RFA-2027-OCOM-03-COMPL: Complaint Investigation Services

New Hampshire Department of Health and Human Services
Complaint Investigation Services
Appendix A - Scope of Services
Scope of Services
1. Statement of Work
1.1. The Contractor must perform statewide complaint investigation services that
consist of conducting investigations for alleged client rights violations of
persons applying for, eligible for, or currently receiving developmental services
or acquired brain disorder services.
1.2. The Contractor must ensure services are available statewide.
1.3. The Contractor must be available to provide complaint investigation services
up to a maximum of thirty-five (35) hours per week for fifty (50) weeks per
twelve (12) month period. There will be no minimum number of guaranteed
hours per week. The hours will depend upon the number of complaints received
and assigned by the Office of Client and Legal Services.
1.4. The Contractor must perform investigations within the timeframes set forth, and
in accordance with, the requirements of the State of New Hampshire's
Administrative Rule He-M 202. The Contractor must conduct interviews and
submit reports to the Department with a determination as to whether an
individual's rights have been violated, pursuant to He-M 310.
1.5. The Contractor must be available to conduct interviews in person throughout
New Hampshire.
1.6. The Contractor must provide complaint investigation for all complaints
assigned by the Department's Office of Client and Legal Services.
1.7. The Contractor must obtain prior approval of the State through the
Department's Office of Client and Legal Services before providing complaint
investigation services.
1.8. The Contractor must:
1.8.1. Provide complaint investigation services statewide, for all assigned
cases from the Office of Client and Legal Services, by investigating
complaints involving rights violations for persons with developmental
disabilities or acquired brain disorders, in accordance with New
Hampshire Administrative Rule He-M 202.
1.8.2. Complete complaint investigation services within the timeframes set
forth in New Hampshire Administrative Rule He-M 202. Selected
Applicant(s) must immediately seek approval from the Department's
Office of Client and Legal Services if additional time is needed to
complete the investigation. Failure to complete the investigation within
the required timeframes without prior approval from Client and Legal
Services may result in payment being withheld.
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New Hampshire Department of Health and Human Services
Complaint Investigation Services
Appendix A - Scope of Services
1.8.3. Perform investigations, including collateral and clinical interviews, with
the complainant; the individual; the guardian; the respondent, and any
witnesses, to gather data relating to allegations.
1.8.4. Determine whether an individual's rights have been violated, pursuant
to He-M 310.
1.8.5. Analyze and interpret complex data, policies, regulations and laws,
human rights, and service provider procedures to identify possible
safeguards and to resolve investigated situations.
1.8.6. Assess and recommend independent investigation findings and follow-
up plans for problem resolution in each investigation, as needed.
1.8.7. Prepare and issue reports which summarize the issues presented,
make investigatory findings of fact, and make determinations regarding
the allegations in accordance with New Hampshire Administrative Rule
He-M 202.
1.8.8. Participate in training programs, case reviews, case conferences, peer
review meetings, and quality assurance program activities specified in
New Hampshire Administrative Rule He-M 202.
1.8.9. Have a valid driver's license and/or have access to transportation for
statewide travel.
1.9. The Contractor must obtain prior written consent from the Office of Client and
Legal Services to investigate a complaint where they are deemed to have a
conflict of interest or the appearance of a conflict of interest with the assigned
case/individual.
1.10. The Contractor will be granted authority as an independent decision-maker
acting in a complaint investigation capacity, in accordance with the State of
New Hampshire Administrative Rule He-M 202.
1.11. The Contractor must keep records of their activities, per complaint assigned by
the Office of Client and Legal Services, which will include, but is not limited to,
hours worked.
1.12. Reporting
1.12.1. The Contractor must submit weekly Status Reports which include, but
are not limited to:
1.12.1.1. Status of each currently assigned investigation;
1.12.1.2. When most recent update/report was provided to the area
agency; and
1.12.1.3. Any barriers to completing the investigation on time.
1.12.2. The Contractor may be required to provide other key data and metrics
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New Hampshire Department of Health and Human Services
Complaint Investigation Services
Appendix A - Scope of Services
to the Department in a format specified by the Department.
1.13. Background Checks
1.13.1. Prior to permitting any individual to provide services under this
Agreement, the Contractor must ensure that said individual has
undergone:
1.13.1.1. A criminal background check, at the Contractor's expense,
and has no convictions for crimes that represent evidence
of behavior that could endanger individuals served under
this Agreement;
1.13.1.2. A name search of the Department's Bureau of Adult and
Aging Services (BAAS) State Registry, pursuant to RSA
161-F:49, with results indicating no evidence of behavior
that could endanger individuals served under this
Agreement; and
1.13.1.3. A name search of the Department's Division for Children,
Youth and Families (DCYF) Central Registry pursuant to
RSA 169-C:35, with results indicating no evidence of
behavior that could endanger individuals served under this
Agreement.
