the termination of the contract.
2.6 SUPPLIER DOCUMENT AUDIT AND INSPECTION/RECORD RETENTION/STUDENT
INFORMATION:
2.6.1 The District reserves the right to audit various Supplier documents as requested by the District.
From time to time, the District may desire to audit certain Supplier documents to ensure compliance with the
Agreement and/or proposal response. Some audits may include but are not limited to: checking Supplier’s invoices,
authenticating the origin, Material Safety Data Sheet (MSDS), shelf life of products and/or other similar types of
documents. The Supplier agrees to furnish the District, in a reasonable time at a mutually agreeable place,
documents requested by the District to perform any such reviews or audits.
2.6.2 HISD, or its authorized representative, shall be afforded unrestricted access to and permitted to
inspect and copy all Supplier’s records, which shall include but not be limited to accounting records (hard copy as
well as computer readable data), correspondence, instructions, drawings, receipts, vouchers, memoranda and similar
data relating to this project. Supplier shall preserve all such records for a period of five (5) fiscal years or for such
longer period as may be required by law, after final payment relating to this project. If this project is funded from
contract/grant funds provided by the U. S. Government or the State of Texas, all documentation, including books, and
records shall be available for review and audit by the Comptroller General of the U. S. and/or the Inspector General
of the federal sponsoring agency, or the State of Texas and its duly authorized representatives.
2.7 CONFIDENTIAL AND PROPRIETARY INFORMATION: The District and the Supplier may provide
technical information, documentation and expertise to each other that is either (1) marked as being confidential or, (2)
if delivered in oral form is summarized in writing within 10 working days and identified as being confidential
(“Confidential Information”). The receiving party shall for a period of five (5) years from the date of disclosure (i) hold
the disclosing party’s Confidential Information in strict confidence, and (ii), except as previously authorized in writing
by the disclosing party, not publish or disclose the disclosing party’s Confidential Information to anyone other than the
receiving party’s employees on a need-to-know basis, and (iii) use the disclosing party’s Confidential Information
solely for performance of this project. The foregoing requirement shall not apply to any portion of a party’s
Confidential Information which (a) becomes publicly known through no wrongful act or omission on the part of the
receiving party; (b) is already known to the receiving party at the time of the disclosure without similar nondisclosure
obligations; (c) is rightfully received by the receiving party from a third party without similar nondisclosure obligations;
(d) is approved for release by written authorization of the disclosing party; (e) is clearly demonstrated by the receiving
party to have been independently developed by the receiving party without access to the disclosing party’s
Confidential Information; or (f) is required to be disclosed by order of a court or governmental body or by applicable
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law, provided that the party intending to make such required disclosure shall notify the other party of such intended
disclosure in order to allow such party to seek a protective order or other remedy.
2.8 DATA AND PROPRIETARY INFORMATION: All work, regarding this project, shall be deemed
“Work Made For Hire” as defined by the United States Copyright Law, and HISD retains for itself sole ownership of all
proprietary rights in and to all designs, engineering details and other data pertaining to any discoveries, inventions,
patent rights, software, improvements and the like made by the Supplier’s personnel in the course of performing the
work.
2.9 TEXAS PUBLIC INFORMATION ACT (TPIA): Supplier acknowledges that the District is subject to
the Texas Public Information Act (TPIA). As such, upon receipt of a request under the TPIA, the
District is required to comply with the requirements of the TPIA. In the event that the request
involves documentation that the Supplier has clearly marked as confidential and/or proprietary,
the District will provide the Supplier with the notices under the TPIA. Supplier acknowledges that
it has the responsibility to file exceptions with the Texas Attorney General's Office on why the
documents identified as confidential and/or proprietary fall within an exception to public
disclosure.
2.10 STUDENT CONFIDENTIALITY: Supplier acknowledges that the District has a legal obligation to
maintain the confidentiality and privacy of student records in accordance with applicable law and
regulations, including, but not limited to the Family Educational Rights and Privacy Act
(“FERPA”). Any student information provided to Supplier shall be provided in compliance with
the requirements and exceptions outlined in FERPA. Supplier must comply with said law and
regulations and safeguard student information. Supplier may not disclose student information to
a third party without prior written consent from the parent or eligible student. Supplier must
destroy any student information received from the District when no longer needed for the
purposes of the Agreement.
2.11 INSURANCE:
2.11.1 Unless otherwise agreed to by HISD, the Supplier shall carry insurance with responsible carriers
acceptable to HISD rated A or better, by A.M. Best with minimum limits of liability coverage, as stated below, against
claims for damages caused by bodily injury, including death, to employees and third parties, and claims for property
damage. The Supplier shall furnish certificates of insurance (Acord Form) to HISD indicating compliance with this
paragraph.
Type of Coverage
1. Workers’ Compensation
and Employer’s Liability
Minimum Limits
Statutory
$100,000 per accident
2. Automobile Liability:
Bodily Injury & Property Damage
$1,000,000 Combined Single Limit
For all owned, non-owned vehicles and
hired vehicles.
3. Commercial General Liability
$1,000,000 Combined Single Limit
4. Professional Liability (errors and omissions) may be required at the discretion of the
Project Manager.
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2.11.2 The Supplier shall submit evidence with the proposal and again at the time of any
execution of the contract/agreement that it has in full force and effect all insurance requirements
listed above. The Supplier shall maintain such insurance in full force and effect throughout the
duration of the Agreement. In the event that it is not commercially feasible to maintain insurance
during the period required by the Agreement, Supplier shall supply HISD with equivalent
assurance to the required insurance, acceptable to HISD.
2.11.3 HISD shall be named as an additional insured on the automobile and commercial
general liability policy. HISD shall be named as an alternate employer on the workers’
compensation policy. A waiver of subrogation shall be issued in favor of HISD in the workers’
compensation, automobile and commercial general liability policies. The Supplier shall provide
HISD with original certificates of insurance, acceptable to HISD. Insofar as allowed by law, such
certificates shall indicate an agreement by each carrier not to cancel or significantly diminish
coverage without a minimum of thirty (30) days prior written notice to HISD. In the event there is
a deductible on any policy, the Supplier may be asked to provide evidence to the satisfaction of
HISD that it is able to satisfy the deductible.
2.11.4 Notice regarding insurance and cancellation or changes should be mailed to:
Project Manager as stated in Section 1.1.5 of this RFP
Houston Independent School District
Procurement Services
4400 West 18th Street
Houston, Texas 77092
2.11.5 HISD reserves the right to require additional insurance coverage to be carried by
the Supplier as deemed desirable by HISD, depending on the type of project.
2.12 TAXES: HISD is exempt from local, state and federal taxes. In the event that taxes are
imposed on the goods and/or services purchased, the District will not be responsible for
payment of the taxes. The Supplier shall absorb the taxes entirely. The District will supply tax
exemption information upon request.
2.13 INVOICES/PAYMENT:
2.13.1 HISD standard payment terms are net 30 days after receipt of invoice. Supplier
may offer the District a cash discount for payment of an invoice(s) with stated discount terms.
Supplier’s invoices should be sent to: Houston Independent School District, Controller’s Office,
Accounts Payable Department, 4400 West 18th Street, Houston, Texas 77092.
2.13.2 Invoices will be date and time stamped upon receipt in the Accounts Payable
Department, and the cash discount, when applicable, will be calculated from the “receipt date”
stamped on the invoice. Supplier’s invoices must contain the appropriate HISD purchase order
number on the face of the invoice. Each line item on the invoice should contain the
corresponding line item number shown on the purchase order. Invoices submitted without the
correct purchase order number shown may be returned to the Supplier for correction. Corrected
invoices will be subject to the same payment provisions as original invoices.
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2.13.3 Invoices should be provided to the District in a timely manner. Supplier is
requested to invoice the District within 30 days of providing goods and/or services to the District.
2.13.4 In the event a Supplier presents the District with invoices, statements, reports, etc. that are
incomplete, inaccurate or in need of substantial internal research, such action could result in delay of payment. The
District will not be responsible for any interest charges and/or late fees as a result of delayed payment due to time
delays caused by inadequate or incomplete information provided in invoices by Supplier.
2.14 QUANTITY:
2.14.1 There is no guaranteed amount of business, expressed or implied, to be purchased, or contracted for
by HISD. However, the Supplier shall furnish all required goods and/or services to the District at the stated price,
when and if required.
2.14.2 The District’s agreement may be offered to other school districts or governmental entities. If
applicable and at the discretion of the District, a forecast of planned usage will be issued as part of the project. This
forecast is based upon the District’s historical usage. If the District exceeds that forecast of usage and the Supplier
experiences a higher volume of sales, the District may request a value consideration to compensate the District for
said increased sales in the form of a volume usage rebate. Supplier should include, in their proposal, the method(s)
they will use to calculate the usage rebate and discuss how the rebate will be calculated and paid.
2.14.3 The District expressly reserves the right to procure any goods or services from other sources or by
other means.
2.15 BONDING: At the District discretion, Performance and Payment Bonds may be required on
certain projects valued in excess of designated amounts ($100,000 for Performance Bond &
$25,000 for Payment Bond). The District will determine the necessity of Performance and
Payment Bond on a project by project basis. The procurement Project Manager will advise
potential Proposers if a particular project requires bonding. A sample of the Performance Bond
and the Payment Bond can be found at the following web address:
http://apptemp.houstonisd.org/Procurement/WebPDF/BondGroup.pdf
2.16 GOVERNING LAW: Any agreement resulting from this RFP shall be governed by, construed
and enforced in accordance with the laws of the State of Texas without regard to the conflicts or
choice of law principles thereof. The parties irrevocably consent to the jurisdiction of the State
of Texas, and agree that any court of competent jurisdiction sitting in the County of Harris, State
of Texas, shall be an appropriate and convenient place of venue, and shall be the sole and
exclusive place of venue, to resolve any dispute with respect to the Agreement.
2.17 RELATIONSHIP OF THE PARTIES: It is understood and agreed that the Supplier is a separate
legal entity from HISD and neither it nor any employees, volunteers, or agents contracted by it shall be deemed for
any purposes to be employees or agents of HISD. The Supplier assumes full responsibility for the actions of its
personnel and volunteers while performing any services incident to the Agreement, and shall remain solely
responsible for their supervision, daily direction and control, payment of salary (including withholding of income taxes
and social security), workers’ compensation, disability benefits and like requirements and obligations.
2.18 NO WAIVER OF IMMUNITY: The District does not waive or relinquish any immunity or defense on
behalf of itself and its trustees, officers, employees, and agents as a result of entering into any agreement or contract
relating to this project or by performing any of the functions or obligations relating to the project. Nothing in any
agreement shall be constructed as creating any personal liability on the part of any trustee, officer, employee, or
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representative of HISD. No waiver of a breach of any provision of the contract and/or agreement shall be construed
to be a waiver of any breach of any other provision. No delay in acting with regard to any breach of any provision
shall be construed to be a waiver of such breach.
2.19 INDEMNIFICATION: THE SUPPLIER SHALL INDEMNIFY, AND HOLD HARMLESS AND DEFEND
HISD AND EACH OF IT’S RESPECTIVE PAST, PRESENT AND FUTURE OFFICERS, TRUSTEES, AGENTS,
AND EMPLOYEES IN THEIR INDIVIDUAL AND OFFICIAL CAPACITIES, FROM AND AGAINST ALL CLAIMS,
LOSSES OR DAMAGES, INCLUDING ATTORNEY’S AND EXPERT’S FEES, COURT COSTS AND EXPENSES
INCURRED BY HISD AND IT’S OFFICERS, TRUSTEES, AGENTS AND EMPLOYEES, FOR INJURY, INCLUDING
DEATH, TO PERSONS, OR DAMAGE TO OR DESTRUCTION OF PROPERTY, AND LAWSUITS, DEMANDS OR
CAUSES OF ACTION OF WHATSOEVER KIND OR NATURE BASED UPON, RESULTING FROM OR ARISING
OUT OF OR IN CONNECTION WITH ANY NEGLIGENT ACT, ERROR, OMISSION, MISREPRESENTATION, OR
MISCONDUCT BY SUPPLIER AND ITS EMPLOYEES, OFFICERS, SUB-CONSULTANTS, OR AGENTS ARISING
OUT OF OR IN CONNECTION WITH SUPPLIER’S PERFORMANCE OF THE AGREEMENT.
All obligations as set forth in this paragraph shall survive the completion of or termination of the Agreement.
It is agreed with respect to any legal limitations now or hereafter in effect and affecting the validity or enforceability of
the indemnification obligation, such legal limitations are made a part of the indemnification obligation to the minimum
extent necessary to bring the provision into conformity with the requirements of such limitations, and as so modified,
the indemnification obligations shall continue in full force and effect.
2.20 NOTICE: Any notice required to be given relating to the Agreement shall be in writing and shall be duly
served when hand-delivered to the addressees set forth below, or shall have been deposited, duly registered or
certified, return receipt requested, via the United States Postal Service, addressed to the other party at the following
addresses:
To:
Supplier’s Contact Name and Address as listed in Form A
To:
Houston Independent School District
Attn: Superintendent of Schools
4400 West 18th Street
Houston, Texas 77092
Copy To:
Mr. Gilberto A. Carles, MBA
General Manager – Procurement Services
4400 West 18th Street
Houston, Texas 77092
Any party may designate a different address by giving the other party ten (10) days prior written notice in the manner
provided above.
2.21 SECTION HEADINGS: The headings of sections and paragraphs contained in any document
related to this project are for convenience only, and they shall not, expressly or by implication,
limit, define, extend, or construe the terms or provisions relating to the project.
2.22 THIRD PARTY BENEFICIARIES: Nothing relating to this project shall be deemed or construed to
create any third party beneficiaries or otherwise give any third party any claim or right of action against HISD or the
Supplier(s).
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2.23 DISPUTE RESOLUTION: At the option of the District, the Supplier and the District agree that prior to
filing any suit, administrative proceeding, or other legal proceeding, related to this Agreement, each party shall submit
any and all disputes to the alternative dispute resolution process of non-binding mediation. The Supplier and the
District further agree to attend the mediation and to participate in settlement negotiations in a good faith effort to
resolve any and all disputes through a written settlement agreement. The mediation shall take place in Harris
County, Texas, and will be conducted by a mediator mutually selected by the parties. If the parties are unable to
agree on a mediator, each party shall submit a list of up to three names as a mediator along with a curriculum vitae
and costs associated with each name submitted. Each party will alternate in striking one name from the list until only
one name remains. The remaining name will be the agreed upon mediator. HISD will have the first opportunity to
strike a name from the list. All fees and costs of the mediator shall be shared equally between the parties. No formal
record shall be made of the mediation.
2.24 TERMINATION:
2.24.1 The District reserves the right to terminate, without cause and for any reason, the Agreement
resulting from this RFP upon thirty (30) calendar days prior written notice, or five (5) days prior written notice for
cause.
2.24.2 HISD also has the right to terminate the Agreement for convenience, without
penalty, for non-appropriation or non-availability of funds by delivery to the Supplier of a "Notice
of Termination" specifying the extent to which performance hereunder is terminated and the
date upon which such termination becomes effective.
2.25 DEFECTIVE / NON-CONFORMING WORK:
2.25.1 If, following seven (7) calendar days of a written notice to a Supplier identifying
defective or nonconforming work, the Supplier or its subcontractors fail to correct such defective
or nonconforming work, HISD may order the Supplier to stop further work, or any portion
thereof, until the defect or nonconformance has been properly corrected by the Supplier or its
subcontractors.
2.25.2 Should the Supplier not proceed with the correction of defective or nonconforming work within three (3) additional calendar days of HISD’s order to stop further work,
as set forth above, HISD may cause the removal, repair or correction of the defective or
nonconforming work and may charge all associated costs of the same to the Supplier.
2.26 DEFAULT CONDITIONS: If the Supplier: (i) breaches any provision of the Agreement; (ii) ,
becomes insolvent, enters voluntary or involuntary bankruptcy, or receivership proceedings, or
makes an assignment for the benefit of creditors; or (iii) is in violation of any state or federal law
(collectively, “event(s) of default”), HISD will have the right (without limiting any other rights or
remedies that it may have in the Agreement or by law) to terminate the Agreement with five (5)
days prior written notice to the Supplier. HISD will then be relieved of all obligations, except to
pay the reasonable value of the Supplier’s prior performance, satisfactory to HISD (at a cost not
exceeding the agreement rate and subject to any claims, costs and expenses incurred by HISD
as a result of Supplier default). In the event of default, HISD is expressly authorized to obtain
the goods or services that would have been provided by Supplier under this Agreement from an
alternative source. The Supplier will be liable to HISD for all costs exceeding the Agreement
price that HISD incurs in completing or procuring the services and goods as provided for in the
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Agreement. HISD’s right to require strict performance of any obligation in the Agreement will not
be affected by any previous waiver, forbearance, or course of dealing.
2.27 WARRANTIES: SUPPLIER EXPRESSLY WARRANTS THAT ALL THE GOODS AND
SERVICES COVERED BY THE AGREEMENT RESULTING FROM THIS RFP WILL BE IN
EXACT ACCORDANCE WITH THE REQUIREMENTS OF THE AWARD OF THE RFP AND
RESULTING AGREEMENT AND FREE FROM DEFECTS IN MATERIALS AND/OR
WORKMANSHIP. SUPPLIER EXPRESSLY WARRANTS MERCHANTABILITY FOR ALL
GOODS PROVIDED PURSUANT TO THE RESULTING AGREEMENT. ALL WARRANTIES
SHALL SURVIVE DELIVERY OF THE GOODS AND COMPLETION OF THE SERVICES,
AND SHALL NOT BE DEEMED WAIVED EITHER BY REASON OF THE DISTRICT’S
ACCEPTANCE OF SAID GOODS AND SERVICES OR BY PAYMENT FOR THEM. ANY
DEVIATIONS FROM THE AGREEMENT, OR DESCRIPTIONS OR SPECIFICATIONS
FURNISHED THEREUNDER, OR ANY OTHER EXCEPTIONS OR ALTERATIONS MUST BE
APPROVED IN WRITING BY THE DISTRICT’S PROCUREMENT GENERAL MANAGER.
2.28 USE BY OTHER GOVERNMENT ENTITIES: The Texas Education Code 44.031 (a)(4) allows for
government entitles, i.e. state agencies, local governments and school districts, to enter into cooperative agreements
to allow the procurement process to be performed by a single entity on behalf of all those electing to participate. Any
of the above entities may be granted the privilege of joining the awarded Agreement. In the event HISD allows
another governmental entity to join the Agreement, it is expressly understood that HISD shall in no way be liable for
the obligations of the joining governmental entity.
2.29 THIRD PARTIES: Nothing in this RFP shall create a contractual relationship with or a cause of action in
favor of a third party against either HISD or the Supplier.
2.30 UNENFORCEABLE SECTIONS: If any portion of this RFP or any Agreement is deemed to be
unenforceable, the remainder of the RFP and Agreement shall be construed as if such unenforceable provisions had
never been contained therein.
2.31 MWBE PARTICIPATION GOAL: The Supplier shall report their MWBE participation goal as a percent
of the total compensation. This information shall be identified per firm, discipline and participation.
2.32 SUBCONTRACTING: The Supplier shall not subcontract services provided in this RFP without prior
written approval by HISD.
2.33 WORK STOPAGE: In no event shall HISD be liable or responsible to the Supplier or any other person for
our on account of, any stoppage or delay in work.
2.34 HAZARDOUS MATERIALS: In the performance of the Supplier’s services, the Supplier shall not cause
any release of Hazardous Substances, including asbestos, or contamination of the environment, including the soil,
the atmosphere or any water course or ground water. Supplier shall be liable for any claims or damages resulting
from such release of or exposures to any such substances as a result of the Supplier’s activities.
2.35 BUSINESS ETHICS: During the course of the project awarded by this RFP, the Supplier will maintain
business ethics standards aimed at avoiding real or apparent impropriety or conflicts of interest. No substantial gifts
over $50, entertainment, payments, loans, or other considerations beyond that which may be collectively categorized
as incidental shall be made to any employees or officials of HISD, its authorized agents and representatives, or to
family members of any of them. At any time the Supplier believe there may have been a violation of this obligation,
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the Supplier shall notify HISD of the possible violation. HISD is entitled to request a representation letter from the
Supplier, its subcontractors or vendors at any time to disclose all things of value passing from the Supplier, its
subcontractors or vendors to HISD’s personnel or its authorized agents and representatives.
2.36 BUSINESS CERTIFICATES / HISD TAXES: All individuals or entries entering into a contract with
HISD must adhere to the following applicable Texas laws as they pertain to their individual type of ownership.
2.36.1 Corporations: (domestic [formed under Texas law] or foreign [formed under laws of another state])
shall be properly registered with the Texas Secretary of State and the Comptroller of Public Accounts as required by
TITLE 34, Part 1, Chapter 3, Subchapter V, Rule 3.546 of the Texas Administrative Code. A current “Certificate of
Good Standing” from the Texas Comptroller of Public Accounts shall be made available upon request stating that the
corporation charter is current and all Texas Franchise Reports and taxes are paid.
2.36.2 Partnerships and Joint Stock Companies, and Limited Liability Partnerships: (domestic [formed under
Texas law] or foreign [formed under laws of another state]) shall be, properly registered with the Texas Secretary of
State in accordance with the Texas Secretary of State in accordance with TITLE 105 – PARTNERSHIPS and JOINT
STOCK COMPANIES, CHAPTER ONE- PARTNERSHIPS, LIMITED PARTNERSHIPS, TEXAS REVISED
PARTNERSHIP ACT, Article 6132a-1, “Texas Revised Limited Partnership Act. All partners in a partnership must file
a “Certificated of Limited Partnership” with the secretary of state, which shall be made available for inspection upon
request.
2.36.3 Entities whether, Corporate, Partnership, or Sole Owner must be current on HISD Property Taxes: If
commercial personal property is located within HISD’s jurisdiction, current renditions of these properties must be filed
with the Chief Appraiser, as required by Chapter 22k Section 22.01 of the Texas “PROPERTY TAX CODE”.
2.37 ATTORNEY FEES: In connection with HISD’s defense of any suit against it and/or HISD’s prosecution of
any claim, counterclaim or action to enforce any of its rights and/or claims related to this RFP or any agreement, in
which HISD prevails as to all or any portion of its defense(s), claims, counterclaims or actions, HISD shall be entitled
to recover its actual attorney’s fee and expenses incurred in defending such suit and/or in prosecuting such claim or
action.
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III. SCOPE OF WORK AND SPECIFIC CONDITIONS
3.1 SCOPE OF WORK: At minimum, the District is seeking the following goods and/or services to be
provided by the Supplier(s):




Employee Assistance Program (EAP),
Diabetes Management Technology,
Expert Medical Opinion,
Neonatal Solutions Program.
3.2 SPECIFIC CONDITIONS: See Section XII, 12.1
3.3 SPECIFICATIONS: See Section XII, 12.1
3.4 COST: Supplier shall provide a 30-day written notice of any price changes during the term of the Agreement
and provide supporting manufacturer and/or distributor documentation to support such price adjustments.
