State of Wisconsin
Dept. of Health Services
Date: 3/17/2016
RFA G-0430 DPH-15
Page 1 of 13
GRANT REQUEST FOR APPLICATION
STATE OF WISCONSIN
DEPARTMENT OF HEALTH SERVICES
DIVISION OF PUBLIC HEALTH
OFFICE OF PREPAREDNESS AND EMERGENCY HEALTH CARE
RFA G-0430 DPH-15
Emergency Preparedness and
Response Health Care Coalition
Medical Advisor - Contract Positions
PROPOSALS MUST BE RECEIVED BY 3:00 PM CT March 19, 2015
LATE PROPOSALS WILL BE REJECTED
FAXED PROPOSALS WILL NOT BE ACCEPTED
THE STATE RESERVES RIGHT TO REJECT ANY AND ALL PROPOSALS
State of Wisconsin
Dept. of Health Services
Date: 3/17/2016
RFA G-0430 DPH-15
Page 2 of 13
TABLES OF CONTENTS
1.0
1.1
1.2
1.3
1.4
1.5
1.6
1.7
1.8
1.9
2.0
2.1
2.2
2.3
2.4
3.0
3.1
3.2
3.3
3.4
3.5
4.0
4.1
4.2
4.3
4.4
4.5
4.6
5.0
GENERAL INFORMATION................................................................................... 3
INTRODUCTION AND BACKGROUND ..............................................................................................................3
PROCURING AND CONTRACTING AGENCY ....................................................................................................3
DEFINITIONS .................................................................................................................................................3
CLARIFICATION AND/OR REVISIONS TO THE SPECIFICATIONS AND REQUIREMENTS......................................4
CONTRACT QUANTITIES / NEW OR DELETED ITEMS ......................................................................................4
CALENDAR OF EVENTS .................................................................................................................................5
CONTRACT TERM AND AVAILABLE FUNDING ...............................................................................................5
RETENTION OF RIGHTS .................................................................................................................................5
WHO MAY SUBMIT AN APPLICATION ...........................................................................................................5
PREPARING AND SUBMITTING A PROPOSAL ................................................ 6
GENERAL INSTRUCTIONS ..............................................................................................................................6
PROPOSAL ORGANIZATION AND FORMAT .....................................................................................................6
MULTIPLE PROPOSALS ..................................................................................................................................7
WITHDRAWAL OF PROPOSALS ......................................................................................................................7
PROPOSAL SELECTION AND AWARD PROCESS ........................................... 7
PRELIMINARY EVALUATION .........................................................................................................................7
PROPOSAL SCORING......................................................................................................................................7
RIGHT TO REJECT APPLICATIONS AND NEGOTIATE AGREEMENT TERM........................................................8
BOARD CERTIFICATION/BOARD ELIGIBLE ....................................................................................................8
LETTERS OF RECOMMENDATION ...................................................................................................................8
PROPOSER INFORMATIONAL SECTION .......................................................... 8
CONTRACT PURPOSE AND SCOPE ..................................................................................................................8
CONTRACT RESPONSIBILITIES .......................................................................................................................9
QUALIFICATIONS ..........................................................................................................................................9
REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES ...........................................................................................9
HIGHLY DESIRABLE KNOWLEDGE, SKILLS, AND ABILITIES ........................................................................ 10
PROPOSAL QUESTIONS ................................................................................................................................ 10
REQUIRED FORMS ........................................................................................... 11
State of Wisconsin
Dept. of Health Services
1.0
Date: 3/17/2016
RFA G-0430 DPH-15
Page 3 of 13
GENERAL INFORMATION
1.1
Introduction and Background
The purpose of this document is to provide interested parties with information to enable them to
prepare and submit a proposal to Office of Preparedness and Emergency Health Care to apply for
Medical Advisor contract positions within the seven Regional Health Care Emergency and
Response Coalitions in Wisconsin. The Department of Health Services (DHS) intends to use the
results of this solicitation to issue Medical Advisor candidate that meet federal and state
requirements.
A HEALTH CARE COALITION (HCC) is defined by the Office of the Assistant Secretary for
Preparedness and Response (ASPR) as a formal collaboration among health care organizations
and public and private-sector partners that is organized to prepare for, and respond to, an
emergency, mass casualty or catastrophic health event. During emergencies, HCCs provide multiagency coordination, advice on decisions made by incident management, information sharing,
and resource coordination. In order to be considered highly developed and functional, an HCC
“…must be able to demonstrate preparedness, response, recovery and mitigation functionality,”
according to the July 2013 ASPR program measures.
