{"text_format":"3","workbook":"xlsx","n_sheets":11,"sheets":["Scope of Services","Overview of Services","Chronic Condition Mgt","Immunizations","Lab Services","Lab Services (OccHealth)","Medications","Occupational Health","Performance Guarantees","Cost-old","Cost"],"not_rendered":{"defined_names":2},"read":"whole","date_system":"1900"}

{"sheet":"Scope of Services","index":0,"n_rows":26,"n_cols":6,"rows_kept":26,"hidden":true,"merged":[[0,0,0,1],[1,0,1,1],[7,0,9,0],[11,0,11,1],[13,0,15,0]]}
["Clinic Priorities",null,"Yes","No ","Additonal comments","Please mark if included in base fee or buy up"]
["Year 1"]
[1,"Preventive care"]
[2,"Primary/episodic non-acute care management (ex: lab work, men's/women's health)"]
[3,"Urgent/episodic acute care management"]
[4,"Immunizations/vaccines (if yes, please complete the immunizations tab)"]
[5,"On-site laboratory services (if yes, please complete the lab services tab)"]
[6,"Services for remote employees"]
[null,"Telemedicine capabilities"]
[null,"Virtual visit capabilities"]
[7,"Occupational and employment-related services (if yes, please complete the occupational health tab)"]
["Future Considerations"]
[8,"Chronic condition management (if yes, please complete the health conditions tab)"]
[9,"Identification of high-risk members"]
[null,"Stratification of risk"]
[null,"Member outreach based on risk level"]
[10,"Onsite dietitian services"]
[11,"Physical therapy services"]
[12,"Onsite chiropractice services"]
[13,"Behavioral health services (if yes, please outline specific services in comments box)"]
[14,"Integration with other employer programs "]
[15,"Coordination with community physicians"]
[16,"Referral to community specialists"]
[17,"Pharmacy Model/Capabilities (if yes, please describe model in additional comments) ex: onsite, top 100 pre-packaged"]
[18,"Specialty Pharmacy capabilities (if yes, please describe model in additional comments)"]
[19,"Additional services for consideration (if yes, please describe in additional comments) ex. Dental, vision"]

{"sheet":"Overview of Services","index":1,"n_rows":46,"n_cols":4,"rows_kept":46,"merged":[[0,1,0,3],[2,0,2,3]]}
["Proposer's Name"]
[]
["Please provide information related to your Onsite Clinic service capabilities"]
[]
[]
["Acute Care","Yes","No","Specifics"]
["Laboratory Tests and Analysis"]
["Immunizations & Injections"]
["Upper Respiratory (colds, sinus, allergies, etc.)"]
["Skin Conditions (rashes, sores, lesions, etc.)"]
["Gastrointestinal (nause, vomiting, diarrhea,etc.)"]
["Generalized illness (body aches, fever, fatigue, etc)"]
["Sprains, Strains, Injuries"]
["Urinary symptoms & vaginal/genital complaints"]
["Eye irritations/infections"]
["Primary & Preventive Care","Yes","No","Specifics"]
["Annual Wellness Exam with Labs"]
["Chronic Condition Mgt"]
["Gaps in Care Closure"]
["Cancer Screening Exams"]
["Referrals into community"]
["Pharmacy","Yes","No","Specifics"]
["Medication Ordering"]
["Medication Dispensing"]
["Wellness","Yes","No","Specifics"]
["Biometric Screenings"]
["Health Coaching"]
["Care Coordination"]
["Risk Stratification & Outreach"]
["Wellness Program Integration"]
["Portal/Website"]
["Mobile App "]
["Ability to integrate with devices"]
["Education/Seminars/Webinars"]
["Wellness Annual Calendar"]
["Occupational Health","Yes","No","Specifics"]
["New Hire Physicals"]
["Return to Work"]
["Drug Screening"]
["Worker's Compensation triage and reporting"]
["Onsite emergency response"]
["Additional Services","Yes","No","Specifics"]
["Behavioral Health Counseling"]
["Physical Therapy"]
["Remote Patient Monitoring"]
["Patient Advocacy"]

