HomeMy WebLinkAboutDoc 094 - RFP Application - OHA - Health
Deschutes County Board of Commissioners
1300 NW Wall St., Suite 200, Bend, OR 97701-1960
(541) 388-6570 - Fax (541) 385-3202 - www.deschutes.org
AGENDA REQUEST & STAFF REPORT
For Board Business Meeting of January 28, 2015
_____________________________
DATE: January 27, 2015.
FROM: Tom Kuhn. Health Services (541) 322-7410
TITLE OF AGENDA ITEM:
Request to Apply for Oregon Health Authority (OHA) Request for Proposal #OHA-3922-14
PUBLIC HEARING ON THIS DATE? No
BACKGROUND AND POLICY IMPLICATIONS:
OHA will sponsor a series of institutes (April through September, 2015) to develop sustainable
relationships for local public health, coordinated care organizations, and chronic disease self-
management programs. PacificSource has agreed to be a full partner in this initiative an other partners
are supportive. Health Services is both local public health the chronic disease self-management
provider. Institutes will help participants to delineate roles and responsibilities; identify staffing and
training needs; outline data sharing and payment agreements; and ultimately create mechanisms to
facilitate better care, better health, and lower cost. Activities funded by the Grant will focus on
diabetes, prediabetes and hypertension.
The location(s) of the Institutes will be determined based on locations of successful applicants. At the
conclusion of the grant, local consortium members will have co-created a plan and agreements that
enhance collaboration, promote community-clinical linkages and advance health system interventions.
The funding period for the grant is February 1, 2015 through August 31, 2015. The application is due
Friday, January 30, 2015.
FISCAL IMPLICATIONS:
Funding requested will be minimal to cover meeting expenses and some staff and partner salary during
the funding period. No additional FTE is being requested.
RECOMMENDATION & ACTION REQUESTED:
Request that approval be granted to Health Services to pursue this opportunity.
ATTENDANCE: Tom Kuhn, Community Health Manager
DISTRIBUTION OF DOCUMENTS:
NA.
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In compliance with the Americans with Disabilities Act, this document is available in alternate
formats such as Braille, large print, audio recordings, Web-based communications and other
electronic formats. To request an alternate format, please send an e-mail to dhs-
oha.publicationrequest@state.or.us or call 503-378-3486 (voice) or 503-378-3523 (TTY) to
arrange for the alternative format.
THE STATE OF OREGON
OREGON HEALTH AUTHORITY
ISSUES THE FOLLOWING
REQUEST FOR GRANT PROPOSALS
for
Sustainable Relationships for Community Health
RFGP #OHA-3922-14
Date of Issuance: December 30, 2014
Proposals Due by: 3:00 P.M. Local Time, January 30, 2015 at the Issuing Office.
Issuing Office: Office of Contracts and Procurement
Sole Point of Contact: Jewelee Bell, Contracts Specialist
250 Winter Street NE, Room 306
Salem, Oregon 97301
Telephone: 503-947-5257
Fax: 503-373-7889
E-mail: jewelee.m.bell@state.or.us
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Table of Contents
SECTION 1 – PURPOSE/OVERVIEW ......................................................................................... 3
1.1. Introduction ...................................................................................................................... 3
1.2. Background and Overview ............................................................................................... 3
1.3. Definitions ........................................................................................................................ 4
1.4. Special Requirements ....................................................................................................... 5
1.5. Authority .......................................................................................................................... 5
SECTION 2 – MINIMUM QUALIFICATIONS ........................................................................... 6
SECTION 3 – PROGRAM DESCRIPTION .................................................................................. 7
SECTION 4 – RFGP PROCESS .................................................................................................. 11
4.1 Sole Point of Contact (SPC) ........................................................................................... 11
4.2 Timeline for RFGP and Proposal Submission ............................................................... 11
4.3 Closing Date for Submittal of Proposals ........................................................................ 11
4.4. Pre-proposal Questions Relating to this RFGP .............................................................. 12
SECTION 5 – PROPOSAL REQUIREMENTS .......................................................................... 13
5.1 General Proposal Requirements ..................................................................................... 13
5.2 Technical Proposal Requirements .................................................................................. 13
5.3 Budget Proposal Requirements ...................................................................................... 15
SECTION 6 – PROPOSAL EVALUATION ............................................................................... 18
6.1 Technical Proposal Evaluation ....................................................................................... 18
6.2 Budget Proposal Worksheet and Narrative .................................................................... 20
6.3 Evaluation Factors Checklist .......................................................................................... 20
6.3 Final Selection and Award ............................................................................................. 20
6.4 Proposal Rejection.......................................................................................................... 21
SECTION 7 – GENERAL INFORMATION ............................................................................... 22
7.1 Changes/Modification and Clarifications....................................................................... 22
7.2 Reservation of OC&P Rights ......................................................................................... 22
7.3 Award Notice ................................................................................................................. 22
7.4 Modification or Withdrawal ........................................................................................... 23
7.5 Release of Information ................................................................................................... 23
7.6 Cost of Proposals ............................................................................................................ 23
7.7 Grant Period ................................................................................................................... 23
7.8 Party Obligations ............................................................................................................ 23
7.9 Grant Documents............................................................................................................ 23
ATTACHMENT 1 - Proposal Cover Sheet .................................................................................. 24
ATTACHMENT 2 - Proposer’s Designation of Confidential Materials ...................................... 25
ATTACHMENT 4 – Form CCO Grant ........................................................................................ 27
ATTACHMENT 4 – Line Item Budget Worksheet ..................................................................... 35
ATTACHMENT 5 – Program Element ........................................................................................ 36
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SECTION 1 – PURPOSE/OVERVIEW
1.1. Introduction
The State of Oregon, Oregon Health Authority (OHA), requests Proposals from qualified
Proposers to participate in an OHA, Public Health Division learning collaborative to
develop Sustainable Relationships for Community Health (SRCH) .
OHA expects to award two to four grants not to exceed $170,000 each for the period
February 2015 through August 31, 2015. The total OHA budget available for this project
is $349,000.
All persons or firms submitting Proposals are referred to as Proposers in this Request for
Grant Proposals (RFGP); after execution of a Grant, the awarded Proposer will be
designated as Recipient.
The Program details and activities are described in Section 3, “Program Description.”
1.2. Background and Overview
Through the continued evolution of health system transformation in Oregon, partners
have identified a need for local public health agencies (LPHAs), coordinated care
organizations (CCOs), and organizations providing supportive community-based services
to align and delineate organizational roles and responsibilities to improve health
outcomes, while leveraging existing community ‐wide health improvement initiatives.
In response, OHA will sponsor a series of institutes to develop sustainable relationships
for community health (SRCH Institutes), consisting of facilitated discussions and
technical assistance to engage cross ‐sector leaders involved in health system
transformation. The SRCH Institutes will focus on developing innovative new models of
care for heart disease, diabetes and prediabetes. Institute participants will specifically
address issues related to areas of quality improvement, including use of quality measures,
electronic health records and health information technology, and traditional health
workers in team ‐based care. Institute participants will also increase the use of evidence-
based Community Self-Management Programs (SMPs) through health system referral
and reimbursement.
In order to achieve the Triple Aim of health system transformation, this project (i.e., the
activities funded by the Grant) will improve community health and reduce health
disparities. It will achieve this goal by addressing major drivers of death and disability
and leading drivers of health care costs in Oregon through SMPs that address chronic
disease through quality improvement initiatives. The activities funded by the Grant will
focus on diabetes, prediabetes and hypertension with the intent that the experiences and
agreements developed can be expanded to address other chronic conditions and risk
factors in the future. OHA will convene the SRCH Institutes for participants to delineate
roles and responsibilities; identify staffing and training needs; outline data sharing and
payment agreements; and ultimately create mechanisms to facilitate better care, better
health, and lower cost. A professional contractor will provide structured facilitation;
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recipients will complete work plan activities between meetings to operationalize their
plans, supported by technical assistance and consultation.
1.3. Definitions
For purposes of this RFGP and the resulting Grant, the terms below shall have the
following meanings:
1.3.1 Closed-Loop Referrals are referrals that, in addition to linking the referred
individual to a given self-management intervention as described below, also
provide the referring entity with timely follow-up information pertinent to the
individual’s continuing care. Examples of information to close the referral loop
include updates on whether the referred individual received the intervention,
outcomes related to receipt of the intervention (e.g., identified self-management
goals, improved disease status, reduction of risk factors such as tobacco use) and
any barriers precluding receipt of the intervention.
