Vendor Conference STARPLUS RFP HHS 0000428 Vendor Conference

Vendor Conference STAR+PLUS RFP #HHS 0000428

Vendor Conference Agenda Procurement Project Activities Overview HUB Questions Break Submittal ? Preliminary Closing 10/31/2020 Responses to Questions Commentary to Questions 2

Introductions Speakers • Robert Sonnier, Procurement Project Manager, HHSC Procurement and Contracting Services (PCS) • Cheryl Bradley, HUB Coordinator, HHSC PCS • Amanda Dillon, Manager, Managed Long Term Services and Supports Utilization Review, Medicaid and CHIP Services (MCS) 10/31/2020 3

Sole Point of Contact Information HHSC Procurement Project Manager Robert Sonnier 512 -406 -2613 Robert. sonnier@hhsc. state. tx. us 10/31/2020 4

Procurement Roles HHSC Procurement Team �PCS - Responsible for procurement activity �Program - Responsible for project scope, requirements, performance, results, contract management and monitoring �Legal – Questions/answers and legal activity 10/31/2020 5

Schedule of Events Upcoming Events Deadline for Submitting Questions Wednesday, December 19, 2017 5: 00 PM Central Standard Time HHSC Posts Responses to Vendor Questions Estimate - Monday, January 8, 2018 Deadline for submission of Solicitation Responses Tuesday, March 6, 2018 2: 00 PM Central Standard Time Anticipated Operations Start Date January 1, 2020 10/31/2020 6

Solicitation Access The posting on the Electronic State Business Daily (ESBD) is located at: http: //www. txsmartbuy. com/sp • HHSC will post all official communication regarding this RFP on the ESBD website, including the notice of award. • HHSC reserves the right to cancel this RFP, or to make no award if it determines such action is in the best interest of the State. • HHSC may, in its discretion, reject any and all proposals or portions thereof. 10/31/2020 7

HHS Sole Point of Contact • All communications relating to this RFP must be directed to the HHSC Sole Point of Contact. • All communications between respondents and other HHSC staff members concerning this RFP are strictly prohibited. • Failure to comply with these requirements may result in proposal disqualification. 10/31/2020 8

RFP Overview

Request for Proposals Requesting proposals from vendors to provide managed care services for the STAR+PLUS program to eligible members. 10/31/2020 10

Program Overview • STAR+PLUS integrates the delivery of acute care and LTSS through a managed care system • Key function: Service Coordination Specialized care management service available to all members and performed by an MCO service coordinator • Populations served in STAR+PLUS are available in Sections 1. 4. 9 through 1. 4. 11 10/31/2020 11

Service Areas Respondents may bid on one or more Service Area (SA). If a respondent proposes to participate in a SA, the respondent must serve all counties in the defined SA. 10/31/2020 12

Contract Term • Initial Contract Period – Contract Effective Date anticipated to occur October 2018 and the initial term will be through August 31, 2022. • HHSC may extend any awarded contract for an additional period or periods, not to exceed a total of eight operational years. 10/31/2020 13

Transition • Develop a comprehensive Transition Plan and implement the plan to operationalize the program and satisfy Operation Phase requirements starting January 1, 2020. 14

Transition Milestones 15

Member Enrollment During Transition • HHSC will notify current Members in a SA about MCO options starting six months prior to the Operational Start Date (OSD). • Members may select their MCO as early as 90 days in advance of the OSD. • HHSC will provide a prospective member file to each MCO as early as 90 days in advance of the OSD. • These timelines allows health information, authorizations, and related data to be shared between MCOs. 16