The current Wisconsin Hospital Emergency Preparedness Program (WHEPP) has been evaluating
its current structure and functionality in the context of this definition and these measures in order
to ensure that a broad spectrum of health care partners are actively involved in coalition
planning. The program will transition to HCC’s as required by ASPR by July 1, 2015. The
Department of Health Services, Office of Preparedness and Emergency Health Care intends to
contract with seven Medical Advisor contract positions, one for each of the seven regions.
1.2
Procuring and Contracting Agency
The Department of Health Services, Office of Preparedness and Emergency Health Care, Health
care Emergency Preparedness and Response Program issued this RFA. DHS will administer any
contract resulting from this RFA. The Contract Administrator will be:
Name: Lisa Pentony
Title: Health Care Emergency Director
Department of Health Services
Office of Preparedness and Emergency Health Care
1 W. Wilson Street, Room 1150
Madison, WI 53704
1.3
Definitions
Throughout the RFA, the following terms are defined as:
1.
2.
3.
4.
5.
6.
7.
ABMS: American Board of Medical Specialties
AMA: American Medical Association
AOA: American Osteopathic Association
ASPR: the Office of the Assistant Secretary for Preparedness and Response
CMS: Centers for Medicaid/Medicare Services
EMS: Emergency Medical Services
Department / DHS: the Wisconsin Department of Health Services.
State of Wisconsin
Dept. of Health Services
Date: 3/17/2016
RFA G-0430 DPH-15
Page 4 of 13
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
DOA: the Wisconsin Department of Administration.
HSEEP: Homeland Security Exercise Evaluation Program
HIPAA: the Health Insurance Portability and Accountability Act of 1996.
HCC: A Health care Coalition
MBE: is defined as Minority Business Enterprise.
OPEHC: Office of Preparedness and Emergency Health Care
Proposer: an entity responding to this RFA.
RFA: is defined as Request for Application
State: the State of Wisconsin.
Subcontract: A written agreement between the contractor and a subcontractor to provide
services.
18. Subcontractor: A third party who contracts with the awarded contractor for the provision of
services, which the contractor has contracted with the Department to perform.
19. WHEPP: Wisconsin Health care Emergency Preparedness Program
1.4
Clarification and/or Revisions to the Specifications and Requirements
Any questions concerning this RFA must be submitted to: Elizabeth Schweitzer,
DHSProcurement@wi.gov.
Written questions must be submitted before 4:00 PM CT on Wednesday, 3/09/15. Questions
should be submitted via email with the following subject line:
Subject: Question RFA G-0430 DPH-15 OPEHC Medical Advisor-XX Proposer Name
Telephone questions will not be accepted. Any oral responses, information, dates, and/or
technical assistance received by a prospective Proposer from the Department or Department staff
shall not, in any manner whatsoever whether before or after the release of this RFA, be binding
on the State of Wisconsin, unless followed-up and explicitly confirmed and stated in writing by
the State.
Proposers are expected to raise any questions, exceptions, or additions they have concerning the
RFA document at this point in the RFA process. If a Proposer discovers any significant
ambiguity, error, conflict, discrepancy, omission, or other deficiency in this RFA, the Proposer
should immediately notify the Contract Administrator of such error and request modification or
clarification of the RFA.
In the event that it becomes necessary to provide additional clarifying data or information, or to
revise any part of this RFA, revisions/amendments and/or supplements will be provided on
VendorNet.
Contact with State employees and/or members of the review committee concerning this RFA are
prohibited except as authorized by the Contract Administrator during the period from date of
release of the RFA until the notice of intent to award is released.
1.5
Contract Quantities / New or Deleted Items
It is the intent of DHS to use the results of the Request for Applications to issue up to seven
contracts for Medical Advisor contract positions. DHS intends to hire one contractor for each of
the seven regions.
State of Wisconsin
Date: 3/17/2016
Dept. of Health Services
RFA G-0430 DPH-15
Page 5 of 13
The procuring and contracting agency does not guarantee to purchase any specific quantity of
services. Proposals that state that the purchasing agency must guarantee a specific quantity or
dollar amount may be disqualified.
The contractor shall not have exclusive rights to provide all services covered under this contract
during the term of the contract or any extension of the contract.
