Nutrition Education/Counseling Services

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1 1 P age REMINDER RFP: Nutrition Education/Counseling Services DEADLINE FOR SUBMISSION IS November 5, 2012 REPLIES ARRIVING AFTER 2 PM ON NOVEMBER 5, 2012 WILL NOT BE ACCEPTED

2 2 P age Request for Proposal Nutrition Education/Counseling Services RFP #: Deadline for Responses: 2 PM November 5, High Ridge Road Boynton Beach, FL (561)

3 3 P age Table of Contents SECTION 1: INTRODUCTION WHAT WE ARE SEEKING OVERVIEW PROPOSAL REQUIREMENTS THE COUNCIL OVERVIEW OF THE CHILDREN S SERVICES COUNCIL OVERVIEW OF THE WOMEN S HEALTH INITIATIVE (WHIN) PROGRAM... 6 SECTION 2: Nutrition Education/Counseling Services BACKGROUND SERVICE DELIVERY PROJECT GOALS REPORTING MINIMUM REQUIREMENTS FUNDING SECTION 3: RFP PROCESS LIMITATIONS ON CONTACTING CSC PERSONNEL PROPOSER DISQUALIFICATION RFP TIMETABLE INQUIRIES ACCEPTANCE OF APPLICATIONS NOTICE OF INTERVIEWS PROCEDURE FOR CONDUCTING INTERVIEWS NOTICE OF QUALIFIED PROPOSERS FOR CONTRACT DISCUSSIONS SECTION 4: RFP RESPONSE INSTRUCTIONS FOR SUBMITTING RESPONSE TO RFP INCOMPLETE RESPONSES RESPONSE FORMAT RESPONSE REVIEW AND SELECTION CRITERIA INSURANCE REQUIREMENTS COMPLIANCE WITH SECTION , FLORIDA STATUTES SECTION 5: SUBMITTAL DOCUMENTS... 17

4 4 P age SECTION 1: INTRODUCTION 1.1 WHAT WE ARE SEEKING The Children s Services Council of Palm Beach County (CSC) is issuing this Request for Proposals (RFP) seeking a nonprofit agency, government organization or qualified individual(s), as independent contractor(s) to design and provide services in the area of Nutrition Education/Counseling, where appropriate, for perinatal women participating in the Healthy Beginnings, Women s Health Initiative (WHIN). The WHIN program targets approximately 100 black women in the high risk 33401, 33403, and zip codes. 1.2 OVERVIEW The purpose of Nutrition Education is to provide program participants with current facts and information in order to improve food selection, eating habits, nutrition, and disease prevention practices. Nutrition Counseling consists of individualized advice and guidance to individuals who are at nutritional risk because of their health or nutritional history, dietary intake, medication use or chronic illness. Both components aim to provide participants culturally competent options for improving their nutritional status with guidance from a Licensed Nutritionist or Registered Dietitian. The selected proposer will be responsible for the following: 1. Assessing nutritional needs of women and their families (e.g. infants, children) with the goal of improving the nutritional health of the woman and family. 2. Providing nutritional education and counseling; where appropriate, developing therapeutic diet plans for those deemed high-risk. 3. Teaching the effects of nutrition on overall health and birth outcomes. 4. Teaching how nutrition can reduce obesity and impact weight (both overweight and underweight). 5. Recognize and support program participants in making appropriate food choices. 6. Offer culturally competent services with acute awareness of the social determinants that impact health. 7. Recognize and create a plan for supporting program participants when food access is a concern within their community. 8. Provide one-on-one in-home consultations. Proposers who are Certified Lactation Consultants are preferred; however, certification is not a requirement for this RFP. If the selected proposer is a certified lactation consultant, CSC may discuss the inclusion of in-home emergency intervention services to breastfeeding women as part of the overall service package. It is expected that women receiving nutrition education services will fall within the low to medium risk range (approximately 65-70% of the population). The remaining population would require nutritional counseling services, a more intensive service. When working with prenatal and postnatal recipients, the services must include one initial assessment (both mom and baby) to be completed within a year, and up to 12 additional hours within a calendar year for counseling and follow-up care, unless additional visits are authorized in collaboration with a designated WHIN nurse.

