The Importance of a Comprehensive Request for Proposal (RFP) For Health Services

Richard Forbus, MBA-HCM, CCHP

When a public agency is seeking services, the start of the formal bid process is the Request for Proposal, or RFP. This is a critical part of the bid process as it lays out the agency’s desired services, needs, and expectations. The RFP provides potential bidders with information on the services being requested so they can make an informed business decision as to whether they should bid or pass on the opportunity.

The RFP process for health services in a correctional facility has further importance. Compared to other more routine services offered in a facility, the provision of health services is a high-risk venture, for both the agency and for potential health care services providers, as lives are literally at stake in a high-liability environment. A well-written RFP is critical to attract the most qualified candidates to submit a proposal, which allows the facility to weigh its options and select the best vendor that can meet its patients’ needs.

The importance of a comprehensive and well-developed RFP for correctional health care services cannot be understated. A flawed RFP can create conflict, ambiguity, or omissions in expected services. If the flaws are not addressed before posting the RFP, it will almost certainly impact the bidding process and the eventual development of a services contract.

If errors are not addressed but are discovered after the RFP is released, addendums become necessary to clarify the desired services and needs of the facility. It is not unusual to see several addendums that come out as questions come in from potential bidders, or upon the discovery of gaps or omissions in RFP content.

Ultimately, gaps or blind spots that are significant may delay the selection of a vendor and create challenges, and in general, these issues can delay contract development. Flaws that are not addressed before vendor selection and contract development can lead to risks to patient safety, potential liability, and increased likelihood of an adverse event.

Although processes vary from organization to organization, if the flaws are serious enough, the entire RFP process may need to be restarted or could even be challenged by bidders who were not selected. That can create delays that put pressure on the process timeline and, in the case of a vendor change, result in added expense through unnecessary short-term extensions of services, as well as other negative perceptions of the process or other impacts. In any of the above examples, it is almost given that there will be increased costs that could have been avoided with a well-written, comprehensive RFP.

Perhaps most importantly, a poorly written RFP can cause the agency to lose out on potential candidates for the provision of health services. Vendors have significant “skin in the game” when it comes to taking on services, and in the case of poorly written or ambiguous RFPs, vendors will opt not to put in if they feel there is no benefit to doing so. When otherwise qualified vendors do not submit a proposal for consideration, the entire purpose of the RFP process is undermined.

Complications in Contract Development

RFP and contract development are complicated processes. When RFP issues are not identified before contract development, confusion in expected services, ambiguity as to who is responsible for payment, provision of certain services, or gaps in care are a typical result. When that occurs, further negotiations and contract amendments may be needed to resolve those issues. As a result, patient care and safety may be impacted, increasing potential liability and costs to provide care while these issues are resolved.

In complex situations where separate contracts are in place for different disciplines of health services, such as mental health, dental, and opioid treatment services, delivery of effective and efficient care can be very complicated. In some cases, there are even separate contracts for medical providers and nursing services that comprise health services. In these cases, it is critical to deconflict RFP and contract language to ensure that the roles and responsibilities of each vendor are clearly defined, and that all required aspects of care are addressed.

Documentation can be especially challenging when multiple vendors are involved, especially in terms of electronic health record management. Because contractors can be a national or regional vendor, a county or state entity, or another third-party service provider, an RFP and contract must clearly define expectations for documentation and record management. To provide comprehensive care, documentation cannot be conducted in silos, and records management is a critical component that is often overlooked.

While the issues discussed above can be an administrative nuisance, the implications can be quite serious if they impact patient safety and service delivery timelines, possibly causing adverse outcomes and liability, especially when access to care is delayed or not provided. At a minimum, costs will be impacted because there is not an option to simply disregard patient needs while contract issues are worked out.

Health care is a complicated venture in its very nature. Correctional health care is even more complex, and it is important to recognize the differences in community care and care provided in a correctional facility. The fact is that individuals in custody have a constitutional right to health care services, where those in the community do not. Consideration must be given to the specialized and complicated nature of correctional health services, the high sensitivity of patients that tend to remain in custody in our facilities, and the capabilities of the community itself.

The importance of engagement and collaboration in the development of an RFP and contract language cannot be understated. Correctional administrators, health services experts, and the facility’s funding body must participate in the development of the best possible RFP and contract. A well-developed RFP will attract the best vendors, set clear expectations for performance, and ultimately result in a contract that benefits patients, protects liability, and meets the needs of the facility and the community.

How Can NCCHC Assist Your Organization?

The challenge in RFP and contract development is that most governmental agencies do not have experience in developing a comprehensive RFP for correctional health services, which differs greatly from community health services. Whether it is a lack of expertise or experience in correctional health care, not having the right staff on your RFP development team can cause significant issues later.

NCCHC Resources, Inc., the consulting and technical assistance affiliate of the National Commission on Correctional Health Care, offers national expertise specific to correctional health care services. Using the NCCHC standards as a foundation of care, NCCHC Resources’ consultants can assist your agency in developing the best possible RFP that protects the interests of the agency, the vendor, and your staff and patients.

Contact NCCHC Resources for a no-obligation consultation to discuss your needs and learn how NCCHC Resources can help with your next RFP and/or contract development process.

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Richard Forbus, MBA-HCM, CCHP, is Vice President of Program Development for the National Commission on Correctional Health Care (NCCHC). He has over 30 years of experience in corrections, retiring as a Corrections Captain after 25 years of service in one of the largest NCCHC-accredited county jail systems in the country. He can be reached at richardforbus@ncchc.org

Contact NCCHC Resources for a no-obligation consultation to discuss your needs and learn how NCCHC Resources can help with your next RFP and/or contract development process.

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