3.5 EVALUATION FACTORS: The evaluations committee will conduct a comprehensive, fair and
impartial evaluation of all proposals received in response to this RFP. Each proposal received
will be analyzed to determine overall responsiveness and completeness as defined in the scope
section and in the instructions on submitting a proposal. Failure to comply with the instructions
or to submit a complete proposal may deem a proposal non-responsive and may at the
discretion of the Evaluation Committee be eliminated from further evaluation.
If the evaluation committee has reasonable grounds to believe that the proposer with the
highest ranking score is unable to perform the required services to the satisfaction of HISD,
HISD reserves the right to make an award to another proposer who in the opinion of the
evaluation committee would offer HISD the best value. Some indicators (but not a complete list)
of probable supplier/proposer performance concerns are: past supplier performance; the
proposer’s financial resources and ability to perform; the proposer’s experience or demonstrated
capability and responsibility; and the supplier’s ability to provide a reliable on-going business
relationship and the maintenance of on-going agreements and support.
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Criteria #
Criteria Description
1
the purchase price
Weighted Value
35%
2
the reputation of the Proposer and of the Proposer’s goods or services
10%
3
the quality of the Proposer’s goods or services
10%
4
the extent to which the goods or services meet the District's needs
15%
5
the Proposer’s past relationship with the District
5%
6
the impact on the ability of the District to comply with laws and rules relating to
historically underutilized businesses
7
0%
the total long-term cost to the District to acquire the Proposer’s goods or services
15%
8
for a contract for goods and services, other than goods and services related to
telecommunications and information services, building construction and
maintenance, or instructional materials, whether the vendor or the vendor's
ultimate parent company or majority owner: (A) has its principal place of business
9
in this state; or (B) employs at least 500 persons in this state
5%
List and weigh any other relevant factors
5%
M/WBE Minority and Women-owned Business Enterprise
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IV. PRICING SHEETS INCLUDING ELECTRONIC SUBMITTAL REQUIREMENTS.
4.1 – This section intentionally left blank.
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V. FORM A - COMPANY INFORMATION:
Notice
This form requires a manual signature after each subsection, a manual
signature on the final page and a notary attestation at the conclusion of the
form, and must be included with the proposal in tab 2 of the Proposal.
STATE OF _____________________
COUNTY OF ___________________
§
§
§ AFFIDAVIT OF OWNERSHIP, CONTROL
AND CORPORATE INFORMATION
BEFORE ME, THE UNDERSIGNED AUTHORITY, ON THIS DAY PERSONALLY APPEARED
___________________________________________________________________[FULL NAME]
(HEREAFTER “AFFIANT”), ________________________________________________ [STATE TITLE/CAPACITY WITH
PROPOSAL] OF (PROPOSAL’S CORPORATE/LEGAL NAME), WHO BEING BY ME DULY SWORN ON OATH STATED AS FOLLOWS:
1. AFFIANT IS AUTHORIZED TO GIVE THIS AFFIDAVIT AND HAS PERSONAL KNOWLEDGE OF THE FACTS AND MATTERS
HEREIN STATED;
2. PROPOSER(S) SEEKS TO DO BUSINESS WITH THE DISTRICT IN CONNECTION WITH
_________________________________ [DESCRIBE PROJECT OR MATTER] WHICH IS EXPECTED TO BE IN THE
AMOUNT THAT EXCEEDS $10,000.
3. THE FOLLOWING INFORMATION IS SUBMITTED IN CONNECTION WITH THE PROPOSAL, SUBMISSION OR BID OF
PROPOSER IN CONNECTION WITH THE ABOVE DESCRIBED PROJECT OR MATTER.
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5.1 SUBSECTION I - COMPANY INFORMATION:
COMPANY NAME ______________________________________________________________________________
DATA UNIVERSAL NUMBERING SYSTEM (DUNS) NUMBER ____________________________________________
HOME OFFICE ________________________________LOCAL OFFICE______________________________________
ADDRESS____________________________________________________________________________________
CITY __________________________________________________________________________________
STATE _________________________________________________ZIP_____________
TELEPHONE ______________FAX__________________TELEPHONE____________________FAX______________
CONTACT PERSON’S NAME______________________________________________________________________
CONTACT PERSON’S TELEPHONE NUMBER_____________________ FAX NUMBER ____________________________
CONTACT PERSON’S E-MAIL ADDRESS _____________________________________________________________
1. NUMBER OF YEARS YOUR ORGANIZATION HAS BEEN IN CONTINUOUS OPERATION____________________________
2. NUMBER OF YEARS YOUR ORGANIZATION HAS BEEN IN BUSINESS UNDER ITS PRESENT BUSINESS NAME____________
3. DOES YOUR COMPANY PAY TAXES TO THE HOUSTON INDEPENDENT SCHOOL DISTRICT?________________________
4. ARE YOUR TAX PAYMENTS TO HISD CURRENT? _____________________________________________________
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5. DOES ANY OFFICER, PARTNER, OWNER, SALES REPRESENTATIVE AND/OR SPOUSE WORK FOR THE
 YES
HOUSTON INDEPENDENT SCHOOL DISTRICT
 NO
6. TYPE OF BUSINESS ENTITY:  PUBLICLY TRADED CORPORATION  PRIVATE CORPORATION  LIMITED PARTNERSHIP
 PARTNERSHIP  SOLE PROPRIETORSHIP  NOT FOR PROFIT ENTITY
7. IF CORPORATION, ANSWER THE FOLLOWING QUESTIONS:
DATE OF INCORPORATION _________________________________________
STATE OF INCORPORATION ________________________________________
CHARTER NUMBER ______________________________________________
PRESIDENT ___________________________________________________
VICE PRESIDENT _______________________________________________
CORPORATE SECRETARY _________________________________________
TREASURER __________________________________________________
8. IF PARTNERSHIP OR CORPORATION , DATE OF ORGANIZATION CREATION ____________________________________
9. IF SOLE PROPRIETOR, NUMBER OF YEARS IN BUSINESS __________________________
10. NUMBER OF YEARS DOING BUSINESS WITH HISD ______________________________
11. DO YOU HAVE EXPERIENCE WITH OTHER SCHOOL DISTRICTS? ________YES _______NO
12. IF YES, PLEASE LIST NAMES OF SCHOOL DISTRICTS_________________________________________
______________________________________________________________________________
______________________________________________________________________________
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13. IS YOUR COMPANY CAPABLE OF PROVIDING A DEDICATED WEBSITE WITH YOUR CATALOG WITH HISD’S PRICING?
________ YES; ________NO. IF YES, CAN YOUR WEBSITE INTERFACE WITH SAP PUBLIC SECTION 7.0 / ECC
6.0 OPEN CATALOG INTERFACE (OCI) COMPLIANT? __________ YES ___________NO.
14. CAN YOUR COMPANY PROVIDE HISD WITH PERIODIC PREFORMATTED FLAT FILE UPDATES OF YOUR CATALOG?
_________ YES; _________NO.
15. NAME AND COMPLETE ADDRESS OF ALL PARTNERS LISTED ON A SEPARATE SHEET AND ATTACHED.
16. IF OTHER THAN CORPORATION OR PARTNERSHIP, DESCRIBE ORGANIZATION AND NAME OF PRINCIPALS:
______________________________________________________________________________
______________________________________________________________________________
17. MINORITY OWNERSHIP:
IS YOUR FIRM A MINORITY AND/OR WOMAN OWNED FIRM?
 YES  NO
PERCENTAGE OF OWNERSHIP THAT IS MINORITY OR WOMAN OWNED ____________________________
MARK ALL THAT ARE APPROPRIATE:
 ANGLO
 AFRICAN AMERICAN
LOCATION:
 HOUSTON
 HISPANIC  AMERICAN INDIAN ASIAN/PACIFIC ISLANDER
 MALE
 FEMALE
 TEXAS
 OUT OF STATE
 OUT OF STATE WITH LOCAL OFFICE
MARK ALL ORGANIZATIONS THAT HAVE ISSUED YOUR MINORITY STATUS:
 THE HOUSTON BUSINESS COUNCIL
 SMALL BUSINESS ADMINISTRATION
 DEPARTMENT OF ENERGY
 DEPARTMENT OF DEFENSE


DEPARTMENT OF TRANSPORTATION
CITY OF HOUSTON

METRO TRANSIT AUTHORITY
18. CHECK ONE OF THE FOLLOWING:
 PROPOSER WILL PROVIDE GOODS AND SERVICES WITH OWN WORK FORCE
 PROPOSER WILL PURCHASE GOODS DIRECTLY FROM THE MANUFACTURER OR OTHER SUPPLIER
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19. NAME OF STATE WHERE YOUR HOME OFFICE/HEADQUARTERS IS LOCATED:___________________________
IF NOT TEXAS, DOES THE STATE HAVE PREFERENTIAL TREATMENT ON BIDS □ YES
□ NO
IF YES, WHAT PERCENTAGE:________________%
20. EQUAL OPPORTUNITY EMPLOYER INFORMATION
THE HOUSTON INDEPENDENT SCHOOL DISTRICT CAN ONLY DO BUSINESS WITH EQUAL OPPORTUNITY EMPLOYERS.
CURRENT TOTAL NUMBER OF EMPLOYEES________ NUMBER OF MALES________ NUMBER OF FEMALES______
OF THE TOTAL NUMBER OF PERSONS CURRENTLY EMPLOYED, PROVIDE THE FOLLOWING INFORMATION:
NUMBER OF ANGLO _______________________
NUMBER OF AFRICAN AMERICAN_______________
NUMBER OF HISPANIC ______________________
MEXICAN-AMERICAN / SPANISH SURNAMES
NUMBER OF OTHER MINORITIES_______________
DO YOU ADVERTISE AS AN “EQUAL OPPORTUNITY EMPLOYER”?
 YES  NO
DO YOU HAVE A WRITTEN NON-DISCRIMINATORY POLICY OF EMPLOYMENT?
 YES  NO
HAS THIS POLICY BEEN CIRCULATED THROUGHOUT YOUR ORGANIZATION?
 YES  NO
NAME AND TITLE OF PERSON TO CONTACT REGARDING EQUAL OPPORTUNITY INFORMATION ISSUES:
NAME___________________________________________________ TITLE_______________________
21. LIST YOUR BANKING REFERENCE:
BANK NAME_________________________________ OFFICER’S NAME_____________________________
BANK ADDRESS_______________________________ CITY STATE ZIP______________________________
OFFICER’S TELEPHONE NUMBER_______________________ OFFICER’S FAX NUMBER____________________
I attest that I have answered the questions regarding company information truthfully and to the best of my knowledge.
________________________________________________
CORPORATE OFFICER’S SIGNATURE
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________________________________________________
PRINTED NAME
________________________________________________
TITLE
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5.2 SUBSECTION II - CERTIFICATION AND DISCLOSURE STATEMENT:
A person or business entity entering into a contract and/or agreement with HISD is required by
Texas Law to disclose, in advance of the contract and/or agreement award, if the person or an
owner or operator of the business entity has been convicted of a felony. The disclosure should
include a general description of the conduct resulting in the conviction of a felony as provided in
section 44.034 of the Texas Education Code. The requested information is being collected in
accordance with applicable law. This requirement does not apply to a publicly held corporation.
If an individually owned Company:
 Yes 
No
Has the owner(s) ever been convicted of a felony?
If a Corporation, Partnership, Limited Partnership, etc:
Has any owner, or partner, of your business entity been convicted of a
felony?
 Yes  No
Has any manager or director of your entity been convicted of a felony?
 Yes  No
Has any employee of your entity been convicted of a felony?
 Yes  No
If Yes, give details:
_____________________________________________________________________________
_______________________________________________________________
______________
If you answered yes to any of the above questions, please provide a general description of the
conduct resulting in the conviction of the felony, including the Case Number, the applicable
dates, the State and County where the conviction occurred, and the sentence. (Attached
additional pages, if necessary.)
I attest that I have answered the questions concerning prior convictions truthfully and to the best
of my knowledge.
_______________________________________________
CORPORATE OFFICER’S SIGNATURE
________________________________________________
PRINTED NAME
________________________________________________
TITLE
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5.3 SUBSECTION III - FREE OF INDEBTEDNESS STATEMENT:
The Texas Education Code (Section 44.044) provides that school districts, by resolution of the Board of Trustees,
may establish regulations requiring that persons or entities entering into a contract and/or agreement or transaction
with the District not be indebted to the District. The Board of Education has approved a resolution establishing policy
that requires that the awarded, or selected, suppliers be free of any indebtedness to the District. The following
information must be completed by individual and/or business entities.
List all the tax account numbers for all property taxes due the Houston Independent School District:
______________________________________
___________________________________
______________________________________
___________________________________
______________________________________
___________________________________
______________________________________
___________________________________
Are all City, County, and Houston Independent School District property taxes, both real and personal, assessed
against property owned by individual and/or business entity paid?
 Yes  No
If you answer “no” to this question, provide detail of the amounts due the District and your current plan to satisfy this
indebtedness.
I attest that I have answered the questions regarding indebtedness to the Houston Independent School
District truthfully and to the best of my knowledge.
________________________________________________
CORPORATE OFFICER’S SIGNATURE
________________________________________________
PRINTED NAME
________________________________________________
TITLE
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5.4 SUBSECTION IV - CERTIFICATION REGARDING DEBARMENT AND SUSPENSION:
The undersigned certifies on behalf of the company and its key employees that neither
the company nor its key employees have been proposed for debarment, debarred or suspended
by any Federal Agency.
The undersigned agrees to notify the District in the event that the company or any of its key employees are
proposed for debarment, debarred or suspended by any Federal Agency or by any State of Texas agency.
Notification shall take place within five (5) business days after the company or employee is notified of either
debarment or suspension or possible debarment or suspension. Notification shall be sent to Mr. Gilberto A. Carles,
M.B.A; General Manager – Procurement Services; Houston Independent School District; 4400 West 18th Street;
Houston, Texas 77092.
I attest that I have answered the questions regarding debarment and suspension truthfully and to the
best of my knowledge.
________________________________________________
CORPORATE OFFICER’S SIGNATURE
________________________________________________
PRINTED NAME
________________________________________________
TITLE
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5.5 SUBSECTION V - STATEMENT OF NON-COLLUSION:
The undersigned Proposer does hereby certify:
a)
That all statements of fact in such proposal are true.
b)
That such proposal was not made in the interest of or on behalf of any undisclosed person, partnership,
company, association, organization or corporation.
c)
That such proposal is genuine and not collusive or sham.
d)
That Proposer(s) has not, directly or indirectly by agreement, communication or conference with anyone,
attempted to induce action prejudicial to the interest of the District or of any other bidder or anyone else
interested in the proposed procurement.
e)
That Proposer(s) did not, directly or indirectly, collude, conspire, connive or agree with anyone else that
said bidder or anyone else would submit a false or sham bid or proposal, or that anyone should refrain
from bidding or withdraw his bid or proposal.
f)
That Proposer(s) did not, in any manner, directly or indirectly seek by agreement, communication or
conference with anyone to raise or fix the bid or proposal price of said bidder or of anyone else, or to
raise or fix any overhead, profit or cost element of his bid or proposal price, or that of anyone else.
g)
That Proposer(s) did not, directly or indirectly, submit his bid or proposal price or any breakdown thereof,
or the contents thereof, or divulge information on data relative thereto, to any corporation, partnership,
company, association, organization, bid depository, or to any member or agent thereof, or to any
individual or group of individuals, except to the District, or to any person or persons who have a
partnership or other financial interest with said Proposer in his business.
h)
That Proposer(s) did not provide, directly or indirectly to any officer or employee of the District any
gratuity, entertainment, meals, or anything of value, whatsoever, which could be construed as intending
to invoke any form of reciprocation or favorable treatment.
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i)
That no officer or principal of the undersigned firm is related to any officer or employee of the District by
blood or marriage within the third degree or is employed, either full or part time, by the District either
currently or within the last two (2) years.
j)
That no officer or principal of the undersigned firm nor any subcontractor to be engaged by the principal
has been convicted by a court of competent jurisdiction of any charge of fraud, bribery, collusion,
conspiracy or any other act in violation of any state or federal anti-trust law in connection with the bidding,
award of, or performance of any public work contract and/or agreement with any public entity.
I attest that I have answered the questions regarding non-collusion truthfully and to the best of my knowledge.
CORPORATE OFFICER’S SIGNATURE
PRINTED NAME
TITLE
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5.6 SUBSECTION VI - SUBSECTION VI ANTITRUST CERTIFICATION STATEMENT:
(Texas Government Code §2155.005)
I affirm under penalty of perjury of the laws of the State of Texas that:
1. I am duly authorized to execute this agreement/contract/proposal on my own behalf or on
behalf of the company, corporation, firm, partnership or individual (Company) listed below;
2. In connection with this proposal, neither I nor any representative of the Company have violated
any provision of the Texas Free Enterprise and Antitrust Act, Tex. Bus & Comm. Code Chapter 15;
3. In connection with this bid, neither I nor any representative of the Company have violated any
federal antitrust law; and
4. Neither I nor any representative of the Company have directly or indirectly communicated any of
the contents of this proposal to a competitor of the Company or any other company, corporation,
firm, partnership or individual engaged in the same line of business as the Company.
Company Name
Company Address
City, State, Zip Code
Phone
Facsimile
Proposer Signature
Proposer Printed Name
Position with Company
(IF DIFFERENT FROM ABOVE)
Official Authorizing Proposal
Corporate Officer’s Signature
Printed Name
Position with Company
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5.7 SUBSECTION VII - CONFLICT OF INTEREST QUESTIONNAIRE FORM:
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COMPANY NAME
CORPORATE OFFICER’S SIGNATURE
PRINTED NAME
TITLE
Affiant certifies that he or she is duly authorized to submit the above information on behalf of the Proposer, that
Affiant is associated with the Proposal in the capacity noted above and has personal knowledge of the accuracy of
the information provided herein, and that the information provided herein is true and correct to the best of Affiant’s
knowledge and belief.
Affiant
SWORN TO AND SUBSCRIBED before me this _____day of ______________, 20___.
(seal)
Notary Public
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VI. FORM B - M/WBE INSTRUCTIONS:
For assistance ON COMPLETING THESE FORMS Contact:
Business Assistance Department: Supplier Diversity
4400 West 18th Street
Houston, TX 77092
Telephone: (713) 556-7273
Fax: (713) 556-7274
Email: BusinessAssistance@houstonisd.org
SPECIFIC CONDITIONS FOR MINORITY AND WOMAN-OWNED BUSINESS ENTERPRISE (M/WBE) PARTICIPATION
The Office of Business Assistance was established by the Houston Independent School District Board of Education in 1988 to assist
minority and women-owned business enterprises (M/WBEs) in the participation of various district business projects. The district’s
M/WBE subcontractor participation goals are as follows:
20% for purchasing of goods & non-professional services over $50,000
20% for construction over $50,000
25% for professional services over $50,000
The district requires all M/WBE documents and supporting materials to be completed and submitted as a part of the response to a
proposal. All required documents should be submitted with an original signature by an official from the proposer’s company.
Although most pre-bid meetings are not mandatory, the district recommends that the proposer attends to become familiar with the
M/WBE requirements.
If you are unable to attend the pre-bid meeting, please contact Supplier Diversity for assistance on
completing the required documentation.
IMPORTANT NOTICE
M/WBE documents are a part of proposer’s evaluation. This documentation is required for your proposal to be evaluated by the
district. HISD will determine whether the proposer’s efforts meet the minimum standards of “Good Faith Effort” consistent with the
district’s policy on the participation of M/WBEs. Failure to provide the required M/WBE documentation will be considered noncompliant. If a company is deemed non-compliant, it can lead to disqualification from the provision of goods and services to the
district for current and/or future projects.
INSTRUCTIONS
1. Review the M/WBE Participation Options and instructions on (page B-3) of this section.
2.
Complete the M/WBE Participation Report on (page B-4) of this section. Submit this form with your proposal.
3.
Complete all additional documentation required for the participation option that your company selected.
4.
Submit all requested/required forms and documentation with your proposal.
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HISD AUTHORITY AND INTERPRETATION OF M/WBE DOCUMENTATION
HISD shall have sole authority for the interpretation of all rules and regulations concerning
M/WBE participation and for all determinations of compliance or non-compliance of any
proposer with the M/WBE participation requirements as set forth herein. The decision of
HISD shall be final and conclusive as to such compliance or non-compliance. All proposers, by
the submission of a proposal, acknowledge and agree that HISD shall have such sole and
exclusive authority to make such interpretations and determinations and that all such
interpretations and determinations shall be conclusive.
M/WBE SPEND REPORTING & COMPLIANCE
To ensure that all M/WBE participation obligations under the awarded contract are met, the Business Assistance Department will
require documentation of the awarded supplier’s M/WBE participation throughout the performance of the contract and upon the
contract renewal.
The awarded supplier will be required to report M/WBE subcontracting participation on a monthly basis to the Business Assistance
Department.
Documents requested by the Business Assistance Department from the awarded supplier’s company to show
documentation of M/WBE spend include, but are not limited to: invoices, purchase orders, and other pertinent documents that the
district deems necessary to verify the usage of M/WBE companies. Awarded proposers will also be required to complete M/WBE
documentation provided by the Business Assistance Department, which includes monthly reporting.
The awarded supplier could be deemed as non-compliant if they fail to meet and/or report their M/WBE subcontracting commitment,
provides inaccurate, incorrect, and/or false information related to reporting M/WBE information.
If the district determines that a supplier is non-compliant, actions include, but are not limited to the following.
1.
If the supplier, during any year of the contract, (i) fails to meet their M/WBE subcontracting commitment; and/or (ii) fails to
provide the requested and accurate M/WBE documentation will be subject to having the contract terminated.
2.
If the supplier is undergoing M/WBE compliance review at the end of their current contract and (i) fails to meet their
M/WBE subcontracting commitment; and/or (ii) fails to provide the requested and accurate M/WBE documentation, the
supplier may not be allowed to bid on the new RFP issued for that particular product or service.
3.
If a supplier fails to meet their M/WBE subcontracting commitment on more than one contract with the district, the supplier
may not be eligible to do business with the district for a minimum of one year.
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M/WBE PARTICIPATION REQUIREMENTS
Proposer must select one (1) of the following M/WBE participation options and submit required documentation.
XIII
OPTION I
Certified M/WBE
Company
Complete this section if proposer’s company is a certified minority and/or
woman-owned business enterprise (M/WBE) with the (1) City of Houston (MBE
and/or WBE only); (2) National Minority Supplier Development Council or local
affiliate; and/or (3) Women’s Business Enterprise National Council or local
affiliate. If a supplier chooses this option, they are expected to maintain their
M/WBE certification throughout the duration of the contract.
1. Proposer must complete & submit (page B-4 & B-5) and attach
current M/WBE certification.
