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 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