ADDENDUM 2. Vendor Questions and Answers Request for Proposals 18RFP114 Student Health Services Issue Date: April 20, 2018

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1 ADDENDUM 2 Vendor Questions and Answers Request for Proposals 18RFP114 Student Health Services Issue Date: April 20, Does a primary healthcare organization need to be the lead proposer? No. 2. Is there a possibility for more funding becoming available within the threeyear initial contract? Additional funding would be dependent upon the AISD Board of Trustees through the annual budget process. 3. Are there priority age-ranges for service? School age, 3 years old-19+ years old 4. If philanthropies wanted to provide supplemental funding would that be acceptable? Yes, if the funding was sustainable. 5. If all schools couldn t be covered with nursing right away is there a process AISD would require to determine which campuses would be covered? In collaboration with a healthcare vendor, the district would help to identify a priority list of campuses for immediate staff. This would be based on campus enrollment, medical acuity, numbers of students who have an Individual Health Care Plan (IHCP), number of medically fragile students, etc. If staffing across all 130 campuses isn t possible upon execution of an agreement, the vendor would be required to submit in writing the plan, timeline, in which all campuses would have staff. 6. Would AISD consider a mental health-only proposal if nursing services couldn t be identified? No.

2 7. Would off-campus services such as clinics or mobile services be considered as value-added and could these kinds of value-added services compensate for some campuses not being initially covered with on-site providers? Yes. 8. We do not have an office in the State of Texas. Is it your preference for the vendor to have an office in the State of Texas to be awarded this RFP? The district would prefer a vendor that is within the State of Texas. 9. Per pg. 4 under Background, would the district accept an all-inclusive hourly rate for nursing services in place of fee-for-service schedule? Or, do you require the vendor to provide rates per evaluations/screenings in addition to the hourly rates? The district doesn t have a preference, as long as the fee-for service or rate per evaluation/screenings doesn t exceed the $7,100, appropriated for student health services. 10. Does the district intend to award to single or multiple vendors? That is to be determined. 11. Could you please let me know the average or projected weekly hours of service for the RN and LVN? This would be dependent on the model a vendor may propose and the campus needs. A campus may need 40 hours/week of an RN, while another campus may only need 20 RN hours and 20 LVN hours weekly. It would be based upon need. 12. How many contracted RNs and LVNs did you use last year? How many RNs and LVNs do you foresee needing for the school year? In , the district (through a sub-contract) had 70 RN s. The current sub-contractor does not provide LVN s for student health services. 13. What would be the average caseload for the RN and LVN? The average caseload varies by campus. Please refer to the attachment in the RFP related to campus enrollment.

3 14. How many working days will the RN and LVN work during the school year (For Example: 180 days or less)? The working days would be How many school locations will be on the RN and LVNs caseload to travel between? Ideally, an RN and/or RN/LVN would not have to travel between campuses. An RN and/or RN/LVN would be assigned to a campus. 16. Are resumes required at the time of proposal submission or only upon award? Only upon reward. 17. What are the district s requirements for the use of telemedicine to provide school health/nursing services? The district would comply with all requirements for use of telemedicine as defined by State law. For the purpose of the RFP, the use of telemedicine on a campus should not be in lieu of health services staff. 18. Per pgs. 9-10, are there any other specific formatting requirements for all of the proposals being submitted? Ex: preferred binding (binders, binding clips, index tabs, dividers, etc.) No specific formatting requirements. 19. Are you requiring vendors to submit a proposal response for all service categories (RN/LVN/CNA/SHA) OR can the vendor submit to only the categories of services they will provide? Please submit a proposal for only the categories of services you can provide. 20. Do you require vendors to guarantee the provision of nursing services, or is it understood that vendors will begin recruiting on a best efforts basis upon contract award? A vendor would have 180 days post award notice to recruit and staff for the school year.

4 21. Can we incur in any penalties or be liable for any damages for not having a RN/LVN available upon your school s request in a timely manner or would your school terminate the RFP contract with our company? If awarded and execute an agreement, the vendor will have the sole responsibility to provide the health services for AISD. This would include the availability of prn staff. Any failure to comply with the executed agreement could result in the termination of a contract as defined in the executed agreement. 22. Per pg. 8-9 under Reporting and Key Performance Measures, do you require the vendor entity or the vendor s contracted RN/LVN to collect, track, and analyze information into the reports listed by utilizing the EMR? Yes. 23. If Austin ISD will find a permanent employee of the district and our services will no longer be needed, will the school provide the awarded vendor with a 30 day out termination written notice? It is the intention of Austin ISD to sub-contract it s student health services to an external vendor. 24. To clarify, what would be the payment terms of Austin ISD (Net 30)? Net 30 days 25. To complete the provision of nursing services, are Testing/Evaluation Materials provided by Austin ISD OR the Vendor? By the vendor. 26. Will your school provide laptops/computers and/or an account to the contracted providers during their assignment? Yes, the district will provide a district assigned laptop, computer, printer, and account. 27. Who will be the representative from Austin ISD to determine which materials/equipment are required for the nursing services? In collaboration with the vendor, the AISD Director of Health Services will determine the materials and equipment required for nursing services. All