2. If M/WBE proposer also subcontracts with other M/WBE companies
other documentation is required. Proposer is required to submit an
M/WBE Subcontracting Plan (page B-6) and M/WBE subcontractor
agreement(s) (page B-7).
OPTION II
Subcontract to
meet district’s
M/WBE goal
Complete this section if proposer’s company will subcontract with M/WBE
firm(s) to meet and/or exceed the district’s M/WBE participation goals. HISD
M/WBE Participation Goals are: 20% for purchasing of goods, non-professional
services & construction projects; 25% for professional services. If a supplier
chooses this option, they are expected to report their M/WBE subcontractor
spend throughout the duration of the contract. Any additions or changes to the
M/WBE subcontractors utilized during the contract require the prior written
approval of the Business Assistance Department before any changes are
permitted. A subcontractor change request form can be found on (page B-13).
1. Proposer must complete & submit (page B-4).
2. Submit an M/WBE Subcontracting Plan (page B-6) and M/WBE
subcontractor agreement(s) (page B-7). Please attach M/WBE
firm(s) current certifications. Companies must be certified by (1) City of
Houston (MBE and/or WBE only); (2) National Minority Supplier
Development Council or local affiliate; and/or (3) Women’s Business
Enterprise National Council or local affiliate.
OPTION III
Good Faith Efforts
Complete this section to comply with the district’s “Good Faith Efforts” (GFE)
documentation. Company has the option to subcontract with M/WBE firm(s), if
they cannot meet the district’s goal. If a supplier chooses to subcontract as
a part of their GFE, they are expected to report their M/WBE subcontractor
spend throughout the duration of their contract. Any additions or changes to
the M/WBE subcontractors utilized during the contract require the prior written
approval of the Business Assistance Department before any changes are
permitted. A subcontractor change request form can be found on (page B-13).
1.
Proposer must complete & submit (page B-4).
2.
Good Faith Efforts (Required) - Proposer must complete & submit
(pages B-4, B-8, B-9, B-10, B-11). Please attach all requested
documentation.
3. Subcontract (Optional) - In addition to the GFE documentation
listed above, submit an M/WBE Subcontracting Plan (page B-6)
and M/WBE subcontractor agreement(s) (page B-7). Attach current
M/WBE certifications for each subcontractor listed. Companies must be
certified by (1) City of Houston (MBE and/or WBE); (2) National
Minority Supplier Development Council or local affiliate; and/or (3)
Women’s Business Enterprise National Council or local affiliate.
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M/WBE PARTICIPCATION REPORT
Business Assistance Department
HISD PROJECT
TITLE:
COMPANY NAME:
PHONE
NUMBER:
TOTAL PROPOSAL
AMOUNT:
$
PROJECT
NUMBER:
CONTACT
NAME:
EMAI
L:
M/WBE
SUBCONTRACTOR:
%
Select one of the following options and complete section. Attach and complete requested documentation.
□ OPTION I – Complete section if company is certified as a minority or woman-owned business (M/WBE).
1. Please select current M/WBE certification(s) that HISD recognizes. Please attach current M/WBE
certification.
□ City of Houston (MBE and/or WBE only)
□ National Minority Supplier Development Council or local affiliate
□ Women’s Business Enterprise National Council or local affiliate
2. Additional M/WBE Subcontractor Contract Commitment: _______%
_________ (initial) Proposer’s company agrees to subcontract with M/WBE companies to meet or exceed the
above
written goal.
Please submit an M/WBE Subcontracting Plan (page B-6) and M/WBE subcontractor agreement(s) (page B-7).
Please
attach M/WBE firm(s) current certifications.
□ OPTION II – Complete section if company agrees to subcontract with M/WBE firm(s) for
the awarded contract.
1. Company will meet or exceed the district’s M/WBE Subcontractor Goals.
20% for purchasing of goods, non professional services & construction; 25% for professional services
2. M/WBE Subcontractor Contract Commitment _______%
_________ (initial) Proposer’s company agrees to subcontract with M/WBE companies to meet or exceed
the above
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Technology (DMT), Expert Medical Opinion (EMO) and Neo-Natal Program (NNP)
written goal.
Please submit an M/WBE Subcontracting Plan (page B-6) and M/WBE subcontractor agreement(s) (page B7). Please
attach M/WBE firm(s) current certifications.
□
OPTION III – Complete section to comply with the district’s “Good Faith Efforts”
documentation.
1. Proposer’s company must complete all “Good Faith Efforts” prior to the bid opening date and
attach
requested documentation.
2. Please complete the district’s “Good Faith Efforts” documentation on page B-8, B-9, B-10 & B-11.
3. Company must complete “Good Faith Efforts” for a total of 100 points.
□ NON-PROFIT ORGANIZATION – Organization is a 501(c)3 non-profit entity.
1. Please attach a copy of the organization’s IRS determination letter.
2. Sign and date the bottom of the form.
____________________________________________
_______________
Signature of Company Officer
Date
____________________________________________
Printed Name
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Option I
M/WBE COMPANY INFORMATION
Please complete the information below if you are a certified M/WBE company. Please attach
current M/WBE certification. Company must be certified by (1) City of Houston (MBE and/or WBE
only); (2) National Minority Supplier Development Council or local affiliate; and/or (3) Women’s
Business Enterprise National Council or local affiliate.
M/WBE COMPANY
NAME:
COMPANY DBA:
OWNER
NAME(S):
OWNERSHIP %
BREAKDOWN:
MAJORITY OWNERSHIP
GENDER:
MAJORITY
OWNERSHIP
ETHNICITY:
□ MALE
□ FEMALE
□ AFRICAN AMERICAN □ ASIAN INDIAN
□ ASIAN PACIFIC □ HISPANIC
□ NATIVE AMERICAN □ OTHER_____________________________
SELECT CURRENT M/WBE CERTIFICATION(S) & ATTACH CURRENT CERTIFICATION(S)
□ City of Houston MBE
□ City of Houston WBE
□ National Minority Supplier Development Council or local
affiliate
□ Women’s Business Enterprise National Council or local
affiliate
COMPANY CONTACT
NAME:
PHONE
NUMBER:
EMAIL ADDRESS:
I attest that the information included has been completed as directed and that the information is accurate to the best of my
knowledge. I understand that any information willfully falsified or omitted may result in, but is not limited to bid disqualification and/or
debarment from doing business with the Houston Independent School District.
_________________________________________
Proposer Officer Signature
_________________________________________
Printed Name
NOTICE for RFP - PAGE 43
_______________________
Date
______________________________________
Printed Title
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Technology (DMT), Expert Medical Opinion (EMO) and Neo-Natal Program (NNP)
Option I/II/III
M/WBE SUBCONTRACTING PLAN
Please complete the information below if you agreed to subcontract with M/WBE companies.
HISD PROJECT NUMBER:
PROPOSAL TITLE:
COMPANY NAME:
CONTACT NAME:
PHONE NUMBER:
EMAIL ADDRESS:
M/WBE SUBCONTRACTOR:
%
M/WBE Subcontractors
M/WBE Company Name / DBA
Scope of Products or Services ProvidedAgreed Price or % of Contract
Total M/WBE Subcontractor Commitment:
Attach current M/WBE certifications for each subcontractor listed. Companies must be certified by (1) City of Houston (MBE and/or WBE
only); (2) National Minority Supplier Development Council or local affiliate; and/or (3) Women’s Business Enterprise National Council or
local affiliate.
Proposer’s company agrees to subcontract with the M/WBE(s) listed above for the percentage of the awarded contract amount with HISD. If
the awarded supplier fails to meet and/or report their M/WBE subcontracting commitment, it may be considered a breach of contract. You will
be required to provide any requested documentation and report M/WBE subcontractor payments monthly.
Proposer must enter into a formal subcontractor agreement with M/WBE firm(s) listed above for their respective product(s) and/or
service(s). Please complete the M/WBE Subcontractor Agreement Form for each M/WBE Subcontractor listed. Any additions or
changes to the M/WBE subcontractors utilized during the contract require the approval of the Business Assistance Department
before any subcontractor changes are made.
___________________________________________
Signature of Company Officer
________________________
Date
___________________________________________
Name of Officer (Print)
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Technology (DMT), Expert Medical Opinion (EMO) and Neo-Natal Program (NNP)
Option I/II/III
M/WBE SUBCONTRACTOR AGREEMENT
Please complete the information below if you agreed to subcontract with M/WBE companies. The
submission of your subcontractor agreement is required for each M/WBE subcontractor.
HISD PROJECT NUMBER:
PROPOSAL TITLE:
PROPOSER COMPANY NAME:
M/WBE SUBCONTRACTOR INFORMATION
M/WBE COMPANY NAME:
COMPANY DBA:
OWNER
NAME(S):
OWNERSHIP %
BREAKDOWN:
MAJORITY OWNERSHIP GENDER:
MAJORITY
OWNERSHIP
ETHNICITY:
□ MALE
□ FEMALE
□ AFRICAN AMERICAN □ ASIAN INDIAN
□ ASIAN PACIFIC
□ HISPANIC
□ NATIVE AMERICAN □ OTHER_____________________________
SELECT CURRENT M/WBE CERTIFICATION(S) & ATTACH CURRENT CERTIFICATION(S)
□ City of Houston MBE
□ City of Houston WBE
□ National Minority Supplier Development Council or local
affiliate
□ Women’s Business Enterprise National Council or local
affiliate
SCOPE OF
SERVICE:
AGREED CONTRACT PRICE OR % OF CONTRACT
AWARD:
COMPANY CONTACT
NAME:
PHONE NUMBER:
EMAIL ADDRESS:
________________________________________
_______________________
M/WBE Subcontractor Officer Signature
Date
________________________________________
NOTICE for RFP - PAGE 45
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Printed Name
Printed Title
_________________________________________
_______________________
Proposer Officer Signature
Date
___________________________________________
Printed Name
NOTICE for RFP - PAGE 46
_________________________________
Printed Title
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Technology (DMT), Expert Medical Opinion (EMO) and Neo-Natal Program (NNP)
M/WBE - OPTION III
Good Faith Efforts
Complete this section if proposer’s company selected “Good Faith Efforts”. Proposer must select a
combination of good faith efforts listed below to total a minimum of 100 points. If proposer fails to
meet the minimum point requirement for the option selected and/or submit the requested documentation,
proposer may be considered non-compliant.
HISD PROJECT NUMBER:
PROPOSAL TITLE:
PROPOSER COMPANY NAME:
Select and complete “Good Faith Efforts” below to total a minimum of 100 points.
□ Company agrees to subcontract with M/WBE(s) for the awarded contract for less than the
goal.
If company selects this option, please choose one of the M/WBE subcontracting commitments below.
□ Subcontract with M/WBE firm(s) from 10% to the subcontracting goal. (65 points)
□ Subcontract with M/WBE firm(s) from 9.99% to 1%. (45 points)
Please complete the following information.
1.
M/WBE Subcontractor Contract Commitment _______%
2.
_________(initial) Proposer’s company agrees to subcontract with M/WBE companies to meet or exceed
the above written goal. Proposer is required to submit an M/WBE subcontracting plan (page AB-6) and the
M/WBE subcontractor agreement(s) (page AB-7) with proposal.
□ Letters of Intent to Find Subcontractors / Follow-Up with M/WBE Subcontractors (35 points)
Proposer must send at least (10) outreach letters to relevant certifying agencies accepted by HISD (City of
Houston, Houston Minority Supplier Development Council, Women’s Business Enterprise Alliance) and individual
M/WBE companies to solicit potential M/WBE subcontractor participation. Please see page B-12 for outreach letter
template. Please see page B-11 to document M/WBE outreach activities. Proposer must solicit M/WBE companies
a minimum of seven (7) business days before the bid opening date.
The following documentation must be attached and includes:
1. Copies of the (10) outreach letters sent via email/fax to individual M/WBE companies.
2. Document outreach activities on page B-11. Attach and submit page B-11.
3. Proposer must respond to M/WBEs who show interest in becoming a subcontractor. Attach additional
email and fax responses and communications from company with potential M/WBE subcontractors.
4. Proposer must follow-up with initial solicitations by contacting the (10) M/WBE companies to determine
whether the companies are interested in proposed subcontracting opportunity. Document follow-up
activities on page B-11 under “follow-up date” and submit.
5. Proposer should provide interested minority and women business enterprises with adequate information
about the plans, specifications and requirements for the subcontracting opportunities available.
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Technology (DMT), Expert Medical Opinion (EMO) and Neo-Natal Program (NNP)
□ Place Advertisement(s) to Find M/WBE Subcontractors (20 points)
Proposer must advertise in at least one general print circulation newspaper, magazine, trade association publication, or minority
and women-focused publication, concerning the potential subcontracting opportunity. Proposer must also advertise to M/WBE
organizations by sending out (5) letters, emails and/or faxes within a minimum of seven (7) business days before the bid
opening date. *Please attach copy of advertisement placed in M/WBE publications and letters sent to M/WBE organizations.
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Technology (DMT), Expert Medical Opinion (EMO) and Neo-Natal Program (NNP)
Option III
Good Faith Efforts (continued)
□ Letters of Acceptance/Rejection to Potential Subcontractors (20 points)
Proposer must provide an explanation of rejection or an acceptance to at least (5) of the M/WBE companies who
were contacted for the “Letters of Intent to Find Subcontractors”. To select this option proposer must have sent
“Letters of Intent to Find Subcontractors”.
1.
2.
3.
A written rejection and/or acceptance letter, including the reason(s) for rejection or the terms of
acceptance, will be sent to at least (5) of the M/WBE companies. If less than (5) M/WBEs responded to
the letter of intent, failure of an M/WBE to respond can be a reason for a rejection letter to be sent.
Please attach a copy of each rejection and/or acceptance letter sent to potential M/WBE subcontractors.
Please attach an explanation to HISD, written on company letterhead, of why company was unable to
utilize M/WBE subcontractors to meet the district’s M/WBE subcontractor goal.
□ Participation as a Mentor to an M/WBE Company (15 points)
Proposer is participating as a mentor to an M/WBE company. Mentoring shall be defined as peer collaboration
between the proposer and at least one M/WBE firm in the areas of technical performance enhancement, business
management assistance, human resource management, and revenue tracking including cash flow and debt
management. Attach a copy of your company’s mentor/protégé agreement. Attach contact information of M/WBE
that is currently being mentored.
□ Attended Pre-Bid Meeting to Network with Potential M/WBE Subcontractors (10 points)
Proposer attended the RFP Pre-Bid Meeting in an effort to meet potential M/WBE subcontractors. * If selected,
Business Assistance will obtain a copy of Pre-Bid Meeting sign-in sheet.
□ M/WBE Assistance (10 points)
Proposer must describe how they have assisted M/WBEs in their business operations. Example of assistance
includes, but is not limited to: assistance in acquiring equipment, capital, lines of credit, or joint pay agreements to
secure loans, supplies; letters of credit, including waiving credit that is ordinarily required.
Please describe how your company assisted M/WBEs in the past 6 months:
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
________________________
__________________________________________________________________________
________
Assisted M/WBE(s) Contact Information:
__________________________________________________________________________
__________________________________________________________________________
________________
□ Company Policies that Support M/WBE Participation (10 points)
Proposer has implemented company policies that assist M/WBEs in doing business with their company. This
includes but is not limited to: having a Supplier Diversity Program, having documentation of a negotiated joint
venture/partnership arrangements in the recent past, establishing quick pay agreements and policies to enable
M/WBE subcontractors to meet cash-flow demands, etc.
1.
Please attach examples of company policies that support and encourage M/WBE participation within
your company.
Please describe your company’s policies that support M/WBE participation:
___________________________________________________________________________
___________________________________________________________________________
______________________________________________________
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Technology (DMT), Expert Medical Opinion (EMO) and Neo-Natal Program (NNP)
Option III
Good Faith Efforts (continued)
□ M/WBE Organization Participation (10 points)
Proposer must identify M/WBE organizations they actively participate in as members and/or donate company
resources. Proposer must include documentation of partnerships, committee involvement, and workshop
participation and training.
Please list current organizations that your organization supports:
___________________________________________________________________________
___________________________________________________________________________
________________
Please describe how your company currently supports M/WBE organizations:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
_______________________
Total Good Faith Efforts Points: _____________
_____________________________________________________________________________________
Signature of Proposing Company’s Officer
NOTICE for RFP - PAGE 50
Date
Printed Name
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Technology (DMT), Expert Medical Opinion (EMO) and Neo-Natal Program (NNP)
Option III
Good Faith Efforts: M/WBE Outreach
Please complete the information below if your company is completing “Good Faith Efforts”
documentation.
HISD PROJECT NUMBER:
PROPOSAL TITLE:
PROPOSER COMPANY NAME:
Please document the potential M/WBE subcontractors and/or M/WBE organizations that you
contacted.
Date
M/WBE Company Name
Phone Number
___________________________________________
Signature of Company Officer
Contact Person
Contacte
Follow-Up
d
Date
Contact Notes
________________________
Date
___________________________________________
Name of Officer (Print)
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M/WBE OUTREACH EXAMPLE LETTER
(Insert Company Contact Information)
(Insert M/WBE Company Contact Information)
Dear M/WBE Supplier-
(Company Name) is bidding on Project (Insert Project Number and Project Title) for the Houston Independent School District. Our
company is looking for possible M/WBE subcontractors. We are currently looking for subcontractors for the following products or
services.
1.
(Insert potential subcontracting opportunity)
2.
(Insert potential subcontracting opportunity)
EXAMPLE
3.
(Insert potential subcontracting opportunity)
Our company will be looking for M/WBE Subcontractors for the next 5 business days. If you are interested in providing the above listed
products or services please contact (Insert contact information) by (Insert Deadline Date).
(Insert Company Signature)
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Technology (DMT), Expert Medical Opinion (EMO) and Neo-Natal Program (NNP)
M/WBE SUBCONTRACTOR CHANGE REQUEST
Business Assistance Department
Telephone: (713) 556-7273 Fax: (713) 556-7274
Email: BusinessAssistance@houstonisd.org
HISD PROJECT NUMBER:
PROPOSAL TITLE:
PROPOSER COMPANY NAME:
Please select the following reason(s) that you need to change your M/WBE subcontractor(s):
1 = Unable to provide verification of M/WBE status
2 = Unable to provide requested products/services
3 = Unable to provide proper insurance/bonding requirements
Reason
M/WBE Company Name
Phone Number
Contact Person
Scope Of
Agreed
Service
Price
ORIGINAL
NEW
ORIGINAL
NEW
ORIGINAL
NEW
ORIGINAL
NEW
Please Note: All “Original” M/WBE Subcontractor information must be listed and followed by the “New” replacement
M/WBE Subcontractor on the change request on the chart above. M/WBE Firm(s) listed must be at least 51% owned
by a woman or a minority; or certified by one of the following M/WBE agencies: (1) City of Houston (MBE and/or
WBE); (2) Houston Minority Supplier Development Council; (3) National Minority Supplier Development Council; (4)
Women’s Business Enterprise National Council; and/or (5) Women’s Business Enterprise Alliance.
Submitted By:
________________________________________
Signature of Company Officer
_______________________
Date
_________________________________________
Printed Name
Approved By:
_________________________________________
Business Assistance
NOTICE for RFP - PAGE 53
_______________________
Date
Revised 2/13/14 – Version 7.8
1
2
3
RFP # 14-04-02 Employee Assistance Program (EAP), Diabetes Management
Technology (DMT), Expert Medical Opinion (EMO) and Neo-Natal Program (NNP)
CERTIFYING AGENCIES
CITY OF HOUSTON OFFICE OF BUSINESS OPPORTUNITY
611 Walker, 7th Floor
Houston, Texas 77002
Phone: (832) 393-0600
Fax: (713) 837-9050
Website: Will.Norwood@houstontx.gov
Email: Will.Norwood@houstontx.gov
HOUSTON MINORITY SUPPLIER DEVELOPMENT COUNCIL
Three Riverway, Suite 555
Houston, Texas 77056
Phone: (713) 271-7805
Fax: (713) 271-9770
Website: www.hmsdc.org
Email: info@hmsdc.org
NATIONAL MINORITY SUPPLIER DEVELOPMENT COUNCIL
1359 Broadway, Tenth Floor
New York, NY 10018
Phone: (212) 944-2430
Fax: (212) 719-9611
Website: www.nmsdc.org
Email: maureen.simonette@nmsdc.org
WOMEN’S BUSINESS ENTERPRISE ALLIANCE
9800 Northwest Freeway Suite 120
Houston, Texas 77092
Phone: (713) 681-9232
Fax: (713) 681-9242
Website: www.wbea-texas.org
Email: aday@wbea-texas.org
WOMEN’S BUSINESS ENTERPRISE NATIONAL ALLIANCE
1120 Connecticut Avenue, NW, Suite 1000
Washington, DC 20036
Phone: (202) 872-5515
Fax: (202) 872-5505
Website: www.wbenc.org
Email: support@wbenc.org
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M/WBE BUSINESS ORGANIZATIONS &
ASSOCIATIONS
ACRES HOME CITIZENS CHAMBER OF
COMMERCE
HOUSTON MINORITY SUPPLIER DEVELOPMENT
COUNCIL
6112 Wheatley
Houston, Texas 77091
Phone: (713) 692-7161
Fax: (713) 961-7131
Website: www.dscreation6754244.homestead.com
Email: info@acreshomecenter.org
Three Riverway, Suite 555
Houston, Texas 77056
Phone: (713) 271-7805
Fax: (713) 271-9770
Website: www.hmsdc.org
Email: info@hmsdc.org
AMERICAN INDIAN CHAMBER OF COMMERCE
OF TEXAS-HOUSTON
INDO AMERICAN CHAMBER OF COMMERCE OF
GREATER HOUSTON (THE)
11245 Indian Trail, 2nd Floor
Dallas, Texas 75229
Phone: (972) 241-6450 ~ Toll Free: (866) 241-6450
Fax: (972) 241-6454
Website: www.aicct.com
Email: tmarshall@aicct.org
1535 West Loop South, Suite 200
Houston, Texas 77027
Phone: (713)-624-7132
Fax:
Website: www.iaccgh.com
Email: info@iaccgh.com
ASIAN CHAMBER OF COMMERCE
LEAGUE OF UNITED LATIN AMERICANS (LULAC)
6833 W. Sam Houston Parkway, Suite 206
Houston, Texas 77072
Phone: (713) 782-7222
Fax: (713) 981-6204
Website: www.asianchamber-hou.org/
Email: info@asianchamber-hou.org
PO Box 8620
Houston, Texas 77249
Phone: (713) 695–5980
Fax: (713) 691–4128
Website: http://www.lulacdistrictviii.org/
Email: d8mgr@lulac.org
CITY OF HOUSTON OFFICE OF BUSINESS
OPPORTUNITY
N.A.A.C.P. ECONOMIC DEVELOPMENT
COMMITTEE
611 Walker, 7th Floor
Houston, Texas 77002
Phone: (832) 393-0600
Fax: (713) 837-9050
Website: Will.Norwood@houstontx.gov
Email: Will.Norwood@houstontx.gov
2002 Wheeler
Houston, Texas 77004
Phone: (713) 526-3389
Fax: (713) 630-2699
Website: www.naacp-houston.org
Email: economics@naacphouston.org
GREATER HOUSTON WOMEN’S CHAMBER OF
COMMERCE
NATIONAL ASSOCIATION OF WOMEN BUSINESS
OWNERS-GREATER HOUSTON CHAPTER
(NAWBO-GHC)
3015 Richmond, Suite 200
Houston, Texas 77098
Phone: (713) 782-3777
Fax: (281) 400-3635
Website: www.ghwcc.org
Email: info@ghwcc.org
GREATER HOUSTON BLACK CHAMBER OF
COMMERCE
P.O. Box 56583
Houston, TX 77256-6583
Phone: (713) 487-8475
Fax: (713) 974-1835
Website: www.nawbohouston.org
Email: membership@nawbohouston.org
NATIVE AMERICAN CHAMBER OF COMMERCE
2808 Wheeler
Houston, Texas 77004
Phone: (713) 522-9745
Fax: (713) 522-5965
Website: www.hccoc.org
Email: info@hccoc.org
7457 Harwin, Suite 307
Houston, Texas 77036
Phone: (832) 251-6367
Fax: (832) 251-6312
Website: www.nativeamericanchamber.org
Email: info@namcham.org
HOUSTON AREA URBAN LEAGUE, INC
TSU/ECONOMIC DEVELOPMENT CENTER
1301 Texas
Houston, Texas 77002
Phone: (713) 393-8700
Fax: (713) 393-8790
Website: www.haul.org
Email:
3100 Cleburne Street, Jesse H. Jones School of Business,
Room 151, Houston, Texas 77004
Phone: (713) 313-7785
Fax: (713) 313-7101
Website: www.tsu.edu
Email: conneraa@tsu.edu
HOUSTON HISPANIC CHAMBER OF COMMERCE
WOMEN’S BUSINESS ENTERPRISE ALLIANCE
1801 Main Street, Suite 890
Houston, TX 77002
Phone: (713) 644-7070
Fax: (713) 644-7377
Website: www.houstonhispanicchamber.com
Email: info@houstonhispanicchamber.com
9800 Northwest Freeway Suite 120
Houston, Texas 77092
Phone: (713) 681-9232
Fax: (713) 681-9242
Website: www.wbea-texas.org
Email: aday@wbea-texas.org
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M/WBE Organizations & Associations
(Construction)