1.3.2 Community Clinical Linkages are connections between community and clinical
sectors to improve population health, including interventions such as clinical
referral, community delivery, and third-party payment for effective programs.
1.3.3 Community Self-Management Programs (CSMPs): according to the Institute
of Medicine, self-management programs are “the systematic provision of
education and supportive interventions…to increase patients’ skills and
confidence in managing their health problems, including regular assessment of
progress and problems, goal setting, and problem-solving support.” Community
Self-Management Programs (CSMPs) are provided in community settings that are
accessible and culturally sensitive to participants, e.g. community centers, places
of worship, community-based organization offices. CSMPs focus on patient-
perceived problems and needs, and emphasize skills such as problem solving and
decision-making. They prepare people with chronic conditions to have the skills
and confidence to manage their disease(s) on a daily basis and to manage its
impact on activities and emotions. Self-management programs improve quality of
life and support the Triple Aim of health systems transformation by reducing
costly health crises and improving health outcomes for chronically ill patients
with conditions such as asthma, cardiovascular disease, depression, diabetes, and
arthritis. CSMPs are delivered by people who are known, trusted, culturally
sensitive and fluent in the language of the target community. CSMP facilitators
need not be health professionals, but they are trained and prepared for their role.
For the purposes of this document, CSMPs are limited to those identified and
supported by the Oregon Health Authority’s Public Health Division. These
currently include Stanford Chronic Disease Self-Management Programs (e.g.,
CDSMP/Living Well, Tomando Control de su Salud, the Diabetes Self-
Management Program, the Positive Self-Management Program, the Chronic Pain
Self-Management Program, and the online Better Choices, Better Health
program), the National Diabetes Prevention Program, and Walk With Ease. For
more information about the evidence-based CSMPs currently supported by
OHA/PHD, see http://www.healthoregon.org/takecontrol.
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1.3.4 Evidence-Based Practice refers to practices set forth in disease management
criteria established by national guideline from expert organizations such as the
Centers for Disease Control and Prevention, Administration for Community
Living, National Institutes of Health, the Community Guide to Preventive
Services, the National Council on Aging, the American Diabetes Association and
the American Heart Association.
1.3.5 Grant means the Grant or Grants awarded as a result of this RFGP.
1.3.6 Health Promotion and Chronic Disease Prevention Program (HPCDP) refers
to the program within Oregon Health Authority’s Public Health Division that is
responsible for administering this funding opportunity.
1.3.7 Health Information Technology (HIT) encompasses a wide range of products
and services including software, hardware and infrastructure designed to collect,
store and exchange patient data throughout the clinical practice of medicine.
1.3.8 Key Personnel or Key Persons means the person or persons on Proposer’s staff
assigned to participate in the Sustainable Relationships for Community Health
learning collaborative. For Key Persons not identified prior to Proposal
submission, please include information in the “Plans for supporting organizational
change” section of the Proposal narrative.
1.3.9 Office of Contracts and Procurement (OC&P) means the entity that is
responsible for the procurement process for OHA.
1.3.10 Proposal means a written response submitted to OC&P in response to this RFGP.
1.3.11 Proposer means the person or entity that submits a Proposal.
1.3.12 Recipient means the Proposer selected through this RFGP to enter into a Grant
with OHA.
1.3.13 RFGP means Request for Grant Proposal.
1.4. Special Requirements
Each funded consortium member must have a 100% tobacco-free facility policy or,
during the course of the grant, develop a plan acceptable to OHA to work toward the
adoption of 100% tobacco-free facility policy.
Each funded consortium member must have adopted nutrition standards for at least one
of the following: 1) meetings, conferences and events, 2) cafeterias, 3) vending machines,
or 4) procurement policies. Or, each funded consortium member must, during the course
of the grant, develop a plan to work toward the adoption of nutrition standards in one or
more of these settings. Sample policies are available at
http://www.wellnessatworkoregon.org/?page_id=53 .
1.5. Authority
OHA issues this RFGP under the authority of ORS 413.033.
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SECTION 2 – MINIMUM QUALIFICATIONS
Proposers must meet all of the following minimum qualifications:
Proposer must be a Lead Fiscal Agent for a consortium that, at a minimum, includes at least one
local public health authority (LPHA), one Coordinated Care Organization (CCO), and one local
CSMP Provider (if neither the LPHA nor CCO are a CSMP Provider) serving a shared
population.
OHA will accept only one Proposal per consortium through the Lead Fiscal Agent that is either a
CCO or an LPHA and the Lead Fiscal Agent will be designated as the Recipient under the
resultant Grant Agreement. Only LPHAs and CCOs are eligible to serve as a Lead Fiscal Agent
for a consortium. Other local entities, including nonprofit organizations, are encouraged to
participate in this opportunity by joining a consortium.
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SECTION 3 – PROGRAM DESCRIPTION
Funds awarded as a result of this RFGP will be used to support the following SRCH program
activities.
3.1 Participate in Institute Activities to create sustainable relationships for community
health (SRCH Institutes)
Successful Proposers, including Key Person(s) from each consortium partner, will
actively participate in Institutes to develop Sustainable Relationships for Community
Health (SRCH Institutes). OHA will convene the SRCH Institutes as a learning
collaborative, where local consortium members will participate in a series of facilitated
discussions and receive technical assistance. Discussions and technical assistance will
engage local leaders involved in health system transformation and development of
community-clinical linkages to align and delineate organizational roles and
responsibilities to improve health outcomes, while leveraging existing community ‐wide
health improvement initiatives.
The SRCH Institutes will assist consortium members to co-design (1) local initiatives to
improve cross-sector partnerships and (2) joint agreements with consortium partners to
address the local burden related to prevention, early detection and self-management of
chronic disease. For the purposes of this funding, the focus will be on diabetes,
prediabetes and hypertension management.
The SRCH Institutes will include three in-person two-day meetings during the period
April through September, 2015. Additionally, successful Proposers will:
· Conduct pre-work on the consortium’s needs, strengths, and goals for participation in
the SRCH Institutes;
· Engage in activities between Institute in-person meetings, including facilitated
Technical Assistance calls/webinars, and individual coaching.
The SRCH Institutes will support LPHAs, CCOs and CSMP Providers in developing
formal commitments, such as memoranda of understanding and data-sharing agreements,
to reinforce collaboration and a long ‐term commitment to health system improvement
and community ‐clinical linkages. Consortium members will share outcomes and assist
OHA with the dissemination of findings.
3.2 Advance Health System Interventions
During the SRCH Institutes, consortium members will participate in structured,
facilitated discussions and activities to co-design and advance health system interventions
addressing prevention, early detection and self-management of chronic disease that:
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· Increase implementation of quality improvement processes in health systems.
· Increase electronic health records (EHR) utilization and the use of health information
technology (HIT) to improve quality of care.
· Increase the institutionalization and monitoring of aggregated/standardized quality
measures at the provider and systems level.
· Increase use of team-based care in clinical and community health systems settings.
· Increase engagement of non-physician team members (e.g., care coordinators,
pharmacists, community health workers, patient navigators, peer support specialists,
peer wellness specialists) in hypertension, prediabetes and diabetes management in
health care systems and community settings.
3.3 Promote Community-Clinical Linkages to support patient self-management
During the SRCH Institutes, consortium members will participate in structured facilitated
discussions and activities that develop and reinforce long-term commitments to
community-clinical linkages, quality improvement, data-sharing, collaboration and
partnerships between LPHA(s), CCO(s), CSMP Providers and others.
Consortium members will co-design self-management support strategies for those
enrolled in the Oregon Health Plan that:
· Increase access to evidence-based chronic disease self-management programs
(CSMPs), especially those delivered in community settings.
· Increase closed-loop referrals and reimbursement for evidence-based chronic disease
self-management programs (CSMPs), especially those delivered in community
settings.
· Increase use of non-physician health workers in community and health care settings
in support of self-management.
3.4 Development and implementation of a plan to sustain relationships for community
health
By the conclusion of the facilitated discussions and technical assistance offered during
the SRCH Institutes, local consortium members will have co-created a plan and
agreements that enhance collaboration, promote community-clinical linkages and
advance health system interventions.