5 5 P age 1.3 PROPOSAL REQUIREMENTS All proposals are expected to adhere to the following requirements: Include a detailed explanation as to how services will be delivered (i.e. plan of work, timeline, educational or other materials to be used, staff approach to engagement). List individual qualifications of proposer staff to be implementing the program Outline of fee schedule (fee scale for services) It is expected that the work plan, qualifications and fee scale will be consistent with the scope of services outlined in this RFP. Proposals will be evaluated based on the soundness of the proposer s approach to operating the program (best strategy at the best cost); meeting the program goals; and utilizing best practices in developing and implementing a Nutrition Education/Counseling Services program. Of particular importance are: 1) evidence of proposer s comprehensive understanding of the goals and activities to be accomplished; and 2) proposer s comprehensive description of planned methodologies to be used in delivering services to the target population. 1.4 THE COUNCIL Children s Services Council of Palm Beach County (CSC), an independent special district created by Palm Beach County voters in 1986, provides leadership, funding and research on behalf of the county s children so they grow up healthy, safe and strong. 1.5 OVERVIEW OF THE CHILDREN S SERVICES COUNCIL The Council invests resources in programs and services that support the physical, social-emotional and psychological development of children. In order to have an impact in those areas, the Council has four goals: Children are born healthy, are free from abuse and neglect, are ready to learn when they enter school, and have access to quality afterschool and summer programming. Supported by a blend of federal, state and local funding, our programs and systems are designed to achieve our goals by providing seamless, efficient, and accountable prevention and early intervention services to Palm Beach County s children and families. These systems include: Healthy Beginnings, which provides comprehensive, integrated direct services to pregnant women, infants, and young children aged 0-5 Quality Counts, which provides services to increase the quality of child care and afterschool providers Bridges, which is a neighborhood-based strategy to achieve CSC s goals at a population level. Bridges address such issues as adult literacy, father involvement, maternal depression, teen pregnancy prevention, cyclical poverty and child development The Council believes that by offering families the right approach and combinations of programs and services at the right time, in the right place, we will achieve our goals. By strengthening the system of care, which is built upon sound research and strong data, we can achieve our child outcomes. For additional information regarding CSC, please visit

6 6 P age 1.6 OVERVIEW OF THE WOMEN S HEALTH INITIATIVE (WHIN) PROGRAM In 2004, the Federal Health Resource Service Administration (HRSA) Healthy Start grant was initially awarded to the Children s Services Council through its non-profit arm, Prevention Partnerships for Children, Inc. (PPC). In Palm Beach County, these federal dollars are used to support the Women s Health Initiative (WHIN) program. The WHIN program is a vital component to the Healthy Beginnings System. This system is an integrated and coordinated set of services for prenatal and postnatal women, and families with children birth to age 5. In partnership with service provider agencies and funding partners, Healthy Beginnings is designed to promote healthy births, reduce child maltreatment, and promote children s eagerness and readiness to learn. The ultimate goal of the WHIN program is to reduce the racial disparities that negatively impact the infant mortality rate for WHIN s target population. The WHIN program is focused on providing high-risk prenatal and interconception women with services to assist in improving their health and, consequently, the birth outcomes for their children. WHIN consists of four key components: The nursing component, which provides intensive home visitation, case management, health education and curriculum-based information to the high risk population in the WHIN zip codes. Women who participate in the nursing component are also eligible for nutrition and dental services. The nutrition component, providing comprehensive assessment, education and nutrition counseling, as identified, to the family. The dental component, encouraging women and their families to access oral care early to prevent negative birth outcomes. The WHIN program also supports the Community Voice: Taking it to the People grassroots health education program. The Community Voice program empowers residents with factual information to help mitigate the health disparities in the black community. In addition, the WHIN program provides depression screening and breastfeeding information/support to encourage healthy and early perinatal care. Participants are encouraged to remain in the program through their child s second birthday in order to receive ongoing interconception services.

