Memo to Board of Supervisors and Pete Kutras, County Executive from Guadalupe S. Olivas, PhD Regarding HIV Test-Counseling Expansion Request for Proposals

U

‘County of Santa Clara

B/S Chair_

Public Health Department

BD of Supv.

3003 Moorpark Avenue

Clerk

San Jose, California 95128
(Tel) 408.423.0701
(Fax)408.423.0702

August 31,2006

RECDSEP 11 2006
TO:

Board ofSupervisors
Pete Kutras, County Executive

FROM:

Guadalupe S. Olivas, Ph.D.

Director,Public Health Department
SUBJECT:

HIV Test-Counseling Expansion Request for Proposals-Informational Only

I would like to let you know,for informational purposes only, that the Public Health Department

has issued the attached Request for Proposals(l^P)on August 30,2006. The issuance ofthis RFP

is in accordance with Board Policies on Contracting and Bidding related to Human Service
contracts. The projected total service dollar amount available through this RFP is approximately
$300,000.

History as a recipient ofHIV Education and Prevention funding within the last three years is
preferred, due to the complexity ofsetting-up and operating an HIV alternative testing site, but it is
not required.

If you have any questions regarding this document, please contact me at(408)423-0701.
Thank you.
\
c:

Kim Roberts, Acting Executive Director, SCVHHS
Jeanette Murphy, ASM,SCVHHS
Amy Carta,SCVHHS

Districts <|7n
The Public Health Department Is a division of Santa Clara Valley Health & Hospital System.

IV

Santa Clara County
Public Health Department
Public Health Administration
3003 Moorpark Avenue
San Jose, CA 95128

HIV Test-Counseling Expansion
Request for Proposals
m

REQUEST FOR PROPOSALS(RFP) NOTIFICATION

The HIV Test-Counseling Expansion RFP will be available on

Wednesday, August 30,2006. You can obtain a copy
through any of the following locations:
httB;//www.sccgov.orq/portal/site/scc/menuitem.a153581586Q2f81e3e23ad6735cda429
WWW,ifpdepot.com

The Bidder's Conference is scheduled for
Friday, September 8,2006

from 2:30 p.m, to 5:00 p.m.
Conference Room 136
770 S. Bascom Avenue
San Jose CA 95128

For more information: please contact Kevin Hutchcroft at
Kevin.Hutchcroft@hhs.co.santa-clara.ca,us

Santa Clara County
Public Health Department

A division ofSanta Clara Valley Health & HospitalSystem

Request for Proposal
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The Santa Clara County Public Health Department HIV/AIDS Prevention and Control Program
(HAP)is currently seeking proposals to expand HIV alternative testing sites in Santa Clara
County. The goal is to make rapid testing accessible to Santa Clara County’s most at-risk
populations. The Department will fund a maximum of five(5)community-based organizations
(CBOs)to provide rapid HIV testing and counseling with the minimum required standards
stipulated by the California Department ofHealth Services(CA DHS)and the Centers for
Disease Control and Prevention(CDC). These standards are presented in the CBO HIV
Alternative Testing Sites Work Plan (Attachment A). The standards have been incorporated as
necessary "start-up”infrastructure development that selected community-based organizations
will need to have in place prior to beginning HIV testing.

A total of$300,000 will be made available to those organizations that can most effectively
address HIV testing expansion funding priorities, preferred capacities, and requirements in their
proposals. The contract period will be November 1, 2006 to October 31,2007. To be eligible, an
organization must be a public or private nonprofit organization that is classified as 501(c)(3)tax
exempt under the Internal Revenue Code. An RFP information meeting is scheduledfor
September 8, 2006, 3:00p.m. to 5p.m., at 770 S. Bascom, Room 136. The deadline for
proposals is 5 p.m. on September 20, 2006.

This Request for Proposal(RFP)is organized as follows:
I. Background
n. Local HIV Data
III.

IV.

CDC Best Practices Based on Science and Evidence-Based Approaches
HIV Testing Expansion Fimding Priorities, Preferred Capacities, and Requirements

V. Application Process
VI. County Contract Requirements
VII. Proposal Deadline
VIII, Selection Criteria

IX. Appeals/Objections
X. RFP Attachments

1

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Santa Clara County’s plan to expand HIV alternative testing sites and identify more residents
who are HrV+ is important for many reasons. In the past, an HIV+ diagnosis was a death
sentence—typically within five years due to fatal opportunistic infections. This is no longer true.
Today,county residents with HP/ can expect to live much longer with appropriate medication

and proper care. As HIV+ status evolves into a more manageable chronic condition and greater
numbers of people are living with HIV/AIDS, there is a greater chance of more residents

becoming infected. In addition to the number ofresidents with HIV/AIDS who have currently
been identified, the CDC estimates that approximately 25% of persons with HP/ZAIDS are not
aware of their diagnosis. And,evidence suggests that as many as two-thirds of the new HfV
infections each year occur through transmission from persons who are unaware oftheir HIV+

status. The incidence and spread ofthe disease will not be curtailed until barriers to early
diagnosis are reduced. Expansion ofHIV alternative testing sites will address barriers to early
diagnosis and provide referrals to Hry-f- residents, who will benefit from access to appropriate
medication and proper care.

As more residents become aware of their HP/+ status, there will be greater need for appropriate
medication and care. The Ryan White Care Act provides critical support for Santa Clara

County’s continuum of HIV/ADDS care, which includes primary medical care, case management,
mental health services, oral health care, food, transportation, substance use/abuse treatment, and
other services for county residents diagnosed with HfV/AIDS. At this time, changes in the
funding formula are moving toward a formula based on the total number of persons living with
Hr//AIDS. Increasing identification ofHIV+ individuals in Santa Clara County will protect
current funding and will likely result in additional resources for HIV/AIDS services through
Ryan White and other similar formula-driven grants. These resources will be needed as more

residents are identified as HIV-t- through the expansion of HP/ alternative testing sites.
Board ofSupervisors Budget Allocation and Requestfor Implementation Plan

On June 6,2006 the Board of Supervisors approved a one-time budget allocation of$375,000 for
FY 2006-07 for expansion ofHP/ testing and counseling sites for targeted at-risk populations in
Santa Clara County. The purpose ofthis allocation is to address gaps and barriers to the
continuum of HfV/AIDS services in the county by(1)Expanding testing and counseling sites to
targeted communities;(2)Expanding availability of rapid testing;(3)Expanding outreach and
counseling by increasing the number of certified counselors; and(4) Continuing to work with
medical providers regarding reporting requirements via the Department’s Surveillance Unit. The
Health and Hospital Committee recommended that $75,000 of the $375,000 go to the Public
Health Department for administrative costs and for campaign marketing costs to maximize
awareness of the availability of expanded HfV testing.

CDC,“Advancing AIDS Prevention, AHP Overview, Interim Technical Guidance for Selected

Interventions, Introduction,” http://www.cdc.gov/hiv/topics/prev_prog/AHP/resources/guidelines
/Interim-Guidance.htm (accessed 7/2006).

2

At that time, the Public Health Department was asked to submit an implementation plan for
review by the Health and Hospital Committee. In response, the Public Health Department
developed an implementation plan for alternative rapid HIV test sites that reflects the voice of
the community. Public Health participated in several meetings with representatives of the HIV
Planning Council and Commimity Planning Group. Their priorities and concerns are
incorporated throughout the implementation plan, which was developed in coordination with
both groups. The plan is also consistent with the Santa Clara County Comprehensive Planfor
HIV/AIDS Services 2006-2008 and the Santa Clara County HIV Prevention Plan 2006-2008.
Implementation Plan Goal and Prioritiesfor Target Populations and Geographic Areas
The goal of the HTV Testing Expansion program is to reduce the prevalence and incidence of
HfV/AIDS through testing, counseling, and referral to care and treatment of residents who are at
risk of HIV/AIDS by 1)increasing the number of certified test counselors in the community, and
2)conducting a minimum of6,944 tests in the target population,2% of which will test positive
for HfV antibodies(140 positive results).

Priority Populations for Expanded HIV Alternative Testing Sites are:
■ Men who have Sex with Men(MSM)
■ Females who have Sex with Men who have Sex with Men(FSMSM)
■ Transgender persons who have Sex with Men(TSM)and Transgender Injection Drug
Users(IDU)


IDU and MSM-IDU

Groups identified among priority populations for expanded HIV testing are:
■ People of Color



Sex Workers
Youth

Geographic Area Priorities are:
■ City of San Jose, where the HIV/AIDS epidemic continues to be concentrated.
■ North County(Sunnyvale, Mountain View, Palo Alto and Los Altos), where the next
highest percentage of reported HIV cases is.
■ South County, which has the smallest number of reported HIV cases to date, but isolation
and limited access to services create challenges that need special attention.

Approval ofthe HIV Alternative Testing Sites Implementation Plan
The implementation plan was submitted to the Health and Hospital Committee on August 16,
2006. The Health and Hospital Committee accepted the plan and forwarded a positive
recommendation to the Board of Supervisors. The Board of Supervisors approved the plan on
August 29, 2006.

The Public Health Department’s HfV/AIDS Prevention and Control Program(HAP)will
administer these funds and provide technical assistance to and coordination for the CBO
alternative testing and counseling programs.