The plan and agreements will delineate roles and responsibilities; identify staffing and
training needs; and ultimately create mechanisms to facilitate better care, better health,
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and lower cost. Each consortium’s plan and agreements shall include specific strategies,
actions, organizational/individual responsibilities and a timeline to:
· Improve the use of quality measures; EHR/HIT, and traditional health workers in
team ‐based care, and;
· Increase the use of CSMPs through development or improvement of systems enabling
Closed Loop Referrals of appropriate patients and payments or reimbursement to
organizations providing CSMPs.
3.5 Reporting Requirements
Successful Proposers shall submit to HPCDP copies of products developed through the
SRCH Institutes including: 1) official agreements such as Memorandum of
Understanding, data sharing agreements, and other legal agreements; 2) protocols for
referrals, payment and data sharing; and 3) other documentation demonstrating successful
implementation which may include position descriptions, staffing plans, business plans,
technology plans, etc. Successful Proposers will also work with OHA to share
experiences and promising practices with others.
3.6 Program Evaluation
Successful Proposers will assist OHA with program evaluation throughout the duration of
the Grant period(s), as well as with final project evaluation. Such activities may include,
but are not limited to, meeting with a state level evaluator soon after execution of a Grant
to help develop an evaluation plan specific to the project, collecting data and maintaining
documentation throughout the Grant period, responding to evaluator’s requests for
information and collaborating with the evaluator to develop final reports to highlight the
outcomes of the work. One representative from each consortium will be required to
participate on a project evaluation advisory group.
3.7 Staffing
It is understood that new positions may be filled using Grant funds. Therefore, for Key
Persons not identified prior to Proposal submission, please include information in the
“Plans for supporting organizational change” section of the Proposal narrative regarding
how the positions will be filled.
The Recipient will designate a point of contact between the Recipient and OHA, and will
maintain sufficient FTE to support regular, consistent communication and coordination
with OHA and other members of their consortium.
3.5 Participation in Additional Required Events
In addition to the SRCH Institutes, each successful Proposer is required to participate in
the annual Grantees and Contractors meeting organized by HPCDP program. The date
and location of this meeting are to be determined. Participation consists of at least one
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representative from the consortium participating in the full event. Additional members
are also welcome to attend. Proposers should include the cost of attending this meeting in
their proposed budget if this meeting occurs within the Grant period.
Each successful Proposer will appoint a representative to participate in the Oregon Self-
Management Network CCO Finance workgroup. This workgroup currently convenes
every other month via phone. Additionally, successful Proposers will be required to
participate in the Self-Management Forum if it occurs within the Grant period.
Participation in additional training opportunities either as a participant or a presenter is
permitted using Grant funds. Successful Proposers must receive approval for specific
opportunities from HPCDP prior to participation. HPCDP reserves the right to require
staff funded as a result of this opportunity to attend any given training that is deemed
pertinent to their role, and will negotiate this with the Recipient on a case by case basis.
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SECTION 4 – RFGP PROCESS
4.1 Sole Point of Contact (SPC)
Jewelee Bell, Contract Specialist
Office of Contracts and Procurement
250 Winter Street NE, Room 306
Salem, Oregon 97301
Telephone: 503-947-5257
Fax: 503-373-7889
E-mail: jewelee.m.bell@state.or.us
TTY: 503-378-3523
All communications concerning this RFGP must be directed to the SPC named above.
Any unauthorized contact regarding this RFGP with other State employees or officials
may result in Proposal rejection. Any oral communications will be considered unofficial
and non-binding. The Oregon Procurement Information Network (ORPIN) will be used
to distribute all information regarding this RFGP. Any additional information received in
writing from the SPC is also considered official.
4.2 Timeline for RFGP and Proposal Submission
RFGP Issued ........................................................................... December 30, 2014
RFGP Questions Due ....................... January 14, 2015 at 5:00 P.M. (Local Time)
RFGP Answers Provided (approximately) ................................. January 19, 2015
RFGP Closes. Proposals Due ......... January 30, 2015 at 3:00 P.M. (Local Time)
Notice of Intent to Award (estimated)) ..................................... February 13, 2015
4.3 Closing Date for Submittal of Proposals
4.3.1 The Office of Contracts and Procurement must receive Proposals by the date and
time specified in Section 4.2, “Timeline for RFGP and Proposal Submission”.
Late Proposals will not be considered. Proposals submitted by electronic means
will not be accepted.
4.3.2 Proposals must be addressed to the Sole Point of Contact above.
4.3.3 Hand delivery of Proposals is optional. Hand delivered Proposals must be
received at the address listed in Section 4.1 by the date and time specified in
Section 4.2. Subject to Section 4.2, OC&P will receive Proposals during its
normal Monday - Friday business hours of 8:00 am to 5:00 pm (Local Time),
except during State of Oregon holidays and other times when OC&P is closed.
OC&P will provide all Proposers who hand deliver their Proposals a completed
receipt of delivery at the time of Proposal delivery. Proposals must be submitted
in a sealed package addressed as shown above, with the name of the SPC and the
RFGP #OHA-3922-14 clearly visible on the outside of the package.
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4.4. Pre-proposal Questions Relating to this RFGP
Questions about this RFGP document, including specifications, Grant terms and
conditions, or the solicitation process, must be submitted and received by the SPC by the
date and time specified in Section 4.2. Questions may be submitted by fax or e-mail.
Notification of any substantive clarifications provided in response to any question will be
provided and published on the ORPIN web site below.
For complete RFGP documentation, please go to the ORPIN web site:
http://orpin.oregon.gov/open.dll/welcome . OC&P will not automatically mail copies of
any addenda or answers but will publish Addenda and Questions and Answers on
ORPIN. Addenda may be downloaded from ORPIN. Proposers are responsible to
frequently check ORPIN until date of RFGP Closing.
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SECTION 5 – PROPOSAL REQUIREMENTS
All Proposals shall include the items listed in this Section. Proposals must address all Proposal
and submission requirements set forth in this RFGP, and must describe how the services will be
provided. Proposals that merely offer to provide services as stated in this RFGP will be
considered non-responsive to this RFGP and will not be considered further.
OHA will evaluate the overall quality of content and responsiveness of Proposals to the purpose
and specifications of this RFGP.
5.1 General Proposal Requirements
5.1.1 Proposals must be submitted using only 8 ½” x 11” white paper. Proposals should
be typed without extensive art work, unusual printing or other materials not
essential to the utility and clarity of the Proposals.
5.1.2 A signed original plus eight copies of the Proposal must be submitted .
Proposals must be submitted in a sealed package addressed to the SPC as shown
in Section 4.1 above with the Proposer’s name, the SPC’s name, and the RFGP
#OHA-3922-14 clearly visible on the outside of the package.
5.1.3 A representative authorized to bind the Proposer must sign the Proposal in ink.
Failure of the authorized representative to sign the Proposal may subject the
Proposal to rejection by OC&P.
5.1.4 Proposal Cover Sheet
Complete all sections of the Proposal Cover Sheet (Attachment 1) including
signature from the authorized representative. This page should be included as the
top page of the Proposal.
5.2 Technical Proposal Requirements
The Technical Proposal shall include the following items in the order listed below. Page
limits are noted, when relevant. Unless otherwise specified, no particular form is
required.
5.2.1 Project Narrative (Limit 10 pages)
Proposers must submit a Project Narrative that describes the following:
5.2.1.1 Current relationships (Recommended page length ½ page)
Describe the current relationships between the CCO(s), the LPHA(s) and the
CSMP Provider organization(s). Relationships will not be scored higher based on
the strength or longevity of the current relationship but on an accurate and
informative description.
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5.2.1.2 Current infrastructure (Recommended page length 1.5 pages)
Provide background information on status of team-based care, electronic health
record utilization, self-management programs delivered in community and clinical
settings, and existing agreements between the consortium partners. Describe how
partners are identifying community members who have hypertension, prediabetes
and diabetes and those who have risk factors for these conditions such as tobacco
use, poor physical activity and poor nutrition.
5.2.1.3 Ties to current organizational and community priorities
(Recommended page length 1.5 pages)
Describe how participation in this opportunity ties with current priorities of the
consortium member organizations. Provide relevant information about strategic
plans, quality improvement plans, technology improvement plans, etc.
Demonstrate a commitment to focus on hypertension, prediabetes and diabetes for
the purposes of this project.