5 campuses have a nurse office that has the necessary equipment and materials (ie; desk, secure filing cabinets, locked cabinets for medication storage, refrigerator, scale, cot(s), etc.) 28. Will the nurses have access to internet capabilities, computers/laptops/ipads, office supplies, fax/copy machine at Austin ISD? Yes. 29. Would the district pay for mileage travelling between school campuses on the same day? If so, what will be the district IRS Standard Rate? The district has appropriated $7,100, for student health services. If the vendor proposes paying employees for travel between campuses, this would be deducted from the $7,100, When is the anticipated award date for this RFP? June 18, Besides a TX state license, background and fingerprints, are there any additional required documents for the nurses to start working at Austin ISD? For Example: TB Test or any other specific Certifications or immunizations. Employees would be required to show current Tb and up to date immunizations required for the position. In addition, all contracted employees would be required to complete the district s background check process. 32. Will Austin ISD consider a price range depending on the candidates level of experience OR does the district only want a fixed flat hourly rate? The district does not have a preference as long as the dollar amount does not exceed $7,100, Can you provide the current incumbent vendor(s) providing RN/LVN/CNA services? What is the incumbent vendor(s) current fee rate(s)? Has your current vendor(s) been able to satisfy your service needs? Our current contract is with Acension/Seton Family Healthcare. The MOU with Acension/Seton Family Healthcare is $7,100, To increase the level of staffing in , they provided $1,800, in additional funds.

6 34. May a respondent propose to serve a subset of campuses, e.g., 30 of the 130 total campuses? A respondent may submit a proposal based on your capacity to provide the services. I would encourage vendors to read the RFP to ensure you would be able to meet the Scope of Work as defined. 35. Would targeted immunization clinics fulfil any direct care requirements related to immunization compliance? Immunization compliance is a monthly monitoring and reporting requirement. It would be TBD how a vendor would ensure all students are compliant with the state required immunizations. 36. Is AISD open to a different staffing matrix that may dramatically reduce numbers and/or use of lower acuity positions: LPN s over RN s? As stated in the RFP, AISD is open to bold and innovative solutions to student health services. 37. Is this RFP being used to replace Seton, or supplement Seton? The RFP for student health services is a comprehensive RFP. 38. Are you asking vendors to cover only the 16 campuses mentioned in the solicitation? No. Please read the Scope of Work in the RFP. 39. In speaking with Tracy she mentioned that Seton s budget was $7.1 million, and that is the allotted budget for as well. Is the district looking to split that $7.1 million between Seton and another vendor? No. The total budget for health services in is $7,100, Are they looking for something more cost effective that $7.1 million? As stated in the RFP, we are looking for bold, innovative health care solutions that do not exceed $7,100,

7 41. Please provide minimum services requested for mental and behavioral health services and what are the reporting and key performance measures for those services. Please review the RFP sections, Scope of Work and Performance Measures and Metrics. 42. Please expand or prioritize the services listed in the first provision. Given the stated budget, we want to understand what s most important to the school district. The priority would be to provide direct student campus based health services, including, but not limited to; comply with all federal and State laws and screening requirements, innovative solutions to maximize dollars, and delivery of quality student health services. 43. Since all student data is the sole property of AISD, could the vendor use EMR data for billing Medicaid? If the vendor is performing the billing, who manages or determines use of the revenue? The district has a Medicaid billing system that the vendor would coordinate with to bill and receive reimbursements. 44. Please clarify if the vendor is to develop a protocol or evaluate an existing protocol. Develop a protocol to evaluate the quality of the health services that are provided. 45. Please define manage and needs. 46. Please define off campus events and please provide estimate of how many per year. What services does the District expect the vendor to provide off campus? Will additional funding be providing for those costs? As the RFP states, off campus events would include field trips and off campus school related events within the State of Texas. This number varies per year and by campus. The district expects the vendor to provide health services that would be applicable to off-site (ie; training for the teacher on medication management, how to respond to a medical emergency, what to do in the event of a minor illness/injury, how to manage and care for students in their class on the field trip that have and IHCP etc). No additional funding is available other than the $7,100,

8 47. In what capacity, will the RN or health assistant have with regard to Prevention Education? Is the vendor being expected to provide curriculum input or lead presentations? Related to prevention education, the expectation the vendor will be able to provide patient education on topics such as human sexuality, health literacy, and general education on health and wellness that is age appropriate, scientifically accurate, is aligned with AISD Board Policy, State law, and evidence based. 48. Please expand on the expectations regarding employee wellness, as the focus of the RFP is for Student Health Services. To collaborate with AISD s Benefits Department and Employee Wellness. 49. How would the District prioritize which areas they are willing to have a phased approached, in particular nursing and behavioral health services? The district s priority is continuity of care. The district currently provides student health services across all 130+ locations and provide behavioral health services at the 16 locations named in the RFP. 50. What are the parameters for phased approach? months? Over the length of the contract? The phased approach would be over months, not years. 51. Is the $7.1M to cover disposable supplies (band-aids, gauze, etc.) or there another district funding source? Previously answered. 52. Will the district provide funding for durable medical equipment (i.e. wheelchairs, cots, otoscopes, BP cuffs, electronic thermometers)? Previously answered. 53. About telemedicine, will the district fund or provide necessary computers/ technology hardware to support the expanded use of telemed and new software programs (EMR)? The district will fund and provide the computer. The digital peripherals (ie; BP cuff, otoscope, dermatoscope, etc.) would be provided by the vendor. The district would provide the EMR.

