Self-Direction: Fiscal Intermediary and Support Brokerage

Location:	Tennessee
Posted:	Mar 4, 2026
Due:	Mar 13, 2026
Agency:	Shelby County
Type of Government:	State & Local
Category:	R - Professional, Administrative and Management Support Services
Solicitation No:	RFP 26-001-72
Publication URL:	To access bid details, please log in.

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Shelby County

Tennessee

Lee Harris, Mayor

QUESTIONS & ANSWERS No. 3

ISSUED: March 3, 2026

RFP 26-001-72

Self-Direction Fiscal Intermediary and Support Brokerage

TO ALL PROSPECTIVE BIDDERS:

The following questions were submitted by a potential bidder. Our answers are

listed below in red:

1. Can you please confirm the current number of participants and how many participants you

anticipate over the life of this contract? How many referrals of new participants for each

program are sent each month? How many participant terminations for each program occur

each month? What has been the growth rate of the program over the last 3-5 years?

We are unable to provide a number of how many persons will choose to participate in

program all persons can choose this option who are currently in Personal

Assistance/Homemaker/family care giver services which is approximately 350 persons. A

program that is not active cannot anticipate terminations. Growth will be dependent on

number of persons who choose the services.

2. Can you please confirm the current number of participants eligible for self-direction?

None

3. How many referrals of new participants for the program are sent each month?

Person will learn about program from ACMS staff and will be able to choose.

4. How many participant terminations for each program occur each month?

As program is not active cannot anticipate terminations.

5. What has been the growth rate of the program over the last 3-5 years?

Growth will be dependent on number of persons who choose this service.

6. How is a newly referred participant’s information sent to the FMS for enrollment?

Forward by ACMS staff

7. What information and/or documents are provided? Name and phone contact will be provided.

Vendor could provide referral sheet for information

8. How is the information submitted?

Email, vendor could provide referral sheet.

9. Can you please clarify:

What specific types of background checks are required for providers? Are fingerprint-based

checks part of the mandated screening process? Current State of Tennessee law is:

TCA 52-2-1002:

• (b) For purposes of this section:

(1) An employee, subcontractor, or volunteer is considered to be in a position that

involves "direct contact" with a person supported if the employee, subcontractor, or

volunteer is supporting the person in the performance of personal care duties or

assistance with activities of daily living for the person receiving services; and

(2) An employee, subcontractor, or volunteer is considered to be in a position that

involves "direct responsibility" for a person supported if the employee, subcontractor, or

volunteer either has responsibility for the person receiving services or supervisory

authority for staff having direct contact with a person receiving services.

• (c) Persons applying for employment shall:

(1) Supply fingerprint samples to be submitted for criminal history records check to be

conducted by the Tennessee bureau of investigation or the federal bureau of

investigation; or

(2) Release information for a criminal background investigation by a state-licensed

private investigation company.

10. Who is responsible for bearing the costs associated with conducting these background

screenings for the self-directed service providers employed by the participants?

The employer of record.

11. How is the participant’s eligibility determined? By whom? How often is eligibility reviewed

and re-determined?

Determined by ACMS. Reviewed annually.

12. What actions should the FMS take should it learn of a participant’s ineligibility?

ACMS will inform vendor if person no longer eligible.

13. Does the participant’s eligibility ever change retroactively?

No.

14. How is the FMS alerted of the participant’s eligibility?

ACMS will inform vendor if person no longer eligible via email.

15. What eligibility items prevent payment, and which are flexible, if any?

ACMS will inform vendor if person no longer eligible via email.

16. How does a participant learn of the option to self-direct?

ACMS informs of this option.

17. What options counseling is provided?

Explanation of option.

18. Are there videos, handouts?

Open to using those provided by vendor.

19. Who provides the information?

ACMS staff

20. How is the FMS notified of a participant terminating from the program? Are there ever any

involuntary terminations?

ACMS staff would inform, not typical.

21. Can you provide details on the provider credentialing process, especially regarding the

verification and re-verification of provider qualifications?

Providers are not credentialed; the RFP process determines vendor.

22. Are there any specific participant or provider trainings required to be delivered by the FMS?

What training requirements exist? Are trainings renewed?

Training is determined by need of participant, vendor requirements, and should any licensed

service be, being provided.

23. Please clarify if workers compensation insurance is required for participants.

Employers of record should follow workers compensation laws.

24. What is the average participant budget size?

No average size, budget cap is $7850 for 12-month period

25. What costs are tied to the participant’s budget?

For example, does the participant’s budget include taxes, insurance, other administrative

costs? All cost is to be covered by this budget.

26. How is the participant’s budget established? Who develops the budget with the participant?

Can DEPARTMENT provide an example of a current budget report?

Budget is capped, all persons may not use all of budget. ACMS determines the cap.

27. How are participants able to use their budget?

Typically used for homemaker / personal assistance services.

28. Directly authorized services only?

Yes.

29. Do they select the pay rate? Within a range?

For example, ACMS will pay $29 per hour for homemaker/personal assistance, that is capped

all employment associated cost and labor cost should be covered by this rate.

30. Are employee bonuses permitted (e.g., health insurance, PTO, retirement, etc.)?

Employers are responsible for employment practices. We will not pay bonuses.

31. Are additional goods/services permitted that are not directly authorized?

32. How are premium pay (e.g., overtime, holiday) factored into the budget?

Employers are responsible for managing cost within capped rates for services and capped

budgets.

33. How are employer taxes budgeted?

Responsibility of the employer.

34. Can participants carry over unused funds from one period to another?

35. What format is authorization data provided?

Vendor will receive electronic authorization.

36. What is the length of the authorization for services? What is the average number of

modifications on an authorization?

Authorization is for twelve-month period. Authorization is for a caped amount.

37. Does the State allow providers to draw down funds related to authorized services?

No, cost reimbursement system.

38. How do participants currently receive their monthly budget reports? What components are

contained in the report? What is the current report format?

Responsibility of the vendor, we do not have a current format.

39. Are participants able to identify under or over utilization easily on their budget report and

take appropriate action as needed?

Budget maintenance is the responsibility of the vendor.

40. Who reviews and responds to questions the participant has on their monthly budget report?

The vendor manages the budget.

41. Does the State allow for invoicing for claims within the same month of services?

Vendor bill monthly

42. What is the frequency of submitting claims allowed by the State?

Monthly

43. Does the contractor have to wait a required amount of time after the service is completed to

submit for reimbursement of claims? If so, what is the amount of time?

Invoices are due the 5th of the month following the provision of the services.

44. In what format are claims submitted? Is there a companion guide for the claims format?

Vendor will be trained by ACMS staff on submitting invoices.

45. What is the timeframe for reimbursing for provider-related claims, including the financial

management PMPM claim?

Invoices are typically paid within 30 days if they are submitted by the 5th of the following

month, if you submit the invoice late, payment will be delayed.

46. What is the denial rate for claims and the top reasons for denial?

Unauthorized services and unauthorized plans will not be reimbursed. Pre authorization is

required.

47. What claim denial codes indicate participant eligibility? What percentage of claims and dollar

amount were denied over the past year for this reason?

This is the opportunity summary page. It provides an overview of this opportunity and a preview of the attached documentation.

Self-Direction: Fiscal Intermediary and Support Brokerage - Questions and Answers No. 3

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See also