Year 1 Budget Request - DHMH - Maryland.gov

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1.26 Procurement Method This Contract will be awarded in accordance with the competitive sealed proposals process under COMAR 21.05.03. 1.27 Verification of Registration and Tax Payment Before a corporation can do business in the State it must be registered with the Department of Assessments and Taxation. Address: State Office Building, Room 803 301 West Preston Street Baltimore, Maryland 21201 Web Address: http://www.dat.state.md.us/sdatweb/datanote.html It is strongly recommended that any potential Offeror complete registration prior to the due date for receipt of proposals. An Offeror’s failure to complete registration with the Department of Assessments and Taxation may disqualify an otherwise successful Offeror from final consideration and recommendation for Contract award. 1.28 False Statements Offerors are advised that the Md. Code Ann., State Finance and Procurement Article, §11-205.1 provides as follows: (a) In connection with a procurement contract a person may not willfully: � Falsify, conceal, or suppress a material fact by any scheme or device; � Make a false or fraudulent statement or representation of a material fact; or � Use a false writing or document that contains a false or fraudulent statement or entry of a material fact. (b) A person may not aid or conspire with another person to commit an act under subsection (a) of this section. (c) A person who violates any provision of this section is guilty of a felony and on conviction is subject to a fine not exceeding $20,000 or imprisonment not exceeding five years or both. 1.29 Payments by Electronic Funds Transfer By submitting a response to this solicitation, the Offeror agrees to accept payments by electronic funds transfer unless the State Comptroller’s Office grants an exemption. The selected Offeror shall register using the COT/GAD X-10 Vendor Electronic Funds (EFT) Registration Request Form. Any request for exemption must be submitted to the State Comptroller’s Office for approval at the address specified on the COT/GAD X-10 form and must include the business identification information as stated on the form and include the reason for the exemption. The COT/GAD X-10 form can be downloaded at: http://compnet.comp.state.md.us/gad/pdf/GADX-10.pdf> 1.30 Living Wage Requirements A solicitation for services under a State Contract valued at $100,000 or more may be subject to Title 18 of the State Finance and Procurement Article of the Annotated Code of Maryland. Additional information regarding the State’s Living Wage requirement is contained in this solicitation (see Attachment F, “Living Wage Requirements for Service Contracts & Affidavit of Agreement”). If the Offeror fails to submit and complete the Living Wage Affidavit of Agreement (see Attachment F-1), the State may determine an Offeror not to be responsible. Contractors and Subcontractors subject to the Living Wage Law shall pay each covered employee at least the minimum amount set by law for the applicable Tier Area. The specific Living Wage rate is determined by whether a majority of services take place in a Tier 1 Area or Tier 2 Area of the State. The Tier 1 Area includes Montgomery, Prince George’s, 12
Howard, Anne Arundel, and Baltimore Counties, and Baltimore City. The Tier 2 Area includes any county in the State not included in the Tier 1 Area. In the event that the employees who perform the services are not located in the State, the head of the unit responsible for a State Contract pursuant to SFP §18-102 (d) shall assign the tier based upon where the recipients of the services are located. The Contract resulting from this solicitation has been deemed to be a Tier 2 Contract. Information pertaining to reporting obligations may be found by going to the DLLR Website http://www.dllr.state.md.us/ and clicking on Living Wage. NOTE: Whereas the Living Wage may change annually, the quoted Contract price may not be changed because of this adjustment. 1.31 Prompt Payment Policy This procurement and the contracts to be awarded pursuant to this solicitation are subject to the Prompt Payment Policy Directive issued by the Governor’s Office of Minority Affairs and dated August 1, 2008. Promulgated pursuant to Md. Code Ann., State Finance and Procurement Article, §§ 11-201, 13-205(a), and Title 14, Subtitle 3 and Code of Maryland Regulations (COMAR) 21.01.01.03 and 21.11.03.01 et seq., the Directive seeks to ensure the prompt payment of all subcontractors on non-construction procurement contracts. The successful Offeror must comply with the prompt payment requirements as outlined in sub-section 31 of the contract resulting from this solicitation (see Attachment A). Additional information is available on the GOMA website at: http://www.mdminoritybusiness.com/documents/PROMPTPAYMENTFAQs_000.pdf 1.32 Federal Funding Acknowledgement and Certifications 1.32.1 There are programmatic conditions that apply to this contract, regardless of the type of funding. These conditions are contained in Attachment G. 1.32.2 The total amount of Federal funds allocated for the Family Health Administration is $138,134,632 in Maryland State fiscal year 2012. This represents 63% of all funds budgeted for the unit in that fiscal year. This does not necessarily represent the amount of funding available for any particular grant, contract, or Invitation for Bid. 1.32.3 This solicitation does contain federal funds. If contained, the source of these federal funds is: Centers for Disease Control and Prevention/ National Cancer Prevention and Control Program/ Maryland Cancer Prevention and Control Program. The CFDA number is: 93.919. The conditions that apply to all federal funds awarded by the Department are contained in Federal Funds Attachment G. Acceptance of this agreement indicates your intent to comply with all conditions, which are part of this agreement. 1.33 HIPAA - Business Associate Agreement Based on the determination by DHMH that the functions to be performed in accordance with Section 3 of this RFP constitute Business Associate functions as defined in HIPAA, the bidder shall execute a business associate agreement as required by HIPAA regulations at 45 CFR §164.501 and set forth in Attachment I . The fully executed business associate agreement must be submitted within 10 working days after notification of award or award of contract, whichever is earlier. Should the Business Associate Agreement not be submitted upon expiration of the ten-day period as required by this solicitation, the Procurement Officer, upon review of the Office of the Attorney General and approval of the Secretary, may withdraw the recommendation for award and make the award to the next qualified Offeror. 1.34 Conflict of Interest Affidavit and Disclosure All Offerors are advised that if a Contract is awarded as a result of this solicitation, the successful Contractor’s personnel and each of the participating subcontractor personnel shall be required to complete agreements such as 13
Page 1 and 2: Request for Proposals Calvert Count
Page 3 and 4: STATE OF MARYLAND DEPARTMENT OF HEA
Page 5 and 6: 4.3 DELIVERY ......................