ALLIANCE OF MINORITY CONTRACTORS OF
HOUSTON
P.O. Box 920859
Houston, Texas 77292-0859
Phone: (713) 802-4154
Fax: (713) 460-0673
Website: www.amch.biz/
Email: info@amc-houston.org
ASIAN AMERICAN ENGINEERS/ARCHITECTS
2525 North Loop West, Suite 300
Houston, Texas 77008-1094
Phone: (713) 861-7068
Fax: (713) 861-4131
Website: www.aaea-houston.org
Email: mrueda@landtech-inc.com
ASSOCIATION OF BLACK CONSULTING
ENGINEERS AND ARCHITECTS
P.O. Box 771992
Houston, Texas 77215
Phone: (713) 988-0145
Fax: (713) 988-4624
Website: www.abcea.org
Email: info@blackarchitectsandengineershouston.org
HOUSTON HISPANIC ARCHITECTS AND
ENGINEERS
NATIONAL ASSOCIATION OF MINORITY
CONTRACTORS, INC. - GREATER HOUSTON
CHAPTER
3825 Dacoma St.
Houston, Texas 77092
Phone: (713) 843-3791
Fax: (713) 843-3777
Website: www.namctexas.org
Email: info@namctexas.org
NATIONAL ASSOCIATION OF WOMEN IN
CONSTRUCTION-HOUSTON CHAPTER (NAWIC)
8354 Sorrell Dr.
Houston, TX 77064
Phone: (281) 639-3841
Fax: (281) 304-1773, fax
Website: www.nawic-houston.com
Email: swhitley@toneyconstruction.com
WOMEN CONTRACTORS ASSOCIATION
134 Vintage Park Blvd, Suite A-171
Houston, Texas 77070
Houston, Texas 77065
Phone: (713) 807-9977
Fax: (713) 807-9917
Website: www.womencontractors.org/
Email: director@womencontractors.org
P.O. 421372
Houston, Texas 77042
Phone: (713) 426-7488
Fax: (713) 850-7308
Website: www.hhae.org
Email: lindac@kirksey.com
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M/WBE NEWSPAPERS AND PERIODICALS
AFRICAN-AMERICAN NEWS & ISSUES
LA PRENSA DE HOUSTON
6130 Wheatley Street
Houston, Texas 77091-3947
Phone: (713) 692-1100
Fax: (713) 692-1892
Website: www.aframnews.com
Email: news@aframnews.com
7100 Regency Square, Suite 217
Houston, Texas 77036
Phone: (713) 334-4959
Fax: (713) 334-4995
Website: www.prensadehouston.com
Email: info@prensadehouston.com
FORWARD TIMES
LA VOZ DE HOUSTON
P. O. Box 8346
Houston, Texas 77004
Phone: (713) 526-4727
Fax: (713) 526-3170
Website: www.forwardtimesonline.com
Email: forwardtimes@forwardtimes.com
4747 SW Freeway
Houston, Texas 77027-6901
Telephone: (713) 362-8100
Fax: (713) 362-8630
Website: http://lavoztx.com/
Email: lavoz@chron.com
HOUSTON DEFENDER (THE)
MINORITY PRINT MEDIA, LLC dba HOUSTON
STYLE MAGAZINE
12401 South Post Oak, #223
Houston, Texas 77045
Phone: (713) 663-6996
Fax: (713) 663-7116
Website: www.defendernetwork.com
Email: ads@defendermediagroup.com
HOUSTON INSIDER (THE)
1713 Rosewood Street
Houston, Texas 77004
Phone: (713) 526-0544
Fax: (713) 526-0545
Website: www.thehoustoninsider.com
Email: sales@thehoustoninsider.com
INFORMER (THE)
9104-A Bellaire
Houston, Texas 77036
Telephone: (713) 771-4363
Fax: (713) 270-8222
LA INFORMACIÓN
6065 Hillcroft, Suite 102
Houston, Texas 77081
Telephone: (713) 272-0100
Fax: (713) 272-0011
Website: http://www.lainformacion.us/
Email: lina.martinez@lainformacion.us
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PO Box 14035
Houston, Texas 77221-4035
Phone: (713) 748-6300
Fax: (713) 748-6320
Website: www.stylemagazine.com
Email: advertising@stylemagazine.com
SOUTHERN CHINESE DAILY NEWS
11122 Bellaire Blvd.
Houston, Texas 77072
Telephone: (281) 498-4310
Fax: (281) 498-2728
Website: http://www.scdaily.com/
Email: ad@scdaily.com
VOICE OF ASIA
8303 S. W. Freeway, Suite 325
Houston, Texas 77074
Phone: (713) 774-5140
Fax: (713) 774-5143
Website: www.voiceofasiaonline.com
Email: voiceasia@aol.com
WORLD JOURNAL OF TEXAS, INC.
10415 Westpark, Suite A
Houston, Texas 77042
Telephone: (713) 771-4363
Fax: (713) 270-8222
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VII. FORM C - ADDENDUM FOR AGREEMENT FUNDED BY U.S. FEDERAL GRANT
(NON-CONSTRUCTION CONTRACTS)
The Houston Independent School District (“the District”) is required to obtain certain certifications from organizations
receiving District payments paid from federal funds budgets.
Pursuant to Circular A-110, all contracts, including small purchases, awarded by the District and the District’s subcontractors shall contain the procurement provisions of Appendix A to Circular A-110, as applicable. Accordingly, the
parties agree that the following terms and conditions apply to the agreement, dated [date] (the “Agreement”),
between the District and [name of vendor] (“Vendor”) in all situations where the vendor has been paid from federal
funds.
1. Equal Employment Opportunity – In fulfilling its obligations under the Agreement, Vendor shall comply with E.O.
11246, "Equal Employment Opportunity," as amended by E.O. 11375, "Amending Executive Order 11246 Relating to
Equal Employment Opportunity," and as supplemented by regulations at 41 CFR part 60, "Office of Federal Contract
Compliance Programs, Equal Employment Opportunity, Department of Labor."
2. Rights to Inventions Made Under a Contract or Agreement – To the extent that the Agreement requires the
performance of experimental, developmental or research work, Vendor agrees that the District shall have rights in
any resulting invention in accordance with 37 CFR part 401, "Rights to Inventions Made by Nonprofit Organizations
and Small Business Firms Under Government Grants, Contracts and Cooperative Agreements," and any
implementing regulations issued by the District from which received financial assistance to carry out the work
contemplated by the Agreement.
3. Clean Air Act (42 U.S.C. § 7401 et seq.) and the Federal Water Pollution Control Act (33 U.S.C. § 1251 et
seq.), as amended – In the event that the fees payable to Vendor under the Agreement exceed $100,000, Vendor
agrees to comply with all applicable standards, orders or regulations issued pursuant to the Clean Air Act (42 U.S.C.
§ 7401 et seq.) and the Federal Water Pollution Control Act as amended (33 U.S.C. § 1251 et seq.). Violations shall
be reported to the Awarding Agency and the Regional Office of the Environmental Protection Agency (EPA).
4. Byrd Anti-Lobbying Amendment (31 U.S.C. § 1352) - In the event that the fees payable to Vendor under the
Agreement exceed $100,000, vendor shall file the certification required under 31 U.S.C. § 1352. Each tier shall
certify to the tier above that it will not and has not used Federal appropriated funds to pay any person or organization
for influencing or attempting to influence an officer or employee of any agency, a member of Congress, officer or
employee of Congress, or an employee of a member of Congress in connection with obtaining any Federal contract,
grant or any other award covered by 31 U.S.C. § 1352. Each tier shall also disclose any lobbying with non-Federal
funds that takes place in connection with obtaining any Federal award. Such disclosures shall be forwarded from tier
to tier up to the vendor.
5. Debarment and Suspension (E.O.s 12549 and 12689) – Vendor certifies that it and its principal employees are
not listed on the General Services Administration's List of Parties Excluded from Federal Procurement or Nonprocurement Programs in accordance with E.O.s 12549 and 12689, "Debarment and Suspension." This list contains
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the names of parties debarred, suspended or otherwise excluded by agencies, and contractors declared ineligible
under statutory or regulatory authority other than E.O. 12549. Contractors with awards that exceed the small
purchase threshold shall provide the required certification regarding its exclusion status and that of its principal
employees.
6. Access to Records – Vendor agrees that the Inspector General of the District or any of their duly authorized
representatives shall have access to any books, documents, papers and records of the Vendor that are directly
pertinent to Vendor’s discharge of its obligations under the Agreement for the purpose of making audits,
examinations, excerpts and transcriptions.
7. Applicability to Subcontractors – Vendor agrees that all contracts it awards pursuant to the Agreement shall be
bound by the foregoing terms and conditions.
Company Name
Corporate Officer’s Signature
Printed Name
Street Address
City, State and Zip Code
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VIII. FORM D - PRICING AND SERVICE AFFIRMATION
Proposal of: ___________________________________
(Proposer Company Name)
To: Houston Independent School District
RFP Number: __________________________________
RFP Name: ______________________________________________________________
Proposer will provide the product/services to the Houston Independent School District (“HISD”) and possibly other
governmental agencies (through Interlocal-agreements). Additionally, the focus is on identifying all costs associated with
the product/services.
HISD is looking to quantify all fees and work towards solutions that minimize costs, while
maintaining or improving current service levels. Please see Price Schedule (Form F) to this RFP.
Ladies and Gentlemen:
Having carefully examined all the specifications and requirements of this RFP and any attachments thereto, the undersigned
proposes to furnish the products/services required pursuant to the above- referenced RFP upon the terms quoted below.
__.1 Price and Products/Services Quotation
The prices quoted shall be HISD’s pricing for the product or service. There shall be no separate or additional charges,
fees, handling or other incidental costs associated in the acquisition of the product/services not disclosed herein.
Proposer understands that HISD makes no guarantee as to the volume, amount or type of product/services that may be
purchased under any Agreement.
Proposer certifies and agrees that all prices and any promotion or rebates quoted in the proposal have been reviewed and
are the final proposed price and product/service offering for this initial RFP response.
__.2
Price Assurance
Proposer agrees that, if Proposer is awarded a contract, equal and identical pricing may be extended to another
governmental agency (see section 2.15.2 and 2.29 of this RFP).
__.3
HISD Payment Terms
HISD’s standard payment terms for services are “net 30 days” from receipt of the invoice. Indicate below the prompt
payment discount that Proposer will provide to HISD:
__.4
General Terms and Conditions
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Proposer agrees to the General Terms and Conditions and all other Terms and Conditions of this RFP unless exceptions
are identified in the Exception Form (Form E).
Prompt Payment Discount _____% ______days / net 30 days.
Respectfully submitted:
Company Name: ______________________________
By: _______________________________
(Corporate Officer’s Signature )
Printed Name: _______________________
Title: _____________________________
Date: _____________________________
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IX. FORM E - EXCEPTION FORM
All deviations and exceptions to this RFP must be expressly stated in this Exception Form
(additional pages to this form may be added if necessary). In the absence of any entry on this Exception Form,
the Proposer(s) assures HISD of their full agreement and compliance with all specifications, terms and conditions,
requirements and obligations of the RFP. THIS EXCEPTION FORM MUST BE SIGNED BY EACH PROPOSER(S)
WHETHER THERE ARE EXCEPTIONS LISTED OR NOT, AND SUBMITTED WITH THE PROPOSAL.
SECTION #,
PARAGRAPH # (OR
SUBSECTION #) AND
PAGE
EXCEPTION
Company Name
Corporate Officer’s Signature
Printed Name
Date
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X. FORM F - (PRICE SCHEDULE)
Proposer is asked to submit pricing as identified in Section IV. A hard copy of Form F must be
submitted under Tab 7 in the proposal.
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XI. FORM G - SUPPLIER RELATIONS – CHE (LOCAL) QUESTIONAIRE:
Board of Education Policy CHE (Local) adopted October 11, 2012 requested that all proposers
supply the Board of Education the information contained below. While this information is
requested in other parts of Form A this questionnaire provides the information specifically related
to CHE (Local).
Legal Name of Business:_________________________________________________________________
Type of Business and
types of products or services provided: _____________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Business Mailing Address: _______________________________________________________________
City: __________________________ State: ______________________Zip Code___________________
Business Street Address: ________________________________________________________________
City: __________________________ State: ______________________Zip Code____________________
Names of parent company, subsidiaries, or other name under which they are currently conducting or have previously conducted
business with the District:
Parent Company
Subsidiaries
Subsidiaries
Other Names
Other Names
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Number of Full Time Employees: ____________________ Part Time Employees:____________________
Names of owners, principal shareholders or stockholders, officers, agents, salespeople and key employees
who have been members of the HISD Board of Education during the last 5 years:
Name
Title
Names of owners, principal shareholders or stockholders, officers, agents, salespeople and key employees
who have been District employees or members of their immediate families who are either working or potentially working on this
District’s contract(s):
Names
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Ethnic group of the majority owners
(to identify minority businesses) ___________________________________________________________
_____________________________________________________________________________________
Authorized agents, including any person or entity who is authorized to ‘act with’ or ‘act on your behalf’, such as consultants, subcontractors, re-sellers, and/or lobbyist, confidants, etc., whether compensated or not compensated.
Names
Names
Certification of authority and/or any license or certificate required to conduct business within the State of Texas and/or City of
Houston in accordance with any governing federal, state, and local statutes, regulations and ordinances:
License Number and Type
License Number and Type
Financial and business references, including bank with which the company conducts business:
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Name of Bank: _________________________________________________________________________
Bank Officer ______________________________ Officers Telephone Number______________________
Other Banking/finance Institutions:
Finance Institution Name
Finance Institution Name
Name of insurance companies and bonding company (if applicable)
Insurance Companies
Insurance Companies
Bonding Company
Bonding Company
Identification of any past, pending, or present litigation involving the District and any company owners, principal shareholders or
stockholders, officers, agents, salespeople or employees.
Style of Litigation
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Type of Litigation
Current Status
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Style of Litigation
Type of Litigation
Current Status
Relationship to any Political Action
Committees (PAC) _____________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
(Make copies of any table if additional rows are needed and attach additional sheets)
I attest that I have answered the questions relating to CHE (Local) truthfully and to be best of my knowledge.
CORPORATE OFFICER’S SIGNATURE
PRINTED NAME
TITLE
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XII Information (District Requirements)
12.1
Explanation to Proposers
Any Proposer who desires an explanation or interpretation of the RFP and its related documents, or who discovers any
discrepancies or omissions in the RFP or related documents, shall notify the designated HISD Project Manager in writing. Each
notification must make specific reference to the applicable section of the RFP (e.g., Section, Page Number, and quote from RFP
document) to be considered by HISD. HISD reserves the right to reject any request that does not conform to these instructions. Oral
explanations or instructions provided will not be binding. Any information given to a Proposer concerning the RFP may be furnished
in writing promptly to all other potential Proposers as an addendum to the RFP, if that information is necessary in submitting offers,
or if the lack of it would be prejudicial to any other Proposers.
All communications regarding this RFP must be coordinated through the HISD Project Manager named in Section 1.1.4/1.1.5 –
Instruction Submission Requirements and Procedures. Failure to do so may result in disqualification of the Proposer from further
consideration.
Proposal Preparation Costs
All costs related to the preparation and submission of this proposal shall be paid by the Proposer. Issuance of this RFP does not
commit HISD, in any way, to pay any costs in the preparation and submission of the proposal. Nor does the issuance of the RFP
obligate HISD to award, enter into an agreement, or purchase any goods and services stated in the RFP.
Addenda
The only method by which any requirement of this RFP may be modified is by written addendum issued by the Procurement
Services Department. All addenda will be posted on the HISD Procurement Services’s Proposal Solicitations Download website. For
more information go to www.houstonisd.org and find the link under Community > Do Business with HISD > Bid Opportunities
http://www.houstonisd.org/Page/68148.
If an addendum to the proposal document is a result of a pre-proposal conference, the District will post the addendum, within a
reasonable time, following the conference to the HISD Proposal Solicitations Download website. The District is not responsible if a
Proposer does not receive the proposal revision in time to include the information with the proposal submission. Proposals may not
be considered if they do not include written information additionally requested in addenda that may be issued regarding the project. If
a Proposer does not have access to the internet, a copy of the addenda may be secured in the Procurement Services Department.
The department is located in the Hattie Mae White Educational Support Center, 4400 West 18th Street, Level 2NE, Houston, Texas
77092. Department business hours are 8 AM to 5 PM Central Time, Monday – Friday (excluding District holidays).
Exceptions
If any exceptions are taken to any portion of this RFP, the Proposer must clearly indicate the exception taken and include a full
explanation as a separate attachment to the proposal. The failure to identify exceptions or proposed changes will constitute
acceptance by the Proposer of the RFP as proposed by the District. The District reserves the right to reject a proposal containing
exceptions, additions, qualifications, or conditions.
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Information to Be Requested from Proposer
To achieve a uniform review process and obtain the maximum degree of comparability, it is required that proposals be organized in
the manner specified.
The table below provides a listing of all parts of this RFP. You will need to ensure that you received each of these parts to confirm
that your proposal is complete and meets all submission requirements.
Proposers must print out hard copies of their completed questionnaire and submit four hardcopies/binders along with the other
required attachments to the addresses listed in this document, as specifically detailed in Section 1.4. The questionnaire should also
be answered and electronically included on a USB flash drive or CD-ROM within each hardcopy submission. If electronic
submissions are password protected, please provide the password for access in bound proposal marked “ORIGINAL”, on the inside
cover. Please respond to requests for information by submitting your responses in a binder with tabs labeled as indicated in the
following table.
Proposer’s Response
Description
Binder Sequence
Title Page
Include RFP subject, name of Proposing firm, address, telephone number, contact person and date.
Table of Contents
Tab 1
Clearly identify the materials provided by section Tabs.
Proposal Submission Forms
Tab 2
Complete Forms A – G with the proposal. The set of forms submitted in the proposal marked
“ORIGINAL” requires original manual signatures. Copies of the forms bearing original signatures
should be included in each additional proposal.
Profile of the Proposer, including financial information
a.
Tab 3
Indicate the number of people in your organization and their level of experience and qualification
and the percentage of their time that will be dedicated to this project.
b.
Provide a list of the Proposer’s top ten current and prior two years’ clients indicating the type of
goods and/or services your organization has performed for each client.
Scope Section
Included in applicable
You will describe the Scope of the project as you answer the questions posed in the RFP. Please
questionnaire responses
answer all questions in the RFP that pertain to the services you are proposing.
(Tab 4 Purposely Omitted)
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Proposer’s Response
Description
Questionnaire Response
Binder Sequence
Tab 5
5.1 Information (District Requirements) (Section 12)
5.2 General Information and Instructions (Section 13)
5.3 Minimum Business Requirements (Section 14)
5.4 Expert Medical Opinion (Section 15)
Place printed copy of completed questionnaire section, along with specified Attachments requested.
Attachment S15: A – Integration
Attachment S15: B – Policies and Procedures
Attachment S15: C – Operational Platform
Attachment S15: D – Standard Performance Guarantees
Attachment S15: E – Standard Reporting
Attachment S15: F – Implementation
Attachment S15: G – Financials/Fees/Pricing
5.4 Employee Assistance Program EAP (Section 16)
Place printed copy of completed questionnaire section, along with specified Attachments requested.
Attachment S16: A – Sample Reporting
Attachment S16: B – Operational Platform
Attachment S16: C – Integration
Attachment S16: D – Communication
Attachment S16: E – Implementation Reporting
Attachment S16: F – Performance Guarantees
5.5 Diabetes Technology Management (Section 17)
Place printed copy of completed questionnaire, along with specified Attachments requested.
Attachment S17: B – Standard Reporting
Attachment S17: C – Integration
Attachment S17: D – Financials
Attachment S17: F – Communications
Attachment S17: H – Implementation Plan
Attachment S17: J – Performance Guarantees
5.6 Neonatal Solutions Program Section 5 (Section 18)
Place printed copy of completed questionnaire section, along with specified Attachments requested.
Attachment S18: A – Standard Reporting
Attachment S18: B – Operational Platform
Attachment S18: C – Financials
Attachment S18: D – Communications
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Proposer’s Response
Description
Binder Sequence
Invoice Procedure
a.
Describe the firm’s invoicing procedures.
b.
Include documentation identifying all of the Proposer’s fees.
c.
Payment terms, The District’s standard payment terms are 30 days after invoice is received.
Tab 6
State any payment discounts that your company offers, i.e., 2% 10 days – net 30 or 5% 7days –
net 30.