3

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From July 2002 through March 2006,1008 people in Santa Clara County have been diagnosed
HrV+. Nine hundred ninety six (996) are alive. The following tables were prepared by the Santa
Clara County Public Health Department, Data Management and Statistics.
Gender
Male

Number

Female
%

861

Number

86.4

Total*

%

130

13.1

991

Race/Ethnicity
African

White

American

Number

I %

497

Number

52.0

96

Asian/Pacific
Islander

Hispanic

%

Number

10.1

310

%

Number

32.5

Total*

%

52

5.4

955

Age Group
0-12

13-19

20-29

30-39

40-49

50-59

60+

Total*

Number/%
7/0.7%

Number/%

Number/%

Number/%

Number/%

Number/%

Number/%

Number

19/1.9%

276/27.9%

404/40.8%

201/20.3%

68/6.9%

16/1.6%

991

Mode of Exposure and Gender
Mode of

Total

Male

Female

Exposure

Number/%

Number/%

Number/%

MSM

630/63.6%

630/73.2%

0/0.0%

IDU

56/5.7%

39/4.5%

17/13.1%

MSM/IDU

61/6.2%

61/7.1%

0/0.0%

127/12.8%

47/5.5%

80/61.5%

102/10.3%

80/9.3%

15/1.5%

4/0.5%

991/100%

861/100%

Heterosexual
Contact
Risk Not

Specified
Other
Total*

22/16.9%
.

11/8.5%
130/100%

Mode of Exposure and Race/Ethnicity
African

Asian/Pacific

Mode of

Total

White

American

Hispanic

Islander

Exposure

Number/%

Number/%

Number/%

Number/%

MSM

630/63.6%

370/74.4%

32/33.3%

190/61.3%

Number/%
29/55.8%

IDU

56/5.7%

33/6.6%

11/11.5%

12/3.9%

0/0.0%

MSM/IDU

61/6.2%

33/6.6%

5/5.2%

21/6.8%

2/3.8%

127/12.8%

28/5.6%

29/30.2%

57/18.4%

12/23.1%

Specified

102/10.3%

26/5.2%

16/16.7%

27/8.7%

7/13.5%

Other

15/1.5%

7/1.4%

3/3.1%

3/1.0%

2/3.8%

991/100%

497/100%

Heterosexual
Contact
Risk Not

Total*

96/100%

310/100%

52/100%

4

fflV

City

Number/%

San Jose

617/64.7%

Santa Clara

60/6.3%

Mountain View

53/5.6%

Sunnyvale
Campbell

29/3.0%

Palo Alto

29/3.0%

Milpitas
Gilroy

20/2.1%

50/5.2%

18/1.9%

Los Gatos

17/1.8%

Missing

17/1.8%

Los Altos

12/1.3%

Cupertino
Morgan Hill
Saratoga

10/1.0%
8/0.8%

Los Altos Hills

1/0.1%

10/1.0%

Stanford

1/0.1%

Total*

954/100%

* The total does not equal 996 in the tables above because information was not recorded or numbers were
too small to maintain confidentiality (e.g., for Native Americans).

in.‘CDC Best Pj-acticei-Based on Science and'Evidencb-Bascid Approaclieif- "
The HTV Planning Council, HIV Prevention Community Planning Group, and the HTV/AIDS

Prevention and Control Program are committed to promoting and supporting the most promising
practices in HIV testing and counseling. All programs funded hy the Public Health Department
must incorporate promising practices and operate with established standards of care that are
consistent with national and local standards.

Advancing HIV Prevention. The Centers for Disease Control and Prevention(CDC)announced
a major new initiative to reduce new infections of HfV in the United States in April 2003. This
initiative. Advancing HIVPrevention: New Strategiesfor a Changing Epidemic(AHP), is
comprised offour strategies to address and meet the needs of all persons who are at increased
risk for HTV. The rationale for this new initiative was that despite much success in the
prevention ofHIV infection, the current reality is that an estimated 40,000 new HIV infections
are still occurring in the United States each year, there has been an increase in racial/ethnic
disparities in the last 25 years, and an estimated 25% of persons living with HIV do not know

they are infected and are at considerable risk for developing AIDS and unknowingly transmitting
HP/.^

One of AHP’s four strategies is to implement new modelsfor diagnosing HIV infections outside
medical settings, the focus ofthe implementation plan for expansion of HIV testing sites. HIV

^ CDC,“Evolution of HIV/AIDS Prevention Programs: United States, 1981-2006,” MMWR 55,
21,(June 2, 2006): 597-603.

5

testing programs in nontraditional settings are more likely to reach some racial/ethnic minorities
and persons who report increased risk for HIV, but do not have access to medical care. The rate

of positive test results in non-traditional settings is generally higher compared with conventional
test sites in medical settings. The recently approved rapid HfV tests can be done outside of a
traditional laboratory setting. They reduce the time it takes to process tests from two weeks to 20

minutes. This advance in HfV testing technologies provides Santa Clara County with the
opportunity to effectively create alternative HIV testing sites to reach residents who are most at
risk for being infected with HIV and to increase the number of at-risk residents who know their

HIV status. This strategy emphasizes the use of proven public health approaches to reducing the
incidence and spread of disease and utilizes the most current HIV testing technologies.
There are two CDC AHP demonstration projects that can serve as models for Santa Clara

County’s alternative testing sites: Rapid HIV Testing in Nonclinical Settings and Using Social
Network Strategies to Reach Persons at High Riskfor HIVInfection in Communities ofColor.
For the Rapid HIV Testing in Nonclinical Settings demonstration project, CDC provided

funding for eight CBOs based in six cities: Boston, Chicago, Detroit, Kansas City, Los Angeles,
and Washington, DC. The CBOs provided rapid HIV testing in nonclinical settings, such as
parks and bars. As of June 2005, 17,149 persons had been tested for HIV and 249 had received
confirmed positive results. The positivity rate was about 1.5%. Further information on this
initiative can be found at:

http://www.cdc.gov/hiv/topics/prev_prog/AHP/resources/guidelines/Interim-rapidtest.htm.
For the Using Social Network Strategies to Reach Persons at High Riskfor HIVInfection in
Communities ofColor demonstration project, CDC funded nine CBOs in seven cities: Boston,

Lafayette(LA), New York City, Orlando ^L),Philadelphia and San Francisco. This strategy is

based on the concept that individuals are linked together to form large social networks and that

infectious diseases often spread through these networks. It is a programmatic, peer-driven,
recruitment strategy that is employed in conjunction with HIV testing and counseling. Through
October 2005, the CBOs’ 408 recruiters had persuaded 2,878 persons in their social, sexual, or
drug-using networks to get tested for HIV. 160 ofthese network associates were confirmed as

HrV+(with a positivity rate of 5.6%), which is five times the average prevalence reported by
publicly funded counseling, testing and referral sites. Further information on this initiative can

be found in the June 24, 2005, Morbidity and Mortality Weekly Report and at
http://www.cdc.gov/hiv/resources/guideIines/snt/pdf7SocialNetworks.pdf
The following are the Santa Clara County HIV Prevention Plan 2006-2008 program
recommendations based on CDC best practices for HfV/AIDS prevention that are applicable to
the alternative rapid test site funding.

^ CDC,“Questions and Answers: The Science Behind the New Initiative,” September 2003,
http://www.cdc.gov/hiv/topics/prev_prog/AHP/resources/qa/AHP_Science.htm (accessed
7/2006).

6



Use a risk behavior model—targeting populations based on the behavior that puts them at
high risk for HTV infection—for HIV prevention and rapid testing. The following are
priority populations and sub-populations based on high-risk for HIV infection.

Priority Populations
TSM & Transgender TOUs
(Men who have Sex
(Females who have
(Transgender persons who
with Men)
Sex with MSM)
have Sex with Men)
Priority Sub-Populations for Access to Testing:
• People of Color
■ Methamphetamine Users
MSMs



FSMSM



Sex Workers



Youth

IDUs and MSM-EDUs
(Injection Drug Users)

Ensure that alternative test sites provide Counseling, Testing, and Referral(CTR), a riskreduction counseling model conducted with HIV testing. CTR is a personalized, clientcentered encounter in which individuals can learn their HIV status. In addition, the counselor
helps the client identify and acknowledge personal HTV risk behaviors and commit to a
single, achievable behavior change step that could reduce the client’s HIV risk.