1.6
Calendar of Events
The table below lists specific and estimated dates and times of actions related to this RFA. The
actions with specific dates must be completed as indicated unless otherwise changed by the State.
In the event that the State finds it necessary to change any of the specific dates and times in the
calendar of events listed below, it will do so by issuing a notice on VendorNet There may or may
not be a formal notification issued for changes in the estimated dates and times.
DATE
2/23/15
3/9/15
3/16/15
3/19/15
03/20-05/15
05/15/15
07/01/2015
1.7
EVENT
RFA Posted to VendorNet
Deadline for Written Questions 4:00 PM CST
All Questions and Answers Posted to DHS Website (estimated)
Proposals due – 3:00 PM CT
Evaluation Period
Notice of Intent to Negotiate Contract (estimated)
Contract Start Dates
Contract Term and Available Funding
The contract shall be effective on the date indicated in the contract and shall run for one year
from that date with an option by mutual agreement of the Department and contractor, to renew for
two additional one year periods. The total amount of funds available through this RFA is $50,000
for each approved contract year. Renewal of the contract for years two and three will be based
upon the Proposer’s satisfactory performance, audit findings and the availability of funds.
Proposers are advised that should additional state or federal funds become available, the Division
may utilize the results of this RFA for additional awards.
1.8
Retention of Rights
The State of Wisconsin retains the right to accept or reject any or all proposals if it is deemed to
be in the best interest of the State of Wisconsin.
If mutually agreed to by the contractor and the State, the results of this solicitation may be used
by other Wisconsin agencies or other states. All proposals become the property of DHS upon
receipt.
1.9
Who May Submit an Application
Any individual may apply for the contract positions. At the time of the contract, it is preferable
that individuals reside in the Health Emergency Region in which they intend to contract.
Proposals will not be accepted from staffing companies.
State of Wisconsin
Dept. of Health Services
2.0
Date: 3/17/2016
RFA G-0430 DPH-15
Page 6 of 13
PREPARING AND SUBMITTING A PROPOSAL
2.1
General Instructions
The selection of a contractor is based on the information submitted in the contractor's
Application. Failure to respond to each of the requirements in the RFA may be the basis for
rejecting an application.
Elaborate Proposals (e.g., expensive artwork), beyond what is sufficient to present a complete and
effective Proposal, is not necessary or desired.
The State of Wisconsin is not liable for any cost incurred by Proposers in replying to this RFA.
Proposers must submit Proposals in strict accordance with the requirements set forth in this
section. All materials must be submitted to:
COMMON CARRIER ADDRESS:
Department of Health Services
Attn: Elizabeth E Schweitzer,
Procurement Manager
1 West Wilson St Room 655
Madison, WI 53703
USPS ADDRESS:
Department of Health Services
Attn: Elizabeth E Schweitzer,
Procurement Manager
1 West Wilson St Room 655
PO Box 7850
Madison, WI 53707-7850
All materials must be received in the prescribed formats by Thursday, 3:00 PM CT, March 19,
2015.
Proposals must be received in the above office by the specified date and time. No Proposals are
allowed to be submitted by fax or email. All such Proposals will be rejected.
2.2
Proposal Organization and Format
Technical proposals must be organized into clearly delineated sections, as shown below. Each
heading and subheading should be separated by tabs or otherwise clearly marked.
Tab 1. Cover Letter
Tab 2. Resume
Tab 3. Proof of Board Certification/Eligibility and Medical License
Tab 4. Responses to the Standard Application Questions (Section 4.6)
Tab 5 Letters of Recommendation, Forms and Supplementary Material
All materials must be received in the prescribed formats by 3:00 PM CT, March 19, 2015
State of Wisconsin
Date: 3/17/2016
Dept. of Health Services
2.3
RFA G-0430 DPH-15
Page 7 of 13
Multiple Proposals
Potential contractors may apply for more than one position in more than one Health care
Emergency Region.
2.4
Withdrawal of Proposals
Proposals shall be irrevocable until contract award unless the Proposal is withdrawn. Proposers
may withdraw a Proposal in writing at any time up to the Proposal closing date and time or upon
expiration of five (5) business days after the due date and time if received by Elizabeth
Schweitzer. The written request must be signed by an authorized representative of the Proposer
and submitted to Elizabeth Schweitzer at the address listed in Section 2.1 General Information. If
a previously submitted Proposal is withdrawn before the Proposal due date and time, the Proposer
may submit another Proposal at any time up to the Proposal closing date and time.