5.2.1.4 Capacity and commitment to serve marginalized populations
(Recommended page length ½ page)
Demonstrate an existing capacity and commitment to serve populations most
affected by health disparities, including culturally and linguistically diverse
populations within the service area.
5.2.1.5 Leadership and traveling team (Recommended page length 2.5 pages)
Describe the leadership for this project. Describe how the applicant will determine
the team that will be attending the SRCH Institutes. Who are the members of this
team and what are their decision making roles within their representative
organizations? Points will be awarded for applicants who demonstrate high-level
leadership and participation by staff with decision-making authority among all
consortium organizations.
5.2.1.6 Plans for supporting organizational change (Recommended page
length 2 pages)
Describe the consortium’s proposed plans for completing assignments between
institutes and for completing the organizational change process to implement
coordinated, team-based care and sustainable, community-clinical linkages
including closed loop referral systems to evidence-based self-management
programs. Who will be responsible for what aspects of this process? How will the
consortium members work together? How will the consortium members track and
evaluate their progress? How will this work be staffed?
5.2.1.7 Capacity and commitment to document and share learning and
experiences (Recommended page length 1 page)
The information and learning experiences gained through this process will be
valuable to organizations across the state and nationally. Learning and experience
may include promising practices, processes, protocols, memoranda of agreement,
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other tangible outputs such as job descriptions and case studies. Describe how
member organizations have shared learning and past experiences and proposed
plans for consortium members to document and share what they have learned
through this process. Points will be awarded for specific suggestion of
opportunities for sharing learning and experiences and additional points will be
awarded for organizations willing to commit to sharing learning and experiences
beyond the end of the Grant period.
5.2.2 Letters of Commitment
Proposer will provide at least three letters of commitment with evidence of
executive or other senior level leadership support from key consortium partners,
including the local CCO, Public Health Authority, and a CSMP Provider if neither
the CCO nor LPHA offer CSMPs. Letters from additional entities will also be
accepted from others involved in the accomplishment of Grant outcomes. (i.e.,
Regional Health Equity Coalition if available in the proposed region, or another
community-based organization).
Letters should state the specific role of each consortium partner and the
commitment to participate in the SRCH Institutes. Letters should be signed by
executive leadership and include details of the agreements to sustain long-term
collaboration.
5.3 Budget Proposal Requirements
Proposer must submit a complete Line Item Budget and Narrative Worksheet for the fiscal
period February 1, 2015 – August 31, 2015, using the required Line Item Budget and Narrative
Worksheet (Attachment 4). Complete all fields, and provide narrative descriptions of the budget
line items as applicable.
The Line Item Budget and Narrative Worksheet should include each of the following Budget
Categories, as relevant:
Salary
List each position funded by the Grant on a separate line. For each position, include the job title,
annual salary, FTE as a percentage, and the number of months requested for each staff person.
The total salary will automatically calculate. Include a narrative for each position briefly
describing their primary responsibilities on this project.
Fringe Benefits
List, if applicable, fringe benefit amounts for each position on a separate line. The total fringe
will automatically calculate. Unless otherwise indicated, it is the general assumption that the
“Salary” will be the total salary budgeted, including any fringe benefits.
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Equipment
Provide a total amount for equipment, as well as a narrative identifying planned purchases and
brief rationale. Office furniture, equipment and computer/software upgrades are allowable
provided they are reasonable expenditures and relate to the activities described in this RFGP.
Supplies
Provide a total amount for supplies. Supplies may include office supplies or meeting supplies.
HPCDP must pre-approve any proposed expenditures for educational materials. If expenditures
are allocated for educational materials, the narrative must include a justification that describes
how such materials are related and essential to specific activities described in this RFGP. Funds
may not be used for clinical cessation services, treatment, or medications.
Travel
Proposers should anticipate complying with the terms of the Oregon Accounting Manual
available at: http://www.oregon.gov/DAS/CFO/SARS/policies/oam/40.10.00.pdf when traveling
in accordance with any Grant awarded as a result of this RFGP.
In-state travel: Provide a narrative statement describing proposed in-state travel. Include local
mileage as well as per diem, lodging and transportation to attend required and requested
meetings. Federal per diem rates limit the amount of reimbursement for in-state travel; please see
U.S. General Services Administration Per Diem Rates (www.gsa.gov/perdiem ).
Note: For the SRCH Institutes, there will be no registration fee. HPCDP will cover the cost of
hotel, mileage to and from the SRHC Institutes, and lunches on SRCH Institute days. Proposers
should include per diem for meals not offered during the meeting and any other expenses related
to this travel.
For the annual Grantees and Contractors Meeting, there will be no registration fee. However,
Proposers should include per diem for meals not offered during the meeting, and mileage for this
annual meeting if it occurs during the Grant period.
Out-of-state: Travel to attend out of state events or conferences is permitted if content is
applicable to the work of the consortium. Provide a narrative statement that includes the name of
the event or conference, and how the proposed travel relates to the work of the consortium.
Include amounts for per diem, lodging, transportation, registration fees, and any other expenses.
Federal per diem rates limit the amount of reimbursement for out of state travel; please see U.S.
General Services Administration Per Diem Rates (www.gsa.gov/perdiem).
Other
List expenses for items not listed above, such as telephone, rent, copying, printing, postage, and
mailing that are directly related to activities described in this RFGP.
Expenses, such as equipment, supplies, indirect rate or cost allocation may not be included in the
“Other” category if they are included elsewhere in the budget.
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Contracts
List each proposed subcontracted program activity and the name of the proposed subcontractor
(if known) along with the amount of the contract. All activities related to the subcontractor must
be clearly related to the work of the consortium, and must include: (1) scope of work, including
tasks and deliverables; (2) time period of the contract; (3) person in your agency who will
supervise or manage the contract; (4) name of the contractor, if known; and (5) what method will
be used to select the contractor, such as bids, RFPs, sole-source, etc.
The Lead fiscal agent submits a master budget with additional organizations listed as contractors.
A copy of the budget form may be used to provide details about the budget of the additional
organizations listed in the master budget as contractors.
Total Direct Costs
The total direct cost line will auto-fill on the worksheet. Confirm that the amount calculated is
correct.
Cost Allocation and Indirect Rate
Indicate the cost allocation or indirect rate. The worksheet will auto-fill the total direct costs and
multiply the cost allocation rate against the total direct to calculate the total cost allocation
amount and total budget request amount. OHA reserves the right to request additional detail on
cost allocation or indirect rates.
Fund Restrictions
Grant funds may not be used to purchase nicotine replacement therapy, or to support staff time
providing tobacco cessation client services, such as classes, coaching, or counseling. Funding
cannot be used for direct services or to support reimbursement models as part of policy
implementation – e.g., funding cannot be used to reimburse for delivery of chronic disease self-
management program or for incentives to participants or leaders of such programs. Funds may
not be used to purchase educational or advocacy media such as paid advertising in newspapers or
radio.
Totals
The worksheet will auto-fill the total budget request amount. Confirm that the amount calculated
is correct.
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SECTION 6 – PROPOSAL EVALUATION
Proposals must be complete at the time of submission and include the required number of copies.
OC&P will verify the Proposals received meet the Minimum Qualifications identified in Section
2 and General Proposal Requirements in Section 5.1. Those Proposals meeting these
requirements will then be evaluated and scored.
OC&P will conduct a comprehensive and impartial evaluation of the Proposals received.
Proposals will be evaluated by an “Evaluation Committee” selected by OHA. The Evaluation
Committee will evaluate the Proposals and rank them according to the scoring system described
below.
Proposals must provide a concise description of the Proposer’s ability to satisfy the requirements
of the RFGP with emphasis on completeness and clarity of content. Evaluators will consider
brevity and clarity of responses when scoring Proposals.
Proposals will be scored by the Evaluation Committee. Maximum point values and evaluation
criteria for each section are described below.
Award, if one is made, will be made to the highest ranked responsive, responsible Proposer
subject to Section 6.3.
6.1 Technical Proposal Evaluation
6.1.1 Project Narrative
6.1.1.1 Current relationships (5 points)
How well did the Proposer describe the current relationships between the CCO(s),
the LPHA(s) and the CSMP Organization(s)? Proposers will not be scored higher
based on the strength or longevity of the current relationship but on an accurate
and informative description.