{"sheet":"Chronic Condition Mgt","index":2,"n_rows":45,"n_cols":6,"rows_kept":45,"merged":[[0,1,0,3]]}
["Proposer's Name"]
[]
["Chronic Condition Management - Health Conditions Covered"]
["Risk Factor","Coaching program is driven by employee specific needs","How is effectiveness of the program measured?","Is there specific criteria for the employee to be offered the program?","Are there lab tests that may be ordered for the employee to measure the impact of the program?","Are there medications that may be prescribed for the employee?"]
["Weight Management"]
["Cholesterol"]
["Stress "]
["Depression"]
["Tobacco Cessation"]
["Prediabetes"]
["Pre-Hypertension"]
["Pre-Natal care"]
["Nutrition"]
["Substance Abuse"]
["Work/Life Balance"]
["Fitness/Physical Activity"]
[]
["Disease Management - Health Conditions Covered"]
["Disease","Yes","No ","Additional Comments"]
["HIV"]
["Arthritis"]
["Chronic Pain Management"]
["Hyperlipidemia"]
["Diabetes"]
["Asthma"]
["COPD (Chronic Obstructive Pulmonary Disease)"]
["Depression"]
["Low Back Pain"]
["Hypertension"]
["Congestive Heart Disease"]
["Coronary Heart Disease"]
["Peripheral Arterial Disease"]
["Migraines"]
["GERD (Acid Reflux)"]
["PUD (Peptic Ulcer Disease)"]
[]
["Disease Management - Health Conditions Covered (continued)"]
["Disease","Yes","No ","Additional Comments"]
["IBD (Inflammatory Bowel Disease)"]
["Osteopenia"]
["Osteoporosis"]
["Osteoarthritis"]
["RA (Rheumatoid Arthritis)"]
["Chronic Kidney Disease"]
["Other (please list)"]

{"sheet":"Immunizations","index":3,"n_rows":18,"n_cols":3,"rows_kept":18,"merged":[[0,1,0,3],[2,0,2,2],[4,1,4,2]]}
["Proposer's Name"]
[]
["Please list the immunizations that you have the capability to provide both in and outside of the onsite clinic"]
[]
[null,"Provided in the health center"]
[null,"Included in the fee quoted in this RFP (Y/N)","If no, provide additional cost to employer to be billed on a monthly basis"]
["Flu"]
["GARDASIL (HPV)"]
["Hepatitis A"]
["Hepatitis B"]
["Menactra (Meningitis)"]
["MMR (Measles, Mumps, Rubella)"]
["PPV (Pneumonia)"]
["Shingles Vaccine"]
["Varicella"]
["Tetanus"]
["COVID "]
["Other (for example travel vaccines, occ health, etc.), Hep A, Hep B, Typhoid, Pneumonia, Tdap"]

