REQUEST FOR BIDS

RFB# GRH 19-010

Advanced Practice Provider (APP): Inter-professional Spine Assessment and Education Clinic (ISAEC) for Low Back Pain for

Guelph and Wellington Region

Request for Bids # GRH19-020

Submission Deadline: Monday March 18th, 2019 @ 3:00:00pm EST

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Table of Contents

Table of Contents 2

PART 1 – INTRODUCTION 3Introduction 3GRH Contact 3PART 2 – BACKGROUND INFORMATION 4Overview of GRH 5Objectives of this Request 4PART 3 – RESPONSE REQUIREMENTS AND RFB PROCESS 8Response Requirements 8RFB Schedule 9PART 4 – SUBMISSION INSTRUCTIONS 10Submission of RFB 10Submission Date and Forms 11APPENDIX A: Respondent Submission Form 12

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PART 1 – INTRODUCTIONIntroductionThis Request for Bids (“RFB”), is issued by Grand River Hospital (GRH) for the purposes of identifying skilled clinicians responsible for delivering rapid patient assessment and education for specific populations of low back pain patients, from their respective practice location. The contract(s) will be in place from April 1, 2019 to March 31, 2020 with contract renewals of one year each up to three years, depending on performance.

GRH Contact“GRH Contact” means Kristen Warden

kristen.warden@grhosp.on.ca

Senior Buyer

835 King Street West, Kitchener

ON N2G 1G3

(519) 749-4300 ext. 2614

Any questions relating to this RFB shall be directed to GRH Contact, and should be submitted electronically via email by the end of business day not later than 1700 hours EST March 12, 2019.

[End of Part 1]

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PART 2 – BACKGROUND INFORMATION Overview

Objectives of this RequestMusculoskeletal (MSK) Central Intake and Assessment Centres (CIAC) are being implemented across the province of Ontario to help people with MSK pain access the right treatment faster. This work stems from the successful pilot program: Inter-professional Spine Assessment and Education Clinics (ISAEC) for low back pain.

The Waterloo Wellington Local Health Integration Network (LHIN) I S A E C Low Back Pain Program (LBP) is an innovative, upstream, shared-care model of care in which patients receive rapid low back pain assessment, education and evidence-based self- management plans. It is designed to decrease the prevalence of unmanageable chronic low back pain, reduce opioid initiation, and reduce unnecessary diagnostic imaging as well as unnecessary specialist referral. The ISAEC LBP is specifically for patients with: (1) persistent low back pain and/or related symptoms (e.g. sciatica, neurogenic claudication) 6 weeks to 12 months post- onset; and (2) recurrent / episodic unmanageable low back pain and/or related symptoms of less than 12 months post-recurrence. The goa l i s t o p rov ide th i s ca re as c lose to home poss ib le fo r the WWLHIN res iden ts . The ISAEC model of care is being implemented across the WW LHIN as part of the system transformation implementation.

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Grand River Hospital (GRH) is a 631 bed comprehensive community hospital located in Kitchener, ON that provides patient-centered care to more than 450,000 residents in the Region of Waterloo and the surrounding communities. GRH offers the following programs and services: Childbirth and Children’s Program, Medical Program, Surgical Services, Oncology Program, Complex Continuing Care Program, Rehabilitation Care Program, Emergency Services, Administrative and Clinical Support Services, Psychiatric and Mental Health Program, Critical Care Services and a Renal Program. GRH is composed of two sites: Kitchener Waterloo site (KW) and Freeport site (Freeport).

Grand River Hospital on behalf of the Waterloo Wellington LHIN is recruiting low back pain Advanced Practice Providers (APPs) from the Guelph/Puslinch and Wellington sub-regions of the WWLHIN (See map above). Up to three APPs will be selected for Guelph/Puslinch and two APP’s for the Wellington Region. As a member of the ISAEC project, the APP acts as the first and primary point of contact for consultation and assessment of referred patients; provides a defined program of care to the patient with an emphasis on education, self- management and health promotion strategies; develops a collaborative care plan with the patient and their primary care provider and documents progress against the care plan; and identifies signs and symptoms requiring a change in the plan of care, diagnostic imaging/testing, or referral to a physician specialist.

The APP is a skilled clinician, with requisite entry to practice training in a regulated health discipline and will be responsible for delivering rapid patient assessment and education for this specific population of patients with low back pain symptoms, from their respective practice location.