Pricing
Tab 7
Respond to Commercial Section include any and all pricing information, including any alternative
pricing proposals that may be acceptable for some projects. Include a hard copy of Form F (Price
Schedule) in section, if applicable.
Addenda
Tab 8
Insert all addenda under this section.
12.2
Expansion of Programs to Other Districts through Interlocal Agreements
It is anticipated that school districts and other governmental entities will recognize the broad applicability of HISD contracts and how
they apply to other entities and school districts. All Proposers should indicate their willingness to provide all or some of the goods
and/or services requested in this proposal to other Districts or organizations. The responses to this proposal will be used as a
baseline to determine which firms may be eligible for further participation in the District’s marketing program. The marketing program
is designed to help school districts improve their educational learning and business environments by the formation of mutually
beneficial partnerships with firms that provide supportive expertise and services. While each Interlocal Agreement will encompass
part, or all of the services requested, each will be individually adapted, using the responses from this RFP, to the individual needs of
the participating District. Separate, but related documents, will be drawn to reflect Contracts/Agreements on each additional District
partnership. Even though the RFP has been developed to be as comprehensive as possible, it is impossible to assure that all
services needed in every interlocal contract will be included in the RFP response. Therefore, all Proposers responding positively to
this section shall also agree that such additional goods and/or services as may be needed to satisfy the requirements of future
Interlocal Agreements to provide goods and/or services to other districts will be included as part of this RFP.
If the agreement/contract resulting from this project is utilized by other districts or agencies, HISD will expect to have a financial
incentive paid to HISD for the increased volume that the awarded supplier will experience. Proposers should indicate the amount of
financial incentive they expect to pay to HISD in their proposal.
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XIII General Information and Instructions (Subject Matter)
13.1
General Information
Introduction
The Health Care Partnership (THCP) is a collective purchasing initiative. Three large Texas-based school district organizations are
included – Houston Independent School District (HISD), Aldine Independent School District (Aldine ISD), and Katy Independent
School District (Katy ISD). THCP began purchasing benefits, benefits administration, and consulting on a collective basis in the
spring of 2001 under the initial name of Texas Independent School District (TISD) collective. As other employers have expressed
interest in collective purchasing, TISD’s name was revised to THCP as expansion outside of Texas is a program goal. THCP is
seeking Employee Assistance Program (EAP), Diabetes Management Technology, Expert Medical Opinion, and Neonatal Solutions
Program for its self-funded plans. For purposes of this RFP, all references to THCP include all referenced districts, unless otherwise
noted.
THCP was started with the idea of controlling trend by improving the overall health status of the employee population. This guiding
principle has advised the various strategic decisions made by each of the Districts throughout the years. The program has evolved to
include many forward-thinking initiatives, plan designs, network strategies, and other programs. The purpose of this RFP is to further
the Districts’ work in these areas.
There are a number of new strategies that are being explored and implemented in the marketplace to improve the quality and
efficiency of healthcare delivery. This RFP seeks to determine the depth and breadth of what is available to the Districts, to
determine the cost to implement and maintain those programs, and to evaluate the possible savings and enhanced service
opportunities available. There are no pre-conceived notions of what will define a successful proposal. Each proposal will be
evaluated on its own merits using the criteria outlined in Section 3.5 (HISD’s RFP / Evaluation Factors) of this Request for Proposal
(RFP).
RFP’s addressing the following will be considered:

Employee Assistance Program (EAP),

Diabetes Management Technology,

Expert Medical Opinion,

Neonatal Solutions Program.
Because of the broad interest in this concept, other government entities may participate in THCP in the future; therefore, through the
Interlocal would be eligible to receive these same services at these quoted price levels. All proposals must clearly indicate any price
reduction for bundled services as well as pricing bands for increased or decreased plan membership.
Houston Independent School District (HISD)
According to 2013 Facts and Figures, HISD, located in Harris County, Texas, is among the largest employers in Houston with a
2012 – 2013 budget exceeding $1.4 billion. It operates as the largest public school system in Texas and the seventh-largest in the
US. HISD serves a population of approximately 203,000 students covering campuses including elementary schools, middle schools,
high schools, charter schools, and community-based alternative programs.
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PROJECT #: 14-04-02
HOUSTON INDEPENDENT SCHOOL DISTRICT
HISD has approximately 26,868 full-time and part-time employees of which approximately 12,000 are teachers. Total benefitseligible employees number approximately 24,000. These employees work at locations in a variety of positions that include teachers,
bus drivers, school principals, custodians, administrators, office support and skilled trades. HISD is seeking proposals for most plan
requests in the RFP for a January 1, 2015 effective date. There may be submissions that will have a different effective date,
depending on District needs and ability to successfully implement proposed solutions.
Aldine Independent School District (Aldine ISD)
Located in North Harris County, Texas, Aldine ISD encompasses 111 square miles and operates as the eleventh-largest school
district in Texas with a budget exceeding $538 million. Aldine ISD serves a population of more than 67,300 students covering 78
campuses including elementary schools, intermediate schools, middle schools, ninth grade schools, high schools, magnet schools,
and alternative campuses.
Currently, Aldine ISD has approximately 8,100 benefits-eligible employees, of which approximately 4,200 are teachers. These
employees work at 85 locations in a variety of positions that include teachers, bus drivers, school principals, custodians,
administrators, office support, and skilled trades. Aldine ISD is seeking proposals for all plan requests in this RFP for a January 1,
2015 effective date. There may be submissions that will have a different effective date, depending on District needs and ability to
successfully implement proposed solutions.
Katy Independent School District (Katy ISD)
Katy ISD is located in Harris, Fort Bend, and Waller Counties, Texas, and is just west of Houston, Texas. Budget allocations for
2013 – 2014 exceeded $648 million. Katy ISD serves an enrollment of more than 66,500 students. The district operates 51
campuses that provide educational programs through elementary, middle, and high schools in addition to charter schools and
community-based alternative programs.
Katy ISD’s staff numbers are approximately 8,500 full- and part-time employees, of which approximately 4,300 are teachers.
Benefits-eligible employees are approximately 8,100 individuals. These employees work at 62 locations in a variety of positions that
include teachers, bus drivers, school principals, custodians, administrators, office support, and skilled trades. Katy ISD is seeking
proposals for all plan requests in the RFP for a January 1, 2015 effective date.
Current Plan Administration
Each District’s current plan offerings are described and explained in detail on the District’s benefits websites. The descriptions
include summary information as well as full plan descriptions, current provider information, and helpful links. Please visit each
District’s benefits website at. www.hisdbenefits.org, www.aldinebenefits.org, and www.katybenefits.org.
Mercer Health & Benefits’ Role
Mercer Health & Benefits is the Consultant of Record for THCP, and as such, strives to implement best business practices to ensure
that THCP’s goals are met. Mercer Health & Benefits is responsible for management aspects related to employee benefits programs
for HISD, Katy ISD, and Aldine ISD. Mercer has worked with THCP to develop and submit this RFP in compliance with the
“Competitive Sealed Proposal” procedures set forth in the Texas Education Code 44.031 required for THCP school districts
participating as part of The Program.
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PROJECT #: 14-04-02
HOUSTON INDEPENDENT SCHOOL DISTRICT
If you are an interested proposer, you must register and follow the directions on the HISD Procurement Services’s Proposal
Solicitations Download website; for more information go to www.houstonisd.org and find the link under Community > Do Business
with HISD > Bid Opportunities http://www.houstonisd.org/Page/68148. Electronic copies of the RFP and its supporting documents
can be obtained from this Proposal Solicitation Download website as well.
Goals and Objectives
THCP has retained Mercer Health & Benefits (Mercer) to assist them in requesting proposals for total health benefit and advanced
strategies. The purpose of this Request for Proposal (RFP) is for Mercer to assist THCP with identifying solutions and programs for
THCP’s medical benefit programs which provide the systems, processes, and capabilities to meet the objectives listed below.
•
Offer financial and operational transparency while controlling THCP’s medical benefit costs.
•
Ensure that members have appropriate access to all medically necessary doctors, hospitals, and services, and that innovative
clinical and wellness programs are in place to ensure patient safety and enhance outcomes.
•
Utilize plan design incentives that encourages cost-effective and appropriate utilization of medical programs.
•
Provide members with a better understanding of the true costs of medical care borne/incurred on their behalf.
•
Leverage new approaches to managing THCP medical utilization and cost trends and provide quality decision support to its
benefits group.
•
Coordinate with other THCP providers (pharmacy benefit manager, wellness firms, etc.) on health improvement and patient
education initiatives.
•
Ease the administrative burden and complexity of the program while maintaining program quality, breadth, and cost
effectiveness.
Current State
THCP’s self-funded medical plans are currently administered by Aetna. Each District offers similar consumer-directed health plan
options and less similar EPO, PPO, and POS options. The self-funded prescription drug plans are administered by Caremark and
feature a number of utilization management programs and similar plan designs which vary by District. Aetna currently provides
Nurseline and Maternity care services. RedBrick Health is currently providing telephonic coaching and lifestyle management for
Aldine ISD and Katy ISD and lifestyle management only for HISD. HISD currently maintains two (2) on-site clinics with services
provided by Concentra. More detail on each program is available on each District’s website at www.hisdbenefits.org,
www.aldinebenefits.org, or www.katybenefits.org.
RFP Process
The RFP process will provide you approximately three (3) weeks to complete your proposal. Mercer will evaluate the proposals
based on District criteria and priorities and present summary results to the Districts and their insurance committee members (varies
by District). The Districts will determine finalists and may or may not invite finalists in for finalist interviews. The Districts may or may
not desire site visits with any or all of the finalists. Administration and committee recommendations will be presented to the Boards of
Education for contract awards. It is preferred for contract drafts to be negotiated prior to the Board approval.
Evaluation Process
Throughout the proposal process, each proposal received initially will be analyzed to determine overall responsiveness, adherence
to format, and completeness of the information requested. Failure to comply with the instructions or to submit a compliant proposal
will deem a proposal unresponsive and may, at the discretion of THCP, affect scoring or result in disqualification.
THCP and Mercer reserve the right to contact the references submitted in the proposal to discuss the services of the respondent. In
addition to the proposal and references, THCP may also require meetings with proposers to discuss additional questions and
concerns. THCP reserves the right to make on-site visits of your facilities to observe your operations and systems.
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REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
HOUSTON INDEPENDENT SCHOOL DISTRICT
Timeline
A tentative timeline of the process is included below. Any deviations from this timeline will be shared with all who register on the
Proposal Solicitations Download website and download the Request for Proposal.
Event
Date
Contact vendors
Thursday, April 10, 2014
Release Request for Proposal (RFP) 12:00 PM)
Thursday, April 10, 2014
1st advertisement of proposal to public
Vendors written responses to questions posted to HISD website
HISD response to 1st round of vendor questions provided
Pre-proposal conference (1:00 PM – 2:00 PM in Building A, Room PL-3,
Saturday, April 12 2014
Monday, April 14, 2014
Wednesday, April 16, 2014
Thursday, April 17, 2014
HISD’s Ryan Professional Development Center, 4001 Hardy Street
Houston, TX 77009)
2nd advertisement of proposal to public
Vendors final opportunity to submit written questions due by 5:00 PM
Saturday, April 19, 2014
Wednesday, April 23 2014
CDT
HISD response to 2nd round of vendor questions provided
Proposals due to all three THCP Districts by 3:00 PM CDT
Thursday, April 24, 2014
Friday, May 2, 2014
Contracts/Effective Dates
This proposal will be incorporated into the final contract. Subject to District limitations, any Agreement which results from a District
RFP shall be for a period of one year from the effective date of the Agreement (i.e., January 1, 2015 for the first term) with an
exclusive option by the District to renew on an annual basis thereafter for up to four additional one-year terms. The preference is to
receive proposals that limit any fee increase for the first three years of the Agreement, with provisions to renew the Agreement for
two one year periods, under specified rules or provisions. However, if Proposer is willing to provide pricing terms more advantageous
to the District for a multi-year initial term, the District will consider such as long as termination of the Agreement by the District is
allowed for convenience, and there is no limitation to the District’s ability to issue alternate or additional requests for proposals and/or
qualifications for the services at any time during the term of any Agreement entered into as a result of this RFP.
At the District’s option, there may be an additional 90-day transitional period added to the term at the end of the Agreement. The
Agreement prices, terms and conditions are to remain in effect during the transitional period.
Any change in rates will occur on January 1 and will need to be documented. Written notification of a premium/fee change will be
presented to THCP at least 10 months prior to the anniversary date for THCP’s consideration.
Mercer Compensation
Mercer will be performing the RFP evaluation in order to provide recommendations and advise THCP. Mercer will be compensated
on a fee-for-service basis by THCP. Please delete any and all consultant/advisor compensation from your quoted premiums/fees.
Should any imbedded compensation be included that cannot be removed, it should be clearly disclosed as part of your proposal.
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Best and final
THCP reserves the right to return to the top candidates to request a best and final proposal based on one or more components of
the initial proposal; however, this does not guarantee that you will be given any opportunity to adjust your submitted proposal. THCP
reserves the right to negotiate certain terms and conditions relative to the contract. All finalist(s) are advised that THCP will require
submission of M/WBE participation compliance documentation.
13.2
Instructions
General Instructions
Your response should include sufficient information for full analysis of each strategy or solution you are proposing. Include a full
description of how the solution or strategy works, the supporting network of providers, network access fees, other program fees, any
IT development costs, file feeds, etc.), potential savings (including information on how the potential savings projections were
derived), savings guarantees. Understand that THCP employers will negotiate collectively but will contract individually with the
service provider;
•
Provide responses to the individual Districts and Mercer as instructed;
•
Conform to the rule that there are to be no calls to THCP or Mercer. All information/questions are to be sent as instructed within
this RFP. Failure to comply can result in disqualification; and
•
Submit questions as instructed within this RFP. Any information given to one prospective Proposer will be furnished to all if
such information is necessary to Proposer in submitting their proposal or if the lack of such information would be prejudicial to
an uninformed Proposer.
Index of Sections, Appendices, and Exhibits
Following is an index of the information provided in addition to this file. You must ensure your response is complete and meets all
submission requirements; specific instruction has been outlined in in Section 3 (HISD’s RFP / Scope of Work and Specific
Conditions).
Description
Provided as:
HISD — Information (District Submission Requirements)
Section 1
HISD — General Terms and Conditions
Section 2
HISD — Scope of Work and Specific Conditions
Section 3
HISD — Pricing Sheets
Section 4 – This section intentionally left blank.
Form A — Company Information
Section 5
Form B — M/WBE Instructions
Section 6
Form C — Addendum For Agreement Funded by U.S. Federal
Section 7
Grant
Form D — Pricing and Service Affirmation
Section 8
Form E — Exception Form
Section 9
Form F — (Price Schedule)
Section 10
Form G — Supplier Relations – CHE (Local) Questionnaire
Section 11
Information (District Requirements)
Section 12
General Information and Instructions (Subject Matter)
Section 13
Minimum Business Requirements
Section 14
Expert Medical Opinion
Section 15
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REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
Description
Provided as:
Employee Assistance Program (EAP)
Section 16
Diabetes Technology Management
Section 17
Neonatal Solutions Program
Section 18
Head Count per District
Exhibit I
HOUSTON INDEPENDENT SCHOOL DISTRICT
Proposal Submission Process
All proposers are to complete all sections of the RFP for which they are proposing to provide services. The omission of any section
should be clearly outlined in the cover letter of their proposal along with brief explanation as to why your organization is not
submitting responses for a particular section.
In addition to the provisions set forth in Section 1.5 (HISD’s RFP / Submission of Proposals), you must submit one signed original,
one electronic copy (USB flash drive or CD-ROM), and three hard copies of your proposal to EACH of the following:
William “Bill” Struska
Houston Independent School District
Board Services - Room 1C03
Hattie Mae White Education Support Center
4400 West 18th Street
Houston, Texas 77092-8501
Ms. Keena Sims-Bradley
Director of Benefits
Aldine Independent School District
15010 Aldine Westfield Road
Houston, Texas 77032
Mr. Lance Naumann
Katy Independent School District
Insurance/Risk Management Office
6301 South Stadium Lane
Katy, TX 77494
Mercer
Attn: Leanna Johnson
500 Dallas Street, Suite 1500
Houston, TX 77002
Each proposal shall be in a sealed envelope plainly marked “SEALED PROPOSAL” – Proposal Title: Request for Proposals to
Provide Employee Assistance Program (EAP), Diabetes Management Technology (DMT), Expert Medical Opinion (EMO), and
Neonatal Solutions Program; and Proposal Number: 14-04-02; and include the company name and address of Proposer. Each
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PROJECT #: 14-04-02
HOUSTON INDEPENDENT SCHOOL DISTRICT
original proposal shall be marked “ORIGINAL” to be distinguished from the copies. If electronic copies are password protected,
provide the password in the front cover of each proposal binder marked “ORIGINAL”.
PROPOSALS MUST BE SUBMITTED PRIOR TO 3:00 PM CDT ON FRIDAY, MAY 2, 2014 AS DIRECTED ABOVE. NO ORAL, TELEGRAPHIC,
TELEPHONIC, OR FACSIMILE PROPOSALS WILL BE CONSIDERED.
Non-compliance with any of the delivery instructions can result in disqualification from the proposal process and any proposals
received without a date/time stamp or after the defined deadline may be returned to the proposer unopened.
Example: Proposer “A” sends its sealed proposal to one but not all of the above District Offices which resulted in its proposal not
being considered.
For hand-delivered proposals, it will be the sole responsibility of the proposer to have its proposal envelope date and time stamped
before the deadline. Proposal envelopes received after the May 2, 2014, 3:00 PM CDT deadline will neither be date/time stamped or
accepted.
Notice of delays
When the Proposer encounters difficulty which delays or threatens to delay timely performance (including actual or potential labor
disputes), the proposer shall immediately give notice thereof in writing to each member of THCP, stating all relevant information with
respect thereto. Such notice shall not in any way constitute a basis for an extension of the delivery or performance schedule or be
construed as a waiver by THCP of any right or remedies to which it is entitled by law or pursuant to provisions herein. Failure to give
such notice, however, may be grounds for denial of any request for an extension of the delivery or performance schedule because of
such delay.
Force majeure
Proposer shall not be liable for delay in delivery or performance or for failure to give notice of delay when such delay is due to factors
beyond its control, including, but not limited to, fires, strikes, explosions, governmental regulations, court orders or decrees, or acts
of nature such as flood, wind, earthquake, tornado, or hurricane. If the proposer is unable to perform any of its obligations as a result
of force majeure, the proposer shall immediately give written notice to THCP of the date of inception of the force majeure condition
and the extent to which it will impact performance.
Questions from Proposers
All responses to the RFP must be prepared in accordance with the proposal format set forth herein in addition to the provisions set
forth in Section 1.3 and 1.5 (HISD’s RFP / Instructions, Submission Requirements and Procedures).
Proposers may make written inquiries concerning this RFP to obtain clarification of the requirements. Inquiries must be submitted no
later than 5:00 PM CDT on April 23, 2014. Inquiries should be submitted to the following via email:
William “Bill” Struska
Procurement Department
Houston Independent School District
Fax: (713) 556-6641
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Email to: WSTRUSKA@houstonisd.org
Questions received by this deadline, and corresponding answers, will be provided by issuance of written addenda.
All proposers are expected to carefully examine the RFP documents. Any ambiguities or inconsistencies should be brought to the
attention of the individual identified above. It is believed that all information necessary to complete a response is included in this
RFP. It is the responsibility of the proposer to obtain clarification of any information contained herein that is not fully understood
either through the written question process or at the pre-proposal conference.
Description of proposed items
In Section 1.4 (HISD’s RFP / Notice for RFP / Instructions Submission Requirements and Procedure), detailed listings of proposal
items have been provided.
Questionnaires
The questionnaires will verify the proposer’s ability and willingness to meet various requirements and expectations about the
services that you will provide to THCP under this contract. It will verify specific aspects of the services you will perform. Failure to
respond affirmatively to all confirmations does not disqualify a vendor.
Responding to the RFP
To respond to this RFP, you are required to have a personal computer with internet access, MS Office (Microsoft Word and Excel),
and respond via the methods mentioned above.
The questionnaire sections of this document are designed to electronically collect responses to this RFP. All responses must be
provided in the designated space. Sections of the document that are not designated for your response have been protected and
cannot be edited. Furthermore, response areas have been preformatted to accept information in a specific manner. DO NOT CHANGE
THE FORMAT OF THE DOCUMENT.
Significant alteration of the RFP format will be reported as a non-response and could significantly
impact your ability to be considered.
Entering Information
In this Request for Proposal, you will be asked to provide responses in three different types of fields:
Check Boxes
To check a “check box”, use your mouse to “click” on the check box. To uncheck a check box, use your mouse to “click” on the box
again.
Drop-down Lists
To select an item from a “drop-down list”, “click” on the arrow to the right of the box and select your response from the drop-down
list.
Text Boxes
Responses may be typed directly into text boxes, which are large, gray blocks. Depending on the context, your response may be
limited to a certain type (some areas only accept numbers, while others accept text) or limited to a particular length. For free form
text responses, the limit of characters varies throughout the sections, up to 2,000 characters including spaces.
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PROJECT #: 14-04-02
HOUSTON INDEPENDENT SCHOOL DISTRICT
If there are any questions that are not applicable to your organization, you MUST enter “N/A” into the text response box. Do not
leave any response box blank.
Navigating in the Document
To view any part of the Request for Proposal, scroll to that section using the scroll bar.
•
If a particular response section is in view, select it with your mouse.
•
To move to the next response, use your mouse or press the <<Tab>> key.
•
To move to the previous response, use your mouse or press the <<Shift-Tab>> key combination.
Completing the File
Each response must be self-contained. Proposers will not refer to responses in other input fields or to other attachments, unless
specifically indicated within the questionnaire. For instance, responses such as “see above response” or “refer to attachments” will
not be recorded.
Using the “Save As” feature, save the file by adding your company name and location in the original file name (i.e., ABC Company_
filename.doc). As you complete the Request for Proposal, it is highly recommended that you periodically save your responses.
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HOUSTON INDEPENDENT SCHOOL DISTRICT
Intent to Bid
Provide the following information via email to Leanna Johnson at Mercer
(Leanna.Johnson@Mercer.com by
May 2, 2014
[Insert Company Name]
has received the invitation to respond to the THCP Request for
Proposal and has the following intentions:
We decline to bid at this time.
We intend to submit a proposal for an Employee Assistance Program.
We intend to submit a proposal for an Expert Medical Opinion Program.
We intend to submit a proposal for a Diabetes Technology Management
Program.
We intend to submit a proposal for a Neonatal Solutions Program.
If applicable, please note your specific reasons for declining to bid below:
Authorization:
Authorized officer’s signature
Company name
Officer’s name (printed/typed)
Title
Date
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XIV Minimum Business Requirements
For whatever role you may play in the THCP program (provide one program, many, or all), please respond to the following minimum
overall contractual/financial requirements. If the question does not apply to the services you are proposing or your organization,
please provide an explanation in the space provided.