{"sheet":"Lab Services","index":4,"n_rows":67,"n_cols":7,"rows_kept":67,"merged":[[0,1,0,3],[2,0,2,6],[3,0,3,1],[4,1,4,3],[4,4,4,6],[35,1,35,3],[35,4,35,6]]}
["Proposer's Name"]
[]
["Please indicate the lab tests and services that you have the capability to provide both in and outside of the onsite clinic"]
[]
[null,"Provided in the onsite clinic",null,null,"Sent to an outside lab"]
[null,"Included in the fee quoted in this RFP (Y/N)","If no, provide additional cost to employer to be billed on a monthly basis","CLIA Waived Lab Test (Y/N)","Included in the fee quoted in this RFP (Y/N)","If no, provide additional cost to employer to be billed on a monthly basis","Billed through medical plan as any lab test ordered by any provider is billed (Y/N)"]
["Fingerstick fasting glucose"]
["Fingerstick non fasting glucose"]
["HgA1c"]
["Fingerstick Lipid Panel"]
["Venipuncture Lipid Panel"]
["Venipuncture LDL cholesterol"]
["Fingerstick LDL cholesterol"]
["Rapid Strep Screen"]
["Urinalysis dip stick"]
["Pregnancy test-Urine"]
["Pregnancy test-venipuncture"]
["Occult Blood, fecal for stool guiac test"]
["Urine drug screen"]
["Venipuncture drug screen"]
["Breath Alcohol Test"]
["COVID Molecular/PCR Test"]
["COVID Antibody Test "]
["Comprehensive Metabolic Panel"]
["TSH "]
["TSH with reflex to FT4"]
["FSH and LH"]
["CBC w/ Differential"]
["Chlamydia/Gonococcus, NAA"]
["Culture, Urine,Routine"]
["THINPREP PAP RFX HR HPV"]
["Vitamin D, 25-HYDROXY, LC/MS/MS"]
["Calcium"]
["Microalbumin, Random Urine(w/ creatinine)"]
["Creatinine"]
[null,"Provided in the onsite clinic",null,null,"Sent to an outside lab"]
[null,"Included in the fee quoted in this RFP (Y/N)","If no, provide additional cost to employer to be billed on a monthly basis","CLIA Waived Lab Test (Y/N)","Included in the fee quoted in this RFP (Y/N)","If no, provide additional cost to employer to be billed on a monthly basis","Billed through medical plan as any lab test ordered by any provider is billed (Y/N)"]
["Hepatic Function Panel"]
["Helicobacter Pylori AG, EIA, STOOL"]
["HIV AB, HIV 1/2, EIA, WITH REFLEXES "]
["Iron and Total Iron binding capacity"]
["RPR (DX) w/refl titer and confirmatory testing "]
["ELISA Antibody"]
["Ferritin"]
["TSH "]
["CBC (H/H, RBC, INDICES, WBC, PLT)"]
["Rheumatoid Factor"]
["Culture, Genital"]
["PSA"]
["Amylase"]
["Lipase"]
["Aerobic Bacterial Culture"]
["Anaerobic and Aerobic Culture"]
["Cortisol, AM"]
["C-Reactive Protein, Cardiac"]
["C-Reactive Protein, Quant"]
["Estradiol"]
["Estrogen Total"]
["Folate"]
["GGT"]
["HCG Quantitative"]
["Magnesium"]
["Testosterone"]
["Vaginitis/Vaginosis"]
["Vitamin B12"]
["Vitamin B12 and Folate"]
["Other, Please list"]

{"sheet":"Lab Services (OccHealth)","index":5,"n_rows":55,"n_cols":4,"rows_kept":55,"merged":[[0,1,0,3],[2,0,2,4],[3,0,3,1],[4,1,4,3],[26,1,26,3],[53,1,53,3]]}
["Proposer's Name"]
[]
["Please indicate the lab tests and services that you have the capability to provide for Occ Health Related Services"]
[]
[null,"Provided in the onsite clinic"]
["Name of Lab","Included in the fee quoted in this RFP (Y/N)","If no, provide additional cost to employer to be billed on a monthly basis","CLIA Waived Lab Test (Y/N)"]
{"$rows_empty":20}
[null,"Provided in the onsite clinic"]
["Name of Lab","Included in the fee quoted in this RFP (Y/N)","If no, provide additional cost to employer to be billed on a monthly basis","CLIA Waived Lab Test (Y/N)"]
{"$rows_empty":25}
[null,"Provided in the onsite clinic"]
["Name of Lab","Included in the fee quoted in this RFP (Y/N)","If no, provide additional cost to employer to be billed on a monthly basis","CLIA Waived Lab Test (Y/N)"]

{"sheet":"Medications","index":6,"n_rows":32,"n_cols":4,"rows_kept":32,"merged":[[0,1,0,3],[2,0,2,3],[3,0,3,1],[4,1,4,2],[30,1,30,2]]}
["Proposer's Name"]
[]
["Please indicate the medications that you have the capability to dispense from the clinic."]
[]
[null,"Dispensed from the  onsite clinic"]
["Generic Name","Dosage","Quantity","Cost"]
{"$rows_empty":24}
[null,"Dispensed from the  onsite clinic"]
["Generic Name","Dosage","Quantity","Cost"]