The APP will be connected to a Clinical Sponsor (physician specialist) and Practice Leader who will provide clinical guidance and advanced low back pain education. Additionally, all APPs will be connected through a centralized referral and case management system.

Onboarding Requirements of APPs

All successful APPs must complete both practical (in person 2 days/week for 4 weeks) and theoretical training (1 week online) in low back pain topics. Must be available to start training in April 2019.

Key Responsibilities

1. Expert PracticeI. Acts as the first and primary point of contact for consultation and assessment of referred

patients with low back pain.II. Provides specialized care, education and counseling for patients.

III. Performs a medical history, physical and health status for patients.IV. Conducts comprehensive assessment and communication of a diagnosis.V. Determines the suitability and eligibility of patients for surgical assessment.VI. Differentiates between inflammatory and non-inflammatory conditions.

VII. Has a broad understanding of indications for different evidence-based treatments for low back pain.

VIII. Identifies signs and symptoms of undiagnosed medical conditions requiring a referral to diagnostic imaging/testing and/or referral to a physician specialist in accordance with established ISAEC guidelines.

IX. Initiates communication and appropriate surgical and non-surgical referrals based on established ISAEC assessment and referral guidelines.

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X. Establishes, communicates and documents clinical impressions/medical diagnoses within a defined scope of practice.

XI. Develops plan of care in collaboration with the patient/family and primary care provider.XII. Documents plan of care according to established ISAEC guidelines.XIII. Communicates internally and externally to facilitate plan of care (i.e. other health care

professionals).XIV. Evaluates and revises the plan of care in collaboration with patient/family and primary

care provider.XV. Communicates specific medical diagnoses to primary care provider.XVI. Utilizes a patient-centered care approach consistent with patient goals, needs and values.

XVII. Provides reports including, but not limited to, # of completed assessments, time from referral to appointment, number of patients with a follow up, volume of follow ups/patient, timing of follow ups, number referred on to the system practice lead.

2. Teaching and LearningI. Participates in ISAEC sponsored regional and central education and training events.II. Collaborates with the ISAEC team to identify learning needs of patients and primary care

providers.III. Provides formal and informal education internally and externally to ISAEC team

members and primary care providers.IV. Facilitates knowledge transfer and evidence-based practice.

3. Organization ResponsibilitiesI. Acts as an active member of ISAEC.II. Accountable to align activities and performance with strategic goals and objectives of

ISAEC.III. Adheres to the ISAEC standards, policies and procedures, including centralized

referral and clinic management system processes.IV. Participates in quality and performance management activities.V. Participates in policy and procedure development.

4. Program EvaluationIn collaboration with ISAEC colleagues, enables, implements and conducts evaluation of clinical services related to the program.

5. Performs other duties consistent with the APP role, as assigned or requested.

APP Assessment Volume

Table 1 – WW LHIN APP Projected Annual Assessment Volumes and # of APPs Required

Sub-region Annual # of Assessments

Guelph Puslinch 550

Wellington* 300

* Note: Providers in the Wellington geographic area are expected to complete a minimum of 100 assessments per provider annually.

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Each referral will include an assessment. Assessments are to be completed within 2 weeks of referral. Approximately half of assessments will also require a follow-up visit (reassessment).

Providers are required to complete a minimum volume of 200 assessments per year; 100 per provider in Wellington.

The contractual volumes will be reviewed annually and may be impacted by performance metrics.

Timeframes for Onboarding

APP onboarding and training will be implemented in a phased strategy allowing for a focused scaling up of sub-regions, starting in April 2019. Training time will be paid at $55/hr.

APP Fee for Service Rate

The ISAEC APP per patient fee for service rate is $81 for a 60 minute initial ISAEC assessment, and $48 for a 30 minute follow-up assessment. Follow-up includes up to a maximum of 3 appointments per ISAEC guidelines.

Conflict of Interest

In order to avoid any actual or perceived conflict of interest, the successful APP shall not refer an ISAEC Patient referred by this program to which they have provided Services to any of the following:

a) themselves,

b) another party working in the capacity of an ISAEC Advanced Practice Provider or Practice Leader working within this program,

c) a party who is employed or affiliated with the APP’s Practice Location.