With rapid testing, a positive result is considered a preliminary positive. Whenever a client
has a preliminary positive result, a confirmatory test is needed and the confirmatory test or a
referral for one should be given at that time. When a high degree oftrust is developed and
tests results indicate a preliminary positive, the counselor should also explore partner
notification. Relevant Standards and Guidelines for CTR include;



o

CDC’s Revised Guidelines for HIV Counseling, Testing, and Referral, 2001
(http://www.cdc.gov/hiv/testing.htm)

o

CDC’s Quality Assurance Guidelines for Testing Using the OraQuick Rapid
HIV-1 Antibody Test, 2003 (http://www.cdc.gov/hiv/rapid_testing/)

o

California Department of Health Services, Office of AIDS, HIV Counseling
and Testing Guidelines, 1997(http;//www.dhs.ca.gov/ps/ooa/)

o

California Department of Health Services, Office of AIDS,Supplement to the
HIV Counseling and Testing Guidelines, 1997- OraQuick Rapid Testing in
Counseling and Testing Settings, 2003 (http;//www.dhs.ca.gov/ps/ooa/)

Provide Outreach at community venues where and at times when priority populations and
sub-populations are most accessible. The purpose of outreach in context ofthis funding is to
recruit individuals into CTR. Examples of community venues where and times when priority
populations and sub-populations are most accessible for outreach and CTR that have been
identified are;

o Venues: gay bars, adult bookstores, head shops, parks or public sex environments,
areas frequented by injection drug users, and areas frequented by sex workers—
transgender MTF(male to female) and heterosexual females—^near gas stations,
convenience stores, and in parks in East San Jose. Additional venues include

7

Needle Exchange Program sites, homeless shelters, and chemical dependency
programs,

o Times: late night and weekend hours.

■ All CTR and Outreach will be culturally competent and appropriate for the intended

population. Staff and volunteers should reflect the broad range of languages spoken in Santa
Clara County.

■ Make free condoms available with all prevention and testing services. CDC and CPG

support a harm reduction approach to HfV prevention in which clients and community
members are encouraged to engage in safer sexual practices.

■ Work collaboratively by providing linkages and referrals, a core component ofeffective CTR
and outreach. The HfV epidemic exists in the context of a host of other health and social

issues, including poverty, homelessness, substance abuse, mental health, incarceration,
immigration, and sexually transmitted diseases that are compounded by deep-rooted social
problems and inequities, such as, racism, homophobia, and gender inequality. HIV
alternative test site providers must be familiar with the multiple needs ofthe individuals and

communities they serve and attempt to address these needs through a network of providers to
which they can refer and link their clients.

■ Design and implement cost-effective programs. Cost-effectiveness is often thought ofin
terms of cost savings. An example would be the costs that would be avoided ifthe estimated

25% of persons living with HTV and not knowing they are infected received testing and knew
their HIV status so that, if they were HIV+,they could reduce their risk for developing AIDS
and of unknowingly transmitting HTV to others. Cost-effectiveness is also making use of
community volunteers when they can effectively reach target populations. Successful

volunteer testing programs, such as the San Francisco Department ofPublic Health’s, can
serve as models for replication.

A copy ofthe Santa Clara County HIVPrevention Plan 2006-2008 is available at

http://www.sccgov.org/SCC/docs/SCC%20Public%20Portal/keyboard%20agenda/Committee%2
0Agenda/2006/February%208,%202006/TMPKeyboard201387529.pdf
HTBI

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The Santa Clara County Public Health Department funding for HfV Alternative Testing Site
Expansion is a one-time budget allocation to expand rapid HIV testing in Santa Clara County.
The goal is to make rapid testing accessible to Santa Clara County’s most at-risk populations.
Funding Priorities:

■ Rapid testing sites will be accessible to/target the most at-risk populations in the county
(MSMs,MSM Methamphetamine users, FSMSMs,IDUs, MSM-IDUs, Transgender IDUs

8

and TSMs)and the following sub-populations within each target population(people ofcolor,
sex workers, and youth). HIV Outreach and testing sites will be:
o in locations and during hours that will most effectively reach these at-risk
populations,
o in the San Jose area, where the HIV/AIDS epidemic is concentrated, as well as in

north county, which has the next highest percentage ofreported HIV cases, and in
south county, where isolation and access to services is a challenge,
o implemented on a consistent schedule to capitalize on word-of-mouth as residents
become familiar with the service.



The HTV/AIDS Prevention and Control Program(HAP)will coordinate testing site locations
and schedules. CBOs may be asked to change sites and/or locations based on the need for

testing of all priority populations or due to changes identified through analysis of HIV/AIDS
data by Public Health Department(PHD)epidemiologists.




History as a recipient ofHIV Education and Prevention Funding within the last three years is
preferred due to the complexity of setting-up and operating an HIV alternative testing site.
For interested CBOs that do not have a history as a recipient of HIV Education and

Prevention Funding, partnership/collaboration with a previous recipient ofthis funding to
apply for these funds is encouraged.



Collaboration among agencies in applying for these funds—^with the goal of having the most
effective staff working with priority populations—is encouraged.

Preferred Capacities:



Culturally competent and appropriate outreach, testing and counseling for the county’s
populations most at-risk and in communities prioritized in this implementation plan.



Demonstrated access to and established trust with targeted high-risk populations.



Effective collaboration with care and support services for HIV/AEDS clients.



Capacity for effective health education dissemination.



Strategies as cost-effective as possible, such as, making use of community volunteers as test
technicians and counselors when they can effectively reach the target population.

Requirementsfor Alternative Testing Sites:



All Alternative Testing Sites operated by funded-CBOs will use Rapid Testing technology to
provide voluntary, anonymous and confidential fi-ee or low cost($5)HIV testing. Test kits
will be provided at no cost by HAP.

9

All testing sites will operate in compliance with relevant state and local regulations and CDC
guidelines applicable to HIV Rapid Testing. HAP will provide technical assistance to CBOs
in preparing Alternative Testing Sites. Requirements are presented in the CBO Alternative
Testing Sites Work Plan (Attachment A).

All testing and counseling staff will be certified after participating in training provided by the
State Office of AIDS, which is available at no cost, and maintain up-to-date certification.

Collect data as required by HAP (e.g., the HP/ Counseling Information Form, Lab Slips, and
Testing Consent Forms for all clients; HIPAA consent for confidential clients; and any
additional recordkeeping required by HAP and Public Health Laboratory).

All funded CBOs will commit to participating in the program evaluation. PHD will perform
the evaluation based on the HIV Testing Expansion Evaluation Plan (Attachment B).

1. Complete and attach the “Application Coversheef’(Attachment C).

2. Proposal Narrative: Describe the following in a maximum offive(5)double-spaced
pages.

a. Organization Overview and Capacity. Describe your organization’s past experience:


Working with HIV/AIDS clients.



Working with the priority population(s).

■ Working in the priority geographical area(s) where the priority population(s) are
most accessible.



Providing health education.



Setting-up and operating complex programs relevant to an HIV alternative
testing and counseling site,

b. Describe how your organization will address funding priorities, preferred capacities,
and requirements presented in Section IV,including:


Target population(s).

■ Specific location(s) within priority geographic areas.
■ Proposed outreach and testing/counseling sites and schedules with rationale
for selection of site(s) and schedule(s).

■ Proposed staffing and why they will be effective in reaching proposed target
population(s),

■ Approach to setting-up and operating an HfV alternative test site(s).
3. Complete the Scope of Work Template (Attachment D).

4. Submit budget and budget narrative(Attachment E). Indirect expenses can equal no
more than 10% of the total project budget.

10

Please Note: Successful bidders will not be funded for provision of services that are
concurrently funded by other sources.
5.

Provide resume(s)/job description(s) of personnel responsible for implementation ofthe
proposal.

6.

Provide proof of insurance coverage as required in Section VI of this proposal
(Attachment F).

7.

Review Confidentiality ofPatient Information(Attachment G). You may sign it and
include it with your proposal, but this is not required.

VI. €bUdty.eonfratt<Reqi||tenijeirts
A. Contractual Requirements.

Applicants may submit only one(1) proposal. The successful bidder must comply with
County contractual requirements, including: indemnification and insurance provisions.
County Contracting Principles, non-discrimination provisions, client confidentiality, and
other contract provisions included in the “Service Agreement”(Attachment H). Proof of
insurance coverage for requested funding, based on requirements in Attachment F,
must be provided with the proposal.

Requirements for evaluation will be included in the “Service Agreement” and will include
collection of all required data (e.g., the HIV Counseling Information Form, Lab Slips, and
Testing Consent Forms for all clients; HIPAA consent for confidential clients; and any
additional recordkeeping required by HAP)and commitment to participating in the Public
Health Department’s evaluation of the HIV testing expansion program (Attachment B). All
projects will be in effect from the date the Agreement is executed through October 31, 2007.
B. County Rights/Obligations
1. The Santa Clara Valley Health and Hospital System(SCVHHS)reserves the right to
reject proposals, as well as the right to cancel this RFP at any time. The County retains
the right to open this solicitation to additional bidders at any time prior to execution of
the final Agreement.
2.

Contractor will not be reimbursed for any costs associated with the preparation or
submittal of responses to this RFP.

3.

SCVHHS reserves the right to waive any minor irregularities or informalities in any
proposal and request clarification ofinformation from any bidder.

4.

The California Public Records Act set forth in Government Code sections 6250 etseq.
governs access to public records. The Act provides that access to information concerning
the conduct of the public’s business is a fundamental and necessary right of a person in

11

the state. Consequently, all Proposals, attachments and other materials submitted in
response to this RFP are considered public information(except as provided herein) and
become the exclusive property ofthe County.