{"sheet":"Occupational Health","index":7,"n_rows":28,"n_cols":5,"rows_kept":28,"hidden":true,"merged":[[17,0,17,4],[18,1,18,4],[19,1,19,4],[20,1,20,4],[21,1,21,4],[22,1,22,4],[23,1,23,4],[24,1,24,4],[25,1,25,4],[26,1,26,4],[27,1,27,4]]}
["Occupational Health"]
["Indicate your organization's ability to provide the following occupational medical services.","Yes","No ","Additional comments","Please mark if included in base fee or buy up"]
["Pre-employment medical examinations and evaluations for perspective employees.",{"$nulls":3},"Included in base fee"]
["Non-DOT urine drug screening.",{"$nulls":3},"Included in base fee"]
["Occupational/environmental health exams and evaluations (e.g., respiratory, hearing, BEI’s, etc.)",{"$nulls":3},"Included in base fee"]
["First aid treatment of minor industrial injuries that do not require more than one follow-up visit",{"$nulls":3},"Included in base fee"]
["Indicate your organization's ability to address these or other safety-related services.","Yes","No ","Additional comments","Please mark if included in base fee or buy up"]
["Respirator certifications (pulmonary function and/or fit testing)",{"$nulls":3},"Included in base fee"]
["Audiometric testing under a hearing conservation program",{"$nulls":3},"Included in base fee"]
["Back safety training",{"$nulls":3},"Included in base fee"]
["Blood borne pathogen training",{"$nulls":3},"Included in base fee"]
["Workplace job safety analysis",{"$nulls":3},"Included in base fee"]
["Review of workplace ergonomics (ergonomic training, including stretches, for employees)",{"$nulls":3},"Included in base fee"]
["Fitness for duty examinations (including DOT physicals)",{"$nulls":3},"Included in base fee"]
["Long-term disability examinations",{"$nulls":3},"No fee for referral coordination.  Outside Provider cost will be a pass-through cost"]
["Second opinions",{"$nulls":3},"Included in base fee"]
["Immunizations/vaccinations",{"$nulls":3},"Included in base fee"]
["Please provide information on how your organization addresses case management & reporting specific to workplace injuries."]
["Explain your process for reporting work related injuries to your clients?"]
["Do you integrate the client's policies and procedures into your process?"]
["Do you provide any consulting with the clients on notification and reporting workplace injuries?"]
["Do your providers evaluate and classify work related injuries?"]
["When do you determine if care is needed for workplace injuries outside of your clinic? "]
["How do you communicate with the treating physician?"]
["How do you communicate with the employee?"]
["How do you transfer necessary records to carriers/treating physicians, etc."]
["How do you assist with stay at work and return to work protocols?"]
["Do you offer reporting on \"claims savings\" based on injuries treated within your clinic versus the community?"]

{"sheet":"Performance Guarantees","index":8,"n_rows":5,"n_cols":2,"rows_kept":5,"hidden":true,"merged":[[0,0,0,1]]}
["Performance Guarantees"]
[1,"What percent of total fees will you put at risk for client satisfaction?"]
[2,"What percent of total fees will you put at risk for outcomes?"]
[3,"What percent of total fees will you put at risk for participant satisfaction?"]
[4,"Describe additional administrative and operational guarantees (ex: Maintain medical plan cost trend) that you will offer and the percent of fees at risk related to these."]

