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Deliverable Number
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Commodity/Service Type
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Major Deliverable
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Method of Payment
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Pediatric services
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A4 continued
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Fixed Price - Lump Sum
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| Major Deliverable: A4 continued |
| Deliverable Price: $37,886.17 |
| Non Price Justification: |
| Performance Metrics: continued |
| Financial Consequences: l. Failure to participate in the design and implementation of the minimum number of quality improvement projects annually as specified will result in a one percent reduction in the quarterly invoice amount for each quality improvement project not implemented.
m. Failure to participate in learning collaboratives and other workgroups as specified will result in a one percent reduction in the quarterly invoice amount for each learning collaborative or workgroup not participated in.
n. Failure to participate in developing public health policy recommendations for systems of care as specified will result in a one percent reduction in the quarterly invoice amount.
o. Failure to create, prepare, and submit the Pulmonary SNAQ Report as specified will result in a one percent reduction in the quarterly invoice amount. An additional one percent will be assessed for every five business days the Pulmonary SNAQ Report is not submitted as specified.
p. Failure to survey the parents and caregivers of patients as specified will result in a one percent reduction in the quarterly invoice amount. An additional one percent will be assessed for every five business days the surveys are not submitted as specified.
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| Deliverable Number: |
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Pediatric services
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A4 continued
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Fixed Price - Lump Sum
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| Major Deliverable: A4 continued |
| Deliverable Price: $37,886.17 |
| Non Price Justification: |
| Performance Metrics: continued |
| Financial Consequences: g. Failure to implement a quality of life measurement tool and provide a copy of it to the Contract Manager as specified will result in a one percent reduction in the quarterly invoice amount. An additional one percent will be assessed for every five business days the quality of life measurement tool is not submitted as specified.
h. Failure to create, prepare, and submit a Quality of Life Report as specified will result in a one percent reduction in the quarterly invoice amount. An additional one percent will be assessed for every five business days the Quality of Life Report is not submitted as specified.
i. Failure to complete and submit the Single Organization Assessment Tool as specified will result in a one percent reduction in the quarterly invoice amount. An additional one percent will be assessed for every five business days the Single Organization Assessment Tool is not submitted as specified.
j. Failure to maintain a SNAQ team and submit team members’ names and the name of the team lead as specified will result in a one percent reduction in the quarterly invoice amount. An additional one percent will be assessed for every five business days the SNAQ team members’ names and the name of the team lead is not submitted as specified.
k. Failure to conduct and submit a needs assessment of the Pediatric Pulmonary Disease Management Program as specified will result in a one percent reduction in the quarterly invoice amount. An additional one percent will be assessed for every five business days the needs assessment is not submitted as specified.
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Pediatric services
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A4 effective 10/9/2019
Quarterly: Provision of comprehensive, family-centered system of care servic...
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Fixed Price - Lump Sum
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| Major Deliverable: A4 effective 10/9/2019
Quarterly: Provision of comprehensive, family-centered system of care services with submission of supporting documentation as specified in Tasks B.1.a.1) through B.1.a.3).
converted to quarterly payments:
FY 19-20 $37,886.17 Q2-4
FY 20-21 $37,886.17 Q1-3 and $37,886.19 Q4 |
| Deliverable Price: $37,886.17 |
| Non Price Justification: |
| Performance Metrics: 1) Create, prepare, and submit a Program Action Plan as specified.
2) Create, prepare, and submit a PCMH/PCP Assignment Report as specified.
3) Create, prepare, and submit a Health Transition Policy as specified.
4) Create, prepare, and submit a Health Transition Report as specified.
5) Create, prepare, and submit a Mental and Behavioral Health Referral Process and Policy as specified.
6) Create, prepare, and submit a Mental and Behavioral Health Report as specified.
7) Implement a quality of life measurement tool and provide a copy of it to the Contract Manager as specified.
8) Create, prepare, and submit a Quality of Life Report as specified.
9) Complete and submit the Single Organization Assessment Tool as specified.
10) Maintain a SNAQ team and submit team members’ names and the name of the team lead as specified.
11) Conduct and submit a needs assessment of the Pediatric Pulmonary Disease Management Program as specified.
12) Participate in the design and implementation of the minimum number of quality improvement projects annually as specified.
13) Participate in learning collaboratives and other workgroups as specified.
14) Participate in developing pubic health policy recommendations for systems of care as specified.
15) Create, prepare, and submit the Pulmonary SNAQ Report as specified.