7 7 P age SECTION 2: Nutrition Education/Counseling Services 2.1 BACKGROUND Considerable epidemiological and clinical data have demonstrated a relationship between poor maternal nutrition and low birth weight. Low birth weight is an important predictor of adverse health status in the immediate postpartum period as well as in early life (DHHS Publication, National Center for Health Statistics, 81). Substantial numbers of pregnant, postpartum, and breastfeeding women, infants, and young children from families with inadequate income are at special risk with respect to their physical and mental health by reason of inadequate nutrition or health care, or both. It is, therefore, the purpose of the Nutrition Education/Counseling Services program to provide: Nutrition education and counseling, including breastfeeding promotion and support as well as linkage to community-based nutrition support services (i.e. WIC). The program shall serve as an adjunct to good health care during critical times of growth and development, to prevent the occurrence of health problems, including gestational diabetes, malnutrition and obesity, and to improve the overall health of perinatal women. Nutrition Education Component The Nutrition Education component aims to provide education/information to participants in an effort to improve poor eating habits, increase informed food choices and educate participants about the correlation between food intake, good perinatal health and positive birth outcomes. Sessions focus on the importance of an adequate diet, recommended weight gain, sodium intake, and other issues such as breastfeeding and improving food choices. Other activities may include: Food guide pyramid knowledge Nutrient-food association knowledge The importance of dairy, fruit and vegetable consumption Developing healthy menus Discussions of hygiene behavior and physical exercise patterns during prenatal and postpartum period Discussions about healthy lifestyle (including nutrition and health problems) during perinatal period Nutrition education shall be designed to be easily understood by participants, and it shall bear a practical relationship to participant nutritional needs, household situations, and cultural preferences including information on how to select food for themselves and their families. Nutrition Counseling Component The Nutrition Counseling services provide face-to-face intensive therapeutic nutrition assessment and counseling to at-risk pregnant and interconception women and their infants with medical conditions. Nutritional counseling services are necessary in order to reduce maternal and infant disease and death.

8 8 P age This could be in the form of medical nutrition therapy focusing on: Assessing drug, alcohol, smoking, vitamin, mineral, and herb intake; history of eating habits; and an assessment of disordered eating or other psychosocial issues that may impact nutritional intake. An individualized therapeutic diet and activity plan guides treatment, taking into consideration an individual's personal preferences, the influence of medications, current health and family health history, appropriate types of physical activity and any eating problems. Both the nutrition education and counseling services include assessment, development of a nutrition care plan, evaluation and follow-up, as appropriate, and are delivered in the context of the ethnic, cultural and geographic preferences of the participants and with consideration for educational and environmental limitations experienced by the participants. 2.2 SERVICE DELIVERY Nutrition services are offered in a home setting and focus on improving health-related behaviors directed toward preventing low gestational weight gain or weight loss, as well as education and information on gestational diabetes and healthy, positive nutrition practices. Nutrition Education/Counseling services must be tailored to the unique needs, interests, experiences, educational level, environmental limitations, culture, capabilities and lifestyle of the participants. Referrals to the selected nutrition proposer will be made through the WHIN nurse home-visiting program. The Nutrition Education/Counseling Services is a voluntary program, therefore frequency and intensity of service is driven by the individual treatment needs and family choice. It is expected that approximately 90% of the approximate 100 women participating in the WHIN program will receive inhome consultations, at minimum receiving a nutritional assessment. The selected proposer must demonstrate the ability to coordinate and work closely with the WHIN program and the individual program participant s network of health and other service providers for successful service delivery. Activities Include: Use of a nutrition curriculum to guide nutrition education component Assessment of the ethnic/cultural needs and resources of the community and development of care plans for women and family, where appropriate participating in the Nutrition Education/Counseling program Participation in case staffing with WHIN nurses and other stakeholders Determination of the best strategy to meet program outcomes (i.e., service dosage and scheduling, assessment needs, auxiliary supports, etc.) Providing appropriate follow-up to program participants based on postpartum needs and treatment goals Identifying and making appropriate connections with dental and breastfeeding services