{"sheet":"Cost-old","index":9,"n_rows":51,"n_cols":5,"rows_kept":51,"hidden":true,"merged":[[0,0,0,4],[1,0,2,4],[3,0,3,4],[4,3,7,4],[8,0,8,4],[16,0,16,4],[17,0,17,1],[17,3,26,3],[17,4,26,4],[26,0,26,1],[27,0,27,4],[46,0,46,1],[47,0,47,1]]}
["Onsite Health & Wellness Center Cost Summary"]
["Complete the following worksheet providing the fee assumptions and proposed staffing model to meet the requirements detailed in the RFP (please feel free to add additional staffing or fees as necessary). Please provide all fees including implementation and operational fees for the years designed below. This worksheet must be completed to avoid disqualification from the review process."]
[]
["Assumptions"]
[null,"Number of Eligible"]
[null,"Projected Participation Rate"]
[null,"Hours of Operation"]
[null,"Duration of Contract (years)"]
["Staffing Model"]
[null,"Resources","FTE"]
[null,"Medical/Clinic Oversight"]
[null,"Clinic Provider (M.D., Mid-level)"]
[null,"R.N./Health Coach"]
[null,"Administrative Assistant/Medical Assistant"]
[]
[]
["Description",null,"Year 1","Year 2","Year 3"]
["Implementation Cost"]
[null,"Implementation Fee",{"v":0,"d":"$0"}]
[null,"Furnishings, Equipment, Supplies",{"v":0,"d":"$0"}]
[null,"Rx Dispensing Set-up Fee",{"v":0,"d":"$0"}]
[null,"Implementation Travel Expenses",{"v":0,"d":"$0"}]
[null,"Start-up IT Cost",{"v":0,"d":"$0"}]
[null,"Space Design/Architect Fee",{"v":0,"d":"$0"}]
[null,"Launch Communications",{"v":0,"d":"$0"}]
[null,"Other",{"v":0,"d":"$0"}]
["Total Implementation Cost",null,{"v":0,"d":"$0"}]
["Annual Operational Cost"]
[null,"Salaries, Wages, Benefits",{"v":0,"d":"$0"},{"v":0,"d":"$0"},{"v":0,"d":"$0"}]
[null,"Staff Training/Development",{"v":0,"d":"$0"},{"v":0,"d":"$0"},{"v":0,"d":"$0"}]
[null,"Staff Replacement/Temporary Cost",{"v":0,"d":"$0"},{"v":0,"d":"$0"},{"v":0,"d":"$0"}]
[null,"Staff Recruitment",{"v":0,"d":"$0"},{"v":0,"d":"$0"},{"v":0,"d":"$0"}]
[null,"Professional/General Liability Insurance",{"v":0,"d":"$0"},{"v":0,"d":"$0"},{"v":0,"d":"$0"}]
[null,"Management/Professional Fee",{"v":0,"d":"$0"},{"v":0,"d":"$0"},{"v":0,"d":"$0"}]
[null,"G&A Fee",{"v":0,"d":"$0"},{"v":0,"d":"$0"},{"v":0,"d":"$0"}]
[null,"Account Team Support Travel & Expenses",{"v":0,"d":"$0"},{"v":0,"d":"$0"},{"v":0,"d":"$0"}]
[null,"Population Health Programs",{"v":0,"d":"$0"},{"v":0,"d":"$0"},{"v":0,"d":"$0"}]
[null,"Medical/Rx Supplies",{"v":0,"d":"$0"},{"v":0,"d":"$0"},{"v":0,"d":"$0"}]
[null,"Office Supplies",{"v":0,"d":"$0"},{"v":0,"d":"$0"},{"v":0,"d":"$0"}]
[null,"Office Equipment Rental ",{"v":0,"d":"$0"},{"v":0,"d":"$0"},{"v":0,"d":"$0"}]
[null,"Mail/Overnight",{"v":0,"d":"$0"},{"v":0,"d":"$0"},{"v":0,"d":"$0"}]
[null,"IT (support, license, upgrades)",{"v":0,"d":"$0"},{"v":0,"d":"$0"},{"v":0,"d":"$0"}]
[null,"Lab Professional Fees",{"v":0,"d":"$0"},{"v":0,"d":"$0"},{"v":0,"d":"$0"}]
[null,"Ongoing Communications",{"v":0,"d":"$0"},{"v":0,"d":"$0"},{"v":0,"d":"$0"}]
[null,"Other (laundry, medical waste removal, subscriptions, etc.)",{"v":0,"d":"$0"},{"v":0,"d":"$0"},{"v":0,"d":"$0"}]
[null,"Wellness Administration"]
["Total Operational Cost",null,{"v":0,"d":"$0"},{"v":0,"d":"$0"},{"v":0,"d":"$0"}]
["Total Annual Cost",null,{"v":0,"d":"$0"},{"v":0,"d":"$0"},{"v":0,"d":"$0"}]
["Additional Assumptions"]
[null,"Estimated percentage of increase in total fees each year"]
[null,"Total percentage of fees at risk related to performance guarantees - indicate if a % of total fees, % of management fee only, etc."]