16) Survey the parents and caregivers of patients as specified. |
| Financial Consequences: a. Failure to create, prepare, and submit a Program Action Plan as specified will result in a five percent reduction in the quarterly invoice amount. An additional one percent will be assessed for every five business days the Program Action Plan is not submitted as specified.
b. Failure to create, prepare, and submit a PCMH/PCP Assignment Report as specified will result in a one percent reduction in the quarterly invoice amount. An additional one percent will be assessed for every five business days the PCMH/PCP Assignment Report is not submitted as specified.
c. Failure to create, prepare, and submit a Health Transition Policy as specified will result in a one percent reduction in the quarterly invoice amount. An additional one percent will be assessed for every five business days the Health Transition Policy is not submitted as specified.
d. Failure to create, prepare, and submit a Health Transition Report as specified will result in a one percent reduction in the quarterly invoice amount. An additional one percent will be assessed for every five business days the Health Transition Report is not submitted as specified.
e. Failure to create, prepare, and submit a Mental and Behavioral Health Referral Process and Policy as specified will result in a one percent reduction in the quarterly invoice amount. An additional one percent will be assessed for every five business days the Mental and Behavioral Health Process and Policy is not submitted as specified.
f. Failure to create, prepare, and submit a Mental and Behavioral Health Report as specified will result in a one percent reduction in the quarterly invoice amount. An additional one percent will be assessed for every five business days the Mental and Behavioral Health Report is not submitted as specified.
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| Source Documentation Page Reference: 13 |
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Pediatric services
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A3
Effective 1/23/2019
no change to performance measures or deliverables
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Fixed Price - Lump Sum
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| Major Deliverable: A3
Effective 1/23/2019
no change to performance measures or deliverables |
| Deliverable Price: $12,628.73 |
| Non Price Justification: |
| Performance Metrics: no change |
| Financial Consequences: no cahnge |
| Source Documentation Page Reference: |
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Pediatric services
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Effective with A2: $12,628.73 (July-May) and $12,628.67 (June)
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Fixed Price - Lump Sum
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| Major Deliverable: Effective with A2: $12,628.73 (July-May) and $12,628.67 (June) |
| Deliverable Price: $12,628.73 |
| Non Price Justification: |
| Performance Metrics: Participate in CMS calls as specified. |
| Financial Consequences: Failure to participate in CMS calls as specified will result in a one percent reduction in that month's invoice. |
| Source Documentation Page Reference: |
| Deliverable Number: |
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Pediatric services
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1. Monthly: Provision of pediatric pulmonary disease management services with submission of documen...
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Fixed Price - Lump Sum
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| Major Deliverable: 1. Monthly: Provision of pediatric pulmonary disease management services with submission of documentation as specified in Tasks B.1.a.1) through B.1.a.19). June payment is $14,042.00. |
| Deliverable Price: $14,031.00 |
| Non Price Justification: |
| Performance Metrics: a) A clinic schedule must be submitted as specified.
b) A pediatric pulmonary disease management team must be established and maintained as specified.
c) Patients must be assessed as specified.
d) Clinic roster summary must be submitted as specified.
e) All scheduled pediatric pulmonary clinics must be conducted as specified.
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| Financial Consequences: 1. Failure to submit the clinic schedule as specified will result in a three percent reduction in that month’s invoice. An additional reduction of one percent will be result for every five business days thereafter the schedule is not submitted.
2. Failure to establish and maintain a pediatric pulmonary disease management team as specified will result in a one percent reduction in that month’s invoice for each team not established.
3. Failure to assess patients to determine their health status as specified will result in a one percent reduction in that month’s invoice for each patient not assessed.
4. Failure to submit the clinic roster summary as specified will result in a three percent reduction in that month’s invoice. An additional reduction of one percent will result for every five business days thereafter the summary is not submitted.
5. Failure to provide a minimum of 90 percent of the scheduled clinics each month as specified will result in a five percent reduction in that month’s invoice. For every additional one percent of clinics not provided as specified, a one percent reduction will be assessed in that month’s invoice. |
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Pediatric services
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CONTINUED. 1. Monthly: Provision of pediatric pulmonary disease management services with submission...
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Fixed Price - Lump Sum
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| Major Deliverable: CONTINUED. 1. Monthly: Provision of pediatric pulmonary disease management services with submission of documentation as specified in Tasks B.1.a.1) through B.1.a.19). |
| Deliverable Price: $0.00 |
| Non Price Justification: Price cannot be determined until the work has been completed |
| Performance Metrics: f) Emergency room, telephone consultation coverage, and inpatient hospital coverage must be provided as specified.
g) Minimum Data Set must be submitted as specified
h) Program Services Report (Attachment V) must be submitted as specified.
i) All surveys must be submitted as specified. |
| Financial Consequences: 6. Failure to provide emergency room, telephone consultation, and hospital coverage as specified will result in a two percent reduction in that month’s invoice. An additional one percent reduction will result for each business day coverage is not provided.
7. Failure to submit Minimum Data Set as specified will result in a two percent reduction in that month’s invoice. An additional one percent reduction will result for every five business days thereafter the report is not submitted.
8. Failure to submit Attachment V as specified will result in a two percent reduction in that month’s invoice. An additional one percent reduction will be assessed for every five days thereafter the attachment is not submitted.
9. Failure to submit all client satisfaction surveys as specified will result in a three percent reduction in that month’s invoice for each survey not submitted. An additional one percent reduction will be assessed for every five business days thereafter the surveys are not submitted.
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