[End of Part 2]

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PART 3 – RESPONSE REQUIREMENTS AND RFB PROCESSResponse RequirementsRespondents should include the following in their response to this RFB:

PART A: MANDATORY REQUIREMENTS:

I. Please confirm compliance to mandatory requirements within Excel document named “Part A Mandatory Requirements” (attached) and upload filled out document to Bonfire

PART B: RESUME INCLUDING THE FOLLOWING:

APP QUALIFICATIONS

I. At least 4 years of clinical experience following completion of an accredited, entry-to- practice program in, a regulated health profession, required; and

II. Including, at least 1 year of clinical experience in the musculoskeletal-spine area, required.

PROFESSIONAL AFFILIATIONS/MEMBERSHIPS

I. Member in good standing of respective professional/legislative college at the provincial level, required; and

II. Member of related national/provincial professional association preferred.III. Please upload Proof of Membership and Liability Insurance in “Supporting Documents” in

Bonfire

EXPERIENCE WITH EDUCATION AND TEACHING

I. Experience with formal and informal education, internally and externally.II. Experience with knowledge transfer and evidence-based practice.

PART A IS WEIGHTED AT 45% OF THE EVALUATION.

PART C: COMPLETION OF PROPOSAL SUBMISSION FORM

(a) Proposed Location: (provide address and postal code; include accessibility by public transit)

(b) Hours of service available including days of the week, evening and weekend hours if applicable

(c) Maximum volume of service available per year(d) Minimum volume per year (e) Proposed number of providers and administrative staff at this location that would be

involved(f) Professional designations (e.g. Chiropractor, Physiotherapy, other)

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PART C IS WEIGHTED AT 30% OF THE EVALUATION.

PART D: INTERVIEW FOR SHORT-LISTED RESPONDENTS

Following evaluation of Parts A and B, the top ranked 3 Respondents for each of the four geographic areas will be short-listed for a 1 hour interview at Grand River Hospital – Freeport Location, 3570 King Street East, Kitchener. Interviews will be starting March 26th, 2019.

PART D INTERVIEWS FOR SHORT-LISTED RESPONDENTS ARE WEIGHTED AT 25% OF THE TOTAL SCORE.

RESPONDENT SUBMISSION FORM

Submissions should include a completed and signed Respondent Submission Form (attached as Appendix A), that acknowledges, among other things, that this RFB and any Respondent submissions shall not create a legal relationship or obligation regarding the procurement of any good or service.

RFB EVALUATION PROCESS

Criteria Evaluation Methodology WeightPart A - Mandatory Requirements Pass/Fail Not ScoredPart B - Resume Scale 45Part C – Completion of Respondent Submission Form Scale 30

Part D - Interview with Short listed group of Respondents. Scale 25

RFB ScheduleThe following is the schedule for this RFB:

Milestone DateClarification Questions Due March 12, 2019 by 5:00pm ESTResponse to Questions March 14, 2019RFB Due March 18, 2019 by 3:00:00 pm ESTRespondent Interviews March 26, 2019Follow-up with RFB Respondents April 2019

[End of Part 3]

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PART 4 – SUBMISSION INSTRUCTIONSSubmission of RFBResponses must be submitted through Bonfire:Requested Information

Name Type # Files Requirement

Part A - Mandatory Requirements

File Type: Excel (.xls, .xlsx) Multiple

Please upload completed attachement found on page 8 of this document

Part B - Resume File Type: PDF (.pdf) Multiple Please upload Resume to Bonfire

Part C - Proposal Submission Form File Type: PDF (.pdf) Multiple Please upload Part C

(Appendix A) to Bonfire

Supporting Documents File Type: PDF (.pdf) Multiple

Please upload Proof of Membership and Liability Insurance in Bonfire

Requested Documents:

Please note the type and number of files allowed. The maximum upload file size is 1000 MB.

Please do not embed any documents within your uploaded files, as they will not be accessible or evaluated.

2. Upload your submission at:

https://grhosp.bonfirehub.ca/opportunities/21641

The Q&A period for this opportunity starts Mar 04, 2019 3:00 PM EST. The Q&A period for this opportunity ends Mar 12, 2019 5:00 PM EDT. You will not be able to send messages after this time.

Your submission must be uploaded, submitted, and finalized prior to the Closing Time of Mar 18, 2019 3:00 PM EDT. We strongly recommend that you give yourself sufficient time and at least ONE (1) day before Closing Time to begin the uploading process and to finalize your submission.