{"sheet":"Cost","index":10,"n_rows":58,"n_cols":5,"rows_kept":58,"merged":[[0,1,0,3],[2,0,2,4],[3,0,4,4],[5,0,5,4],[6,3,9,4],[10,0,10,4],[11,3,19,4],[20,0,20,4],[21,0,21,1],[21,3,31,4],[31,0,31,1],[32,0,32,1],[49,0,49,1],[53,0,53,1],[54,0,54,1],[59,0,59,2],[60,0,60,2],[61,0,61,2]]}
["Proposer's Name"]
[]
["Onsite Health Center Cost Summary"]
["Complete the following worksheet providing the fee assumptions and proposed staffing model to meet the requirements detailed in the RFP. Please provide all fees including implementation and operational fees for the years designed below. You may add line items as necessary and indicate N/A where applicable. If certain fees are in aggregate/applicable to all locations, please merge cells or note as such. This worksheet must be completed to avoid disqualification from the review process."]
[]
["Assumptions"]
[null,"Number of Eligible",1600]
[null,"Projected Participation Rate"]
[null,"Hours of Operation"]
[null,"Duration of Contract (years)"]
["Staffing Model"]
[null,"Resources - FTE","FTE"]
[null,"Medical/Clinic Oversight"]
[null,"Nurse Practitioner"]
[null,"Physical Therapist"]
[null,"Medical Assistant/Phlebotomist"]
[null,"Patient Service Representative"]
[null,"Dietitian "]
[null,"Health Coach"]
[null,"Dedicated Program Manager (Registered Nurse)"]
["Description"]
["Implementation Cost"]
[null,"Implementation Fee"]
[null,"Furnishings, Equipment, Supplies"]
[null,"Rx Dispensing Set-up Fee"]
[null,"Implementation Travel Expenses"]
[null,"Start-up IT Cost"]
[null,"Space Design/Architect Fee"]
[null,"Launch Communications"]
[null,"Training Period Salaries"]
[null,"Provider EMR License"]
[]
["Annual Operational Cost",null,"Year 1","Year 2","Year 3"]
[null,"Salaries, Wages, Benefits"]
[null,"Staff Training/Development"]
[null,"Staff Replacement/Temporary Cost"]
[null,"Staff Recruitment"]
[null,"Professional/General Liability Insurance"]
[null,"Management/Professional Fee"]
[null,"G&A Fee"]
[null,"Account Team Support Travel & Expenses"]
[null,"Population Health Programs "]
[null,"Medical/Rx Supplies "]
[null,"Office Supplies "]
[null,"Office Equipment Rental  "]
[null,"Mail/Overnight "]
[null,"IT (support, license, upgrades)"]
[null,"Lab Professional Fees"]
[null,"Ongoing Communications"]
["Annual Operational Cost",null,"Year 1","Year 2","Year 3"]
[null,"Other (laundry, medical waste removal, subscriptions, etc.)"]
[null,"License and Dues"]
[null,"Occupational Management Fee"]
[]
["Total Annual Cost"]
["Additional Assumptions"]
[null,"Estimated % of increase in total fees each year"]
[null,"Total percentage of fees at risk related to performance guarantees - indicate if a % of total fees, % of management fee only, etc."]