5. Notwithstanding the foregoing, no Proposal materials will be released to the public nor
may the public have access to such Proposal materials during the RFP process.
Thereafter, the public will have access to the Proposal materials, as provided in this RFP.

m

The original plus 10 copies ofthe completed proposal must be delivered to the Santa Clara
County Public Health Department, Attn: HAP,3003 Moorpark Avenue, San Jose, CA,95128 no

later than 5 p.m., Wednesday,September 20,2006. No exceptions will be allowed. Each
proposal must be in a secured folder, stapled or otherwise secured, and include completed forms
and responses to Attachments C-F. Faxes, electronic copies, incomplete or late submittals will
not be accepted and will be returned to bidders.

Contact the HAP Manager, Kevin Hutchcroft, in writing by e-mail with any questions:
Kevin.Hutchcroft@hhs.co.santa-clara.ca.us. All questions and responses will be made public to
all vendors on the website: www.sccgov.org/r^_list.

\TiI. Selection'Criteria

The Public Health Department will conduct a review ofthe submitted proposals. The review
may also include interviews of the prospective bidders. A contract will be negotiated with
bidder(s) whose proposal(s) best demonstrates the ability to address funding priorities at a
reasonable cost. The Public Health Department reserves the right to cancel or reopen the RFP
process as it deems appropriate. Notification ofthe County’s decision will be provided to all
applicants no later than October 2, 2006.

The following review criteria will be applied in the selection process:
Review Criteria

Proposal Narrative(up to 50 points):
Organization Overview and Capacity:
■ Presentation and clarity.
■ Experience and past successes.
■ Capacity to work effectively with the target population(s).
■ Capacity to work effectively in priority geographic area(s).
■ Capacity to set-up and operate an HW alternative testing site(s).


Points

0-20

Capacity to provide health education.

Approach to addressing funding priorities, preferred capacities,

0-30

and requirements:

12




Presentation and clarity.
Quality of approach/strategies to addressing funding priorities;
■ Target population(s).
■ Locations within priority geographic area(s).
■ HIV Outreach and Testing/Counseling Site(s)
and rationale for selection.




Proposed staff and ability to reach target population(s).
Setting-up and operating an HIV alternative test site(s).

Scope of Work Template(Attachment D)

0-20

Budget:
■ Proposed budget and budget narrative.
■ Maximum of 10% for indirect cost(s).

0-20

Proposal Attachments:
■ Completed Application Cover Sheet with required signature.
■ Job Descriptions/Resumes for key staff.

0-10



ProofofInsurance Coverage(see Section V, VI, and Attachment F).

Local Preference* Bonus Points

5

*When two or more competing vendors are equally qualified, local firms shall be given
preference,(Board of Supervisor’s policy 5.3.13)

rlS;

m

Appeals or objections to a rejection or award under this RFP must be submitted in writing within
five(5) business days ofthe postmarked notice of award or rejection. Such an appeal or
objection must be specific, identifying the nature ofthe protest or objection and stating all the
facts that form the basis for the appeal. All reason(s)for the appeal or objection, citing law, rule,
regulation or procedures upon which the appeal is based must be specified. Any appeal or
objection must be forwarded to the County by certified or registered mail or delivered in person,
with proposer obtaining a receipt of delivery, in the time provided herein to the following
address:

Dolores Alvarado, MSW,MPH

Division Director, Community Health Promotion
Santa Clara County Public Health Department
3003 Moorpark Avenue
San Jose, CA 95128

All appeals or objections received after the five(5) business day period described above will be
automatically disallowed and the original decision that is the subject of the protest or objection
will be upheld. All appeals that are timely will be referred to the Director of the Public Health
Department for review and consideration. Applicants submitting appeals or objections will be

13

notified by the Director of the Public Health Department ofthe decision on any such appeal. The
Public Health Director’s decision on any appeal or objection will be final.

'Mi

’ff

m

iiiiife

A. CBO HfV Alternative Testing Sites Work Plan
B. HfV Testing Expansion Program Evaluation Plan
C. Application Cover Sheet

D. Scope of Work Template

E. Budget and Budget Justification Template

F. Insurance Requirements for Standard Service Contracts (Insurance Exhibit B-2A)
G. Confidentiality ofPatient Information

H. Sample Service Agreement Template
I.

RFP Timeline

14

Attachment A

CBO HIV Alternative Testing Sites Work Plan
Activities

Meet HIV testing certification requirements:
■ Participate in mandatory certification training(60
hours).
■ Participate in annual continuing education
training to keep certificate up-to-date.


Timeframe

CBO/ATS Staff and

11/2006-1/2007

Volunteers

Perform at least 12 tests per month.

Participate in trainings and meetings as arranged by
HAP.

Identify coordinator for ATS project.
Select Alternative Testing Sites:
■ Identify sites at high-risk venues: gay bars, adult
bookstores, head shops, parks or public sex
environments, areas frequented by injection drug
users, and areas frequented by sex workers—
transgender MTF(male to female) and
heterosexual females—near gas stations,
convenience stores, in parks in East San Jose,
Needle Exchange Program sites, homeless
shelters, and chemical dependency programs.
■ Assess proposed settings for feasibility of
implementing rapid HIV testing and counseling
(e.g., does the setting have acceptable lighting for
test readability, temperature control, private space
for providing counseling and test results).


Responsible Party

CBO/ATS Staff and

Ongoing

Volunteers

CBO Administration

11/2006

CBO/ATS Staff

11/2006-1/2007

CBO/ATS Staff

11/2006-1/2007

CBO/ATS Staff

11/2006-1/2007

CBO/ATS Staff

11/2006-1/2007

Coordinate with the HAP ATS Coordinator to

ensure priority risk behavior and geographic
coverage(San Jose plus north and south county).
■ Create a site plan (locations and schedules).
Develop systems and procedures to ensure client
privacy and confidentiality.
Establish procedures for protecting all client-related
data.

Develop systems and procedures for informed
consent procedures in accordance with local and state
requirements and CDC guidelines.
■ Establish unambiguous and easy to implement
guidelines to define sobriety standards and to
identify chronic mental health conditions that
may interfere with ability to provide informed
consent.

15

Activities (cont.)

Develop a process to document consent for testing
and testing results, and to track specimens sent for

Responsible Party

Timeframe

CBO/ATS Staff

11/2006-1/2007

CBO/ATS Staff

11/2006-1/2007

CBO/ATS Staff

11/2006-1/2007

CBO/ATS Staff

11/2006-1/2007

CBO/ATS Staff

11/2006-1/2007

CBO Staff

1/2007

CBO Staff

2/2007-11/2007

CBO Staff

2/2007-11/2007

confirmatory testing.

Develop a process for obtaining detailed locating
information on clients whose test results are

preliminary positive so that they can be contacted and
encouraged to come in for care if they fail to return
for their follow-up appointment.
Develop a plan to ensure compliance with the
Clinical Laboratory Improvement Amendment

(CLIA)regulations related to HfV rapid testing
(which will be explained in detail at the 9/30 RFP
information meeting) and with relevant state and

local regulations applicable to HIV Rapid Testing.
Refer to :www.cms.hhs.gov/CLIA

Develop a plan for handling infectious waste,
complying with the regulations ofthe Occupational
Safety and Health Administration, and handling
potential occupational exposures.
Develop a plan to maintain staff and volunteer safety
at settings that may pose a risk to them (e.g., safety
training and taking precautions, such as, working in
teams).

Participate in site visit by Public Health staff(HAP
and Laboratory staff) to confirm readiness to begin
HIV testing (required before testing can begin).
Operate alternative test sites and outreach at high-risk
venues, as coordinated with HAP ATS Coordinator.



Provide HIV testing and counseling to high-risk
clients(MSMs,MSM Methamphetamine users,
FSMSMs,IDUs & MSM IDUs, TSMs, and
Transgender IDUs).



Whenever a client has a preliminary positive test
result, have a system in place for confirmatory
testing (see OraQuick Guidelines).
■ Provide condoms for prevention (harm

reduction).
Collect Data:



Complete the HIV Counseling Information Form
(CEF), Lab Slips and Testing Consent Forms for
all clients; HIPAA consent for confidential

clients; and any additional HAP requirements.

16

Activities(cont)

Manage Referrals:
■ Link with Public Health Laboratory for
confirmatory testing of preliminary positive rapid
test specimens.
■ Arrange linkages with medical and social
referrals for comprehensive follow-up.
■ Develop procedures for making referrals,
assisting clients with getting to referrals, and
confirming that referred clients acted on the
referrals and received, or are receiving, services

Responsible Party

Timeframe

CBO Staff

2/2007-11/2007

CBO Staff

11/2007-12/2007

as a result of the referral.

Participate in Public Health Department evaluation.

17

Attachment B

HIV Testing Expansion Program Evaluation Plan
FY08

Program Name

HIV Rapid Testing and Counseling Expansion Implementation Plan

Target Population

Residents of Santa Clara County who are High Risk Population for HIV/AIDS:(1) men who have sex with
men(MSM),(2)MSM Methamphetamine users,(3)Female partners of MSM(FSMSMs),(4)Intravenous

Drug Users(IDUs)and MSM IDUs,(5)Transgender IDUs and TSMs.
Problem Statement

Increasing rates ofHIV infection in several identified populations are posing threat to the public health of
Santa Clara County. Both CDC and local estimates indicate about 25% ofthose living with HTV/AIDS are
unaware oftheir diagnosis. In Santa Clara County, there are an estimated 879 persons who are living with
HTV/AIDS who are unaware oftheir diagnosis. The local positive rate for testing at the Pubhc Health
Department Laboratory is 1.67%, while the statewide average positive rate is 2.6%. The local positive rate for
MSM is 2.4-4.0%, while the statewide MSM rate is 12-20%.