The form below outlines the minimum proposal requirements for providing health benefits and other services to THCP. Please note
the following instructions for completing this form:
•
If your answer is “agree”, you acknowledge your full agreement to incorporate the standard minimum requirements exactly as
worded below into the final contract with no other language to adjust or caveat the intent. Additionally, you acknowledge that
your final cost proposal is reflective of providing these services as defined.
•
If your answer is “agree, with exception”, you acknowledge your general agreement with standard minimum requirements as
stated; however, your agreement may include an exception. Provide a detailed explanation of your agreement and any
exceptions, including exact suggested language, for THCP’s consideration, while understanding that this may result in
disqualification.
•
If your answer is “disagree”, please provide a detailed explanation of your response for THCP consideration while
understanding that this may result in disqualification.
14.1
General Questions
Minimum business requirements questionnaire
Agree,
Agree with exception,
or Disagree
Evidence/supporting detail
General
1.
Award or rejection
<Choose One>
Vendor agrees that all qualified proposals
will be evaluated and the award will be
made to the vendor whose combination of
cost and services are deemed to best
satisfy the objectives of THCP. THCP
reserves the right to accept or reject any
subcontractor the vendor may include in
their proposal. This document is only part
of the RFP and is in no way to be
misconstrued as a commitment to
purchase on the part of THCP.
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Minimum business requirements questionnaire
2.
Time for acceptance
Agree,
Agree with exception,
or Disagree
HOUSTON INDEPENDENT SCHOOL DISTRICT
Evidence/supporting detail
<Choose One>
Vendor agrees to be bound by its proposal
from the date submitted until the effective
date of the contract, during which time
THCP may request clarification or
correction of the proposal for the purpose
of evaluation. Amendments or
clarifications shall affect only that portion
of the proposal so amended or clarified.
3.
Confidentiality agreement
<Choose One>
Vendor agrees to keep the information
provided herein confidential. This
requirement applies whether or not the
recipient of the RFP package agrees to
propose. Other than reports submitted to
either THCP or Mercer, the vendor agrees
not to publish or reproduce or in any other
way divulge such information in whole or
part, in any manner or form, or authorize
or permit others to do so. Please do not
divulge the contents of your proposal to
any THCP personnel. This stipulation is
neither to impede nor inhibit your
marketing or sales activity, but rather to
ensure the confidentiality of your proposal.
4.
Binding proposal acknowledgment
<Choose One>
Vendor agrees that a duly authorized
officer of the responding organization must
sign each proposal, and the completed
proposal shall be without interlineations,
alterations or erasures. It will be assumed
that all representations made in your
proposal will be binding, and that your
organization has agreed to all of the
requirements of the RFP unless
specifically stated otherwise in the front of
your proposal. Vendor agrees to include in
its contract drafts the exact provisions,
caveats, and pricing as were negotiated
during the RFP and vendor selection
process, including email communications
and confirmations. Failure to provide this
consistency in contract provisions could
result in vendor not being selected or
failure of the proposal prior to full
implementation.
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Minimum business requirements questionnaire
5.
Reservation of rights
Agree,
Agree with exception,
or Disagree
HOUSTON INDEPENDENT SCHOOL DISTRICT
Evidence/supporting detail
<Choose One>
THCP and Mercer agree not to disclose
any proprietary or confidential information;
however, all proposals are subject to the
Texas Open Records Act and other
applicable open records requirements.
Vendor agrees that even though its
proposal may be rejected, THCP reserves
the right to adapt any of the concepts or
ideas contained therein without incurring
any liability. No specifications, drawings,
sketches, models, samples, technical
information or data, written, oral or
otherwise, furnished by you to THCP
pursuant to this RFP shall be considered
by THCP member Districts to be
confidential or proprietary. This does not,
however, limit your right to mark
information in your proposal as confidential
or proprietary for the purposes of
administration of the open records
requirements, including but not limited to
notifying you if information you mark as
confidential or proprietary is being
released to the Office of Attorney General
for determination of its releasability, and
you are exercising your right to object to
disclosure.
6.
Cost for proposal preparation
<Choose One>
Vendor agrees that THCP assumes no
responsibility or liability for any costs
vendors may incur in responding to this
RFP, including attending meetings, site
visits, or negotiations. Any costs incurred
by vendors in preparing or submitting
proposals are the vendor’s sole
responsibility. Vendors will not be
reimbursed for these costs.
7.
Proposer’s responsibility
<Choose One>
Vendor agrees that it is solely responsible
for ensuring that all pertinent and required
information is included in its proposal.
Failure to adhere to the described format
and to include the required information
could result in disqualification or a low
evaluation of the proposer’s proposal.
THCP reserves the sole right to determine
if a proposal is incomplete or nonresponsive.
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Minimum business requirements questionnaire
8.
Obligations of plan sponsor
Agree,
Agree with exception,
or Disagree
HOUSTON INDEPENDENT SCHOOL DISTRICT
Evidence/supporting detail
<Choose One>
Vendor agrees that this RFP shall not be
construed in any manner to create an
obligation on the part of THCP to enter into
any contract or to serve as a basis for any
claim whatsoever for reimbursement of
costs for efforts expended by the proposer.
This RFP may be withdrawn or cancelled
by THCP at any time, and THCP reserves
the right to reject any or all proposals
submitted hereunder for any reason
whatsoever.
9.
Subcontractor disclosure
<Choose One>
Agent, subsidiary, affiliate, and vendor
agree to disclose all subcontractor
relationships that will be used in the
performance of services for THCP. During
the contract period, vendor will notify
THCP at least 90 days in advance of any
changes to the provision of services by
agent, subsidiary, an affiliate, or to its
subcontracted relationships. This should
include any off-shore or domestic
subcontracted relationships for member,
physician, pharmacist, or other support.
THCP will have the right to approve or
reject any subcontractor or agent change.
10.
Report monthly and evaluate quarterly all
performance guarantees.
<Choose One>
11.
Actively participate in two annual vendor
one-day summits in Houston and at least
quarterly conference calls to continue
brainstorming ways to better integrate with
THCP’s partners.
<Choose One>
12.
Annual web-based participant satisfaction
survey of your services conducted by a
third party; content pre-approved by
THCP.
<Choose One>
13.
Your organization currently has more than
five employer clients who have more than
10,000 employees with programs in place
for more than two years.
<Choose One>
14.
Your technology platform can verify a
patient’s eligibility and insurance coverage.
<Choose One>
86
MERCER
REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
Minimum business requirements questionnaire
Agree,
Agree with exception,
or Disagree
15.
Is your system compatible with all major
insurance payers and billing clearinghouse
systems? What clearinghouse would you
recommend using if required?
<Choose One>
16.
You will submit claims to Aetna via their
prescribed methods for services rendered.
<Choose One>
17.
Your organization has experience in
coordinating and exchanging data with
data warehouse vendors, health
management vendors, and on-site clinics
to promote health improvement initiatives.
<Choose One>
18.
What are the normal hours of the clinic
that will support the THCP districts? What
different hours will you offer for the THCP
districts? If different for different services
being proposed, please provide all of
them.
19.
Allow THCP’s designee on site to
complete an annual site evaluation of the
services in which you are proposing, if
requested.
<Choose One>
20.
Conduct quarterly on-site meetings with
client and/or client’s consultant (up to eight
days per year) to review program results,
all time and expense, and travel expenses
are included in your quoted fees.
<Choose One>
21.
Participate in an annual health fair per
District for at least 2 days per year (likely
Friday and Saturday), providing
information and promotional materials to
employees. The number of participants will
vary by service provided but will require at
least 2 per provider.
<Choose One>
22.
Designated implementation team from
initial project launch date through 90 days
following the effective date.
<Choose One>
23.
All deliverables should be delivered to
client in an electronic format 2 business
days in advance of presentation to the
client.
<Choose One>
24.
Create detailed issues log maintained by
vendor and reported to consultant and
THCP not less than monthly.
<Choose One>
HOUSTON INDEPENDENT SCHOOL DISTRICT
Evidence/supporting detail
87
MERCER
REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
Minimum business requirements questionnaire
Agree,
Agree with exception,
or Disagree
25.
You agree to extend similar proposal
terms and conditions to other clients who
may join THCP.
<Choose One>
26.
You agree to co-brand your online
appointment scheduler and all
communications materials conforming to
District portal graphic identities/style
sheets.
<Choose One>
27.
You agree that THCP reserves the right to
retain third party contractor(s) (Designated
Agent(s)) to receive claims/utilization
information and/or data (Data) from
Supplier and store the data on THCP's
behalf.
<Choose One>
28.
THCP shall put in place policies and
procedures to protect the confidentiality of
the Data consistent with HIPAA (and all
applicable amendments) requirements.
You agree that you will be required to do
the same, including the execution of a
Business Associate Agreement where
applicable.
<Choose One>
29.
You agree to cooperate with THCP or
THCP's Designated Agent(s) in the
fulfillment of Supplier's duties under this
agreement, including the provision of Data
as specified below without constraint on its
use to the extent allowed by law.
<Choose One>
30.
Provide a designated clinical team. If you
are willing to provide dedicated resources
in this area, please “agree” with this
question, and provide more detail in the
“evidence/supporting detail” box
<Choose One>
31.
Will you act in accordance with the documents and instruments
governing our clients plans and comply with all applicable state and
federal laws and regulations including, but not limited to, the following:
HOUSTON INDEPENDENT SCHOOL DISTRICT
Evidence/supporting detail
(Select)
HIPAA of 1996 (including HITECH and all other amendments),
including the nondiscrimination, special enrollment, coverage
certification, privacy, security, EDI, and other HIPAA requirements.
32.
To the extent applicable, are you now and will you remain duly in full
compliance with all federal and state statutory administrative
requirements?
33.
Ability to report on both data driven and
self-reported clinical measures.
(Select)
<Choose One>
88
MERCER
REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
Minimum business requirements questionnaire
34.
Describe your regulations, processes, and
procedures for protecting members’ Social
Security numbers
35.
What are your notification procedures
regarding privacy breaches?
Confirm you are compliant with all
applicable laws and regulations.
HOUSTON INDEPENDENT SCHOOL DISTRICT
Agree,
Agree with exception,
or Disagree
Evidence/supporting detail
(Select)
Describe any additional measures you
have in place.
14.2
Company-Specific Information
General information questionnaire
Response
1.
How many years have you been in business, specifically for the
services you are proposing on?
2.
Please provide references for three current accounts comparable in size to THCP in Houston. Public sector clients are
preferred:
Client 1
Length of relationship
years
Number of participating employees
employees
Services provided
Contact name
Contact phone number
Client 2
Length of relationship
years
Number of participating employees
employees
Services provided
Contact name
Contact phone number
Client 3
Length of relationship
years
Number of participating employees
employees
Services provided
Contact name
Contact phone number
89
MERCER
REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
General information questionnaire
3.
4.
HOUSTON INDEPENDENT SCHOOL DISTRICT
Response
How many clients (i.e., in coordinated, contracted employers) do
you currently have?
•
What is the average size?
•
How many clients over 20,000 employees do you have?
Please list any third-party organizations who will participate in the execution of the services you will provide to THCP under
this proposal (name, nature of relationship, year partnership began, contract time period, performance guarantees).
Partner
Partner
Partner
Partner
Partner
Partner
Partner
Partner
Partner
5.
Is your organization accredited?
•
6.
7.
8.
If yes, which organization(s) are your programs accredited
through?
Has your organization received any awards of excellence over
the past 5 years?
•
(Select)
Which ones and when?
Are your attending physicians contracted with the Aetna network?
(Select)
(a)
(Select)
Can you agree to only offering services through your innetwork physicians?
Do you provide marketing/promotion services to members?
•
If yes, what services are typically included, and what are the
costs for those services?
•
Will you agree to coordinate all and receive approval for
these services?
9.
Are you able to track the effectiveness of these
marketing/promotional services (e.g., hits on website)?
10.
How do you keep users engaged in your adherence to treatment
plan?
11.
Will you agree to add one school district as part of your user
advisory group?
•
12.
(Select)
(Select)
(Select)
(Select)
(Select)
Please describe your user advisory group and the role the
District representative would play.
What type of data will you need from THCP to implement the
proposed services?
90
MERCER
REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
General information questionnaire
13.
•
How often will THCP need to supply you with data and in
what format?
•
How should this data be delivered?
HOUSTON INDEPENDENT SCHOOL DISTRICT
Response
Detail your organization’s standard approach to measuring
program success.
91
MERCER
REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
HOUSTON INDEPENDENT SCHOOL DISTRICT
XV Expert Medical Opinion
15.1
General Questions
General questions
1.
List and briefly describe your Medical Decision Support Services.
2.
What types of medical conditions are appropriate for your services?
•
What types are not?
3.
Describe what, if any, conditions are not covered under your Medical Decision Support program
and why.
4.
How does your product directly improve diagnostic accuracy?
5.
Describe the types of client organizations and number of lives currently served by your organization
for Medical Decision Support Services.
6.
Please describe how your program helps individuals become better health care consumers.
7.
Describe how your service helps support members in getting to a highly qualified physician in a
given member's geographic area for treatment and/or support of a condition and/or general health.
•
8.
How is this information evaluated?
Please describe how you assure the highest level of relevant clinical expertise when a physician
consultation occurs.
•
10.
What objective data is used to measure the quality of these physicians?
From what sources do you obtain the information and content you provide to patients?
•
9.
How do you ensure the recommendations are supported by evidenced based medicine?
Do you subcontract one or more components of the Medical Decision Support Services program?
•
Describe any formal alliances or licensing arrangements with other organizations that contribute to
your product offering.
12.
Provide a brief overview of your firm, including background, ownership, mission, size, and when
your Medical Decision Support Service offering was first introduced.
13.
Please list all accreditations, including effective and expiration dates.
14.
List any relevant awards, accolades, and other distinctions that either your organization or your staff
received in the past three years.
15.
Do you currently have full time physicians or a Medical Director(s) on staff dedicated to your
Medical Decision Support Services offering?
•
(Select)
If yes, describe their roles and qualifications and impact on client results and differentiate
between the numbers of full-time employees versus contractors.
16.
Please elaborate on how you determine the appropriate staffing model to ensure the relevant
clinical expertise is incorporated during all complex consultations.
17.
Do you have a medical advisory committee?
•
(Select)
If yes, specify which program, subcontracted components, reason for subcontract, and to
whom the component is subcontracted.
11.
18.
Response
(Select)
If yes, describe roles and qualifications.
Describe your system failure protocols and data backup and recovery processes.
92
MERCER
REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
19.
HOUSTON INDEPENDENT SCHOOL DISTRICT
Do you have a Privacy Officer?
•
(Select)
If yes, what are his/her responsibilities?
Account Management
Account Management questions
1.
Response
Provide two benefits manager/director client references with contact information.
•
Client reference #1:
•
Client reference #2:
2.
Describe your strengths and value proposition provided to your clients.
3.
Describe how you are different from competitor companies?
4.
Does your service provide second opinions or generalized patient education?
5.
How long has your organization been providing services?
6.
What mergers and acquisitions has your company experienced in the last five years?
7.
Is medical malpractice insurance maintained?
•
If yes, specify the limits.
•
Has your organization ever been named in a malpractice suit?
8.
Describe in detail how you collect and store sensitive patient information.
9.
Is any data sent to a third party?
•
(Select)
(Select)
(Select)
(Select)
If yes, how it is protected?
10.
Describe your security practices and policies.
11.
Do you have a documented Security Incident Response Plan?
(Select)
•
(Select)
If yes, please attach a copy for review in Attachment S15: B – Policies and Procedures
12.
How do you manage intrusion detection on your networks and systems?
13.
Describe in narrative detail, accompanied by a diagram, every step in the entire process from first
contact to case resolution
14.
What is the process you use when members are denied service because of a non-qualified medical
condition?
15.
What percentage of your patients receive a written medical opinion?
•
What percentage receives another service (list services)?
•
What is the triage process for deciding which services are provided?
16.
What are the qualifications of the clinical staff who work directly with members (i.e., case
managers)?
17.
What are the qualifications of the clinical staff who follow up with treating physicians?
18.
What are the qualifications of the administrative staff who work directly with members?
19.
What are the qualifications of the specialists who review cases and provide opinions?
20.
How do you perform expedited review, and what are the criteria for expedited review?
21.
Are members responsible for contacting your program, or
(Select)
•
(Select)
Does your company make proactive outreach?
22.
What is your protocol for following up with members to enroll them in the program?
23.
Do you request medical records or does the member?
24.
Describe your peer-to-peer outreach to the participant’s treating physician?
(Select)
93
MERCER
REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
•
HOUSTON INDEPENDENT SCHOOL DISTRICT
Who engages in this discussion (e.g., case manager, contracted specialist, medical director)?
25.
In what percentage of cases do you coordinate directly with the treating physician?
26.
How often does a participant make contact with the case manager?
27.
•
What is the average amount of contact?
•
Is there a limit?
•
If yes, what is the limit?
(Select)
Typically, how long does it take to generate an opinion report?
•
What is the average?
•
How is case duration managed?
28.
What is the preferred method of communicating with patients?
29.
What are the hours of operation for your customer service operation?
30.
How is your process different if the patient is a child?
31.
What happens when the opinions of two or more expert specialists are not in agreement?
32.
What communications resources and support do you provide to clients to help increase member
awareness and understanding of your programs?
•
Please indicate any additional charges, if applicable.
33.
Describe how you assure the highest level of relevant clinical expertise when a physician
consultation occurs.
34.
Once a member calls seeking your service, does that member maintain a consistent relationship
with one person or are they exposed to multiple clinicians throughout the process?
35.
Which services make the most productive referral partners for your service?
36.
Describe the series of contacts that are made with the referring partner, after the referral has been
received.
37.
How do you coordinate with health plan nurse lines?
38.
How do you coordinate with health plan customer service?
39.
How do you coordinate with case management?
40.
How do you coordinate with disease management?
41.
How do you coordinate with advocacy services?
42.
How do you coordinate with EAP?
43.
How do you coordinate with on-site clinics?
44.
Please provide a case study that illustrates effective integration in Attachment S15: A – Integration.
45.
How often will you need an eligibility file?
46.
How do you ensure quality implementation of the program?

•
Can you take any format?
(Select)
(Select)
What resources support this goal?
47.
Please provide an implementation plan in Attachment S15: F – Implementation Plan. Please
include what the key risks are to successful implementation.
48.
How does your program create hard dollar savings for the plan sponsor?
49.
What impact does your service have on productivity, disability, and absence?
50.
Please provide information on member satisfaction with your programs.
51.
Please provide a copy of all your standard reports.
52.
Please list the frequency reports will be delivered.
(Select)
(Select)
94
MERCER
REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
•
53.
HOUSTON INDEPENDENT SCHOOL DISTRICT
Can they be customized?
(Select)
Provide a blinded, sample report for the following conditions:
•
Anorexia Nervosa
(Select)
•
Chronic Back Pain
(Select)
•
Ovarian Cancer
(Select)
Quality
Quality questions
1.
Response
What is the depth and breadth of the database of physicians that you use for your clinical advocacy
program?
•
Is the database used for other purposes in support of client membership?
•
If yes, what else is it used for?
2.
Do you utilize a continuous quality improvement model in identifying expert physicians to ensure
maximum impact from your program?
3.
For the past two years, for patients with at least one of your covered chronic conditions, what is
your book-of-business average for:
•
Change in diagnosis
•
Change in treatment alternatives
•
Change in interpretation of pathology results
4.
What is the average utilization (% of employees) of your program on an annual basis?
5.
What is the highest utilization achieved by a client?
6.
Please describe your strategies to optimize utilization.
7.
What program outcomes do you measure and provide on reports?
•
(Select)
(Select)
How often do you provide these reports?
8.
Provide a sample of your best two-page dashboard report which outlines your most compelling
financial and clinical metrics for Medical Decision Support Services in Attachment S15: E –
Standard Reporting.
(Select)
9.
Please provide your book-of-business results for each of your standard metrics in Attachment S15:
E – Standard Reporting.
(Select)
10.
Provide your best results to date for a large national client.
11.
How do you measure participant satisfaction? Please describe the process and defined measures.
12.
Will Client-specific participant satisfaction results be monitored and reported?
(Select)
13.
Is a third party involved in measuring satisfaction?
(Select)
•
14.
If so, describe their level of involvement.
Do you offer performance guarantees in the area of participant satisfaction?
•
(Select)
If yes, please describe.
15.
Are you capable and willing to furnish Client the metrics reporting referenced above on a regular
basis?
(Select)
16.
What is your frequency for your reporting (monthly, quarterly, annually, etc.)?
(Select)
17.
Please describe any metrics beyond those included in the two-page dashboard report that you
would recommend including in supplemental reporting.
18.
Explain components of typical metrics report and provide example.
95
MERCER
REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
HOUSTON INDEPENDENT SCHOOL DISTRICT
19.
Describe your ad-hoc reporting capabilities?
20.
What clinical and financial performance guarantees are you willing to offer to Client and to what
extent are you willing to put your fees at risk in delivery of the services?
Services
Services questions
Response
1.
Please provide a detailed description including a flow chart describing the member's experience
from point (and method) of entry through data collection, clinical consultation, and feedback to
patient and physician in Attachment S15: C – Operational Platform.
(Select)
2.
Please describe the format for delivery for any materials to a member (hard copy; online, phone
call, etc.).
3.
Describe how your service varies based upon the severity of the condition, including the timing of
reporting and return of materials to patients.
4.
Please describe the training and qualification of each person that has interaction with a member
during the process described above.
5.
Client has a designated team with RedBrick Health for wellness (HRA, online, and telephonic
lifestyle management) and care management (disease management) services.
6.
•
How could your Medical Decision Support Services support the members engaged in this
program?
•
Please provide actual examples from your book of business demonstrating this support model.
(Select)
Describe how your program supports patients in ensuring accurate interpretation, staging, and
grading of pathologies.
•
Please provide actual examples from your book of business demonstrating this support model
in Attachment S15: C – Operational Platform.
7.
Describe your fact-finding and medical history gathering process occurring prior to providing
information and guidance to your members with conditions.
8.
Please describe with specificity the number of communications, degree of customization, mail
capabilities, and mailing costs included in your standard price.
9.
Please provide case examples of your best communication offerings resulting in driving higher than
standard levels of engagement in Attachment S15: C – Operational Platform.
10.
Describe your on-site activities at client locations during the year to drive utilization?
•
Do these activities cost extra or are they included in the program fee?
(Select)
(Select)
(Select)
11.
How does your program collaborate with and provide direct support to your members' treating
physicians?
12.
Please provide a sample of the report and/or materials provided to members as well as their
treating physicians for at least two of your covered conditions in Attachment S15: C – Operational
Platform.
(Select)
13.
Do the member and the treating physician receive the same materials?
(Select)
•
If not, please explain.
14.