9 9 P age Connecting and engaging participants to community services that support pregnant and interconception women s nutritional health Where appropriate, providing group nutrition education activities for interested women who may have difficulty accessing other community supports The selected proposer of nutrition services will provide services to eligible black women (in the targeted zip codes) who are: Pregnant and post-natal/interconception women; Between 10 and 44 years of age; and Referred by the WHIN nurses The criteria for determining if a pregnant woman is at high risk nutritionally (and therefore eligible for nutrition counseling) includes: Chronic or metabolic diseases; Any disease or condition that requires a prescribed therapeutic diet; Underweight before conception; Inadequate or excessive weight gain during pregnancy; A history of substance abuse; A history of low birth weight infants; Multiple fetuses; Anemia; Intrauterine growth retardation; or A maternal age of 15 or less 2.3 PROJECT GOALS The goal of this RFP is to ensure: Access to high-quality nutrition education and counseling services provided by a Licensed Nutritionist or Registered Dietitian for women enrolled in the WHIN program Women establish and meet goals for reduction in Body Mass Index (BMI) and/or maintenance of recommended BMI Women and family gain knowledge about healthy eating and practical skills to prepare healthy foods Reduction in the number of pregnant women who gain too much or too little weight during pregnancy Positive change in food habits, resulting in improved nutritional status and in the prevention of nutrition-related problems for pregnant, postpartum, and breastfeeding women, infants and their families

10 10 P age 2.4 REPORTING Documentation must be provided for every program participant encounter and shall be done in the Healthy Beginnings Data System (HBDS). Additionally, as the Nutrition Education/Counseling Services program receives funds through the U.S. Health Resource Service Administration (HRSA) grant, the proposer, working with CSC, will compile data necessary for reporting to the federal project. Data will be reported to the Children s Services Council. 2.5 MINIMUM REQUIREMENTS In order to ensure Proposers possess the minimum qualifications and/or experience needed to support CSC s needs, applicants must meet the following requirements: Demonstrate significant experience and competence in designing and delivering nutrition education and counseling programs to diverse populations Experience in taking an outcomes-oriented approach (e.g., measuring individual-level changes based on services provided) to providing nutrition counseling services Current State of Florida license for Dietitian/Nutrition (RD, LD/N or LNC) Demonstrate capacity to service black women in the targeted WHIN zip codes (33401, 33403, and 33407) Demonstrate the ability to work collaboratively and provide services in a system context Experience in working with data systems and completing electronic data entry on an ongoing basis Complete and submit all required submission documents and sign as required by deadline Participate in an interview process, upon request Provide three professional references specifically relating to assignments completed within the past five years 2.6 FUNDING The Children s Services Council will reimburse (based on fee-for-service model). The selected proposer is expected to include in its proposal a fee scale, appropriate to delivering the activities outlined in this RFP, and other reasonable services associated with developing and delivering the Nutrition Education/Counseling program. Contract term is nine months, starting January 1, 2013, with the possibility of renewal for additional years contingent on funding and additional needs to be addressed. Continued funding of this program is contingent upon the approval and ongoing availability of funds through the CSC s Health Resource Service Administration (HRSA) grant.

11 11 P age SECTION 3: RFP PROCESS 3.1 LIMITATIONS ON CONTACTING CSC PERSONNEL This Request for Proposals is issued by the Children s Services Council of Palm Beach County. The contact person listed below is the sole point of contact for this RFP: Adrienne Heritage, Administrative Assistant All contact shall be by only 3.2 PROPOSER DISQUALIFICATION Proposers are prohibited from contacting CSC personnel or board members regarding this solicitation other than the person identified above. Any occurrence of a violation may result in the disqualification of the proposer. Failure to have performed any contractual obligations with CSC in a manner satisfactory to CSC will be sufficient cause for disqualification. To be disqualified as a proposer under this provision, the proposer must have: Previously failed to satisfactorily perform in a contract with CSC, been notified by CSC of unsatisfactory performance, and failed to correct the unsatisfactory performance to the satisfaction of CSC; or Had a contract terminated by CSC, by any other county or state agency, or by any Children s Services Council for cause.