3.0
PROPOSAL SELECTION AND AWARD PROCESS
3.1
Preliminary Evaluation
The purpose of the preliminary evaluation is to determine if each Proposal is sufficiently
responsive to the RFA to permit a complete evaluation. Proposals must comply with the
instructions to Proposers contained in this RFA. Failure to comply with the instructions may
cause the Proposal to be rejected without further consideration. The state reserves the right to
waive any minor irregularities in the Proposal.
3.2
Proposal Scoring
Proposals accepted through the preliminary evaluation process are reviewed by an evaluation
committee and scored against chosen criteria. A Proposer may not contact any member of an
evaluation committee except with the Contract Administrator’s written approval.
Proposal Evaluation Criteria
The proposal evaluation committee will review all proposals against stated criteria. Proposals
from eligible applicants will be scored according to the following competitive criterion:
Maximum Points (100 Total)
PROPOSAL EVALUATION CRITERIA
MAXIMUM POINTS
• Cover letter
10 points
• Resume
20 points
• Board certified/board eligible by American Board of Medical Specialties (ABMS) or American
Osteopathic Association (AOA) and unrestricted license to practice medicine or osteopathy in the
State of Wisconsin
20 points
• References
• Responses to Proposal Questions and Subsequent Interview
TOTAL
10 points
40 points
100 points
After proposal review and acceptance, potential contractors will interview with Department of
Health Services personnel, Regional Health care Coalition Board members, and other Disaster
and Emergency Medical Experts to determine the contractors’ ability to serve as Medical Adviser
State of Wisconsin
Dept. of Health Services
Date: 3/17/2016
RFA G-0430 DPH-15
Page 8 of 13
for a Regional Medical Coordination Center in a disaster. The interview evaluation criteria are
based on: medical coordination in a disaster, advising on surge capacity and continuity of medical
operations in an emergency.
3.3
Right to Reject Applications and Negotiate Agreement Term
The State reserves the right to reject any and all applications. The State may negotiate the terms
of the contract, including the award amount, with the selected applicant prior to entering into a
contract. If contract negotiations cannot be concluded successfully with the recommended
applicant or upon unfavorable review of the applicant’s references, the Department may terminate
contract negotiations.
The Contract Administrator or designee will review each RFA Response Package and Statement
of Applicant Qualifications to verify the Applicant meets the requirements specified in this RFA
based on a pass or fail protocol. This determination is the sole responsibility of the Department.
3.4
Board Certification/Board Eligible
Proposers are required to submit documentation for Board certified/board eligible by American
Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA) and
unrestricted license to practice medicine or osteopathy in the state of Wisconsin.
3.5
Letters of Recommendation
Applicants are required to submit three letters of support. Letters should be professional
recommendations. Letters may come from individuals, stakeholder organizations, businesses,
educational institutions, and/or other health and human service provider agencies. Letters of
support should address the potential for success in the contractor’s ability to serve as the Medical
Advisor. The evaluation committee will consider letters of recommendation in review of the
proposals.
4.0
PROPOSER INFORMATIONAL SECTION
Section 4.0 contains information for Proposers regarding the responsibilities, deliverables and
outcomes the contractor is responsible for as the Regional Medical Advisor.
Listed below are the minimum specifications and responsibilities. If no Proposers are able to
comply with any given specification, condition of proposal or provide a specific item, the state
reserves the right to delete that specification, condition of proposal or item.
4.1
Contract Purpose and Scope
The applicant will provide medical, administrative, and policy leadership and technical
consultation for the region’s health care coalition and partners. The applicant will report to the
regional health care coalition’s Board of Directors, the state leadership committee and to the State
of Wisconsin Department of Health Services. The regional health care coalition (HCC) is a multidisciplinary, multi-organizational structure that allows for efficient, coordinated use of health care
resources to provide care to patients in a disaster or other critical incident. The health care
coalition seamlessly matches patient needs to available resources in a collaborative manner to
improve the health of the individual and the community.