Key Performance Standards During Transition Performance Standard Measurement Period Timely and successfully Transition Phase meet Readiness Review requirements set forth § 2. 4 in no later than 60 calendar days prior to the Operational Start Date for each applicable HHSC Program, per Service Area (SA). The MCO must be operational no later than the agreed upon Operational Start Date. HHSC, or its agent, will determine when the MCO is considered to be operational based on the requirements in §§ 2. 4 and 2. 5 of the RFP. Measurement Assessment Liquidated Damages Each calendar day of noncompliance, for each applicable HHSC Program, per SA HHSC may assess up to $25, 000 per calendar day for each day beyond the 60 -day pre Operations Start Date due date that the MCO has not met the standard unless a delay is otherwise approved in writing by HHSC. Operations Phase Each calendar day of noncompliance, per SA HHSC may assess up to $50, 000 per calendar day for each day beyond the Operational Start Date that the MCO is not operational until the day that the MCO is operational, including all systems. 17

Scope of Work: Items to Note SERVING MBCC MEMBERS • In the event the MCO serves a member ages 18 -21 in the Medicaid for Breast and Cervical Cancer (MBCC) program, the MCO must comply with Texas Health Steps and Frew related requirements, in addition to federal Early and Periodic Screening, Diagnostic and Treatment (EPSDT) requirements. 10/31/2020 18

Scope of Work: Items to Note MEDICARE PLAN OBLIGATION • The MCO… o MUST operate a Medicare-Medicaid Plan (MMP) in the Dual Demonstration counties. o MUST Operate a Medicare Advantage Dual Eligible Special Needs Plan (MA Dual SNP) in counties where there is no Dual Demonstration product. o CANNOT operate a MA Dual SNP in counties where there is a Dual Demonstration product. • Dual Demonstration counties are Bexar, Dallas, El Paso, Harris, Hidalgo, and Tarrant. 19

Scope of Work: Items to Note MCO PORTAL – ACCESS TO ASSESSMENTS • Members receiving LTSS will have access to their functional assessments and service plans through the MCO portal. • Providers will have access to the functional assessments and service plans for which the provider holds an authorization through the MCO portal. 10/31/2020 20

Scope of Work: Items to Note PREFFERED PROVIDERS • The MCO must profile all providers of a service or supply for no less than 12 months and the results of the profiling must be used to determine the Provider(s) selected for a preferred arrangement. • Members must be able to opt-out of using a preferred Provider. 10/31/2020 21

Scope of Work: Items to Note MEMBER HOTLINE • The MCO must have a single hotline number for Member Services which can transfer to the required nurse advice team, service coordination team, or member services staff. Any hotline staff must be trained in assisting members with IDD. 10/31/2020 22

Scope of Work: Items to Note SIGNIFICANT TRADITIONAL PROVIDER (STP) • HHSC reserves the right to invoke STP requirements should new services or populations be added to STAR+PLUS. • The MCO is required to develop their own networks, based on their member’s providers. 10/31/2020 23

Scope of Work: Items to Note SERVICE COORDINATION • Qualified IDD professionals can be service coordinators. • Training requirements for service coordinators are revised to be more specific and allow the MCO to tailor training, depending on their member case load. 10/31/2020 24

Scope of Work: Items to Note STAR+PLUS HCBS • A member must receive at least one Home and Community Based Service (HCBS) service each quarter of the member’s service plan year to remain enrolled in the program. 10/31/2020 25

Scope of Work: Items to Note FUTURE POTENTIAL CHANGES • Potential changes to STAR+PLUS services and populations are noted in Section 2. 5. 3 o For example, at a future date HHSC may add the following to the STAR+PLUS program: § LTSS waiver services for individuals with intellectual and developmental disabilities § Wrap services for individuals with both Medicaid and Medicare • Potential changes are contingent upon agency decision-making authority and direction from the Texas Legislature 26

