REQUEST FOR PROPOSALS (FDDC #2007-HC-5300)
White Paper: Redefining Medical Necessity
The Florida Developmental Disabilities Council (FDDC) announces the availability of a Request for Proposals (RFP). This RFP is being issued to enhance the information base necessary for the FDDCs continued efforts to improve the delivery of services to the states children and adults with developmental disabilities.
In an era of increasing health care cost and emphasis on reducing the growth rate of Medicaid funded care, the definition of medical necessity may lead to limitations on services needed by persons with developmental disabilities. According to a 1999 report by the Kennedy Foundation, the range of services that may be needed for good health outcomes for this population may be quite specialized and extends beyond narrowly defined medical services. (Defining Medical Necessity, page 4) The Foundation recommends an approach to defining medical necessity within a developmental framework that incorporates the concept of inclusion.
The Council funded initial efforts to study this issue by examining cost data in reports by Dr. Lise Youngblade of the Institute for Child Health Policy and Dr. Henry Ireys of Mathmatica Policy Research, Inc. The studies concluded that adults and children with disabilities do not significantly increase public funding (Medicaid funds) when they have the opportunity to obtain enhanced services through the Medicaid waiver program, implying that a broader definition of medical necessity would not substantially increase overall expenditures. The study data showed an overall decrease in the cost of inpatient and outpatient hospital services.
What is needed now is to use the concepts and model suggested by the Kennedy Foundation, along with the data on services and expenditures, to more fully develop a plan for
This project will develop a white paper that promotes the development of a revised definition of medical necessity which is based optimal functioning and community inclusion standards. Specific requirements for the white paper are delineated in the RFP.
The provider will establish an advisory committee to oversee the activities of the project and provide direction to the project staff. The provider will propose an evaluation component to provide for an ongoing assessment of performance, based on a detailed work plan describing the activities of the project and a final overall assessment of performance and outcomes. The provider will present a draft of the white paper to the Council and facilitate discussion to obtain the Councils endorsement. The provider will revise the draft as directed by the Council and prepare a final report for distribution.
Copies of this RFP will be available from: Florida Developmental Disabilities Council, 124 Marriott Drive, Suite 203, Tallahassee, FL 32301, (850)488-4180 or Toll Free 1(800)580-7801 or TDD Toll Free 1(888)488-8633. The deadline for submitting letters of intent and written questions is prior to 4:00 p.m. (EST), on December 18, 2006. The deadline for submitting proposals is prior to 2:00 p.m. EST on February 5, 2007. Letters of Intent will only be accepted by fax, mail, or hand delivery. Letters of Intent by e-mail will not be accepted.
THE ABOVE ANNOUNCEMENT WILL APPEAR IN THE F.A.W. AND THE FDDC WEB PAGE (fddc.org) ON NOVEMBER 17, 2006.
PLEASE FORWARD ALL REQUESTS FOR COPIES OF THE RFP TO Misty.
QUESTIONS ARE TO BE SUBMITTED IN WRITTEN FORMAT ONLY. THIS IS A LEGAL PROCESS; WE CANNOT ANSWER QUESTIONS VERBALLY.