Important Notes:

Each item of Requested Information will only be visible after the Closing Time.

Uploading large documents may take significant time, depending on the size of the file(s) and your Internet connection speed.

You will receive an email confirmation receipt with a unique confirmation number once you finalize your submission.

Minimum system requirements: Internet Explorer 11, Microsoft Edge, Google Chrome, or Mozilla Firefox. Javascript must be enabled. Browser cookies must be enabled.

Need Help?

Grand River Hospital uses a Bonfire portal for accepting and evaluating proposals digitally. Please contact Bonfire at Support@GoBonfire.com for technical questions related to your submission. You can also visit their help forum at https://bonfirehub.zendesk.com/hc

Responses by other methods will not be accepted.

Submission Date and FormsRespondents are asked to submit their information by March 18, 2019 3:00:00pm Eastern Standard Time.

Submissions should include a completed and signed Respondent Submission Form (attached as Appendix A), that acknowledges, among other things, that this RFB and any Respondent submissions shall not create a legal relationship or obligation regarding the procurement of any good or service.

APPENDIX A: Respondent Submission Form

1. Respondent Information

a) Respondent’s registered legal business name and any other name under which it carries on business:

b) Name, address, telephone and e-mail address of the contact person(s) for the Respondent:

c) Name of the person who is primarily responsible for the submission:

d) Whether the Respondent is an individual, a sole proprietorship, a corporation, a partnership, a joint venture, an incorporated consortium or a consortium that is a partnership or other legally recognized entity:

2. Service Provision

(a) Proposed Location: (provide address and postal code; include accessibility by public transit)

__________________________________________________________________

(b) Hours of service available including days of the week, evening and weekend hours if applicable

__________________________________________________________________

(c) Maximum volume of service available per year

_________________________________________________________________

(d) Minimum volume per year

___________________________________________________________________

(e) Number of providers at this location that would be involved e.g. clerical/administrative support

_____________________________________________________________

Professional designations (e.g. Chiropractor, PT, other) _______________________________

__________________________________________________________________________

A single provider is required to complete a minimum volume of 200 assessments annually; 100 per provider annually in Rural Wellington

3. Terms of Reference

In responding to this RFB each Respondent should submit this completed and signed Respondent Submission Form that, among other things, acknowledges its acceptance of the RFB Terms of Reference as contained hereunder are in addition to any and all other rights of GRH that existed prior to the issuance of this RFB.

This RFB and any R e s p o n d e n t submissions shall not create a legal relationship or obligation regarding the procurement of any good or service.

Information in RFB Only an EstimateGRH and its advisors make no representation, warranty or guarantee as to the accuracy of the information contained in the RFB or issued by way of addenda. Any quantities shown or data contained in this RFB, or provided by way of addenda, are estimates only provided as general background information.

Parties Shall Bear Their Own CostsGRH shall not be liable for any expenses incurred, including the expenses associated with the cost of preparing responses to this RFB. The parties shall bear their own costs associated with or incurred through this RFB process, including any costs arising out of or incurred in: (a) the preparation and issuance of this RFB; (b) the preparation and making of a submission; or (c) any other activities related to this RFB process.

Accuracy of ResponsesThe Respondent acknowledges that the information provided is, to the best of its knowledge, complete and accurate.

Submissions Property of GRHExcept where expressly set out to the contrary in this RFB or in the Respondent’s submission, the submission and any accompanying documentation provided by a Respondent shall become the property of GRH and shall not be returned.

Confidential Information of GRH

All information provided by or obtained from GRH in any form in connection with this RFB either before or after the issuance of this RFB: (a) is the sole property of GRH and must be treated as confidential; (b) is not to be used for any purpose other than replying to this RFB; (c) must not be disclosed without prior written authorization from GRH and (d) shall be returned by the Respondents to GRH immediately upon request.

A Respondent may not at any time directly or indirectly communicate with the media in relation to this RFB without first obtaining the written permission of GRH.

The Respondent hereby agrees to the terms set out in the Terms of Reference and in the RFB.

Signature of Witness Signature of Respondent Representative:

Name of Witness: Name and Title:

Date of Signature:

I have authority to bind the Respondent

141 Weber St. S.Wate3 5500Toll Free: 888 883 3313www.waterloowellingtonlhin.on.ca