Historically Underutilized Business (HUB) Requirements

HUB PARTICIPTATION REQUIREMENTS Requirements Responses that do not include a complete HSP shall be Rejected pursuant to Texas Gov’t Code § 2161. 252(b). The goal for this solicitation is: Responding entities must choose an HSP method and provide proper, and complete documentation. A Notification to solicit HUBs is preferred to be in writing. Review attached HSP Checklist for assistance. To meet eligibility requirement for HUB certification you must be: For Profit, 51% owned by an Asian Pacific American, Black American, Hispanic American, American Women, Native American and/or Service Disabled Veteran who reside in Texas and actively participate in the control, operations and management of the company’s affairs. Definitions: Respondent – a person that submits a response – go to CPA website: Rule 20. 282, (24), that is posted on ESBD or other websites, providing a bid for the entire project. Subcontractor – firm providing Respondent with bid – go to CPA website: Rule 20. 282, (27) for a particular scope or portion of the solicitation including supplies. 2

HUB SUBCONTRACTING PLAN (HSP) METHODS & REQUIREMENTS Method V Method III Method I HSP Methods HSP Submission Requires Respondent Information List of Subcontractors + percentage Self Performing Justification Good Faith Effort – Attachment A when using all certified HUB’s for project, or meeting or Exceeding the HUB goals Good Faith Effort – Attachment B use when HUB total does not meet or exceed HUB goals HUB Subcontracting Opportunity Notification form (optional) Progress Assessment Report 29

HSP SUBMISSION METHODS HSP Method Options Method I 100 % of your subcontracting opportunities will be performed using only HUB vendors; Method II Method utilizes HUB protégé (HUB only) for one or more of the subcontracting opportunities. Which is an approved M/P relationship by a state agency and posted on CPA’s website. Method III Method utilizes HUB’s and Non-HUB’s to perform the subcontracting work identified and the HUB goal identified in the solicitation is met or exceeded. Method IV Method utilizes HUB’s and Non-HUB’s to perform the subcontracting work identified and the HUB goal identified in the solicitation is not met or exceeded. Method V Respondent intends to self-perform all of the work utilizing their own resources, equipment, materials, supplies, transportation, delivery and employees. All Methods Require respondent information, company name and requisition number, plus subcontracting intentions and affirmation signature. 30

HSP SUBMISSION METHODS HSP Method Options All Methods Require Respondent, Company and Requisition information, plus subcontracting intentions and affirmation signature. (Note: Please be sure to thoroughly read page 3 section 4 of the HSP) 31

HUB SUBCONTRACTING PLAN – RESPONDENT PLANNING ON SUBCONTRACTING 1 2 1. Respondent Name/ Req. Number 2. Respondent’s Subcontracting Intentions 3 3. Subcontracting Opportunities This page is for subcontracting opportunities identified by the scope of work. Place subcontracting opportunity description, percentage of the contract expected to be subcontracted to HUBs and Non. HUBs in correct column. 32

HSP ATTACHMENT A – IF USING METHOD I OR III (required for each subcontracting opportunity listed) 1 2 1. Respondent Name/ Req. Number 2. Subcontracting Opportunity 3 3. Subcontractor Selection Identify: Company Name Texas Certified HUB (Y) or (N) (note: VID # is required, for HUB and Non-HUB. Do not enter Social Security Numbers). • Texas VID or Federal EIN # • Number Percentage • Dollar Amount 33

HSP ATTACHMENT B – IF USING METHOD II (required for each subcontracting opportunity listed) 1 1. Respondent Name/ Req. Number 2 2. Subcontracting Opportunity Description 3 3. Mentor Protégé Program (check yes) Complete section B 2: if the respondent is participating in a Mentor Protégé Program please complete section B 1 and B 2 for each subcontracting opportunity. 34

HSP ATTACHMENT B – IF USING METHOD IV (required for each subcontracting opportunity listed) 1 1. Respondent Name/ Req. Number 2 2. Subcontracting Opportunity Description 3. Subcontractor Written Notification 3 Complete form documenting contact information for each subcontracting opportunity listed. List (3) three certified HUBs and (2) two Trade Organizations or Development Centers for each subcontracting opportunity listed. Provide Supporting documentation (email, fax, etc. ). Contact potential bidders with a minimum of 7 Working days. The initial day of notification is Considered to be “day zero”. 35

