HRIF Request for Application

HRIF Request for Application (RFA)

This HRIF RFA is a formal solicitation for Applications from California Children's Services (CCS) approved Regional Neonatal Intensive Care Units (NICU) to provide these Coordinator services. A Regional NICU is defined as a nursery that has the capability of providing a full range of neonatal care services (intensive, intermediate, and continuing care) including neonatal surgery for severely ill neonates and infants. Applicants must maintain their status as a CCS approved Regional NICU for the duration of this Contract. Also, Applicants must be members of the California Perinatal Quality Care Collaborative (CPQCC) and maintain that membership for the duration of this Contract.

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Questions

Cover Letter

Request for Application

Exhibits

Attachments

Questions

Cover Letter

Request for Application

Exhibits

Exhibit	Title
Exhibit A1	Standard Agreement
Exhibit A	Scope of Work
Exhibit B	Budget Detail and Payment Provisions
Exhibit C	General Terms and Conditions (GTC 1005)
Exhibit D (F)	Special Terms and Conditions
Exhibit E	Additional Provisions
Exhibit F	Contractor's Release
Exhibit G	Travel Reimbursement Information
Exhibit H	HIPAA Business Associate Addendum
Exhibit I	Contractor Certification Clauses
Exhibit J	Contract Information Form
Exhibit K	CCS Approved NICUs: Regional, Community and Intermediate
Exhibit L	CCS Program Service Code Grouping 06 - HRIF Program
Exhibit M	Individual Provider Paneling Application for Allied Health Care Professionals

Attachments

Attachment	Title
Attachment 1	Application Cover Page
Attachment 2	Certification of Agreement Checklist
Attachment 3	Payee Data Record
Attachment 4 BI Attachment 4 BII Attachment 4 BIII	Budget Detail Worksheet - Attachments BI, BII, and BIII
Attachment 5	List of CCS Approved NICUs for which the Applicant Provides HRIF Services
Attachment 6	HRIF Coordinator Curriculum Vitae/Resume
Attachment 7	Contractor Certification Clauses
Attachment 8	Contract Information Form