GEORGIA DEPARTMENT OF COMMUNITY HEALTH STATEMENT OF NEED FOR MANAGEMENT CONSULTING SERVICES SOLICITATION INFORMATION Name of Issuing State Entity Georgia Department of Community Response Due Date & Time: Health (DCH) Letter of Intent (LOI) is due: May 10, 2019, 5:00 P.M. EDT Proposal is due: May 20, 2019, 5:00 P.M. EDT State Entity Address 2 Peachtree St., NW, 40th Floor Atlanta, GA 30303 Release Date May 6, 2019 Submit Response (and Questions) by email to: Annette Bazhaw Agency Procurement Officer Annette.Bazhaw@dch.ga.gov (404) 651-6917 Subject Line: Supplier Name - Waiver Consulting PROJECT SUMMARY I. Overview: Pursuant to House Bill 30 (HB 30), the Amended SFY 2019 appropriations act, the Georgia Department of Community Health (DCH/Department) is seeking a highly-qualified consultant firm to assist the Department with evaluation of the past, current and projected national and Georgia-specific healthcare insurance environment. This includes identifying opportunities for the state to leverage Section 1115 and 1332 Waivers to develop a set of recommendations for consideration by the Office of the Governor. HB 30, line 699, provides funding and directs DCH to engage, “…an external consultant to study, review, and analyze Waiver opportunities available under Social Security Act section 1115 and Patient Protection and Affordable Care Act (ACA) section 1332 waiver options for the purpose of drafting and preparing waiver policy recommendations for approval from the Governor’s Office.”1 Upon receiving approval of the Department’s recommendations from the Office of the Governor the Department will expect the offeror to provide technical assistance and waiver drafting support to prepare a formal submission of 1115 and 1332 Waiver applications to the U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) and the Department of the Treasury. Offeror is further expected to provide technical assistance and support to the Department during both Waiver review and negotiation processes between the state and federal authorities. Please refer to Attachment A of this Statement of Need for additional detail on these expectations. Attachment A is a proposed plan. Offeror’s are encouraged to identify areas where the proposed plan can be improved. It is the Department’s expectation that the plan will result in a December 31, 2019 or earlier completion date. Offerors should include in their proposal a thorough description of the following: A. A comprehensive project plan overview, including a thorough overview of the resources the offeror will dedicate to this project in order to successfully complete all phases on or before December 31, 2019. B. An overview of one or more states in which the offeror has been engaged that has resulted in the state’s 1115 and/or 1332 Waiver request by the federal government. Offerors must have actual experience assisting one or more states that have received approval for a 1115 or a 1332 Waiver. C. A detailed description of the subject matter expertise the offeror proposes to dedicate to this engagement, including but not limited to: 1) Federal and state law, rules, regulations, guidance and related policies to the Medicaid program in general, as well as opportunities to leverage Social Security Act Waiver authorities to advance policy and budget priorities identified by the state of Georgia. 2) Federal and state law, rules, regulations, guidance and related policies pertaining to the Patient Protection and Affordable Care Act (ACA) 3) Private sector health insurance market design and administration, including but not limited to individual and small group health insurance markets, large group fully-insured plans and self-funded plans established under authority of the Employee Retirement Income Security Act 1 http://www.house.ga.gov/budget/Documents/2019_FiscalYear/AFY_2019_Bill_As_Passed.pdf (ERISA). 4) Federal and state 1115 and 1332 approval processes, including depth of knowledge that the offeror believes would be advantageous to the State of Georgia in order to evaluate, develop, submit and receive federal approval of both Waivers. 5) Understanding of existing healthcare delivery systems, including utilization of Medicaid Care Management Organizations (MCOs), FeeFor-Service (FFS) programs, as well as potential future state delivery system innovation available under federal and state authorities. 6) A thorough understanding of healthcare priorities of the President, HHS and CMS leadership, particularly with regard to the Affordable Care Act and 1115 and 1332 Waiver opportunities. 7) Expertise and experience in engaging federal officials, at the direction of and in conjunction with the Department, to participate on technical assistance and Waiver approval discussions to advance the priorities of Senate Bill 106, the “Patients First Act.” 2 D. A comprehensive overview of the offeror’s experience in evaluating and advising with regard to national and state healthcare environments, including but not limited to, health insurance status, demographic, employment and household composition, and how such 1115 and 1332 Waivers would likely affect Georgians. E. A comprehensive overview of the offeror’s experience in evaluating and advising with regard to healthcare access variables, such as provider availability and healthcare system capacity to deliver care across multiple specialties (physical health, behavioral health, long term care services, Home and Community-Based (HCBS) services, dental services and vision services) and the ability to evaluate current state and advise the Department on potential strategies to address any noted deficiencies in