Page 7 and 8: n. Normal State Business Hours - No
Page 9 and 10: 1.9 Questions Written questions fro
Page 11: 1.19 Access to Public Information A
Page 15 and 16: 2. Filing of protests; 3. Filing of
Page 17 and 18: Purpose SECTION 3 - SCOPE OF WORK 3
Page 19 and 20: 3.2.2.3 Priority Populations The ta
Page 21 and 22: Services to Be Performed by the Con
Page 23 and 24: 3.2.3.2 Follow-Up Services 10. Moni
Page 25 and 26: 14. Use staff to carry out responsi
Page 27 and 28: detection and treatment of breast a
Page 29 and 30: 3.3.3 Criminal Background Check The
Page 31 and 32: circumstance which changes the Proc
Page 33 and 34: work under the Contract, or the rep
Page 35 and 36: 4.3.2 Hand-delivery includes delive
Page 37 and 38: DHMH reserves the right to request
Page 39 and 40: contractor has committed, including
Page 41 and 42: SECTION 5- EVALUATION CRITERIA AND
Page 43 and 44: SECTION 6 - ATTACHMENTS ATTACHMENT
Page 45 and 46: ATTACHMENT A - STANDARD CONTRACT TI
Page 47 and 48: 5.2 The Contractor agrees that at a
Page 49 and 50: 13.3 Any and all references to the
Page 51 and 52: a. That pursuant to 42 Code of Fede
Page 53 and 54: 31.1 If the Contractor withholds pa
Page 55 and 56: 33 Federal Department of Health and
Page 57 and 58: A. AUTHORITY I HEREBY AFFIRM THAT:
Page 59 and 60: (9) Admitted in writing or under oa
Page 61 and 62: I DO SOLEMNLY DECLARE AND AFFIRM UN
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in the aggregate $100,000 or more s
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ATTACHMENT D - PRE-PROPOSAL CONFERE
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vi. Data entry and data entry super
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ATTACHMENT E-1 BUDGET JUSTIFICATION
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Justification: Postage costs relate
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Offeror’s Name: Year 2 Budget Req
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Offeror’s Name: Year 4 Budget Req
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Row # Offeror’s Name ____________
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imposition of any of the requiremen
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The employee(s) proposed to work on
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Page two This clause must appear in
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CERTIFICATION REGARDING ENVIRONMENT
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1. Type of Federal Action: a. Contr
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SUMMARY OF ADDITIONAL FEDERAL FUND
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ATTACHMENT I - BUSINESS ASSOCIATE A
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after an incident even if Business
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C. Effect of Termination. 1. Except
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IN WITNESS WHEREOF and acknowledgin
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ATTACHMENT J - BCCP CASE MANAGEMENT
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Initials Case Manager Signature Ini
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ATTACHMENT K - BCCP DATA ENTRY FORM
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BREAST CANCER SCREENING INFORMATION
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CaST ID: LAST NAME: FIRST NAME: ___
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CaST ID: LAST NAME: FIRST NAME: BRE
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BREAST CANCER DIAGNOSTIC AND TREATM
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CERVICAL CANCER DIAGNOSTIC AND TREA
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ATTACHMENT L - BCCP CONSENT FORM Br
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Part I. The Contractor agrees to: C
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Qualifications and Insurance O. Hav
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45 CFR Parts 160 and 164, (“HIPAA
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L. The following attached documents
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Part I. The Contractor agrees to: R
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K. Obtain and maintain appropriate
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F. 1. The activities covered by thi
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Preamble Laboratory Service Contrac
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H. Send patient results as follows:
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Other W. Not be in arrears with res
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K. The Contract Monitor for the Con
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Hospital Service Contract Maryland
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Billing F. ** Submit all claims for
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provided by the contractor after fu
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In witness whereof, these authorize
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Billing B. ** Submit all claims for
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H. Regarding HIPAA: 5. The activiti
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Preamble Anesthesia Service Contrac
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N. Not bill a patient for any charg
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previously executed grant agreement
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Preamble Colposcopy Service Contrac
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H. See patients referred by the LHD
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AA. Comply with the Health Insuranc
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non-federal funds using Standard Fo
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Part I. The Contractor agrees to: C
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R. Not bill the LHD for any service
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H. The Contract Monitor for the Con
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ATTACHMENT N - MINIMUM STANDARDS FO
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9. Send a copy of the certified let
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6. If patient is contacted and refu
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ATTACHMENT O - BCCP PERFORMANCE MEA
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ATTACHMENT P - REPORTING SCHEDULE B
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DHMH 437 INSTRUCTIONS (continued) Q
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DHMH 437 INSTRUCTIONS (continued) *
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DHMH 438 Instructions (continued) T
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ATTACHMENT S - CONDITIONS OF AWARD
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23. As stipulated in the “Nationa
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Work Plan Calvert County Breast and
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