Overall Program
Goals

Program
Components

To reduce the prevalence and incidence ofHIV/AIDS through testing, counseling, referral to care and
treatment to residents who are at risk of HTV/AIDS.
1. Assessment
2. Outreach

3. Clinical Health Services (Testing, Health Education, Counseling, Treatment)

4. Community Collaboration
Program
Description

Confidential and anonymous testing will be provided at HIV test sites. Rapid testing will be used at locations

Program Theory

Health Belief Model

where populations at greater risk for HTV/AIDS will be more likely to access services. Counsehng and

referrals are also provided to clients as needed.

Trans-theoretical model(Stages of change)
Harm reduction

18

Program Component: Outreach, Clinical services
Measurable
Program Activities to Evaluation Methodology

Data

Reporting

Source

Timeframe

Link to ES Indicator

Objectives
1. By December
2007, at least 2% of
people will test

populations such as

Data collection - reports
from testing sites on

MSM,TSMs,IDUs

munber oftests

health services and assure

positive for HTV
antibodies among

and their partners, and
females having sex

conducted, results and
demographics of clients

the provision of health

test sites within

with MSM.

achieve objectives
a. Targeting high risk

mv6

Quarterly

ELI

Essential Service(ES)7:
Lmk people to needed

care when otherwise
unavailable.

Santa Clara County.
b. Conducting at least
6944 HIV tests

Program Component: Clinical services(counseling and referral)
Measurable

Objective
2. By December
2007, 100% of
clients who are

Program Activities
to achieve objectives

Evaluation Methodology

Data

Reporting

Source

Timeframe

Link to ES Indicator

a. Training staff on

a. Coimt number of training

a. Staff

resources available to
refer clients

sessions and number ofstaff

reports &

Essential Service(ES)7:
Link people to needed

participating

survey

health services and

HIV positive will

Quarterly

staff who

assure the provision of

be referred to

b. Providing adequate b. Determine percentage ofclients

received

health care when

care.

resources to clients

referred to care

training

otherwise imavailable.

c. Report from testing site on # of
referrals to which providers

b.HIV6

d. Record offollow-up activities
(phone calls to clients, providers,
etc.)
e. Record ofreferral information

provided to client

19

Program Component: Community collaboration
Measurable objective

Program activities

Evaluation methodology

Data source

to achieve ob jectives

Reporting

Link to ES indicator

Timeframe

3. By December 2007,

a. Conducting focus

a. Conduct 2 to 3 focus

at least 70% of the

groups

community providers
and partners will report
high level of

groups with community
providers and partners

b. Administering the
Community Provider

satisfaction with the

and Partner

satisfaction sxjrvey to

Public Health

Satisfaction Surveys

community providers

a. Notes/

Annual

Results

Essential Service(ES)7:
Link people to needed

from focus

health services and

groups

assure the provision of

b. Analysis ofresults from

Department

health care when
otherwise imavailable.

b. Provider
and Partner
satisfaction
surveys

Program Component: Clinical Health Services
Measurable objective

Program activities
to achieve objectives

Evaluation

4. By the end of
December 2007, at least

a. Conducting client
satisfaction surveys

Analysis ofsurvey
results(SPSS)

80% ofthe clients will

focusing on the
quahty and
accessibility of the
services provided

report high levels of
satisfaction with the

Community-Based

Organizations providing

Data source

methodology

Reporting

Link to ES indicator

Timeframe
Client

satisfaction
survey

Annual

Essential Service(ES)7:
Link people to needed
health services and assure

the provision of health
care when otherwise
imavailable.

services.

20

Program Component: Community collaboration, clinical services
Measurable objective

Program activities

Evaluation

to achieve

methodology

Data source

Reporting

Links to ES indicators

Timeframe

objectives

5. By the end of
December 2007,

a. Include

questions(s) on the

Analysis of survey
results(SPSS)

Client

Quarterly

satisfaction

Essential Service(ES)7:
Link people to needed

survey

health services and assure

80% of clients who

client satisfaction

participate in the

survey to assess

risk reduction

the provision of health

whether there was

counseling session

mcrease m

care when otherwise
unavailable.

will have increased

knowledge about
HIV prevention

knowledge of
personal
HIV/AIDS

prevention
strategies.

* The Centers for Disease Control’s(CDC)National Public Health Performance Standards Program’s Ten Essential Services ofPubhc

Health document presented a method to organize the many diverse programs within the Department and support conclusions about
overall department impact. The essential services represent the ten core responsibilities of a local department of public health.

21

Santa Clara County
Public Health Department

AdMilo<MilSanuaaram€fHuiAia>ipUalSynm

Attachment C
I.

APPLICATION COVERSHEET

Fill out completely and include as thefront page ofthe application.
Name ofProject:

Applicant Name/Organization:
Mailing Address:

City:
Phone:

,CA Zip:
Fax:

Other:

Contact Person:
Title:

Phone:

Tax Identification Number:

Funding Amount Requested: $

Briefdescription ofthe proposed project:

Applicant understands that the submission ofthis document does not guarantee funding, nor that funding
will be allocated at the level requested. Final contract provisions will take precedence over the
information contained in the proposal.

The undersigned hereby affirms that they have read the attached County of Santa Clara Contracting

Principles, Insurance requirements. Nondiscrimination Policy and other required County Contract
provisions provided in the RFP packet. Further, statements contained in the application package are true
and complete to the best of the applicant’s knowledge. The undersigned recognizes that all proposals,
attachments, and other materials submitted in response to this RFP shall be considered public information
and open to public inspection. The undersigned further understands that if selected, the contractor will
perform all work and services described in the Agreement as an independent contractor and not as an
officer, agent, servant or employee of the County of Santa Clara.
Person authorized to sign:

Signature:

Date:

22

Attachment D

SCOPE OF WORK Template
CBO Name;

Proposed Alternative HIV Outreach and Testing Sites (add rows to the table as needed to include all proposed sites)
Target
Population(s)

Target

Location

Proposed

Numbers

of Site(s)

Schedule

for Testing

Activity
(Outreach/
Testing/
Coimseling)

Staff Responsible

(include strengths re: reaching the
target population)

We will work with HAP to perform all activities in the CBO HTV Alternative Testing Site Work Plan(Attachment A)and
compliance with State and CDC rules and regulations regarding HTV rapid testing. □ Yes
We will monitor staff participation in training and maintenance of certification. □ Yes

We will complete and submit all required data collection, as requested by HAP.
We will work closely with HAP and participate in HIV rapid testing meetings.

□ Yes
□ Yes

ensure

□ No

□ No

□ No
□ No

We will participate in the Public Health Department’s HIV Testing Expansion Evaluation Plan (Attachment B). □ Yes □ No

23

HIV BUDGET - ATTACHMENT E

Organization Name;

Subcontractor(s)Name (if any)
Contract Period:

A. PERSONNEL

DaicripBon
Position Title

Name

Annual Salary

FTE

Direct Service

I Hof Months I

Administration

TOTAL

EMPLOYEE PERSONNEL COSTS
t

1
$
i

$
$
$
$
$

TOTAL SALARIES SWAGES

FRINGE BENEFITS0 S OF SALARY AND WAGES EXPENSE
DesctIpMon
Position Title

Name

Hourly Rate

FTE

Direct Service

I « of Months f

Administration

TOTAL

CONTRACT PERSONNEL COSTS
$
$
i
$
$

i
$
$
$
$

TOTAL CONTRACT PERSONNEL COSTS

i
B, OPERATING EXPENSES

TOTAL OPERATING EXPENSES
C.

SUBCONTRACT(S)(please have subcontracting agencies complete this form and attach It to this budget)

TOTAL SUBCONTRACT COSTS
D. OTHER COSTS

$
$

H

i

TOTAL OTHER COSTS

$

W/M/M

E. INDIRECT COSTS(10% maximum)

I
GRAND TOTAL

TOTAL PROPOSED BUDGET

i

1
i

EXHIBIT B-2A (revised)

INSURANCE REQUIREMENTS FOR

STANDARD SERVICE CONTRACTS
BETWEEN $50.001 AND $100.000

Indemnity

The Contractor shall indemnify, defend, and hold harmless the County of Santa Clara (hereinafter
"County"), its officers, agents and employees from any claim, liability, loss, injury or damage
arising out of, or in connection with, performance ofthis Agreement by Contractor and/or its agents,
employees or sub-contractors, excepting only loss, injury or damage caused by the negligence or
willful misconduct of personnel employed by the County. It is the intent of the parties to this
Agreement to provide the broadest possible coverage for the County. The Contractor shall
reimburse the County for all costs, attorneys' fees, expenses and liabilities incurred with respect to
any litigation in which the Contractor is obligated to indemnify, defend and hold harmless the
County under this Agreement.