6.1.1.2 Current infrastructure (15 points)
Did the Proposer provide adequate background information on status of team
based care, electronic health record utilization, CSMP in community and clinical
settings, and existing agreements between the consortium partners? Did the
Proposer adequately describe how partners are identifying community members
who have hypertension, prediabetes and diabetes, and those who have risk factors
for these conditions such as tobacco use, poor physical activity and poor
nutrition? To receive full points the Proposer must include at least some
information about the CCO(s), LPHA(s) and CSMP Providers(s) in the
consortium.
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6.1.1.3 Ties to current organizational and community priorities (15 points)
How well does the Proposer describe how participation in this opportunity ties
with current priorities of the participating consortium member organizations? Did
the Proposer provide relevant information about strategic plans, quality
improvement plans, technology improvement plans, etc.? Does the Proposer
demonstrate a commitment to focus on hypertension, prediabetes and diabetes for
the purposes of this funding?
6.1.1.4 Capacity and commitment to serve marginalized populations (5
points)
How well does the Proposer demonstrate an existing capacity and commitment to
serve populations most affected by health disparities, including culturally and
linguistically diverse populations within the service area?
6.1.1.5 Leadership and traveling team (25 points)
How well did the Proposer describe the leadership for this project? Did the
Proposer adequately describe how they will determine the team that will attend
the SRCH Institutes including a description of the members of this team and their
decision making roles within their representative organizations? Points will be
awarded to Proposers who demonstrate high-level leadership and participation by
staff with decision-making authority among all consortium organizations.
6.1.1.6 Plans for supporting organizational change (20 points)
How well does the Proposer describe the consortium’s proposed plans for
completing assignments between SRCH institutes and for completing the
organizational change process to implement coordinated, team-based care and
sustainable, community-clinical linkages including closed loop referral systems to
evidence-based self-management programs? Did the Proposer include adequate
information about who will be responsible for what aspects of this process, how
the consortium members will work together, how the consortium members will
track and evaluate their progress and how this work will be staffed?
6.1.1.7 Capacity and commitment to document and share learning and past
experiences (10 points)
How well did the Proposer describe how member organizations have shared
learning and past experiences and propose plans for consortium members to
document and share what they have learned through this process? Proposers will
be scored based on specific suggestion of opportunities for sharing learning and
experiences, and to organizations willing to commit to sharing learning and past
experiences beyond the end of the grant period.
6.1.2 Letters of Commitment (20 points)
Did Proposer provide at least three letters of commitment with evidence of
executive or other senior level leadership support from key consortium partners,
including the local CCO, Public Health Authority, and a CSMP if neither the
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CCO nor LPHA offer CSMPs?
Did Proposer provide letters from additional entities involved in the
accomplishment of Grant outcomes? (i.e., Regional Health Equity Coalition if
available in the proposed region, or another community-based organization)
Do the Letters provided clearly outline the specific role of each consortium
partner and the commitment to participate in the SRCH Institutes? Are the Letters
signed by executive leadership and include details regarding the agreements to
sustain long-term collaboration?
6.2 Budget Proposal Worksheet and Narrative
Did the Proposer submit a complete Line Item Budget and Narrative Worksheet for the
fiscal period February 1, 2015 – August 31, 2015, using the required Line Item Budget
and Narrative Worksheet? Did the Proposer complete all fields, including all budget
categories, and provide narrative descriptions of the budget line items as applicable?
6.3 Evaluation Factors Checklist
Each Proposal must clearly meet the pass/fail criteria and address the scored criteria.
Evaluation factors and maximum points are presented below.
PASS OR FAIL CRITERIA
Section 2 Minimum Qualifications Pass or Fail
Section 5.1 Proposal Requirements Pass or Fail
SCORED CRITERIA
Evaluation Criteria
Maximum Possible
Score
Section 6.1 Technical Proposal Evaluation
Project Narrative 95
Letters of Commitment 20
Section 6.2 Budget Proposal Worksheet and Narrative 0
TOTAL POINTS 115
6.3 Final Selection and Award
Proposer ranking will be determined by the sum of its scores on the Technical Application.
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After the OHA Evaluation Committee completes the ranking, an OHA Executive Panel will
review the ranked list and make the final selection of Recipients and award amounts.
In making the final selection, the OHA Executive Panel will consider size and geographic
diversity of regions served, health burden of the intervention population, and diversity of
partners, diversity of consortium structures.
OHA will enter into negotiations beginning with the highest ranked Applicant(s) for award of
funding and continuing down the list of selected Applicants until funds are exhausted. OHA
reserves the right to negotiate award budget amounts. OHA may choose to not award an
Agreement. In the event that Agreement negotiations with the selected highest ranked
Applicant(s) are not successful within a reasonable time frame, OHA reserves the right to
terminate negotiations with the selected highest ranked Applicant(s), and negotiate with the
next selected highest ranked Applicant(s) and so on, until successful negotiations are
completed, funds are obligated or OHA decides to terminate all negotiations and cancel the
solicitation. OHA reserves the right to negotiate the budget and activities proposed by the
selected highest ranked Applicant(s). The determination of what constitutes a reasonable
time frame for purposes of this paragraph shall be solely at the determination of OHA. This
protocol will be followed until Agreements are been signed and funds are obligated. If all
Applications are rejected, Applicants will be promptly notified.
6.4 Proposal Rejection
6.4.1 OC&P will reject a Proposer’s Proposal if the Proposer attempts to influence a
member of the Proposal Evaluation Committee regarding the Proposal review and
evaluation process.
6.4.2 OC&P may reject a Proposal for any of the following additional reasons:
a. The Proposer fails to substantially comply with all prescribed solicitation
procedures and requirements, including but not limited to the requirement
that Proposer’s authorized representative sign the Proposal in ink; or
b. The Proposer makes any unauthorized contact regarding this RFGP with
State employees or officials other than the SPC.
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SECTION 7 – GENERAL INFORMATION
7.1 Changes/Modification and Clarifications
When appropriate, OC&P will issue revisions, substitutions, or clarifications as addenda
to this RFGP. Changes and modifications to the RFGP shall be recognized only if in the
form of written addenda issued by OC&P and posted on the ORPIN website
(http://orpin.oregon.gov/ ).
7.2 Reservation of OC&P Rights
OC&P reserves all rights regarding this RFGP, including, without limitation, the right to:
7.2.1 Amend or cancel this RFGP without liability if it is in the best interest of the
State;
7.2.2 .Reject any and all Proposals received by reason of this RFGP upon finding that it
is in the best interest of the State to do so;
7.2.3 Waive any minor informality;
7.2.4 Seek clarification of each Proposal;
7.2.5 Negotiate the statement of work within the scope of work described in this RFGP
and to negotiate the budget;
7.2.6 Amend or extend the term of any Grant that is issued as a result of this RFGP;
7.2.7 Engage Proposer by selection or procurement for different or additional services
independent of this RFGP process and any agreements entered into pursuant
hereto;
7.2.8 Enter into direct negotiations to execute a Grant with a responsive Proposer, in the
event that the Proposer is the sole Proposer to this RFGP, and OC&P determines
that the Proposer satisfies the minimum RFGP requirements;
7.2.9 Reject any Proposal upon finding that to accept the Proposal may impair the
integrity of the procurement process or that rejecting the Proposal is in the best
interest of the State.
7.2.10 Reservation of Rights regarding the Evaluation Process and Criteria
The “Best and Final Offer” permits OC&P to request a “Best and Final Offer”
from one or more Proposers if additional information is required to make a final
decision. Proposer may be contacted asking that they submit their “Best and Final
Offer”, which must include any and all discussed and negotiated changes. OC&P
reserves the right to request a “Best and Final Offer” for this RFGP based on any
factor.
7.3 Award Notice
The apparent successful Proposer shall be notified in writing and OC&P will set the time
lines for Grant negotiation as applicable.
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7.4 Modification or Withdrawal
a. Modifications: A Proposer may modify its Proposal in writing prior to the
closing. A Proposer must prepare and submit any modification to its Proposal to
OC&P Sole Point of Contact (SPC). Any modification must include the
Proposer’s statement that the modification amends and supersedes the prior
Proposal. The Proposer must mark the submitted modification “Proposal
Modification RFGP #OHA-3922-14”, and be addressed to the attention of the
SPC.
b. Withdrawals: A Proposer may withdraw its Proposal by submitting written
notice, submitted on the Proposer’s letterhead, signed by an authorized
representative of the Proposer, delivered to the SPC. The Proposer must mark the
written request to withdraw “Proposal Withdrawal to RFGP #OHA-3922-14”.