HSP ATTACHMENT B – IF USING METHOD II OR IV (required for each subcontracting opportunity listed) 1 2 1. Respondent Name/ Req. Number 3 2. Subcontractor Selection 3. Subcontractor Selection Name Identify: Company Name Texas Certified HUB (Y) or (N) (note: VID # is required, for HUB and Non-HUB. Do not enter Social Security Numbers). • Texas VID or Federal EIN # • Number Percentage • Dollar Amount (please provide justification if Non-HUB subcontractor is not selected) 36

HSP if using Method V Requires Respondents, Company, Requisition information, subcontracting intentions, page 3 “Self Performing Justification and affirmation signature. 1. Respondent Name/ Req. Number 1 2 2. Respondent’s Subcontracting Intentions 3. Self Performing Justification 4. Affirmation Signature 3 4 37

HSP REMINDERS Communication Changes to the HSP are not allowed by the Respondent, until after Contracts are awarded. The HUB Program Office must be notified immediately and in advance in order to receive approval of the HUB Subcontracting Plan. The HUB Program Office will contact the awarded contractor requesting their participation in a Post Award Meeting once the contract has been awarded. Supporting Documentation for Method IV Documentation is also a key to a successful HUB Subcontracting Plan. The Respondent must submit documentation to the HUB Program Office with their initial response to demonstrate that a Good Faith Effort was made in the process of developing and submitting an HSP. Examples include : 1. Read Receipt from email 2. Fax Log 3. Certified Letter 38

POST AWARD REMINDERS Prime Contractor Progress Assessment Report • Required Monthly with All Pay Request. • List All Sub-contractors payments (HUBs and Non-HUBs). • Required even if you are Self-Performing all the work. Send notification to subcontractors within 10 days of the award and Email a copy to the HUB Program Office at HHSCHUB@hhsc. state. tx. us 39

QUESTIONS – HHS HUB PROGRAM COORDINATORS HHS HUB Operations Manager Sherice Williams – 512/406 -2542 sherice. williams@hhsc. state. tx. us HHS HUB Assistant Manager Stella Roland – 512/406 -2534 stella. roland@hhsc. state. tx. us DSHS Michael Herman – 512/406 -2523 michael. herman@hhsc. state. tx. us HHSC Cheryl Bradley– 512/406 -2529 cheryl. bradley@hhsc. state. tx. us HUB Coordinator Marticia Lee– 512/406 -2519 marticia. lee@hhsc. state. tx. us HUB Coordinator Linda Rogers – 512/406 -2569 linda. rogers 02@hhsc. state. tx. us The link below will access general information and step by step instructions concerning the required steps to complete the form(s). http: //www. hhsc. state. tx. us/about_hhsc/Contracting/rfp_attch/HSPPKG. pdf The link below will access the HHSC website for HUB organizations and subcontracting opportunities. http: //comptroller. texas. gov/procurement/prog/hub/searching_cmbl. html Health and Human Services Commission – HHSC Department of State Health Services - DSHS 14

Questions and Answers 41

Questions and Answers All questions must be submitted in writing to the Procurement Project Manager at: Robert. sonnier@hhsc. state. tx. us using the specified Exhibit K in the Solicitation. USE THE EXACT EXHIBIT and FORMAT Do not submit in PDF, do not password protect Reminder: All additional questions, requests for clarification, etc. , are due in writing no later than December 19, 2017 by 5 pm. 42

Closing Comments • Respondents are responsible for meeting the RFP requirements, including any addenda. • Respondents must check the ESBD frequently for any new amendments that may have been added to this solicitation. • HHSC’s Historically Underutilized Business (HUB) Coordinator will work with potential awardees to ensure HUB compliance. • Vendor Questions/HHSC Responses will be posted to the ESBD. 35

That’s It! 10/31/2020 44