9 54. Will the District provide physical space, that is HIPAA compliant, needed to effectively implement services, especially utilization of virtual care? The vendor will need to be involved in deciding the best placement for virtual care services. Based on the campus, the district and the vendor will determine the best space and place on the campus(es) that will provide telemedicine as an additional resource to the students and families. 55. Cost that does not increase implies no coverage for inflation or cost of living increases for 3 years (the minimum term of the contract). Could a 3% per year increase be considered? Any increase to the contract above the $7,100, will be at the discretion and appropriated by the Board of Trustees during the annual budget process. 56. Please define adequate and please provide a list of special campuses. The special campuses include: Alternative Learning Center 901 Neal St. Austin, TX Clifton Career Development School 1519 Coronado Hills Dr. Austin, TX Rosedale School 2117 W. 49 th St. Austin, TX What are the expectations regarding bilingual staff? Are there requirements beyond utilizing? Language Line/Services? The expectations would be to provide bilingual staff on campuses where having multi lingual staff would be appropriate. If having a bilingual health care provider is not an option having a language line and/or translation services would be ideal.

10 58. Underperformance can be subjectively defined. Please explain how unsatisfactory employees would be identified. 59. What are the district s minimum job qualifications or specifications that the vendor would need to know prior to developing job description? 60. Please explain who are Community Health Workers. Who employs these workers? Are they to be funded out of AISD s health services appropriated budget; the $7.1M? 61. Please provide parameters of utilization of student health services. What is the district s hope or goal? 62. What is the district s role in facilitating or obtaining government subsidies, grants, or partnerships? 63. Is there any information that District expects the vendor to collect, track, or analyze that is not already collected in the district s EMR? 64. What is the difference between the Phase 1 criteria and Phase 2 criteria? They seem to have the same point value and descriptions. If a vendor is selected to provide an oral presentation, when would they be notified? Would the presentation need to occur by May 17th? Also, what would need to be demo 65. Is AISD open to different staffing matrix? YES. More detailed information is contained within the RFP. Could be a mix of nursing types (RNs, LVNs, practitioners, etc.) Schools want certified professionals, with licensure in the state of Texas. Because of medical acuity, varied medical plans, student body makeup, it would make sense to have mix of service providers. Staffing matrix will be determined by medical acuity of the campus. School-based health clinics are an option with

11 those campuses possibly having a lesser-processional assigned to facilitate the on-site clinic. Open to non-traditional, innovative, bold health solutions. 66. Is there a breakdown of sites, population at each campus? YES. The RFP contains a breakdown of sites, populations, estimated budgets for each campus. 67. Is there a timeline for the awarded vendor to have everything up and running? YES. It is expected that all campus would begin receiving services by the newly-awarded vendor by January Will contracted employees work year-round? YES. The contract will be written for a 12-month period. Employees would work during the SY (August thru May), with other administrative work to be completed outside of the SY. There is also a possibility that additional (nursing) services will be requested for Summer School & Summer Camp at varied campuses, however, those services would be provided under an entirely separate contract. 69. Equipment and Supplies All campuses have a health room, and all items in the health room convey with the space. Campuses have their own budgets for supplies, while equipment is provided by Austin ISD. If a nurse wants a specific item not in stock, a request can be made to the department. Vendor shall use AISD s electronic medical records system, and understands that AISD owns all data outright. 70. If the $7.1 million dollar award is for the SY, are there additional funds allocated for the next 12-month period or will there be a subsequent RFP issued? This RFP will result in a multi-year contract of up-to 5-years. Any services beyond the maximum 5-year period would require a new RFP. There is $7.1million for the SY; amount of funding available for subsequent years is dependent on the allocation of funds by the Board of Trustees. NOTE: Funding allocation for the SY will be split between existing and new vendor due to current contractual requirements.

12 71. If a new vendor is awarded, will there be an opportunity for current SMHC to continue during the 6-month transition? It is expected that proposal responses will include a solution for SMHCs to continue services, in partnership with existing provider. The expectation is that beginning January 2019, there would be a solution for those 16 campuses. Preference is for continuity of care for those campuses. 72. Phase I & II of Evaluation The goal is to complete the evaluation and make an award based on Phase I of the evaluation process. If Phase II of the evaluation process is needed, this would be completed between May 2-17, 2018.