access to care for citizens across the state of Georgia. F. A comprehensive overview of the offeror’s experience in evaluating federal, state and potentially local fiscal impacts of various proposals, including actuarial services and fiscal impact forecasting capabilities. G. A comprehensive overview of the offeror’s experience in monitoring indirect economic development activity associated with increased access and coverage of healthcare services within states. Such overview should also include experience in identifying state funded services, such as behavioral health, corrections, public health and other state-funded services that would be impacted by 1115 and 1332 Waiver approval for affected populations. H. Offerors should also identify and propose additional areas of focus, based upon successful experience, not described herein. II. Minimum Qualifications: Offerors must satisfactorily meet the following minimum qualifications to be considered for this engagement: A. For which states has your firm been responsible for research, analysis, correspondence with CMS, and all responsibilities from preparation of waiver application/s through approval with CMS? For each state, (a) list the specific dates in year/s of engagement for each state, (b) indicate the type/s of waiver/s sought, (c) indicate status of each waiver request: pending, denied, approved. If approved, date of approval, (d) indicate whether your firm is still involved in each of the waiver requests. B. Is your firm experienced in providing services as summarized in the state agency’s “1115 and 1332 Waiver Research and Development Overview”? C. Are key staff based in Georgia who will perform services under this engagement? If so, which city? If not, where are they based? D. Are key staff immediately available to perform the services sought under this engagement? E. Is your firm presently assisting with waiver implementation in any state? If so, which state? F. Will your firm provide references specific to the type of work sought under this engagement? G. Does your firm intend to utilize internal staff and resources for completion of this engagement, or do you intend to utilize subcontractors for components of the work? If the firm intends to subcontract with external parties, identify the parties, provide your justification for subcontracting with the party, and identify what functions the subcontractor is expected to perform under the engagement. H. Are key staff, as identified by the state, willing to participate in meetings, conference calls and videoconference meetings utilizing Skype on an as needed basis as determined by the Department within reasonable working hours and as necessary on weekends? III. Consultant Selection Process: DCH intends to pursue this engagement through the Department of Administrative Services (DOAS) Management Consulting Services Statewide Contract #99999-SPD-SPD0000162. Eligible offerors are limited to the following firms which were awarded contracts under the categories of operations and strategic planning management consultation services: A. B. C. D. E. F. Accenture LLP Deloitte Consulting LLP Ernst & Young, LLP US KPMG LLP McKinsey & Company Public Consulting Group, Inc. 2 http://www.legis.ga.gov/Legislation/20192020/182938.pdf Upon receipt of the above-listed firm’s Letter of Intent (LOI) to provide a proposal to the Department for this engagement, DCH will host an opportunity for firms who desire to present their proposal to the state an opportunity to do so. Each eligible offeror will have an opportunity to meet with DCH executive leadership to provide information that supports your firm’s proposal. Upon receipt of an offeror’s LOI, DCH staff will advise the identified point of contact to schedule a date for this presentation. We anticipate that each interested offeror will be given two (2) hours for each presentation, which may be extended at the discretion of the Department. IV. Desired Outcomes/Deliverables: A. Assimilation of current state environment at the national and state level, including sub-state-level analyses, developed to inform decision makers with regard to 1115 and 1332 Waiver option development. B. Up to three (3) proposed 1115 alternatives for consideration by the Office of the Governor. C. Up to three (3) proposed 1332 alternatives for consideration by the Office of the Governor. D. Completion of a formal 1115 Waiver application to CMS. E. Completion of a formal 1332 Waiver application to the Department of the Treasury and CMS. F. Assistance with negotiating approval of the formal 1115 and 1332 Waiver applications to respective federal authorities. V. Timeframe Requirements: All phases must be completed to the Department’s satisfaction on or before December 31, 2019 VI. Other Available/Impacting Information (Budget, Website References, etc.): Refer to Attachment A SUMMARY OF PROPOSED STATEMENT OF WORK (TO BE COMPLETED BY QUALIFIED CONSULTANT) Consulting Firm/ Contact Name Contact Title Contact Phone Contact E-mail Summary Scope of Work: Relevant Experience/Results: Milestones/Deliverables: Estimated Time to Completion: General Staffing Plan: Consultant’s Travel Requirements: Consultant’s Onsite Workspace Requirements: Estimated Cost (should reflect categories of service, rate, estimated hours, etc.): ATTACHMENTS State Entities and responsive consultant firm(s) may submit additional attachments (including a fully-developed SOW) for consideration and clarification purposes. All documents may become binding within the final, executed statement of work between the two parties. SIGNATURES Responding Firm Authorized Signature Name and Title Date