1.14. Confidential Data
1.14.1. The Contractor must meet all information security and privacy
requirements as set by the Department and in accordance with the
Department's Information Security Requirements Exhibit as
referenced below.
1.14.2. The Contractor must ensure any individuals involved in delivering
services through this Agreement contract sign an attestation agreeing
to access, view, store, and discuss Confidential Data in accordance
with federal and state laws and regulations and the Department's
Information Security Requirements Exhibit. The Contractor must
ensure said individuals have a justifiable business need to access
confidential data. The Contractor must provide attestations upon
Department request.
1.15. Privacy Impact Assessment
1.15.1. Upon request, the Contractor must allow and assist the Department
in conducting a Privacy Impact Assessment (PIA) of its
system(s)/application(s)/web portal(s)/website(s) or Department
system(s)/application(s)/web portal(s)/website(s) hosted by the
Contractor, if Personally Identifiable Information (PII) is collected,
used, accessed, shared, or stored. To conduct the PIA the Contractor
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New Hampshire Department of Health and Human Services
Complaint Investigation Services
Appendix A - Scope of Services
must provide the Department access to applicable systems and
documentation sufficient to allow the Department to assess, at
minimum, the following:
1.15.1.1. How PII is gathered and stored;
1.15.1.2. Who will have access to PII;
1.15.1.3. How PII will be used in the system;
1.15.1.4. How individual consent will be achieved and revoked;
and
1.15.1.5. Privacy practices.
1.15.2. The Department may conduct follow-up PIAs in the event there are
either significant process changes or new technologies impacting the
collection, processing or storage of PII.
1.16. Department Owned Devices, Systems and Network Usage
1.16.1. Contractor End Users, defined in the Department's Information
Security Requirements Exhibit that is incorporated into this
Agreement, authorized by the Department's Information Security
Office to use a Department issued device (e.g. computer, tablet,
mobile telephone) or access the Department network in the fulfilment
of this Agreement, must:
1.16.1.1. Sign and abide by applicable Department and New
Hampshire Department of Information Technology (NH
DoIT) use agreements, policies, standards, procedures
and guidelines, and complete applicable trainings as
required;
1.16.1.2. Use the information that they have permission to access
solely for conducting official Department business and
agree that all other use or access is strictly forbidden
including, but not limited, to personal or other private and
non-Department use, and that at no time shall they
access or attempt to access information without having
the express authority of the Department to do so;
1.16.1.3. Not access or attempt to access information in a manner
inconsistent with the approved policies, procedures,
and/or agreement relating to system entry/access;
1.16.1.4. Not copy, share, distribute, sub-license, modify, reverse
engineer, rent, or sell software licensed, developed, or
being evaluated by the Department, and at all times must
use utmost care to protect and keep such software strictly
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New Hampshire Department of Health and Human Services
Complaint Investigation Services
Appendix A - Scope of Services
confidential in accordance with the license or any other
agreement executed by the Department;
1.16.1.5. Only use equipment, software, or subscription(s)
authorized by the Department's Information Security
Office or designee;
1.16.1.6. Not install non-standard software on any Department
equipment unless authorized by the Department's
Information Security Office or designee;
1.16.1.7. Agree that email and other electronic communication
messages created, sent, and received on a Department-
issued email system are the property of the Department
of New Hampshire and to be used for business purposes
only. Email is defined as "internal email systems" or
"Department-funded email systems."
1.16.1.8. Agree that use of email must follow Department and NH
DoIT policies, standards, and/or guidelines; and
1.16.1.9. Agree when utilizing the Department's email system:
1.16.1.9.1. To only use a Department email address
assigned to them with a "@
affiliate.DHHS.NH.Gov".
1.16.1.9.2. Include in the signature lines information
identifying the End User as a non-Department
workforce member; and
1.16.1.9.3. Ensure the following confidentiality notice is
embedded underneath the signature line:
CONFIDENTIALITY NOTICE: "This message may
contain information that is privileged and confidential
and is intended only for the use of the individual(s)
to whom it is addressed. If you receive this message
in error, please notify the sender immediately and
delete this electronic message and any attachments
from your system. Thank you for your cooperation."
1.16.1.10. Contractor End Users with a Department issued email,
access or potential access to Confidential Data, and/or a
workspace in a Department building/facility, must:
1.16.1.10.1. Complete the Department's Annual
Information Security & Compliance
Awareness Training prior to accessing,
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Complaint Investigation Services
Appendix A - Scope of Services
viewing, handling, hearing, or
transmitting Department Data or
Confidential Data.