7.5 Release of Information
No information shall be given to any Proposer (or any other individual) relative to their
standing with other Proposers during the RFGP process.
7.6 Cost of Proposals
All costs incurred in preparing and submitting a Proposal in response to this RFGP will
be the responsibility of the Proposer and will not be reimbursed by OHA.
7.7 Grant Period
Initial term of the Grant shall be for the period stated in Section 1.1. If OHA determines
that the work performed has been satisfactory, OHA may, at its option, amend or extend
the Grant for additional time and for additional dollars without further solicitation for a
total Grant term of up to three years. Modifications or extensions shall be by written
amendment duly executed by the parties to the original Grant; see Form Grant,
Attachment 3.
7.8 Party Obligations
All Proposers who submit a Proposal in response to this RFGP understand and agree that
OHA is not obligated thereby to enter into a Grant with any Proposer and, further, has
absolutely no financial obligation to any Proposer.
7.9 Grant Documents
The final Grant Agreement with successful CCO Proposers will be based on the Form
CCO Grant Agreement, which is attached as Attachment 3 to this RFGP, and will include
all exhibits and attachments identified in the Agreement. The terms and conditions
included in Attachment 4, other than Exhibits A, Part 1-3 and Attachments A and B are
not subject to negotiation. The final Grant Agreement with successful LPHA Proposers
will be based on the Program Element, attached as Attachment 5 to this RFGP, will be
incorporated by amendment into the current LPHA Financial Assistance Agreement.
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ATTACHMENT 1 - Proposal Cover Sheet
Proposer Information – RFGP #OHA-3922-14
Proposer Name:
Primary Contact Person: Title:
Address: City, State, Zip
Telephone: Fax: E-mail Address:
Name and title of the person(s) authorized to represent the Proposer:
Name: Title:
By signing this page and submitting a Proposal, the Authorized Representative certifies that the following
statements are true:
1. No attempt has been made or will be made by the Proposer to induce any other person or
organization to submit or not submit a Proposal.
2. Proposers agree to follow the HPCDP Recommended Nutrition Protocols on Healthy Meetings,
Conferences and Events, available through HPCDP.
3. Each proposed consortium member has a 100% tobacco-free facility policy or, during the course
of the Grant, will develop a plan acceptable to OHA to work toward the adoption of 100%
tobacco-free facility policy.
4. Each proposed consortium member has adopted nutrition standards for at least one of the
following: 1) meetings, conferences and events, 2) cafeterias, 3) vending machines, or 4)
procurement policies. Or, each funded consortium member will, during the course of the Grant,
develop a plan to work toward the adoption of nutrition standards in one or more of these
settings. Sample policies are available at http://www.wellnessatworkoregon.org/?page_id=53.
5. Proposer does not discriminate in its employment practices with regard to race, creed, age,
religious affiliation, sex, disability, sexual orientation or national origin, nor has Proposer or will
Proposer discriminate against a subcontractor in the awarding of a subcontract because the
subcontractor is a minority, women or emerging small business enterprise certified under ORS
200.055.
6. Information and costs included in this Proposal shall remain valid for 90 days after the Proposal
due date or until a Grant is approved, whichever comes first.
7. The statements contained in this Proposal are true and complete to the best of the Proposer’s
knowledge and Proposer accepts as a condition of any resultant award, the obligation to comply
with the applicable state and federal requirements, policies, standards, and regulations. The
undersigned recognizes that Proposals are public documents and open to public inspection.
8. The Proposer acknowledges receipt of all addenda issued under this RFGP.
Signature: Date:
(Authorized to Bind Proposer)
*** THIS PAGE SHOULD BE THE TOP PAGE OF THE PROPOSAL ***
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ATTACHMENT 2 - Proposer’s Designation of Confidential Materials
RFGP #OHA-3922-14
Proposer Name:
Instructions for completing this form:
As a public entity, OC&P is subject to the Oregon Public Records Law which confers a right for any person to
inspect any public records of a public body in Oregon, subject to certain exemptions and limitations. See ORS
192.410 through 192.505. Exemptions are generally narrowly construed in favor of disclosure in furtherance of
a policy of open government. Your Proposal will be a public record that is subject to disclosure except for
material that qualifies as a public records exemption.
It is OC&P’s responsibility to redact from disclosure only material exempt from the Oregon Public Records
Law. It is the Proposer’s responsibility to only mark material that legitimately qualifies under an exemption
from disclosure. To designate a portion of a Proposal as exempt from disclosure under the Oregon Public
Records Law, the Proposer should complete the following steps:
1) Clearly identify in the body of the Proposal only the limited material that is a trade secret or would
otherwise be exempt under public records law. If a Proposal fails to identify portions of the Proposal as
exempt, Proposer is deemed to waive any future claim of non-disclosure of that information.
2) List, in the space provided below, the portions of your Proposal that you have marked in step 1 as
exempt under public records law and the public records law exemption (e.g., a trade secret) you believe
applies to each portion. If a Proposal fails to list in this Attachment a portion of the Proposal as exempt,
Proposer is deemed to waive any future claim of non-disclosure of that information.
3) Provide, in the space provide below, justification how each portion designated as exempt meets the
exemption criteria under the Oregon Public Records Law. If you are asserting trade secret over any
material, please indicate how such material meets all the criteria of a trade secret listed below. Please do
not use broad statements of conclusion not supported by evidence.
Application of the Oregon Public Records Law shall determine whether any information is actually exempt
from disclosure. Prospective Proposers are advised to consult with legal counsel regarding disclosure issues.
Proposer may wish to limit the amount of truly trade secret information submitted, providing only what is
necessary to submit a complete and competitive Proposal.
In order for records to be exempt from disclosure as a trade secret, the records must meet all four of the
following requirements:
· The information must not be patented;
· It must be known only to certain individuals within an organization and used in a business the
organization conducts;
· It must be information that has actual or potential commercial value; and,
· It must give its users an opportunity to obtain a business advantage over competitors who do not know
or use it.
Keep in mind that the trade secret exemption is very limited. Not all material that you might prefer be kept
from review by a competitor qualifies as trade secret material. OC&P is required to release information in the
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Proposal unless it meets the requirements of a trade secret or other exemption from disclosure and it is the
Proposer’s responsibility to provide the basis for which exemption should apply.
In support of the principle of an open competitive process, “bottom-line pricing” or pricing used for objective
cost evaluation for award, or the total cost of the Grant, will not be considered as exempt material under a
public records request. Examples of material that would also not likely be considered a trade secret would
include résumés, audited financial statements of publicly traded companies, material that is available publicly,
such as a screen shot of a software interface or a software report format.
To designate material as confidential and qualified under an exemption from disclosure under Oregon Public
Records Law, a Proposer must complete this form as follows:
Part I: List all portions of the Proposal, if any, that Proposer is designating as exempt from disclosure under
Oregon Public Records Law. For each item in the list, state the applicable exemption in Oregon Public Records
Law that qualifies the material as exempt from disclosure.
“This data is exempt from disclosure under the Oregon Public Records Law pursuant to [ insert specific
exemption from ORS 192, such as a “ORS 192.501(2) ‘trade secret’” ], and is not to be disclosed except
in accordance with the Oregon Public Records Law, ORS 192.410 through 192.505.”
In the space provided below, state Proposer’s list of material exempt from disclosure and include specific pages
and section references of your Proposal.
1.
2.
3.
[This list may be expanded as necessary.]
Part II: For each item listed above, provide clear justification how that item meets the exemption criteria under
Oregon Public Records Law. If you are asserting trade secret over any material, state how such material meets
all the criteria of a trade secret listed above in this Attachment.
In the space provided below, state Proposer’s justification for non-disclosure for each item in the list in Part I
of this Attachment:
1.
2.
3.
[This list may be expanded as necessary.]
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ATTACHMENT 4 – Form CCO Grant
RFGP #OHA-3922-14
Grant Agreement Number 000000
State of Oregon
Grant Agreement
In compliance with the Americans with Disabilities Act, this document is available in alternate formats such as
Braille, large print, audio recordings, Web-based communications and other electronic formats. To request an
alternate format, please send an e-mail to dhs-oha.publicationrequest@state.or.us or call 503-378-3486 (voice)
or 503-378-3523 (TTY) to arrange for the alternative format.