Identify the individual prospectively assigned as client manager as well as their potential account
management team (dedicated A team) in Attachment S15: C – Operational Platform.
(Select)
15.
Please describe the qualifications and background of your client and account managers Attachment
S15: C – Operational Platform.
(Select)
16.
Do you track the member’s pre- and post-consultation intended action?
(Select)
17.
What differentiates your services offerings from others in the market place?
96
MERCER
REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
18.
HOUSTON INDEPENDENT SCHOOL DISTRICT
In addition to Expert Medical Opinion what new program offerings do you provide that would be
ideal for this client?
•
Do the programs have an additional cost and are they included in the program fee?
(Select)
•
In no, please provide in Attachment S15: G – Pricing/Fees.
(Select)
Provide the location of your organization’s telephonic support call center that will service THCP members.
Average
2011,
Required
number of
2012 and
Total
education
Average
years with
2013
number of
and
years of
your
turnover
Direct participant contact
FTEs
experience
experience
organization
rate
Role(s)
RNs
Physicians
Customer Service
Other:
Please indicate the hours of operation for each call center for the following:
Hours of operation (Central Time)
Monday through Friday
From
To
Saturday
From
Sunday
To
From
To
Inbound access to clinician
Inbound access to live customer
service
Inbound message service
Inbound IVR
Outbound – Engagement calls
Outbound – Clinical management
calls
Other:
Contract Terms
Contract Terms questions
Response
1.
Proposed services assume a three year contract and “most favored nation” pricing will be held for
three years. This applies to future customers purchasing through the Mercer preferred vendor
arrangement.
(Select)
2.
Offer a provision to enable extension of contract terms for successive one year periods by mutual
agreement.
(Select)
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MERCER
REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
HOUSTON INDEPENDENT SCHOOL DISTRICT
Implementation
Implementation questions
Response
1.
Able to adhere to the 90-day timeline.
(Select)
2.
Provide, as an attachment S15: F – Implementation, your implementation plan that includes the
process, key steps, timing, and all client responsibilities.
(Select)
Financials
Financials questions
Response
1.
(Select)
Provide a fee structure that includes a Mercer commission level of 10%.
•
Describe if/how/when results have been validated by external sources.
•
What level of ROI are you willing to guarantee?
Performance Guarantees
Performance Guaranteesquestions
1.
2.
Response
Please indicate whether you are able to provide performance guarantees and fees at risk on the
following measures. Mercer would require at least 60% of the fees at risk be distributed to the
Return of Investment.
•
Return on investment (ROI)
(Select)
•
Medical report turnaround time
(Select)
•
Member satisfaction
(Select)
•
Clinical outcomes – change in diagnosis
(Select)
•
Clinical outcomes – change in treatment plan
(Select)
•
Implementation within 90 days
(Select)
Please state whether you can report on the measures listed below. Please add other reporting
metrics your organization typically measure.
•
Implementation within 90 days
(Select)
•
Return on investment (ROI)
(Select)
•
Medical report turnaround time
(Select)
•
Case disposition
(Select)
•
Call back time within 1 business day
(Select)
•
Call abandonment rate no more than 2%
(Select)
•
Member satisfaction
(Select)
•
Carrier integration
(Select)
•
Utilization/engagement
(Select)
•
Clinical outcomes – change in diagnosis
(Select)
•
Clinical outcomes – change in treatment plan
(Select)
•
Other:
(Select)
Pricing
Pricing questions
Response
98
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REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
1.
HOUSTON INDEPENDENT SCHOOL DISTRICT
Please indicate what your cost is per service.
•
Consult fee
•
Other
2.
Please include if you have additional methods to price the program (PMPM, blocks of cases, etc.).
3.
If you would rather price by client size rather than a single rate for all companies in the Mercer
Expert Opinion Collaborative, please fill out the following template:
4.
•
Less than 2,500 employees
•
2,500 – 4,999 employees
•
5,000 – 9,999 employees
•
10,000 – 24,999 employees
•
25,000 – 49,999 employees
•
50,000 – 99,999 employees
•
100,000+ employees
OR Please also provide your fee schedule by completing the table below for administration fees
based on your own standard employer size buckets:
•
Bucket 1:
•
Bucket 2:
•
Bucket 3:
•
Bucket 4:
•
Bucket 5:
•
Bucket 6:
•
Bucket 7:
5.
Please provide a full list of what is included in your fees above, and what is not.
6.
Describe the process for invoicing the client any PEPM administrative fees you charge. If you have
any minimum participation/utilization requirements, identify those here. Also, describe your process
for billing the consult fee if it does not flow through a carrier.
7.
Please confirm that the fees in the attached fee schedule are guaranteed for a three year period
and will be held as the best in market during that time. If better fees become available for other
clients during the term of this contract, this program will automatically convert to the lower fee
schedule to remain best in market.
(Select)
8.
Please confirm that the Mercer’s 10% commissions level is included in your above quoted admin
fees.
(Select)
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MERCER
REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
HOUSTON INDEPENDENT SCHOOL DISTRICT
XVI Employee Assistance Program (EAP)
16.1
Technical Questionnaire
Organization
Organization questions
1.
Response
Please list the service center location(s) you are proposing for the THCP account, including the
types of service provided at each proposed location. Include service center locations of any
subcontractor(s) providing any proposed service. Do not list service centers that will not service this
account. Space is provided for a primary and after-hours service center. If additional locations are
proposed for this account, enter additional locations under "Other Service Center". Number each
entry in the “Location” row and keep the numbering consistent by service center in the "Services at
this location" row. An example for a vendor with two additional service centers is provided in italics
under "Other service centers" for illustration. Delete this example in your submission and replace
with either "N/A" or any additional proposed service centers.
Monday through Friday
Weekends
Holidays
Primary Service Center
After Hours Service Center
Other Service Centers
•
•
•
2.
3.
For the primary service center proposed in, please report the annual turnover rate for each of the
following positions and the number of current open positions. For turnover, use the following
formula:
•
Numerator = Number of employees who held position(s) listed in denominator for the 12month period plus number of open positions for the 12-month minus the number of positions
listed in the denominator
•
Denominator = Number of positions in staffing category for the 12-month period.
•
Turnover by position: Primary service center.
•
Clinical Intake (answer 1-800 clinical line): 2013 turnover / 2012 turnover / # open positions
•
EAP Coordinators (handle clinical issues including crisis calls): 2013 turnover / 2012 turnover /
# open positions
•
Management Consultants
2013 turnover / 2012 turnover / # open positions
•
Critical Incident Stress Debriefers
2013 turnover / 2012 turnover / # open positions
•
Work/Life Specialists
2013 turnover / 2012 turnover / # open positions
•
Account Management
2013 turnover / 2012 turnover / # open positions
In the last three years, what is the total number of new contracts your organization has been
awarded where your organization has requested a fee adjustment prior to the end of the initial term
of the contract? Understanding that contract language may be finalized after the implementation or
"go-live" date, please consider the initial term of the contract as running from the implementation
date to the end date defined in your proposal or best and final offer, whether a contract has been
finalized (signed) or not.
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MERCER
REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
HOUSTON INDEPENDENT SCHOOL DISTRICT
4.
In the last three years, what is the total number of renewals your organization has negotiated where
your organization subsequently requested an off-cycle (prior to the end of the renewal period) fee
adjustment?
5.
How many school district and/or public entity accounts have you served in the last three years with
an EAP, WorkLife, or Behavioral Health product?
6.
List three active accounts that are most similar to THCP (i.e., entertainment, retail, etc.). We will not
contact for reference.
Client No. 1
Client No. 2
Client No. 3
Name of client
Industry
Number of participants
Services provided
Length of relationship
Initial contract date
Contact name
Contact phone number
Contact email address
7.
Provide a list of three terminated clients to be contacted as references. The three terminated
accounts should be terminated in the last three years for reasons other than mergers or
acquisitions. Indicate if termination resulted in closing a service center, a reduction in force,
changes in business processes, etc.
Client No. 1
Client No. 2
Client No. 3
Name of client
Address
City, State, Zip
Telephone number
Reason for termination
General Terms and Conditions
General Terms and Conditions questions
Response
1.
(Select)
Information submitted by the Bidder to the MIC in response to the EAP RFP will be shared with
THCP.
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REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
HOUSTON INDEPENDENT SCHOOL DISTRICT
2.
All data included in this RFP, accompanying information, or information obtained by the Bidder from (Select)
THCP shall be considered proprietary and confidential to THCP. Bidder agrees that, except as
required by law or by any government regulatory agency with regard to such information: (1) they
will use reasonable means, not less than that used to protect their own proprietary and confidential
information to safeguard THCP’s information; (2) other than reports submitted to either THCP
and/or its consultants, they will not show, publish, reproduce, or in any other way divulge such
information in whole or in part, in any manner or form, or permit others to do so, without the express
written consent of THCP; (3) they will use the information only for the business purposes
contemplated by this RFP; and (4) they will, upon award of services or upon cancellation of this
RFP, whether such award is to Bidder, return to THCP, if requested, all documents, information,
and materials received from or developed for THCP in any format whatsoever. Bidder shall require
their subcontractors of any type, if any, to expressly comply with the confidentiality provisions as set
forth herein. Bidder agrees that this duty of confidentiality will survive the award or termination of
the work under this RFP.
3.
All responses, inquiries, or correspondence relating to or in reference to this RFP and all reports,
charts, displays, schedules, exhibits, and other documentation produced by the Bidder will, when
received by THCP, become the property of THCP.
(Select)
4.
As part of the bid process, THCP and/or its consultants may conduct site visits, which may involve
staff interviews, test calls, and facility evaluation. Similar evaluations of subcontractors are
expressly authorized.
(Select)
5.
Acceptance of the bid is not complete unless and until an administrative agreement (Agreement)
satisfactory to THCP is signed by the parties.
(Select)
6.
Your organization agrees to be bound by its proposal until the effective date and up to one year
thereafter, during which time THCP may request clarification or correction of the proposal for the
purpose of evaluation. Amendments or clarifications shall affect only that portion of the proposal so
amended or clarified.
(Select)
7.
The proposed effective date is January 1, 2015 for Houston ISD, Aldine ISD, and Katy ISD.
(Select)
8.
Acceptable performance will be a condition of the Agreement. It shall be understood and agreed
that THCP and its consultants shall determine the satisfactory quality of the services furnished
under the Agreement. Failure to meet performance requirements is a reason for termination of the
Agreement.
(Select)
9.
THCP reserves the right to audit, including, but not limited to, a claims audit, either directly or
through its authorized agent(s), the health plan administrator’s compliance with the terms of the
Agreement. THCP further reserves the right, either directly or through its authorized agent(s), to
conduct a chart audit or other appropriate review to assess the quality of any services performed by
the health plan administrator or its affiliated health care providers, upon reasonable advance notice
to the health plan administrator. Upon providing appropriate assurances as to confidentiality and
proper use of medical information, the health plan administrator agrees to provide THCP or its
authorized agent(s) with the medical records maintained by the health plan administrator, as well as
any data needed to perform audits or other reviews. Any audits will be completed with no additional
cost to THCP for the services provided relative to the audit.
(Select)
10.
The vendor will indemnify, hold harmless, and save THCP, its agents, officers, and employees from
liability of any kind or nature (including costs, expenses, or attorney's fees) for damages suffered by
any entity or person as a result of error, negligence, reckless or willful acts, or omissions of the
vendor, its agents, officers, or employees. This shall hold for the term of the contract with the
vendor even if not expressly provided for in the contract.
(Select)
11.
You understand that THCP is subject to federal and state provisions directed for school districts
including a provision that states the Districts may not indemnify another organization.
(Select)
12.
You agree to notify THCP of contract termination no later than 240 days prior to the renewal date.
(Select)
13.
You agree that THCP can terminate your contract without cause with 90-day advance notification.
(Select)
14.
You agree to notify THCP of any changes to fees 120 days prior to the effective date of the change.
(Select)
15.
You agree that THCP can immediately terminate your contract with cause.
(Select)
16.
You will identify your subcontracted relationships and will be responsible for their performance.
(Select)
102
MERCER
REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
HOUSTON INDEPENDENT SCHOOL DISTRICT
17.
Your organization will comply with THCP’s requirement of a 90-day notification in a change of any
subcontractors.
(Select)
18.
Contractual arrangements with health care providers affiliated with your organization prohibit such
providers from holding any member liable for the payment of any fees and other protections for its
members from liability as provided by applicable state or federal laws.
(Select)
19.
Your organization will maintain appropriate general and professional liability insurance in the
amount of at least $5,000,000 per occurrence. Contracting physicians and other clinicians shall, at
all times, maintain professional liability and/or malpractice insurance to cover all program activities.
If at any time liability insurance is canceled, the vendor will notify THCP within 48 hours.
(Select)
20.
Quoted rates do not include commissions.
(Select)
21.
Confirm that the bank(s) for fund account transfers will be determined by THCP.
(Select)
22.
Confirm that your quoted fee includes issuance and preparation of full financial accounting and rate
renewal data.
(Select)
23.
Confirm that your organization will comply with all applicable state and federal laws, including those
laws pertaining to confidentiality of health, financial, or other proprietary information.
(Select)
24.
Confirm that your organization will assist THCP to demonstrate compliance with all applicable state
and federal laws, including providing access to required information such as policies and
procedures.
(Select)
25.
Your organization agrees to permit THCP or its designee access to policies and procedures and
other necessary information for purposes of evaluating compliance with applicable federal and state
laws.
(Select)
26.
Your organization will conduct health data transactions using the final formats, standards, and
identifiers as promulgated by DHHS under HIPAA, as of the required compliance dates for health
plans (or as of dates otherwise agreed to by you and THCP).
(Select)
27.
Your organization agrees that it is a covered entity as defined by HIPAA or will enter into a
Business Associate Agreement with THCP.
(Select)
28.
The vendor agrees to maintain the confidentiality of all medical, financial, and other patient-specific (Select)
data pertaining to Members as required by state and federal law. The vendor agrees that, except as
otherwise provided herein, such data will not be released to individuals or entities other than the
Member to which the data relates, or such Member’s authorized representative, except as required
by law or as may be required by order of a court having jurisdiction over the Member. The vendor
also agrees that THCP has the right to use and disclose all medical, financial, and other patientspecific data pertaining to Members and the health plan, as defined by law, and upon providing
appropriate assurances as to compliance with HIPAA and other privacy standards.
29.
The vendor will be prepared to assist THCP with all state and federal compliance issues, including
(Select)
negotiating, in good faith, appropriate business associate and similar “chain-of-trust” agreements
and contractual provisions in order to comply with the DHHS final health care privacy and security
regulations and, if necessary, any applicable state law. These agreements may include (1) addenda
to the vendor contract to provide the required business associate contractual provisions under the
DHHS privacy and security regulations, and (2) similar Business Associate Agreements with any
subcontractors (as approved by THCP) of the selected vendor and other service vendors to THCP
and THCP’s health plans, as necessary.
Scope of Work
Scope of Work questions
Response
1.
Eligibility for EAP services will be presumed for all individuals that contact your organization by
telephone.
(Select)
2.
Your organization will accept electronic transmissions from THCP as plan sponsor (e.g., enrollment, (Select)
disenrollment, and premium payment transmissions) in THCP’s current proprietary format.
103
MERCER
REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
HOUSTON INDEPENDENT SCHOOL DISTRICT
3.
Your organization will waive the actively-at-work clause and cover beneficiaries (current, future,
disabled, and COBRA enrollees) as actives until they are no longer eligible for coverage, as
determined by THCP.
(Select)
4.
The vendor agrees to act promptly in response to complaints received from members. The vendor
will maintain electronic and written records of all complaints. The records will include, but are not
limited to, the date and nature of the complaint filed and the date and manner by which the vendor
administrator responded. The vendor shall have a grievance and appeal procedure for addressing
complaints and shall make such process available when addressing complaints. THCP shall have
the right to inspect such written records during normal business hours by providing advance written
notice to the vendor and complying with privacy laws.
(Select)
5.
Your bid includes access to web-based services, including an article library, self-help tools, and
resource and referral databases.
(Select)
6.
Your organization will ensure 24/7 dedicated toll-free telephone access staffed by qualified
personnel who can provide information, assessment, and referral to covered individuals, family
members, supervisors, etc. Answering machines or taped messages are not acceptable.
(Select)
7.
Your organization will provide adequate toll-free telephone lines that must be available for access
by employees 24/7 and meet the following standards on a quarterly basis:
•
•
•
•
No busy signals. Adequate toll-free telephone lines to avoid busy signals throughout the day
must be maintained
Call pick-up by end of third ring or average speed of answer less than 30 seconds
(Select)
Queuing (on hold with recording) averaging under 30 seconds and never more than 60
seconds
Call abandonment rate less than three percent
(Select)
(Select)
(Select)
8.
Your bid includes access to EAP services through a network of qualified employee assistance
professionals, community-based resources, and non-treatment programs located in areas
populated by THCP enrollees and their eligible dependents. Professional providers must be
available to meet in person with eligible participants to evaluate their needs, provide counseling (as
needed), recommend other appropriate treatment, and refer to the appropriate medical plan (as
needed). Referrals from the EAP into the BH benefit must be monitored as to timeliness,
appropriateness, and risk of non-compliance with recommended treatment.
(Select)
9.
Your proposal includes proactive management of the patient’s BH condition within the terms of the
available EAP benefit.
(Select)
10.
The network shall be established and maintained through contracts between your organization and
participating providers. Providers in the network should have sufficient capacity to accommodate
requests for service in accordance with the National Committee for Quality Assurance (NCQA)
access standards. In providing and maintaining such a network, your organization shall monitor:
•
Health providers maintenance of licensure and certification
(Select)
•
(Select)
•
Evidence of appropriate and sufficient background and skills in provision of EAP services, as
distinct from generic psychotherapy skills
Evidence of appropriate and sufficient background and skills in the provision of treatment for
mental illness and SA for EAP providers
Provider contracts which remain in force
•
Evidence that physical facilities are safe, accessible, and appropriate
(Select)
•
Maintenance of sufficient liability insurance
(Select)
•
Ease and timeliness of scheduling appointments
(Select)
•
Referral patterns and utilization of services
(Select)
•
•
11.
Treatment outcomes including, but not limited to, member satisfaction, complaint rates,
improvements in functional status/wellbeing, recidivism, and relapse data
Your EAP/WorkLife quote includes access to up to 3 to 6 in-person counseling visits.
(Select)
(Select)
(Select)
(Select)
104
MERCER
REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
HOUSTON INDEPENDENT SCHOOL DISTRICT
12.
Your EAP quote includes the provision of unlimited management consultation, available 24/7
through a toll-free line, to assist in the development of THCP’s policies and procedures to enhance
effective administration of the EAP.
(Select)
13.
Your EAP quote includes coordination with THCP managers or supervisors for any mandatory
referrals.
(Select)
14.
Your organization will provide active concurrent telephone review of inpatient and outpatient
treatment, involving frequent clinical consultation by a qualified professional with the primary
clinician, and frequent modification and updating of the authorized treatment plan, including
discharge planning in the case of intensive inpatient or outpatient treatment.
(Select)
15.
Your organization will offer recommendations for plan or program design to encourage precertification of care and minimize the use of “emergency admissions” to avoid pre-certification
approval.
(Select)
16.
Your bid includes monitoring of patient participation in aftercare treatment plans for substance
abuse cases that originate with the EAP on a regular basis, for one year after completion of the
initial phase of treatment (assuming the patient agrees and is still benefit-eligible).
(Select)
17.
Your EAP quote includes a bank of hours for the provision of orientation, wellness, prevention, and
other ongoing training and education services to THCP members and THCP supervisory personnel
on selected BH and wellness topics using a formal curriculum, as directed by THCP. See
Attachment S16: B – Operational Platform for current allotted benefit hours.
(Select)
18.
Your quote includes a bank of hours for the provision of Critical Illness Stress Debrief (CISD)
services that will be provided in coordination with THCP’s designated internal staff. Your
organization will coordinate timely delivery of on-site crisis intervention and CISD and follow-up
services. See Attachment S16: A – Sample Reporting for current allotted benefit hours.
(Select)
19.
The bank of hours may be used in any combination of training and CISD services. See Attachment
S16: A – Sample Reporting for current allotted benefit hours.
(Select)
20.
Your EAP or Work/Life quote includes threat assessment and workplace safety consultation and
services.
(Select)
21.
Your EAP quote includes unlimited telephonic consultation with a licensed EAP clinician.
(Select)
22.
Your EAP quote includes a specified number of hours per week of on-site EAP services at THCP’s
locations to be provided by an EAP counselor approved by THCP and confirmed by the bidder as
meeting credentialing standards. See Attachment S16: A – Sample Reporting for current allotted
benefit hours.
(Select)
23.
Your EAP or Work/Life quote includes legal, financial, federal tax, and pre-retirement consultation
services.
(Select)
24.
Your WorkLife quote includes consultation and qualified resource and referral by a WorkLife
specialist for the following:
•
Dependent care
(Select)
•
Elder care
(Select)
•
25.
26.
Educational institutions including but not limited to private schools, summer camp, colleges, or
universities
Your WorkLife quote includes consultation, assistance, and support by a WorkLife specialist for the
following live events:
(Select)
•
Relocation
(Select)
•
Adoption
(Select)
•
Retirement
(Select)
•
Chronic condition
(Select)
Your EAP or WorkLife quote includes convenience services, Care kits (i.e., smoking cessation, new
baby, and weight control), and wellness programs (i.e., obesity/weight management, smoking
cessation).
(Select)
105
MERCER
REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
27.
HOUSTON INDEPENDENT SCHOOL DISTRICT
Your organization will provide monthly, quarterly, and annual reports that include the following
minimum reporting elements:
•
Twenty-four hour information and referral line contacts
•
Opened and closed cases by type of problem, including
(Select)
─
Job stress
(Select)
─
Family relationships
(Select)
─
Chemical dependency
(Select)
─
Financial problems
(Select)
─
Legal problems
(Select)
─
Supervisory referrals
(Select)
─
Elder care referrals
(Select)
─
Dependent care referrals
(Select)
─
Number of EAP in-person assessments and counseling sessions
(Select)
─
Outcome of assessments or case disposition
(Select)
─
(Select)
─
Number of persons referred for treatment to the BH network, including distribution of the
number of in-person EAP counseling visits at the point of referral
Number of CISD sessions
─
Number of management consultations, including disposition
(Select)
─
Number of training sessions, including topics and number of attendees
(Select)
─
Aftercare monitoring activities
(Select)
─
Number of “hits” to the web site
(Select)
─
Reports should provide:
−
−
−
−
−
For each measure, the relevant bidder’s book of business (BOB) or other normative
statistics that provide reference points for THCP-specific data
Data for the current month, quarter, and year-to-date
A comparison to performance in the prior year beginning in 2012 (incumbent only)
or in 2013
Regional, geographic, or medical plan breakouts in monthly, quarterly, and annual
reports, if requested by client
Metrics will include raw numbers and, where applicable, percentages
−
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
Annual report with summary information for the account and BOB with data covering
utilization and expense by provider type, diagnosis type, geographic location, and/or
by medical plan
Your organization will provide a single point-of-contact for THCP for all account management
needs. If a separate contact is needed for CISD scheduling, limit this to a single point-of-contact for
all CISD.