1.16.1.10.2. Sign the Department's Business Use
and Confidentiality Agreement and
Asset Use Agreement, and the NH
DoIT Department wide Computer Use
Agreement upon execution of the
Agreement and annually thereafter.
1.16.1.10.3. Only access the Department's intranet
to view the Department's Policies and
Procedures and Information Security
webpages.
1.16.1.11. Contractor agrees, if any End User is found to be in
violation of any of the above terms and conditions, said
End User may face removal from the Agreement, and/or
criminal and/or civil prosecution, if the act constitutes a
violation of law.
1.16.1.12. Contractor agrees to notify the Department a minimum of
three business days prior to any upcoming transfers or
terminations of End Users who possess Department
credentials and/or badges or who have system privileges.
If End Users who possess Department credentials and/or
badges or who have system privileges resign or are
dismissed without advance notice, the Contractor agrees
to notify the Department's Information Security Office or
designee immediately.
2. Exhibits Incorporated
2.1. The Contractor must manage all confidential data related to this Agreement in
accordance with the terms of Exhibit E, DHHS Information Security
Requirements.
2.2. The Contractor must use and disclose Protected Health Information in
compliance with the Standards for Privacy of Individually Identifiable Health
Information (Privacy Rule) (45 CFR Parts 160 and 164) under the Health
Insurance Portability and Accountability Act (HIPAA) of 1996, and in
accordance with the attached Exhibit F, Business Associate Agreement, which
has been executed by the parties.
3. Additional Terms
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New Hampshire Department of Health and Human Services
Complaint Investigation Services
Appendix A - Scope of Services
3.1. Impacts Resulting from Court Orders or Legislative Changes
3.1.1. The Contractor agrees that, to the extent future state or federal
legislation or court orders may have an impact on the Services
described herein, the State has the right to modify Service priorities
and expenditure requirements under this Agreement so as to achieve
compliance therewith.
3.2. Federal Civil Rights Laws Compliance: Culturally and Linguistically
Appropriate Programs and Services
3.2.1. The Contractor must submit:
3.2.1.1. A detailed description of the language assistance
services, within ten (10) days of the Effective Date of the
Agreement, to be provided to ensure meaningful access
to programs and/or services to individuals with limited
English proficiency; individuals who are deaf or have
hearing loss; individuals who are blind or have low
vision; and individuals who have speech challenges.
3.2.1.2. A written attestation, within forty-five (45) days of the
Effective Date of the Agreement and annually
thereafter, that all personnel involved the provision of
services to individuals under this Agreement have
completed, within the last twelve (12) months, the
Contractor Required Training Video on Civil Rights-
related Provisions in DHHS Procurement Processes,
which is accessible on the Department's website
(https://www.dhhs.nh.gov/doing-business-dhhs/civil-
right-compliance-dhhs-vendors); and
3.2.1.3. The Department's Federal Civil Rights Compliance
Checklist within ten (10) days of the Effective Date of
the Agreement. The Federal Civil Rights Compliance
Checklist must have been completed within the last
twelve (12) months and is accessible on the
Department's website (https://www.dhhs.nh.gov/doing-
business-dhhs/civil-right-compliance-dhhs-vendors).
4. Records
4.1. The Contractor must keep records that include, but are not limited to:
4.1.1. Books, records, documents and other electronic or physical data
evidencing and reflecting all costs and other expenses incurred by the
Contractor in the performance of the Contract, and all income received
or collected by the Contractor.
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New Hampshire Department of Health and Human Services
Complaint Investigation Services
Appendix A - Scope of Services
4.1.2. All records must be maintained in accordance with accounting
procedures and practices, which sufficiently and properly reflect all such
costs and expenses, and which are acceptable to the Department, and
to include, without limitation, all ledgers, books, records, and original
evidence of costs such as purchase requisitions and orders, vouchers,
requisitions for materials, inventories, valuations of in-kind contributions,
labor time cards, payrolls, and other records requested or required by
the Department.
4.2. Records regarding the provision of services and all invoices submitted to the
Department to obtain payment for such services. During the term of this
Agreement and the period for retention hereunder, the Department, the United
States Department of Health and Human Services, and any of their designated
representatives must have access to all reports and records maintained
pursuant to the Agreement for purposes of audit, examination, excerpts and
transcripts.
4.3. If, upon further review, the Department must disallow any expenses claimed by
the Contractor as costs hereunder, the Department retains the right, at its
discretion, to deduct the amount of such expenses as are disallowed or to
recover such sums from the Contractor.
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