12 12 P age 3.3 RFP TIMETABLE 10/4/2012 RFP packets are available on the CSC website ( 10/24/2012 Deadline for submission of questions regarding clarification of RFP 10/29/2012 Final posting of questions and answers and/or clarification or addenda to RFP (if any) on CSC website ( 11/5/2012 RESPONSE DEADLINE - All RFP responses are due by 2 PM at: Children s Services Council of Palm Beach County 2300 High Ridge Road, Reception Boynton Beach, FL Responses are opened publicly at 2:01 PM 11/6/ Evaluation of responses by CSC 11/13/ /13/2012 Estimated date for notification by to proposers selected for interviews and list of those selected for interviews posted on CSC website ( 11/14/2012 Interviews at CSC offices 11/19/ /20/2012 Estimated date for notification by of proposers not selected for further contract negotiations and list of those selected posted on CSC website 11/26/2012 Contract negotiations begin 12/6/2012 Recommendation(s) approved by the Council 12/7/2012 Estimated date for notice of intent to award contract posted on the CSC website 1/1/2013 Estimated date for contract period to begin

13 13 P age 3.4 INQUIRIES All inquiries requesting clarification regarding this RFP must be made in writing and ed to the identified contact person by 10/24/2012. During the RFP period, proposers must not provide CSC with any marketing or promotional materials that would raise the proposer s profile or give the proposer an advantage or benefit not enjoyed by other perspective proposers. Copies of responses to all inquiries that require clarifications and/or addenda to the RFP will be made available no later than 5 PM 10/29/2012 on CSC s website. CSC reserves the right to adjust the timetable and any adjustments will be made available on the CSC website. 3.5 ACCEPTANCE OF APPLICATIONS All responses must be received at the following address no later than November 5, 2012 by 2 PM at: Children s Services Council of Palm Beach County 2300 High Ridge Road Boynton Beach, FL Attention: Reception RFP No changes, modifications or additions to the responses submitted will be accepted by, or binding on, CSC after the deadline for submissions has passed. CSC reserves the right to request clarifying information from any proposer. RESPONSES NOT RECEIVED AT THE SPECIFIED LOCATION OR BY THE SPECIFIED DATE AND TIME OR BOTH WILL BE REJECTED AND RETURNED UNOPENED TO THE PROPOSER BY THE CSC. CSC reserves the right to reject any and all responses or to waive minor irregularities when doing so would be in the best interest of CSC. A minor irregularity is defined as a variation from the RFP terms and conditions that do not affect the price of the application, or do not give the proposer an advantage or benefit not enjoyed by other prospective proposers, or do not adversely impact the interest of CSC. 3.6 NOTICE OF INTERVIEWS CSC will post a list of qualified proposers for interviews on the CSC website and also identified proposers. It is estimated this will occur by 11/13/2012.

14 14 P age 3.7 PROCEDURE FOR CONDUCTING INTERVIEWS After completion of the scoring process based on the review criteria, CSC will determine which, if any, proposers meet the minimum requirements deemed necessary by CSC for interviews. Assuming that such minimum requirements have been met, CSC will require face-to-face interviews with one or more proposers. 3.8 NOTICE OF QUALIFIED PROPOSERS FOR CONTRACT DISCUSSIONS CSC will post list of qualified proposers for contract negotiations on the CSC website ( It is estimated this will occur by 11/14/2012.

15 15 P age SECTION 4: RFP RESPONSE 4.1 INSTRUCTIONS FOR SUBMITTING RESPONSE TO RFP All responses must be submitted on the forms included in this package (forms available on CSC website ( All proposals are to be signed by an official/individual who is legally authorized to bind the proposer to the proposed activity. Please submit 1 original and 1 PDF (CD) copy of response in a sealed package no later than November 5, 2012 at 2 PM. Responses must be prepared using the format outlined below. 4.2 INCOMPLETE RESPONSES Failure to respond to any item, including providing any requested information, or failure to follow these instructions shall be considered submission of an incomplete response and may result in disqualification from further consideration. 4.3 RESPONSE FORMAT The typewritten portion of your response is to be submitted on the RFP forms included in Section 5, single-spaced with font style and size Calibri 11 point. The forms are available on CSC s website: RESPONSE REVIEW AND SELECTION CRITERIA Proposer selection will be based upon the following criteria: 1. Proposer s previous experience and references 40 points 2. Proposer s service delivery approach 50 points 3. Cost 10 points