(Select)
29.
Your organization will provide a designated Account Team to include designated EAP, intake, and
network staff.
(Select)
30.
You agree to provide assistance during the implementation process (including, but not limited to,
informed support at employee meetings), then be available for at least four face-to-face meetings
per year with THCP benefits staff to discuss outstanding issues, and one annual meeting with
THCP vendors to discuss integration challenges and solutions.
(Select)
31.
Your bid includes coordination services with THCP corporate and local benefits staff, as well as
other suppliers of THCP insurance benefits, including medical and short-term disability/long-term
disability services.
(Select)
32.
Your organization will provide information and assistance to management and designated internal
staff regarding intervention and return-to-work issues, as appropriate and as requested.
(Select)
28.
(Select)
106
MERCER
REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
HOUSTON INDEPENDENT SCHOOL DISTRICT
Intake and Referral
Intake and Referral questions
1.
Response
Please complete the following table from the last 12 calendar months for the primary service center
proposed organization. If a second service center will answer after-hours calls or if you can report
separate call statistics for business hours versus after-hours in your primary service center, please
provide:
Proposed primary call center: 2013
clinical line call responsiveness
statistics
After-hours call center: 2013 clinical
line call responsiveness statistics
Call volume
Call abandonment rate
Percent busy standard
Average talk time
Maximum ring
Average speed of answer (Time from 1st ring
to pick up by a live person)
2.
In the event of a caller in crisis, answer the following questions.
•
List the risk screening questions that the clinician handling the call is required to ask.
•
Are these questions programmed into the on-line clinical record?
─
3.
4.
5.
6.
(Select)
If yes, can the staff member override the required question:
−
The clinician can override the question, resulting in a blank entry or default value
entry
(Select)
−
The clinician must answer the question before closing the screen
(Select)
−
Other, explain in 100 characters or less
What supervisory back up is available to EAP staff? Address number of supervisors, their
credentials, and whether they are available on site after hours
•
During business hours?
•
After business hours?
What medical or clinical back-up or oversight is available to EAP staff? Address number of MDs
and RNs and whether they are on site.
•
During business hours?
•
After business hours?
How many EAP coordinators are proficient in Spanish at your proposed service center(s)? Please
list numbers by staff category.
•
During business hours?
•
After business hours.
If you are proposing more than one EAP call center, describe how the call centers will be linked.
Address:
•
How calls are routed?
107
MERCER
REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
•
HOUSTON INDEPENDENT SCHOOL DISTRICT
How information on specific cases is shared when the case is managed by more than one
location?
Communications
Communications questions
1.
Response
To what extent can member materials be customized including editing content and/or branding of
communications materials? Clearly indicate what is included in your quoted price and what would
be an additional fee.
•
Are member materials available in English and Spanish?
(Select)
•
Are member materials produced in-house?
(Select)
EAP Services
EAP Services questions
1.
Response
Provide the EAP utilization that you anticipate in each of the first three years for this account.
•
•
•
•
•
•
•
Number of unique cases* to the EAP line per 100 employees
─
Aldine ISD
per 100 ee’s
─
Houston ISD
per 100 ee’s
─
Katy ISD
per 100 ee’s
Percent of unique cases* referred directly into the BH benefit
─
Aldine ISD
%
─
Houston ISD
%
─
Katy ISD
%
Percent of unique EAP cases* referred to telephonic counseling sessions
─
Aldine ISD
%
─
Houston ISD
%
─
Katy ISD
%
Percent of unique EAP cases* referred to in-person counseling sessions
─
Aldine ISD
%
─
Houston ISD
%
─
Katy ISD
%
Number of in-person EAP sessions per in-person referral
─
Aldine ISD
─
Houston ISD
─
Katy ISD
Percent of unique cases* referred into the EAP benefit where the case was resolved within the
EAP benefit
─
Aldine ISD
%
─
Houston ISD
%
─
Katy ISD
%
Number of unique cases* who speak with a WorkLife specialist per 100 employees
─
Aldine ISD
per 100 ee’s
108
MERCER
REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
•
─
Houston ISD
per 100 ee’s
─
Katy ISD
per 100 ee’s
HOUSTON INDEPENDENT SCHOOL DISTRICT
Number of unique cases* with at least one qualified Work/Life referral**
─
Aldine ISD
─
Houston ISD
─
Katy ISD
*A unique caller is a single individual regardless of how many times the individual calls in an EAP
benefit year. Do not include web hits, mailings, training seminar, or CISD participants, etc.
**A qualified referral is defined as a WorkLife specialist assisted referral in which the WorkLife
specialist consults with the caller about their service needs and completes the necessary research
to identify two or more service providers who meet the caller’s needs.
2.
What interventions in the last year have contributed the most to improving participation rates in your
EAP program?
3.
Please provide a recent client example that illustrates the value of your organization’s management
consultant in Attachment S16: B – Operational Platform. Page limit one page.
4.
Please describe your organization’s threat assessment/workplace safety services.
•
Provide an example of how you assisted another employer with a workplace safety program.
Attachment S16: B – Operational Platform. Page limit two pages
5.
What is your process of transition of care from the previous EAP vendor?
6.
Answer the following questions to describe your organization’s experience in providing on-site EAP
services
•
For how many clients has your organization provided on-site EAP services in the last two
years? Do not include clients for whom you have provided only on-site training or CISD.
•
Other than training and CISD, what on-site services have you provided to these clients?
(Select)
─
Face to face assessments and brief counseling
(Select)
─
Group counseling
(Select)
─
Supervisory/management consultation
(Select)
─
Organizational development
(Select)
−
─
7.
(Select)
Please describe:
Other (please list/describe):
Describe the strategies your organization has implemented to ensure that on-site EAP personnel
are integrated into your EAP team and regularly utilized. At a minimum, address training, oversight,
account meetings/communication, intake and referral, access to on-line tools, reporting, and
financial or other incentives.
Integration
Integration questions
Response
1.
What types of incentives, engagement tools, or integration strategies do you recommend to
improve cross-vendor collaboration with your EAP programs? Provide evidence of their impact.
Page limit two pages in Attachment S16: C – Integration.
(Select)
2.
Indicate your organization’s capability to capture inbound and outbound referral data with other
health, wellness, and absence programs. Check one option for inbound referrals and one option for
outbound referrals that most closely reflects your current capability.
•
Can track inbound referrals by referral source
(Select)
•
Can track outbound referrals by referral source
(Select)
109
MERCER
REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
3.
HOUSTON INDEPENDENT SCHOOL DISTRICT
•
Can track inbound referrals for a limited number or type of referral sources
(Select)
•
Can track outbound referrals for a limited number or type of referral sources
(Select)
•
Can track number of inbound referrals but not by referral source
(Select)
•
Can track number of inbound referrals but not by referral source
(Select)
•
Do not track inbound referrals
(Select)
•
Do not track outbound referrals
(Select)
•
Other (please describe):
How will your organization leverage the EAP and WorkLife services to assist in the management of
disability costs or productivity in the workplace at no additional cost to THCP?
Page limit one page Attachment S16: C – Integration.
•
How have you leveraged your EAP program resources to assist in the management of
worker's compensation costs or productivity in the workplace?
•
Describe other intervention programs you have implemented for patients who screen positive
during implementation of the protocols described in first bullet.
•
What are examples of case studies or statistics on the impact of these programs on outcomes
or cost?
4.
Describe how your organization has integrated with your client’s wellness and disease
management programs offered through external partners, including health risk assessment (HRA),
online and telephonic lifestyle management programs, navigational advocacy, disease
management, and on-site clinics. Please provide specific steps and actions taken for current
clients.
5.
Describe how your organization has integrated with your client’s other benefit offerings, including
medical, dental, vision, life, etc. Please provide specific steps and actions taken for current clients.
(Select)
Provider Network
Provider Network questions
1.
Indicate how many of each of the following providers is included in your network. Do not count
single practitioners with multiple Taxpayer Identification Numbers or multiple office locations more
than once. If a provider has dual degrees, enter them into each degree category, but remove
duplication in the total count. Report Aldine, Houston, and Katy area separated by a “/.”
•
2.
Response
Report Aldine, Houston, and Katy areas separated by a “/”
─
MD
─
RN
─
Psychologist (PhD, PsyD, EdD)
─
Masters-Prepared Clinicians (LCSW, LMFT, etc.)
─
Certified Employee Assistance Professional (CEAP)
─
Total unduplicated
Conduct a geographic access analysis and provide the percent of THCP employees whose
residential zip code (see Exhibit I for head count) complies with the access standards listed below.
Please confirm that the standard zip codes in the GeoAccess software remain unaltered. If for
some reason you have altered the default coding and cannot provide an analysis any other way, a
list of the changes made to the default values is required as part of your submission (list those zip
codes moved from urban to suburban, suburban to rural, etc.). If you are using an analysis tool
other than GeoAccess, provide the name of the tool used, and if you have altered the default values
for this tool, provide a list of such changes. For the entire population, please use the following
criteria:
•
Two EAP professionals within 5 miles (high density urban)
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REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
•
Two EAP professionals within 10 miles (Urban)
•
Two EAP professionals within 20 miles (Suburban)
•
Two EAP professionals within 45 miles (Rural)
HOUSTON INDEPENDENT SCHOOL DISTRICT
3.
In what ways is your EAP provider network able to meet the needs of a diverse population? Assess
the networks ability to address both languages other than English and cultural preferences of the
member.
4.
Indicate the percentage of minority providers included in your Texas network:
Report Aldine, Houston, and Katy areas separated by a “/”
•
Houston %/Aldine %/Katy %
•
MD
•
RN
•
Psychologist (PhD, PsyD, EdD)
•
Masters-Prepared Clinicians (LCSW, LMFT, etc.)
•
Certified Employee Assistance Professional (CEAP)
•
Total unduplicated
Implementation
Implementation questions
1.
Response
Complete the following grid for the implementation team that would be assigned to the client
account regarding percentage of time (reflected as a full-time equivalent [FTE]) dedicated to the
implementation and during the contract year. Name/Title/% FTEs assigned to account during
implementation/% FTEs assigned to account during contract year.
•
List implementation staff
─
─
─
─
•
Additional #’s
─
2.
Total FTE assigned to account
Provide the name, title, credentials, and number of other accounts for the three individuals on the
proposed team who will maintain primary responsibility for management of the THCP account
following implementation.
Individual 1
Individual 2
Individual 3
Name
Title
Years of serve with your organization
Years of experience in account management
Clinical background
•
Degree
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REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
Individual 1
•
Type
•
Amount of experience
HOUSTON INDEPENDENT SCHOOL DISTRICT
Individual 2
Individual 3
Other accounts individual is on
•
Number
•
Size
•
Demands
3.
Complete the following table for any new account implementations scheduled between January 1,
2013 and December 31, 2013 for the proposed service center and the proposed account
executive(s).
New Account
Implementation #1
New Account
Implementation #2
New Account
Implementation #3
New Account
Implementation #4
Name of account
Number of lives
Date of implementation
Affects service center
Affects account executive(s)
Document Request
Document Request questions
Response
1.
If your organization has been named a party in any litigation currently pending or resolved in the
last five years, please provide information regarding the litigation and any impact on your
organization’s financial status or ability to perform under the contract as Attachment S16: B –
Operational Platform.
(Select)
•
(Select)
Have you ever filed for protection under one of the bankruptcy laws?
─
If yes, what is the current situation?
2.
Provide a sample quarterly and annual account management/utilization report for the EAP program
described in this RFP as Attachment S16: A – Sample reporting.
(Select)
3.
Provide screen prints of your EAP clinical record system that illustrate the following as Attachment
S16: B – Operational Platform.
(Select)
•
All of the screening questions including those referenced in response above.
(Select)
•
All other EAP clinical record system templates, tools, etc.
(Select)
4.
Provide copies of your current EAP member and provider communication packages as Attachment
S16: D – Communication.
(Select)
5.
Provide a catalogue of training seminars as well as samples of EAP member materials (e.g., care
kits, educational materials) as Attachment S16: D – Communication.
(Select)
6.
Provide a copy of a proposed implementation plan outlining tasks necessary to install the program
for THCP by January 1, 2015 for Houston ISD, Aldine ISD, and Katy ISD as Attachment S16: E –
Implementation. Include the timetable and the parties responsible.
(Select)
7.
Provide Geographic Access reports used to respond to as Attachment S16: A – Sample reporting.
(Select)
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REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
HOUSTON INDEPENDENT SCHOOL DISTRICT
Performance Guarantees
Please provide you standard performance guarantees as Attachment S16: F – Performance Guarantee.
Pricing
In preparing your Pricing Proposal, please include all assumptions. All fees related to subcontracted services should also be
included in the pricing. It is expected that THCP International, Inc. will not incur any additional fees throughout the duration of this
contract if not addressed in the financial response. Please consider the following in developing your pricing:
Fees are presented in USD ($)
All pricing must be based on a per employee per month pricing model (except where indicated otherwise).
Fees must be guaranteed for three years with no contingencies regarding enrollment or program participation.
Implementation or Setup fees.
Summary of Current Program Offerings:
6 In-person sessions per problem per year
Employee education, supervisor training, wellness seminars
Crisis intervention/critical incident debriefing
Supervisor/Manager consultation
24/7 Telephonic service access
WorkLife services, including Legal and Financial Assistance
Cost proposal
1.
Years 1 – 3
Quote the following required, optional, and per use services. Quote for EAP should be
broken down to 5–6 and 7–8 session models.
Required services
PEPM
•
EAP
($ x .xx)
•
WorkLife (with counselor assisted qualified referrals)
($ x .xx)
•
Bundled EAP/WorkLife Quote
($ x .xx)
•
Unbundled EAP/WorkLife Quote
($ x .xx)
Optional services
•
On-site EAP services
─
Training/Orientation/CISD hours (number included in EAP quote)
PEPM
($ x .xx)
•
TBD
─
Other EAP optional services on a PEPM basis include wellness programs,
convenience services, concierge services, etc. In addition, legal or financial
consultation and training hours can be unbundled from the core WL and listed here
as optional services.
($ x .xx)
•
Bundled Quote with Optional Services
($ x .xx)
•
Unbundled Quote with Optional Services
($ x .xx)
•
Training (over # hours)
($ x .xx)
•
CISD (over # hours)
($ x .xx)
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REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
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•
HOUSTON INDEPENDENT SCHOOL DISTRICT
Optional per use services can include care kits, DOT required SAP assessments, etc.
($ x .xx)
2.
Confirm your proposal is for a three year fixed price quote.
(Select)
3.
If you answered disagree to the prior question, are you willing to guarantee a maximum
percentage increase?
Yes, a
%
maximum increase
No
N/A
4.
Confirm your EAP quote is based on estimated membership of all three (3) district eligible
employees (40,600).
5.
Confirm your EAP quote is based on estimated membership of each district eligible
employee.
•
Houston 24,000
•
Aldine 8,100
•
Katy 8,100
(Select)
6.
Confirm your EAP quote is based on utilization you projected in the Questionnaire.
(Select)
7.
Please confirm that you are willing to put a minimum of 20 percent of your quoted fees at
risk.
(Select)
•
If no, please indicate what level of performance guarantee you will accept; performance
metrics, standards, and weighting may be renegotiated by mutual agreement of the
parties 30 days prior to the end of each contract year for the following contract year.
8.
Identify areas in any of the proposed performance metrics that you cannot guarantee; state
why and propose alternative standards.
9.
Confirm that performance guarantees will be based on THCP International, Inc.-specific
information.
10.
If you will subcontract any portion of the required activities to another vendor, what
assumptions have you made regarding how any performance penalties will be allocated
between you and your subcontractor?
11.
Describe any conditions under which your fees and performance guarantees would need to
be modified (e.g., headcount changes, plan design, etc.).
12.
Confirm your organization can accommodate a 45-day grace period to pay fees.
(Select)
(Select)
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REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
HOUSTON INDEPENDENT SCHOOL DISTRICT
XVII Diabetes Technology
17.1
General Questions
General
General questions
1.
Please describe your diabetes technology and solution in detail.
2.
Who are your top competitors?
3.
What technology is used to capture and transmit data from your device?
•
Response
What are the current testing compliance rates with your device?
4.
Does your device transmit real-time blood glucose readings?
(Select)
5.
Is your device and data transmission server currently FDA-cleared?
(Select)
6.
What date did you receive clearance from the FDA?
7.
Describe the tools you provided to members and how are they used?
•
Are they available online/mobile?
(Select)
8.
Provide a description of your product, including features and benefits as well as your target market.
9.
Describe any changes or enhancements you plan for your product over the next two years.
10.
Indicate where your product you are offering today is currently available; is it national or only in
specific states?
11.
What clients do you currently serve?
12.
What is the scalability of your product? Do you have any capacity limits? Do you plan to grow
capacity over the next two years?
13.
Is your Clinical staff in-house or contracted?
(Select)
14.
Is your program designed to replace existing diabetes disease management programs?
(Select)
15.
Do you offer pre-implementation/post-implementation analytics?
(Select)
16.
Please provide a sample report of your pre-implementation analysis in Attachment S17; B –
Standard Reporting.
(Select)
17.
What sales and marketing support would you be able to provide to a health plan to assist them in
selling your product to their large clients?
Program Integration and Care Team Support
Program Integration and Care Team Support questions
Response
1.
What level of integration does your organization offer your clients?
2.
Provide examples of population health programs (care management and wellness) where your
solution is currently integrated in S10: C – Integration.
(Select)
•
(Select)
Do you offer clinical intervention services for your clients?
3.
Do you offer clinical intervention services for your clients?
(Select)
4.
Does your device offer messaging to members?
(Select)
•
Do you offer the client the ability to customize messages?
(Select)
•
What type of messages is available?
5.
Can a care team member send customized messages to members?
(Select)
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REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
6.
HOUSTON INDEPENDENT SCHOOL DISTRICT
Does your platform offer a notification system for care team members to prioritize interventions?
•
(Select)
How does the notification process work?
7.
Do you offer the client the ability to determine clinical ranges for exceptions?
8.
What resources do you offer to help members maintain engagement?
(Select)
Implementation
Implementation questions
Response
1.
Please describe your implementation process and timeline. Please provide example of your
implementation plan in Attachment S17: H – Implementation Plan.
(Select)
2.
Describe your process and what is needed from client or health plan to support or maintain those
efforts?
3.
What is your current engagement rate?
4.
How do you measure engagement?
5.
What is included in your on-boarding process?
6.
What communication methods do you offer your clients?
•
7.
Please provide examples of communication in Attachment S17: F – Communications
(Select)
Do you require an eligibility file?
(Select)
•
How often do you need to receive the eligibility file?
(Select)
•
Do you require additional information for on-boarding?
(Select)
─
If yes, what information do you require?
8.
Please describe how you identify members for participation?
9.
Please describe all of the options your offer for distribution?
10.
Do you offer a customer service unit?
•
(Select)
What are the hours of operation?
11.
Do you allow both inbound and outbound contact?
12.
Please describe your communication process and what is offered to the client?
(Select)
Reporting
Reporting questions
Response
1.
What reporting capabilities do you provide to the client?
2.
Describe the frequency of the reporting.
(Select)
3.
Are reports customizable?
(Select)
•
(Select)
Provide samples of reporting as Attachment S17: B – Standard Reporting.
Financial
Financial questions
1.
Please describe your solution pricing on a PEPM/PMPM basis.
•
2.
Response
Provide detail for each component of your solution in Attachment S17: D – Financial.
Do you recommend plan design changes to encourage participation?
•
(Select)
(Select)
If yes, what changes do you recommend?
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PROJECT #: 14-04-02
3.
Do you recommend additional incentives be applied to help drive participation?
•
4.
HOUSTON INDEPENDENT SCHOOL DISTRICT
(Select)
If yes, what incentives do you recommend?
What is your ROI methodology?
•
How do you measure and support ROI and/or financial savings?
•
Is this client specific or book-of-business?
5.
What are the average estimated savings for your program?
6.
Describe how you measure clinical outcomes?
•
What clinical measures are reported?
•
Are also reported as financial savings?
(Select)
(Select)
Performance Guarantees
Performance Guarantees questions
1.
Response
Please provide performance guarantees on the following in Attachment S17: J – Performance
Guarantee:
•
Produce installation
10%
•
Satisfaction surveys
10%
•
Telephone responsiveness for clinical lines
20%
•
Utilization
10%
•
Reports
20%
•
Complaint resolution
10%
•
Access
20%
117
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REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
HOUSTON INDEPENDENT SCHOOL DISTRICT
XVIII Neonatal Solutions Program
18.1
General Questions
General questions
1.
Please provide detailed description of your Neo-Natal solution program.
2.
What tools and content would members utilize to access a Care management Nurse Coach?
3.
Who is eligible?
4.
How long?
5.
Please describe your technology used to better engage member parents with NICU children?
6.
Will you sponsor a pilot of your program at no cost to district or its employee?
•
Response
(Select)
If so, please provide details regarding your pilot program, and how long do you intend to
extend the pilot.
7.
How do you plan to engage the members after the pilot?
8.
Is there additional cost once the pilot is over?
(Select)
•
(Select)
Is yes, please provide all pricing in Attachment S18: C – Financials
9.
Can you provide nurse support 24/7/365?
10.
In what method is your support provided?
(Select)
•
Telephone
(Select)
•
Webchat
(Select)
•
In-person
(Select)
11.
What are the credentials of your nurses?
12.
What tools do you provide to the members?
13.
What health education do you provide to members?
14.
What communication tools do you have available to recruit participants and advertise your
services? Please provide in Attachment S18: D – Communications.
15.
What are your capabilities to share data with the carrier to integrate care?
16.
Can you provide data feeds to the carrier?
(Select)
17.
What is your de-identified reporting plan for the client? (daily, monthly, quarterly, annually)
(Select)
•
Please provide in Attachment S18: A – Standard Reporting
(Select)
•
If other, please explain.
(Select)
18.
Do you utilize an incentive or rewards program for participation?
(Select)
19.
Please provide three case studies of the utilization of your services and outcome in Attachment
S18: B – Operational Platform.
(Select)
20.
Please provide your estimated cost in Attachment S18: C – Financials.
(Select)
118
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REQUEST FOR PROPOSAL: EAP, DMT, EMO, NEO-NATAL PROGRAM
PROJECT #: 14-04-02
21.
HOUSTON INDEPENDENT SCHOOL DISTRICT
Does your program establish:
•
ROI
(Select)
•
Cost savings
(Select)
•
Cost avoidance models
(Select)
119
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Mercer Health & Benefits LLC
500 Dallas Street, Suite 1500
Houston, TX 77002
+1 713 276 2100
Services provided by Mercer Health & Benefits LLC.