This Agreement is between the State of Oregon, acting by and through its Oregon Health Authority, hereinafter
referred to as “OHA,” and
Recipient Legal Entity Name
Address
Address
Telephone:
Facsimile:
E-mail address
home page URL, if applicable
hereinafter referred to as “Recipient.” Recipient and OHA are party to that certain Health Plan Services
Contract, Coordinated Care Organization Contract # [ To Be Determined ] (as amended from time to time, the
“CCO Contract”).
The Program to be supported under this Agreement relates principally to the OHA’s
Public Health Division
Health Promotion & Chronic Disease Prevention
800 NE Oregon Street
Portland, Oregon 97232
1. Effective Date and Duration
This Agreement is effective on the date this Agreement has been fully executed by every party and
approved by Department of Justice or on [ To be Determined ], whichever date is later. Unless extended
or terminated earlier in accordance with its terms, this Agreement shall expire on [ Date ]. Agreement
termination shall not extinguish or prejudice OHA’s right to enforce this Agreement with respect to any
default by Recipient that has not been cured.
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2. Agreement Documents
a. This Agreement consists of this document and includes the following listed exhibits which are
incorporated into this Agreement:
(1) Exhibit A, Part 1: Grant Activities
(2) Exhibit A, Part 2: Program Description
(3) Exhibit A, Part 3: Payment, Budget and Financial Reporting
(4) Exhibit B: Standard Terms and Conditions
(5) Exhibit C: Federal Terms and Conditions
(6) Attachment A: Form of Expenditure Report
(7) Attachment B: Form of Activity Report
There are no other Agreement documents unless specifically referenced and incorporated in this
Agreement.
b. This Agreement and the documents listed in Section 2, Agreement Documents, Subsection a.
above, shall be in the following descending order of precedence: this Agreement less all exhibits,
Exhibit C, Exhibit B, then the remaining agreement documents in the sequence attached.
3. Grant Disbursement Generally
The total Grant funds that may be disbursed to Recipient under this Grant Agreement are $_________.
OHA will disburse the Grant to Recipient as described in Exhibit A.
4. Recipient Data and Certification
a. Recipient Information. Recipient will provide the information set forth below. This information
is requested pursuant to ORS 305.385.
Please print or type the following information
Name (exactly as filed with the IRS)
Address
E-mail address:
Telephone: ( ) - Facsimile: ( ) -
b. Recipient is required to provide its Federal Employer Identification Number (FEIN) or Social
Security Number (SSN), as applicable to OHA. By Recipient’s signature on this Agreement,
Recipient hereby certifies that the FEIN or SSN provided to OHA is true and accurate. If this
information changes, Recipient is also required to provide OHA with the new FEIN or SSN
within 10 days.
c. The information shown in this Section 4, Recipient Data and Certification, is Recipient’s true,
accurate and correct information.
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RECIPIENT, BY EXECUTION OF THIS AGREEMENT, HEREBY ACKNOWLEDGES THAT
RECIPIENT HAS READ THIS AGREEMENT, UNDERSTANDS IT, AND AGREES TO BE BOUND
BY ITS TERMS AND CONDITIONS.
Signatures
Recipient:
Authorized Signature Title Date
OHA:
Authorized Signature Title Date
Approved:
Assistant Attorney General Date
OHA Office of Contracts and Procurement:
Contract Specialist Date
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EXHIBIT A
Part 1
Grant Activities
1. Recipient will use the Grant funds for activities that:
a. Are described in Exhibit A, Part 2 (as amended from time to time), and for no other purposes;
b. Support better health, better health care and lower costs in their communities; and
c. Support the partnership of Local Public Health Authorities (LPHA), Coordinated Care
Organizations (CCO) and local Community Self-Management Program (CSMP) organizations to
align and delineate organizational roles and responsibilities to improve health outcomes, while
leveraging existing community-wide health improvement initiatives.
d. Increase the use of evidence-based Community Self-Management Programs (CSMP) through
closed-loop health system referral and reimbursement.
2. Grant funds may not be used to purchase nicotine replacement therapy, or to support staff time
providing tobacco cessation client services, such as classes, coaching, or counseling. Funding cannot be
used for direct services or to support reimbursement models as part of policy implementation – e.g.,
funding cannot be used to reimburse for delivery of chronic disease self-management program or for
incentives to participants or leaders of such programs. Funds may not be used to purchase educational or
advocacy media such as paid advertising in newspapers or radio. Funds may not be used to supplant
state covered services, nor to replace services provided under Proposer’s CCO contract with OHA.
Funded activities may include, but are not limited to: personnel, travel expenses, meetings and supplies,
consultants, and indirect expenses affiliated with the project such as administrative support, telephone,
and computers.
EXHIBIT A
Part 2
Program Description
Activities that describe the Recipient’s project to be supported under this Grant Agreement. This may
include:
1. Executive Summary
2. Project Description
3. Project Timeline
4. Measurable Project Objectives and Metrics
5. Spread of Innovation
To be negotiated and finalized prior to agreement execution. Additional Program Description provisions will
be negotiated and finalized prior to agreement execution.
EXHIBIT A
Part 3
Budget, Financial and Grant Activities Reporting
To be negotiated and finalized prior to agreement execution. Additional Budget, Financial and Grant
Activities Reporting provisions will be negotiated and finalized prior to agreement execution.
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EXHIBIT B
Standard Terms and Conditions
This Grant Agreement is governed by the Standard Terms and Conditions in Exhibit D to the CCO Contract
(with “Recipient” substituted for “Contractor,” “Subrecipient” substituted for “Subcontractor,” and “Grant
Agreement” substituted for “Contract”), except as follows:
1. In addition to any other grounds for termination in Section Exhibit D, 10.e, this Grant Agreement will be
terminated automatically without notice in the event of termination of the CCO Contract. Termination of
this Grant Agreement does not alter the obligation of Recipient to utilize and report on Grant funds
already disbursed in accordance with this Grant Agreement.
2. The provisions governing Sanctions in Exhibit D, Sections 32 to 35 will not apply.
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EXHIBIT C
Federal Terms and Conditions
This Grant Agreement is governed by the Required Federal Terms and Conditions in Exhibit E to the CCO
Contract (with “Recipient” substituted for “Contractor,” “Subrecipient” substituted for “Subcontractor,” and
“Grant Agreement” substituted for “Contract”).
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Attachment A: Form of Expenditure Report
To be finalized prior to agreement execution.
Attachment B: Form of Activity Report
To be finalized prior to agreement execution.
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ATTACHMENT 4 – Line Item Budget Worksheet
RFGP # OHA-3922-14
~ See MS Excel Worksheet attached separately in ORPIN Attachments Folder ~
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ATTACHMENT 5 – Program Element
RFGP # OHA-3922-14
Program Element #XX: Sustainable Relationships for Community Health (SRCH)
1. Description. Funds provided under the Financial Assistance Agreement for this Program Element may
only be used, in accordance with and subject to the requirements and limitations set forth below, for a
Local Public Health Authority (LPHA) to partner with their regional Coordinated Care Organizations
(CCO) and local Community Self-Management Program (CSMP) organizations to align and delineate
organizational roles and responsibilities to improve health outcomes, while leveraging existing
community-wide health improvement initiatives. Recipients will specifically address issues related to
areas of quality improvement, including use of quality measures, electronic health records and health
information technology, and traditional health workers in team ‐based care. Recipients will also increase
the use of evidence-based Community Self-Management Programs (CSMP) through closed-loop health
system referral and reimbursement.