Insurance

Without limiting the Contractor's indemnification of the County, the Contractor shall provide and
maintain at its own expense, during the term of this Agreement, or as may be further required
herein,the following insurance coverages and provisions:

A. Evidence of Coverage

Prior to commencement of this Agreement, the Contractor shall provide a Certificate of
Insurance certifying that coverage as required herein has been obtained. Individual
endorsements executed by the insurance carrier shall accompany the certificate. In addition,
a certified copy of the policy or policies shall be provided by the Contractor upon request.

This verification of coverage shall be sent to the requesting County department, unless
otherwise directed. The Contractor shall not receive a Notice to Proceed with the work

under the Agreement until it has obtained all insurance required and such insurance has been
approved by the County. This approval of insurance shall neither relieve nor decrease the
liability ofthe Contractor.

B. Qualifying Insurers

All coverages, except surety, shall be issued by companies which hold a current policy
holder's alphabetic and financial size category rating of not less than A- V, according to the
current Best's Key Rating Guide or a company of equal financial stability that is approved
by the County's Insurance Manager,

Rev. 4/2002

1

EXHIBIT B-2A (revised)

C. Notice of Cancellation

All coverage as required herein shall not be canceled or changed so as to no longer meet
the specified County insurance requirements without 30 days' prior written notice of such
cancellation or change being delivered to the County of Santa Clara or their designated
agent.
D. Insurance Required
1.

Commercial General Liability Insurance - for bodily injury (including death) and
property damage which provides limits as follows:
a. Each occurrence

$1,000,000

b. General aggregate -

$1,000,000

c. Products/Completed Operations aggregate - $1,000,000
d. Personal Injury

2.

3.

$1,000,000

General liability coverage shall include:
a.

Premises and Operations

b.

Products/Completed

c.

Personal Injury liability

d.

Severability of interest

General liability coverage shall include the following endorsement, a copy of which
shall be provided to the County:
Additional Insured Endorsement, which shall read:

“County of Santa Clara, and members of the Board of Supervisors of
the County of Santa Clara, and the officers, agents, and employees of
the County of Santa Clara, individually and collectively, as additional
insureds.”

Insurance afforded by the additional insured endorsement shall apply as primary
insurance, and other insurance maintained by the County of Santa Clara, its
officers, agents, and employees shall be excess only and not contributing with
insurance provided under this policy. Public Entities may also be added to the
Rev. 4/2002

2

EXHIBIT B-2A (revised)

additional insured endorsement as applicable and the contractor shall be notified by
the contracting department ofthese requirements.

4.

Automobile Liability Insurance

For bodily injury (including death) and property damage which provides total limits
of not less than one hundred thousand dollars ($100,000) combined single limit per
occurrence applicable to all owned, non-owned and hired vehicles.

4a.

Aircraft/Watercraft Liability Insurance rRequired if Contractor or any of its agents
or subcontractors will operate aircraft or watercraft in the scope ofthe Agreement)

For bodily injury (including death) and property damage which provides total limits
of not less than one hundred thousand dollars ($100,000) combined single limit per
occurrence applicable to all owned, non-owned and hired aircraft/watercraft.

5.

Workers' Compensation and Employer's Liability Insurance
a.

Statutory California Workers' Compensation coverage including broad form
all-states coverage.

b.

Employer's Liability coverage for not less than one million dollars
($1,000,000) per occurrence.

E. Special Provisions

The following provisions shall apply to this Agreement:
1.

The foregoing requirements as to the types and limits of insurance coverage to be
maintained by the Contractor and any approval of said insurance by the County or
its insurance consultant(s) are not intended to and shall not in any manner limit or
qualify the liabilities and obligations otherwise assumed by the Contractor pursuant
to this Agreement, including but not limited to the provisions concerning
indemnification.

2.

The County acknowledges that some insurance requirements contained in this
Agreement may be fulfilled by self-insurance on the part of the Contractor.
However, this shall not in any way limit liabilities assumed by the Contractor under
this Agreement. Any self-insurance shall be approved in writing by the County
upon satisfactory evidence of financial capacity. Contractors obligation hereunder
may be satisfied in whole or in part by adequately funded self-insurance programs
or self-insurance retentions.

Rev. 4/2002

3

EXHIBIT B-2A (revised)

3.

Should any of the work under this Agreement be sublet, the Contractor shall require
each of its subcontractors of any tier to carry the aforementioned coverages, or
Contractor may insure subcontractors under its own policies.

4.

The County reserves the right to withhold payments to the Contractor in the event
of material noncompliance with the insurance requirements outlined above.

F. Fidelity Bonds (Required only if contractor will be receiving advanced funds or payments)
Before receiving compensation under this Agreement, Contractor will furnish

County with evidence that all officials, employees, and agents handling or having
access to funds received or disbursed under this Agreement,or authorized to sign or
countersign checks, are covered by a BLANKET FIDELITY BOND in an amount

of AT LEAST fifteen percent (15%) of the maximum financial obligation of the
County cited herein. If such bond is canceled or reduced. Contractor will notify
County immediately, and County may withhold further payment to Contractor until
proper coverage has been obtained. Failure to give such notice may be cause for
termination of this Agreement, at the option of County.

Rev. 4/2002

4

Attadunent G

Confidentiality of Patient Information
SANTA CLARA

VALLEY
HEALTH & HOSPITAL SYSTEM

Name (print)

Social Security #

Department (print)

□ Employee

Work Site (location)

□ Contractor #

Index Code

□ Other

□ Volunteer

□ Student

Subject to the provisions of the Confidentiality of Medical Information Act (California Civil Code §56-56.37), which
permits the disclosure of certain information, it is the policy of the Santa Clara Valley Health and Hospital System
(SCVHHS) that all patients have a right to confidential treatment of all communication and records pertaining to tlieir
care and stay in the hospital. All SCVHHS employees shall respect the rights of the patients in regard to
confidentiality of such information. Violation of the guidelines regarding release of patient information is a cause for
disciplinary action and may result in criminal and/or civil liability charges. The following are penalties from the Santa
Clara County Ordinance Code, §A16-13, that could be imposed should the guidelines be violated;
(a)

(b)

The intentional violation of any provision of this division (§A16) or any rules adopted thereunder, by
an officer or employee of any agency shall constitute a cause for discipline, including termination of
the intentional employment.
Any person who intentionally provides any record containing personal information to any unauthorized
person in violation of any provision of this division shall be guilty of a misdemeanor and be fined not
more than five thousand dollars ($5,000.00) per occurrence, or imprisoned not more than one year, or
both.

(c)

Any person who requests or obtains any record containing personal or confidential information from an
agency under false pretenses shall be guilty of a misdemeanor and fined not more than five thousand
dollars ($5,000.00) per occurrence, or imprisoned not more than one year, or both.

A patient whose medical information has been unlawfully used may recover actual damages as well as punitive
damages up to $3,000.00, plus attorney fees and court costs.
As a SCVHHS employee, volunteer, student, vendor, or other person doing business with SCVHHS, I have both a

legal and ethical responsibility to protect the privacy of patients. All information that I see or hear regarding patieints,
directly or indirectly, is completely confidential and must not be discussed or released in any form, except when
required in the performance of my duties.

Additionally, if I have access to employee information or financial information or any other proprietary information,
I am expected to treat the confidentiality of such information in the same manner as patient information.

I understand and agree that in the performance of my duties at SCVHHS, I must hold patient, employee, and
proprietary information in confidence as outlined above. I understand that any violation of confidentiality may
result in disciplinary action.

I will continue to maintain confidentiality of information obtained during cry employment, service, or training
with SCVHHS upon voluntary/ involuntary termination.

Signature:

Date

Attachment H - County of Santa Clara - Service Agreement
SECTION 1; GENERAL INFORMATION
Date:

P.O. Number:
(Procurement Department Use Only)

Agency / Dept. Name:

Dept. No.:

Brief Description of Services:

Maximum Financial Obligation:
Term of Agreement: Start Date:

End Date:

For County Use Only-SAP
Account

General

Assignment

Ledger

Cost Center

Amount

WBS

Internal Order

Oiilfrt'ft

SECTION II; PARTIES TO AGREEMENT
CONTRACTOR

COUNTY of SANTA CLARA

Legal notices pertaining to this agreement will be sent to
the name, address and contact person below:

Mail Invoices to County of Santa Clara at:

Name:

Agency/Dept:

Contact Person:

Contract Monitor:

Address:

Address:

City/State/Zip:

City/State/Zip:

Telephone:

Fax:

see Vendor No.(SAP):

Telephone:

Fax:

Fiscal Contact:

SECTION III: CONTRACT AUTHORIZATION
It is agreed between County and Contractor that Contractor will, for the compensation described in this Agreement, perform the work described in Section V in

accordance with all terms and conditions of this Agreement including all exhibits. In addition. County and Contractor certify that the tax withholding status and

benefit documentation (Section IVO accurately reflect the anticipated working relationship between County and Contractor. Further, contractor certifies that the
Contracting Principles self-declaration (Section Vn, Part B), and insurance waiver information (Section VIII, Part B)of this form are true and correct. For
independent Contractors, a certificate demonstrating appropriate insurance is required before work may begin.
Signatures

Contract is not valid until signed by Contractor and Procurement Department on behalf of the County. Signatures of the
County Counsel and Office of the County Executive are required for contracts executed by a delegation of authority
Contractor:

Date:

Procurement Department:

Date:

Agency/Dept. Manager:

Date:

Agency/Department Fiscal Officer:

Date:

County Counsel:
(Signature required when the Standard Provisions language(Section VI)is changed orfor ITServices of$500,000 or less. It

Date:

is also required when contract was approved by a delegation ofauthorityfrom the Board)

Office of the County Executive:
(Signature required when Board approved contract by a delegation ofauthority)

Page 1 of 8 - Effective July 2006

Date:

Attachment H - County of Santa Clara - Service Agreement
SECTION IV; DETERMINATION OF TAX WITHHOLDING AND BENEFIT STATUS

For federal tax purposes Dependent/independent status is an important distinction. It affects how the contractor
files tax returns and the contractor’s responsibility for federal income tax, social security and Medicare tax. The
questionnaire also determines the contractor’s eligibility for Medicare and Social Security, Public Employees’
Retirement System benefits, and other benefits.