State of Wisconsin
Dept. of Health Services
Date: 3/17/2016
RFA G-0430 DPH-15
Page 9 of 13
The involvement of physicians in disaster planning and response is supported by numerous
medical professional societies. The American Medical Association (AMA) states that, “In
preparing for epidemics, terrorist attacks, and other disasters, physicians as a profession must
provide medical expertise and work with others to develop public health policies that are
designed to improve the effectiveness and availability of medical care during such events. These
policies must be based on sound science and respect for patients.” (AMA "Physician Obligation
in Disaster Preparedness and Response” December 2004)
Physician involvement is essential for patient advocacy and leadership in developing and
sustaining a functional health care coalition. The planning and response for disasters and
emergency incidents should be based on sound ethical principles and evidence-based clinical
management. The physician should work collaboratively with disciplines and organizations
involved in emergency management and response.
4.2
Contract Responsibilities
Applicants will be expected to perform all the duties associated with the Medical Examiner
Contracted position, including but not limited to:











4.3
Assist region in development of health care coalition by promoting multi-disciplinary,
multi-organizational collaboration and functioning as a representative of regional HCC
board to coalition partners.
Assist in development and operations of disaster medical coordination structure
Advocate for evidence-based best practices in disaster medical care
Serve as chief medical expert and advisor for regional HCC
Serve as regional medical EMS resource
Provide medical consultation/oversight of HCC disaster coordination and medical surge
activities
Provide technical expertise as needed related to medical issues (clinical, operational, and
administrative) and surge planning to HCC, its members, and partners (such as regional
trauma committee, public health departments, and emergency management agencies)
Serve as HCC liaison to medical community
Serve on state medical advisory committee
Representative of regional HCC to state
Liaison between Wisconsin Department of Health Services/WHEPP and medical
community
Qualifications
Applicants must be board certified/board eligible by American Board of Medical Specialties
(ABMS) or American Osteopathic Association (AOA) and have an unrestricted license to
practice medicine or osteopathy in the state of Wisconsin
4.4
Required knowledge, skills, and abilities
Applicants shall have:


Certification in Incident Command IS-100, IS-200, IS-700, IS-800 courses
Knowledge of mass casualty and disaster medicine
State of Wisconsin
Dept. of Health Services


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


Date: 3/17/2016
RFA G-0430 DPH-15
Page 10 of 13
Knowledge of out-of-hospital patient care
Knowledge of emergency management principles
Knowledge of public health principles
Knowledge of Emergency Medical Services (EMS) systems principles
Knowledge of federal and state health care laws and regulations
Knowledge of fundamental administrative and business practices
Ability to travel is required for this position.
4.5
Highly Desirable Knowledge, Skills, and Abilities
Applicants will have:
 Experience/involvement with preparedness planning
 Certification in Incident Command IS-300, IS-400
 Board certification in Emergency Medical Services by American Board of Emergency
Medicine
 Experience as EMS medical director or physician
 Completion of WI online EMS Medical Director Course (or National Association of
EMS Physicians or American College of Emergency Physicians EMS medical director
course)
4.6
Proposal Questions
All applications must address the following two questions in their proposal. To complete these
section applicants will need to provide narrative responses to both questions that will allow DHS
to determine whether the applicant meets the minimum qualifications for this position.
1. Please describe your experience as a medical advisor for disaster coordination and medical
surge activities in an emergency. Please limit your response to two double spaced typed pages.
2. The applicant has the primary responsibility for building a Regional Health care Coalition
planning, response, and recovery network through coordination with multi-disciplinary partners.
Based on the requirements listed in Section 4.1-4.6 please describe similar experience in
planning, communicating and coordinating with hospitals and other health care coalition partners
in emergency preparedness planning, response, and recovery.
Please limit your response to two double spaced typed pages.
State of Wisconsin
Dept. of Health Services
5.0
Date: 3/17/2016
RFA G-0430 DPH-15
Page 11 of 13
REQUIRED FORMS
The following pages contain the ancillary forms required to be submitted as part of the Proposal
packet. Please reference Section 2.2 for information related to the proper order of these forms in the
Proposal packet.
1. Name the person to contact for questions concerning this Proposal.
Name
Title
Phone (
)
Toll Free Phone (
)
Fax (
)
Email Address
Address
City, State Zip + 4
2. Mailing address to which state purchase orders are mailed and person the department may contact
concerning orders and billings.
Name
Title
Phone (
)
Toll Free Phone (
)
Fax (
)
Email Address
Address
City, State Zip + 4
State of Wisconsin
Dept. of Health Services
APPENDIX A
Wisconsin Health Emergency Regions
Date: 3/17/2016
RFA G-0430 DPH-15
Page 12 of 13