16 16 P age 4.5 INSURANCE REQUIREMENTS Proposer must provide, upon award of contract, proof of insurance meeting or exceeding the following requirements: Worker s Compensation Insurance as required by law. This policy must include Employer s Liability with the following limits - $100,000 for accident. CSC will accept filed certificates of exemption forms for Worker s Compensation Insurance General Liability Insurance - $300,000 general aggregate, $300,000 per person, $300,000 each occurrence and $300,000 per accident for bodily injury Automobile Liability Insurance for owned vehicles, non-owned vehicles and hired vehicles, coverage shall provide minimum limits of liability of $300,000 per accident Combined Single Limit for Bodily Injury and Property Damage A certificate of insurance naming Children s Services Council of Palm Beach County as additional insured must be submitted no later than ten (10) days after award and prior to execution of Statement of Work. 4.6 COMPLIANCE WITH SECTION , FLORIDA STATUTES In accordance with Section , Florida Statutes, persons and affiliates who have been placed on the convicted proposer list may not submit responses, contract with, or perform work (as a contractor, supplier, subcontractor or consultant) with CSC in excess of the threshold amount provided in Section , Florida Statutes, for Category Two for a period of thirty-six (36) months from the date of being placed on the convicted proposer list. Any response received from a person, entity or affiliate who has been placed on the convicted proposer list shall be rejected by CSC as unresponsive and shall not be further evaluated.

17 17 P age SECTION 5: SUBMITTAL DOCUMENTS The following documents can be downloaded from CSC s website at: Reference file name: RFP # forms Responses should be assembled in the following manner: 1. Cover Page Complete this entire document and include with response. 2. Questionnaire Complete this entire document and include with response. 3. References - List three clients professional references associated with work previously performed by the Proposer within the past 5 years. For each reference, please specify: a) Name, address, telephone number (primary and alternate contact if available) b) Project start date and duration c) Scope and cost of project d) Role in project e) Outcome of project 4. Fee Schedule Provide a schedule of fees (can include hourly, per unit, per person, per activity, per session, etc.) on the Fee Schedule Table. 5. Non-Collusion Affidavit Complete this document and include with response. 6. Resume - Submit a current resume or vitae for each individual who will be working with the Nutrition Education/Counseling program

18 18 P age COVER PAGE Submit this RFP response to: Children s Services Council of Palm Beach County Attn: Reception 2300 High Ridge Road Boynton Beach, Florida RFP Title: Nutrition Education/Counseling Services RFP #: NAME OF FIRM, ENTITY, ORGANIZATION: NAME OF CONTACT PERSON: TITLE: PHONE NUMBER: FAX NUMBER: MAILING ADDRESS: CITY: STATE: ZIP CODE: HEADQUARTERS ADDRESS (If different than mailing address): FEDERAL EMPLOYER IDENTIFICATION NUMBER (EIN): STATE OF FLORIDA BUSINESS LICENSE NUMBER (If Applicable): ORGANIZATION STRUCTURE (Please check one): Corporation Partnership Proprietorship Joint Venture Other If Corporation, please provide the following: (A) Date of incorporation (B) State or Country of incorporation: I certify that this Proposal is made without prior understanding, agreement, or connection with any corporation, firm, or person submitting a proposal for the same materials, supplies, or equipment, and is in all respects fair and without collusion or fraud. I agree to abide by all terms and conditions of this RFP and certify that I am authorized to sign this Proposal and that this Proposal is in compliance with all requirements of the Request for Proposals, including but not limited to, certification requirements. Authorized Signature (Manual) (Authorized Signature (Print or Type) Title (Print or Type)