Is contractor a government entity, corporation, nonprofit organization or school district?
YES - This is an Independent Contractor. Proceed to Section V

I

I NO - Complete the Questionnaire (For help with the Questionnaire, visit www.oba)

Questionnaire to Determine Dependent or Independent Status of Contractor
YES
1

Supervision: Will the County have the right to teil the contractor how to do the work, when to
arrive or leave work, or when to take breaks? Do you have other employees performing similar
work with a similar degree of supervision? If the answer to any of these questions is YES,

2

Training: Will the County instruct the contractor on how to do the job or pay for external

NO

mark the box YES. If NO, please explain.

training? If NO, please explain.
3

Incomplete Work: Will the Contractor be able to resign or terminate the contract without being
held either financiaily or legaily liable for unfinished work? If NO, please explain.

4

Place of Work/Tools: Will the County provide the Contactor with a place to work at a County
location and tools to do the job, i.e. computers, telephones, etc? If NO, please explain.

5

Length of Relationship: When the Contractor is hired to complete ongoing departmental
duties or functions—answer YES. When the contractor is hired to complete a specific project—
answer NO and explain briefly.

6

Other Customers: Does the County prevent the Contractor from performing similar services
for other customers, either due to the amount of work (full-time), or by contractual provision? If
NO, please explain.

7

Designation as Business Entity: If the Contractor has a business license or business

certificate, mark the box “No”. (This does not pertain to professional licenses or certificates
such as a licenses of physicians or architects.) Enter below the business license number
and the city/entity where issued.
8

Payment Schedule: Will payments be made either as an hourly wage or as weekly/monthly
salary? If payment is by commission or based on project milestones or deliverables, answer
“NO” to this question. If NO, please explain. Be sure this answer matches the contract
payment schedule in Section V.

9

Support Services: Will County employees or other independent contractors provide
assistance to this Contractor? Assistance is defined as clerical, technical or professional
support. If NO, please explain.

O If at least 5 of the above questions were answered “NO". Contractor is an Independent Contractor.

□ If 5 or more of the above questions were answered “YES”. Contractor is a Dependent Contractor, where the releitionship
resembles that of employer/employee. Tax withholding is required and benefits are provided. Complete and attach the
following forms: Employee’s Withholding Allowance Certificate-Fe deral Form W-4, State Withholding, Form DE-4,
Determining PERS Eligibility and PERS Member Action Request. Visit www.oba for more information regarding Dependent
Contractors. County insurance requirements do not apply to Dependent Contractors.

Contractor understands and agrees that the tax withholding and benefit status checked above is correct. Any changes to
the contractor’s tax withholding and benefit status require a new contract. Contractor is responsible for any penalties and
liabilities assessed by any taxing authority, based on a change of tax withholding and benefit status.
Contractor’s Initials:

.
Page 2 of 8 - Effective July 2006

Attachment H - County of Santa Clara - Service Agreement|
SECTION V! CONTRACT SPECIFICS

Describe the services to be performed or unique elements of the contract. If more space is needed, attach a

document—Attachment A”. If the contractor wishes to add contract language or modify the Standard Serviceseparate
Agreement
then County Counsel must approve and sign the Agreement. County Counsel approval is not required if Attachment A

refers to Contract Specifics listed on this page.
A.

Service Description and Expected Outcome(scope of service)

Or Q See Attachment

B.

Deliverabies, Milestones, Timeline for Performance

Or □ See Attachment

C.

attached hereto and incorporated herein by this reference

attached hereto and incorporated herein by this reference

Performance Standards

List specific standards and criteria sufficient to evaluate Contractor’s performance and quality of deliverables.

Or □ See Attachment
D.

attached hereto and incorporated herein by this reference

Payment Schedule

Be specific as to hourly rate, payment by milestones, etc.

OrD See Attachment

attached hereto and incorporated herein by this reference
Page 3 of 8 - Effective Julv 2006

Attachment H - County of Santa Clara - Service Agreement
Changes to the terms and conditions on this page require approval of County Counsel
SECTION Vi; STANDARD PROVISIONS

A. Entire Agreement

This document represents the entire Agreement between the parties. All prior negotiations and written and/or orai agreements
between the parties with respect to the subject matter of the agreement are merged into this Agreement.
B. Conflicts of Interest

In accepting this Agreement, Contractor covenants that it presently has no interest, and wiil not acquire any interest, direct
or indirect, financial or otherwise, which would conflict in any manner or degree with the performance of this Agreement.
Contractor further covenants that, in the performance of this Agreement, it wiil not employ any contractor or person having
such an interest.

C. Governing Law, Venue
This Agreement has been executed and deiivered in, and shali be construed and enforced in accordance with, the iaws of
the State of Caiifornia. Proper venue for iegal action regarding this Agreement shail be in the County of Santa Clara.

D. Assignment
No assignment of this Agreement or of the rights and obligations hereunder shail be valid without the prior written consent
of the other party.
E. Waiver

No delay or failure to require performance of any provision of this Agreement shail constitute a waiver of that provision as
to that or any other instance. Any waiver granted by a party must be in writing and shall apply to the specific instance
expressiy stated.
F. NON-DISCRIMINATION

□ Standard Non-Discrimination Language
Contractor shail comply with ail applicable Federal, State, and local laws and regulations including Santa Ciara County’s
policies concerning nondiscrimination and equal opportunity in contracting. Such laws include but are not limited to the
foilowing; Titie VII of the Civil Rights Act of 1964 as amended; Americans with Disabiiities Act of 1990; The Rehabilitation
Act of 1973 (Sections 503 and 504); California Fair Employment and Housing Act (Government Code sections 12900 et
seq.); and California Labor Code sections 1101 and 1102. Contractor shall not discriminate against any subcontractor,
employee, or applicant for employment because of age, race, color, national origin, ancestry, religion, sex/gender, sexual
orientation, mental disability, physical disability, medical condition, political beliefs, organizational affiliations, or marital
status in the recruitment, selection for training including apprenticeship, hiring, employment, utilization, promotion, layoff,
rates of pay or other forms of compensation. Nor shall Contractor discriminate in provision of services provided under this
contract because of age, race, color, national origin, ancestry, religion, sex/gender, sexual orientation, mental disability,
physical disability, medical condition, political beliefs, organizational affiliations, or marital status.
- OR-

□ Alternate Non-Discrimination Language Attached (Requires County Counsel Approval)
G. TERMINATION

□ Standard Termination Language
The County may, by written notice to Contractor, terminate all or part of this Agreement at any time for the convenience of
the County. The notice shall specify the effective date and the scope of the termination. In the event of termination,
Contractor shall deliver to County all documents prepared pursuant to the Agreement, whether complete or incomplete.
Contractor may retain a copy for its records. Upon receipt of the documents. Contractor shall be compensated based on
the completion of services provided, as solely and reasonably determined by County.
-OR-

□ Alternate Termination Language Attached (Requires County Counsel approval.)

Panfi 4 nf ft - Effective Julv 2006

[| Attachment H - County of Santa Clara - Service Agreement|
SECTION VII; CONTRACTING PRINCIPLES

A. Other Current County Contracts
If contractor's cumulative total ofcontracts with the County exceeds $100,000, this contract is likely to be a Type II contract
Refer to the Contracting Principies.

□ Contractor has no other current County contracts for same or similar services

□ Contractor has other contracts for same or similar services within the County
Enter contract information for other contracts in table below

Agency / Dept / Division

Current Fiscal Year

Type of Service

Contract Amount

$
$
Total of all Current Fiscal
Year Contracts

$

Or □ See Attachment
B.

Contractor Self-Declaration
TYPE I CONTRACT

□ Contractor declares that this is a Type I service contract under the Board of Supervisor’s Resolution on Contracting
Principles. If this box is checked, please complete the following:

Type I Category:

Explanation;

TYPE I CONTRACT:

Type I service contracts are subject to the Resolution of Contracting Principles adopted by the Board of Supervisors on October 28.
1997. Accordingly, Contractor shall comply with all of the following;

Contractor shall, during the term of this contract, comply with all applicable federal, state, and local rules, regulations, and laws.

