TECHNICAL PROPOSAL FORM Online Autism Intervention Pilot for the Benefit of Children with Autism Spectrum Disorder RFP No. 538-15-3000029780 Respondent Legal Entity Name: Part A - RESPONDENT ORGANIZATION 1. Describe your organization's background and experience as it relates to providing products or services for children with Autism Spectrum Disorder and their parents that address the requirements described in this RFP. Include the length of time that your organization has provided the proposed services. 2. Provide an organizational chart and place it behind Tab C. The chart should represent your organization's overall structure. The organizational chart must show job titles and the number of personnel per job title as well as clearly illustrate lines of reporting/supervision. 3. Provide job descriptions, including roles and responsibilities, for all staff that provide (or will provide) customer support to DARS consumers. Provide qualifications (resumes, curricula vitae) for those who develop and/or select content and materials that will be used by DARS consumers. Place these documents behind Tab C along with this completed form. 4. Provide job descriptions, including job titles and primary responsibilities for staff performing the following administrative functions: a. Oversight of financial systems b. Timely and accurate invoicing for services rendered c. Collection and reporting of service-related data Attach a copy of your pertinent policies and procedures for these specific processes. 5. What information is maintained on parents and children using your services? Include your policy and procedures for maintaining client confidentiality, including storage, release, and transmission of protected personal and health information in Tab C. Page 1 of 3 6. Describe the program management and oversight systems or processes you have in place to fulfill the following responsibilities: a. Timely delivery of quality product or service; b. Compliance with all contract requirements, including safeguards to ensure submission of accurate and complete financial, service, and evaluation data by required reporting deadlines; c. Accountability for all funds and materials received from DARS; and d. Correction of fiscal and program deficiencies identified through self-evaluation, external reviewers, if relevant, and the DARS’ compliance monitoring process. If your organization has an internal quality assurance process, please include how that process applies to each area. Part B - TECHNICAL APPROACH 1. Describe in detail your proposed online autism intervention product or services? Describe all of its elements, including but not limited to: a. the areas of development or behavioral needs that may be addressed by the service (e.g. communication, language/speech, social skills, functional skills, academic skills, life skills, motor skills, play, behavior, etc.); b. individual online tools, if any; c. materials that might be customized for an individual child, if any; d. any online tools used to determine a child’s needs and level of services to ensure appropriate access including any specific standardized assessment instruments; e. any pre-tests and post-tests used to determine the child’s baseline including any specific standardized assessment instruments; and, f. if applicable, the amount of time that the parent will be expected to devote to each specific online task and what educational level (e.g. reading and verbal comprehension) and computer/technical skills are necessary to successfully use the product or service. 2. On what platform(s) will your product or service be available (e.g. i-pad, other tablet, computer, i-Phone, other phone, etc.)? What are the software requirements and will it be necessary for parents using the service to update software? 3. Describe supports available to parents for: a. any questions the parent may have regarding the material; and b. technical issues experienced with online materials. Indicate how supports will be provided (e.g. by phone, online chat, FAQs etc.) and when the supports will be available (e.g. 24 hours/day, 7 days/week). 4. Regarding readiness to perform and based on a contract start date of April 1, 2015, could your product or services be fully implemented on April 1, 2015, if provided with contact information for eligible families? If not what would be your timeline for implementation, including key milestones, and what are the factors that affect the start of services? Page 2 of 3 5. How does your product or service promote generalization of skills/behavior across environments that children are part of including home, school, and other community settings? How does the product or service support collaboration between members of the treatment team, teachers, and family? 6. How many individuals in the following categories have you provided autism products or services to in the previous twelve months? a) Children ages 3-15 with a diagnosis of ASD b) Parents of children ages 3-15 with a diagnosis of ASD 7. What research can be cited that supports the efficacy of your proposed product or service? Submit 3-5 research articles which are most relevant to supporting the use of your proposed online product or services. Provide one printed copy (behind Tab C) of each study/report referenced and links to research that is available electronically. Include an electronic copy (pdf, Word) of each study on the USB drive along with this completed Technical Proposal Form. 8. How is the product/services received by the consumer documented? Will the number of times the parents access the online product or services, and the total amount of time that parents use the product or services be available in a report? 9. Describe how your proposed product or service will address different language, cultural and socio-economic backgrounds of families. Page 3 of 3