2. Definitions specific to this Program Element:
· Community Self-Management Program (CSMP) according to the Institute of Medicine, self-
management programs are “the systematic provision of education and supportive
interventions…to increase patients’ skills and confidence in managing their health problems,
including regular assessment of progress and problems, goal setting, and problem-solving
support.” Community Self-Management Programs (CSMPs) are provided in community settings
that are accessible and culturally sensitive to participants, e.g. community centers, places of
worship, community-based organization offices. CSMPs focus on patient-perceived problems
and needs, and emphasize skills such as problem solving and decision-making. They prepare
people with chronic conditions to have the skills and confidence to manage their disease(s) on a
daily basis and to manage its impact on activities and emotions. Self-management programs
improve quality of life and support the Triple Aim of health systems transformation by reducing
costly health crises and improving health outcomes for chronically ill patients with conditions
such as asthma, cardiovascular disease, depression, diabetes, and arthritis. CSMPs are delivered
by people who are known, trusted, culturally sensitive and fluent in the language of the target
community. CSMP facilitators need not be health professionals, but they are trained and
prepared for their role. For the purposes of this document, CSMPs are limited to those identified
and supported by the Oregon Health Authority’s Public Health Division. These currently include
Stanford Chronic Disease Self-Management Programs (e.g., CDSMP/Living Well, Tomando
Control de su Salud, the Diabetes Self-Management Program, the Positive Self-Management
Program, the Chronic Pain Self-Management Program, and the online Better Choices, Better
Health program), the National Diabetes Prevention Program, and Walk With Ease. For more
information about the evidence-based CSMPs currently supported by OHA/PHD, see
http://www.healthoregon.org/takecontrol .
· Closed-Loop Referrals are referrals that, in addition to linking the referred individual to a given
self-management intervention as described below, also provide the referring entity with timely
follow-up information pertinent to the individual’s continuing care. Examples of information to
close the referral loop include updates on whether the referred individual received the
intervention, outcomes related to receipt of the intervention (e.g., identified self-management
goals, improved disease status, reduction of risk factors such as tobacco use) and any barriers
precluding receipt of the intervention.
· Evidence-Based Practice refers to practices set forth in disease management criteria established
by national guideline from expert organizations such as the Centers for Disease Control and
Prevention, Administration for Community Living, National Institutes of Health, the Community
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Guide to Preventive Services, the National Council on Aging, the American Diabetes
Association and the American Heart Association.
· Health Information Technology (HIT) encompasses a wide range of products and services
including software, hardware and infrastructure designed to collect, store and exchange patient
data throughout the clinical practice of medicine.
3. Local Activities. LPHAs, CCOs and CSMP organizations (consortium partners), will focus efforts on
the activities described in subsections 3.a. through 3.d. below. Together, these activities will support
participating partners in the development of plans to improve inter-organizational partnerships and the
creation of joint agreements with LPHAs, regional CCO and local community-based organization to
address chronic disease prevention, early detection and self-management.
a. Participate in Institute Activities to create sustainable relationships for community health
(SRCH Institutes). Successful Proposers, including Key Person(s) from each consortium
partner, will actively participate in Institutes to develop Sustainable Relationships for
Community Health (SRCH Institutes). OHA will convene the SRCH Institutes as a “learning
collaborative,” where local consortium members will participate in a series of facilitated
discussions and receive technical assistance. Discussions and technical assistance will engage
local leaders involved in health system transformation and development of community-clinical
linkages to align and delineate organizational roles and responsibilities to improve health
outcomes, while leveraging existing community‐wide health improvement initiatives.
The SRCH Institutes will assist consortium members to co-design (1) local initiatives to improve
cross-sector partnerships and (2) joint agreements with consortium partners to address the local
burden related to prevention, early detection and self-management.
The SRCH Institutes will include three in-person two-day meetings during the period April
through September, 2015. Additionally, successful Proposers will:
· Conduct pre-work on the consortium’s needs, strengths, and goals for participation in the
SRCH Institutes;
· Engage in activities between Institute in-person meetings, including facilitated Technical
Assistance calls/webinars, and individual coaching;
· The SRCH Institutes will support LPHAs, CCOs and CSMP Providers in developing formal
commitments, such as memoranda of understanding and data-sharing agreements, to
reinforce collaboration and a long ‐term commitment to health system improvement and
community ‐clinical linkages. Consortium members will share outcomes and assist OHA with
the dissemination of findings.
b. Advance Health System Interventions. During the SRCH Institutes, consortium members will
participate in structured, facilitated discussions and activities to co- design and advance health
system interventions addressing prevention, early detection and self-management of chronic
disease that:
· Increase implementation of quality improvement processes in health systems.
· Increase electronic health records (EHR) utilization and the use of health information
technology (HIT) to improve quality of care.
· Increase the institutionalization and monitoring of aggregated/standardized quality measures
at the provider and systems level.
· Increase use of team-based care in clinical and community health systems settings.
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· Increase engagement of non-physician team members (e.g., care coordinators, pharmacists,
community health workers, patient navigators, peer support specialists, peer wellness
specialists) in hypertension, prediabetes and diabetes management in health care systems and
community settings.
· Promote Community-Clinical Linkages to support patient self-management.
c. Promote Community-Clinical Linkages to support patient self-management. During the
SRCH Institutes, consortium members will participate in structured facilitated discussions and
activities that develop and reinforce long-term commitments to community-clinical linkages,
quality improvement, data-sharing, collaboration and partnerships between LPHA(s), CCO(s),
CSMP Providers and others. Consortium members will co-design self-management support
strategies for those enrolled in the Oregon Health Plan that:
· Increase access to evidence-based chronic disease self-management programs (CSMPs),
especially those delivered in community settings
· Increase closed-loop referrals and reimbursement for evidence-based chronic disease self-
management programs (CSMPs), especially those delivered in community settings.
· Increase use of non-physician health workers in community and health care settings in
support of self-management.
d. Development and implementation of a plan to sustain relationships for community health.
By the conclusion of the facilitated discussions and technical assistance offered during the SRCH
Institutes, local consortium members will have co-created a plan and agreements that enhance
collaboration, promote community-clinical linkages and advance health system interventions.
The plan and agreements will delineate roles and responsibilities; identify staffing and training needs;
and ultimately create mechanisms to facilitate better care, better health, and lower cost. Each
consortium’s plan and agreements shall include specific strategies, actions, organizational/individual
responsibilities and a timeline to:
· Improve the use of quality measures; EHR/HIT, and traditional health workers in team ‐based care,
and;
· Increase the use of CSMPs through development or improvement of systems enabling Closed Loop
Referrals of appropriate patients and payments or reimbursement to organizations providing CSMPs.
4. Procedural and Operational Requirements. By accepting and using the financial assistance funding
provided by Department under the Financial Assistance Agreement and this Program Element, LPHA
agrees to conduct activities in accordance with the following requirements:
· LPHA shall implement its activities in accordance with this Program Element.
· LPHA must assure that it is staffed at the appropriate level to address subsections 3.a. through 3.d. of
this Program Element. LPHA will designate a point of contact between the Recipient and OHA.
Funds for this program element are to be directed to personnel, travel and other expenses in support
of subsections 3.a. through 3.d.
· LPHA must use the funds awarded under this Agreement for this Program Element in accordance
with its budget as approved by the Department. Modifications to the budget may only be made with
Department approval.
· LPHA must attend all Institute Meetings with partnering CCO and community-based organizations.
· LPHA must attend all meetings reasonably required by HPCDP.
· LPHA must comply with Department’s Health Promotion and Chronic Disease Prevention Program
Guidelines and Policies.
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· In the event of any omission from, or conflict or inconsistency between, the provisions of the Budget
and the provisions of the Agreement and this Program Element, the provisions of the Agreement and
this Program Element shall control.
5. Reporting Requirements. Successful Proposers shall submit to HPCDP copies of products developed
through the SRCH Institutes including: 1) official agreements such as Memorandum of Understanding,
data sharing agreements, and other legal agreements; 2) protocols for referrals, payment and data
sharing; and 3) other documentation demonstrating successful implementation which may include
position descriptions, staffing plans, business plans, technology plans, etc. Successful Proposers will
also work with OHA to share experiences and promising practices with others.
6. Program Evaluation . Successful Proposers will assist OHA with program evaluation throughout the
duration of the grant period(s), as well as with final project evaluation. Such activities may include, but
are not limited to, meeting with a state level evaluator soon after execution of a Grant to help develop an
evaluation plan specific to the project, collecting data and maintaining documentation throughout the
Grant period, responding to evaluator’s requests for information and collaborating with the evaluator to
develop final reports to highlight the outcomes of the work. One representative from each consortium
will be required to participate on a project evaluation advisory group.
7. Performance Measures. LPHA’s that complete fewer than 75% of the planned activities in its Local
Program Plan for two consecutive calendar quarters in one state fiscal year will not be eligible to receive
funding under this Program Element in the next state fiscal year.