Contractor shall maintain financial records adequate to show that County funds paid under the contract were used for purposes
consistent with the terms of the contract. These records shall be maintained during the term of this contract and for a period of three (3)
years from termination of this contract or until all claims if any, have been resolved, whichever period is longer, or longer if otherwise
required under other provisions of this contract.

The failure of Contractor to comply with this Section or any portion thereof may be considered a material breach of this contract and

may, at the option of the County, constitute grounds for the termination and/or non-renewal of the contract. Contractor shall be provided
reasonable notice of any intended termination or non-renewal on the ground of non-compliance with this Section, and the opportunity to
respond and discuss the County's intended action.

- OR -

Page 5 of 8 - Effective July 2006

Attachment H - County of Santa Clara - Service Agreement

r

TYPE II CONTRACT

Q Contractor declares that this is a Type II contract under the Board of Supervisor’s Resolution on Contracting Principles.
TYPE II CONTRACT

This contract is a Type II service contract subject to the resolution of Contracting Principles (Resolution) adopted by the
Board of Supervisors on October 28,1997. Accordingly, Contractor shall comply with all of the following during the term of
this contract;
a.

Contractor shall comply with ail applicable federal, state, and local rules, regulations, and laws.

b. Contractor shall maintain financial records adequate to show that County funds paid under the contract were

used for purposes consistent with the terms of the contract. These records shall be maintained during the term
of this contract and for a period of three (3) years from termination of this contract or until all claims, if any,
have been resolved, whichever period is longer or longer if otherwise required under other provisions of this
contract.
c.

To enable County to determine compliance with the requirements of the Resolution and this contract.

Contractor shall, through its designated representatives, provide to County or its designated agents reasonable
access to facilities, records, and employees used and employed in conjunction with the provision of services
under the contract, except where such access is prohibited by federal or state laws, regulations, or rules.
d. Contractor shall provide to the County Department /Agency responsible for monitoring the contract, within

fifteen (15)days of receipt by Contractor, with copies of any and all financial audits completed during the term
of the contract. For the purposes of this section, “financial audif includes any final audit report transmitted to
Contractor by the auditor, but does not include draft reports, of performance or program audits.
e.

Contractor shall use County funds paid under this contract for County services and shall not use County funds
for general employer costs that do not support or otherwise directly relate to the scope of contracted services.
Consistent with the financial provisions of the contract, this requirement shall not preclude the realization of
profit or savings.

f.

Contractor shall promptly advise the County Department/Agency responsible for monitoring the contract of:(1)
the issuance of any legal complaint by an enforcement agency, or of any enforcement proceedings by any
Federal, State, or Local agency for alleged violations of federal, state or local rules, regulations or laws, and/or
(2)the issuance of citations, court findings or administrative findings for violations of applicable federal, state or
local rules, regulations, or laws.

g-

As required under the Resolution and the County’s implementing procedures. Contractor provided to County
as a part of the selection [substitute “renewal,” “extension,”or “amendment”as appropriate] process certain
information pertaining to the provision of services under this contract and/or expenditures to be charged under
the contract, including information concerning wages and benefits for Contractor’s employees, length of
service, staff turnover and training, complaints (if any) regarding legal violations and collective bargaining
agreements and/or personnel policies. Contractor warrants and represents that the information so provided
was complete and accurate.

The failure of Contractor to comply with any portion of Section VII. including the Contractor Self-Declaration of Status is
considered a material breach of this contract and may, at the option of the County, constitute grounds for the termination
and non-renewal of the contract. Contractor may be provided reasonable notice of any intended termination or non-renewal

on the grounds of noncompliance with this Section, and will have the opportunity to respond and discuss the County’s
intended action.

Paas 6 of 8- Effective Julv 2006

Attachment H - County of Santa Clara - Service Agreement
SECTION VIII: INSURANCE / INDEMNIFICATION

Independent Contractors must comply with the County’s insurance and indemnification requirements as
indicated below. These requirements do not apply to Dependent Contractors.
A. TYPE OF INSURANCE LANGUAGE

□ The following standard insurance and indemnification language is attached and incorporated into this
agreement:
O

B-2 Standard Service Contracts Above $100,000

O

B-2A Standard Service Contracts Between $50,001 and $100,000

O

B-2B Standard Service Contracts Between $10,001 and $50,000

O

B-2C Standard Service Contracts Up To $10,000

O

B-2D Environmental Services Contracts

O

B-3 Professional Services Contracts (e.g. Medical, Legal, Financial, etc.)

O

B-3A Architects and Engineers Service Contracts

O

B-9 Part-time Trainer Contracts up to $50,000

□ Modification or Waiver Attached if Appropriate

B. DETERMINATiON OF iNSURANCE REQUIREMENTS AND WAIVER DECLARATION
YES

NO

1. Workers Compensation: Does the contractor have employees? If ‘YES”, then,
WORKER’S COMPENSATION/EMPLOYER'S LIABILITY INSURANCE IS REQUIRED.

2. Owned Auto Insurance: Will the contractor use any owned autos in the provision of
direct services, such as transporting clients in autos or operating autos in performance of
the work itself? If “YES", then INSURANCE FOR OWNED AUTOS IS REQUIRED.

3. Hired Auto Insurance: Will the contractor use any hired autos in the provision of direct
services, such as transporting clients in autos or operating autos in performance of the
work itself? If “YES", then INSURANCE FOR HIRED AUTOS IS REQUIRED.

4. Non-owned Auto Insurance: Will the contractor be using any non-owned autos in the
provision of direct services, such as transporting clients in non-owned autos or operating
non-owned autos in performance of the work itself? If “YES” then, INSURANCE FOR
NON-OWNED AUTOS IS REQUIRED.

When “NO” is checked, this declaration will serve as a waiver for the specified type of insurance.

Page 7 of 8 - Effective July 2006

Attachment H - County of Santa Clara - Service Agreement
SECTION IX; FEDERAL / STATE REQUIRED PROVISIONS

(e.g. Drug-free Workplace Activity, HIPAA Business Associate Language, etc)
□ A. Federal Required Language Attached (optional)

Only add special language if services included in the contract require language different from or in addition to that
in Section VI.

□ b. State Required Language Attached (optional)
Only add special language if services included in the contract require language different from or in addition to that
in Section VI.

SECTION X: ADDITIONAL ATTACHED EXHIBIT (S) (optional)
If exhibits are added to this Service Agreement, the contract will require review, approval and signature of County
Counsel, with the exception of attachments that further explain the Contract Specifics as outlined in Section V, and
insurance exhibits. Examples of attachments that require County Counsel approval are: 1) Contractor’s tenns and
conditions that are different than, or add to the standard provisions language, 2) Any changes to the language in
Section VI—Standard Provisions.

□ Exhibit Name(s)

The Exhibits named above are attached hereto and incorporated herein by this reference

SECTION XI;

MISCELLANEOUS

□ Statement of Economic interest, FORM 700
If Form 700 is required, it must be filed with the Clerk of the Board within 30 days of the contract’s effective date of
. Contractor must submit Form 700 by
to the County’s Contract Monitor. County’s
with
the
Form
700
cover sheet to the Clerk of the Board by
Contract Monitor will submit the completed Form 700

Page 8 of 8 - Effective July 2006

ATTACHMENT I: RTF TIMELINE

HIV Testing and Counseling RFP
SCHEDULE OF ACTIVITIES
Mailing address for this Request for Proposal is:
Santa Clara Valley Health & Hospital System
HIV/AIDS Prevention and Control Program
Attn: Colleen Mullins

3003 Moorpark Avenue
San Jose, CA 95128

ACTIVITY

DUE DATE

1.

August 30, 2006

Release RFP

Friday, September 8, 2006
3:00- 5:00 PM

2.

Informational Meeting

(770 South Bascom Avenue, Room 136,
large conference room)

3.

Written Questions Regarding RFP

Tuesday, September 12, 2006 at 4:00 PM

Proposals Due
(1 original and 7 copies)

September 20, 2006, 5:00 PM

6.

Review Panel Meeting

Wednesday, September 27, 2006

7.

Award Announcement: e-mailed to

4.

Executive Directors followed by post

Monday, October 2,2006

8.

Written Appeals Deadline

Monday, October 9,2006, 4:00 PM

9.

Contract Negotiations begin

Tuesday October 3, 2006

10. Appeals Reviewed and Responses
Mailed
11. Contract Finalized

12. SCVHHS Administration Approval of
Contract

13. Project Implementation

Wednesday, October 11, 2006
Friday, October 27, 2006

Tuesday, October 31, 2006
Wednesday, November 1, 2006

These deadlines may be changed based on unforeseen circumstances.
All participants will be notified of any changes to the schedule.
Document

Memo to Board of Supervisors and Pete Kutras, County Executive, From Guadalupe S. Olivas, PhD. HIV Test-Counseling Expansion Request for Proposals - Informational Only

Collection

James T. Beall, Jr.

Content Type

Memoranda

Resource Type

Document

Date

08/31/2006

District

District 4

Creator

Guadalupe S. Olivas, PhD

Language

English

City

San Jose

Rights

No Copyright: http://rightsstatements.org/vocab/NoC-US/1.0/