19 19 P age QUESTIONNAIRE The following Questionnaire shall be completed and submitted in no more than 12 pages. Proposer guarantees the truth and accuracy of all statements and answers herein contained. 1. How many years have you/your organization/company been in business? 2. Have you ever failed to complete work awarded to you? NO YES If so, where and why? 3. Availability to Perform the Requested Services Indicate current and anticipated workload (current caseload or patient /client population). How would you integrate the WHIN participants into your practice? Provide information concerning all contracts in progress as of the date of submission of this Proposal. 4. Provide details on the qualification of the individual(s) who will perform the work; including relevant education and experience with similar work. Include the applicable State of Florida License Number. 5. Please describe your experience in providing perinatal nutritional services to women from various cultural backgrounds. Describe your expertise in delivering nutrition counseling support to high-risk women. What treatment modalities will you use? Include a summary of similar current and completed work. 6. Please describe your experience providing nutritional services in in-home settings and working within a system context (team structure); how will you ensure that nutritional information will be integrated into a cohesive plan of care for the participant? Include experience in working with similar target populations and communities. 7. Describe your knowledge of community resources and your ability to navigate and link participants to the appropriate service provider for supplemental nutrition support, if indicated. 8. What steps will you take to establish a positive rapport with the participants? What nutrition education curriculum will be used and how will you demonstrate increase in knowledge with the target population? Indicate the measurement or tool to be used.

20 20 P age 9. Please describe the behavior modification strategies you will implement to engage program participants in making positive sustainable changes in their nutritional health. Describe your interviewing, teaching and follow-up strategies to ensure nutritional change with the target population. 10. Describe the process that you will use to collect, assess and report data. Please include how you will use data to evaluate service effectiveness and solicit participant and partner feedback. REFERENCES List three clients, current or past, that can serve as a reference on the development of similar work performed by the Proposer in the past five years. For each reference, please specify: Name, address, telephone number Project start date and duration Scope and cost of project Role in project Outcome of project Reference #1: Reference #2: Reference #3:

21 21 P age FEE SCHEDULE PURPOSE: The purpose and intent of this RFP is to secure a fixed and firm fee schedule and establish a term-contract for professional services. CSC intends to award contract(s) to the most efficient, responsive, responsible, qualified Proposer in response to this RFP, taking into consideration experience, staffing, materials, references and past performance. In the case of disputes in the award of contract(s), the decision by CSC shall be final and binding on both parties. PRICES SHALL BE FIXED AND FIRM FOR TERM OF CONTRACT: If the Proposer is awarded a contract under this solicitation, the prices negotiated by the Proposer and CSC shall remain fixed and firm during the term of the contract. FEE SCHEDULE* Service Assessments Nutritional Education Nutritional Counseling Staffing** Group Education Rate * All rates should be inclusive of travel time/costs and time for documentation. ** Includes time to meet with system staff to establish procedures during start-up phase, and clientspecific meetings during implementation. Please describe your fee scale, including all relevant fees associated with professional services (i.e. hourly rate, travel expenditures, unit cost, etc.). Justification should be given for fees based on projections and/or assumptions. Briefly describe the basis for the cost calculations and any rationale that serves to support the process used.

22 22 P age NON-COLLUSION AFFIDAVIT By submission of this affidavit, the Proposer certifies that this price is made independently and free from collusion. Proposer shall disclose below, to the best of its knowledge, any CSC Council member, employee, or any spouse, son, daughter, stepson, stepdaughter, or parent of any such officer or employee, who is an officer or director of, or has a material interest in, the Proposer s business. For purposes hereof, a person has a material interest if he or she directly or indirectly owns more than five percent (5%) of the total assets or capital stock of any business entity, or if he or she otherwise stands to personally gain if the contract is awarded to this proposer. Failure of a proposer to disclose any relationship described herein shall be reason for debarment. NAME RELATIONSHIPS (Print Name) (Print Name) (Proposer s Signature) Sworn to and subscribed before me in the state and county first mentioned above on this day of, Notary Public (Affix seal) My commission expires

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