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State of Wisconsin
Wis. Statutes s.16.75
DOA-3070 (R08/2003)
BIDS MUST BE SEALED AND ADDRESSED TO: Remove from bidder list for this commodity/service. (Return this page only.)
AGENCY ADDRESS: Bid envelope must be sealed and plainly marked in lower corner with due date and Request for Bid
#SN-2125. Late bids will be rejected. Bids MUST be date and time stamped by the soliciting
purchasing office on or before the date and time that the bid is due. Bids dated and time stamped in
DEPARTMENT OF CORRECTIONS
another office will be rejected. Receipt of a bid by the mail system does not constitute receipt of a
SCOTT NOREUIL / PURCHASING SERVICES SECTION bid by the purchasing office. Any bid which is inadvertently opened as a result of not being properly
3099 E WASHINGTON AVENUE and clearly marked is subject to rejection. Bids must be submitted separately, i.e., not included with
P.O. BOX 7991 sample packages or other bids. Bid openings are public unless otherwise specified. Records will
MADISON, WI 53707-7991 be available for public inspection after issuance of the notice of intent to award or the award of the
contract. Bidder should contact person named below for an appointment to view the bid record.
Bids shall be firm for acceptance for sixty (60) days from date of bid opening, unless otherwise
REQUEST FOR BID noted. The attached terms and conditions apply to any subsequent award.
THIS IS NOT AN ORDER Bids MUST be in this office no later than
BIDDER (Name and Address) June 26, 2009 2:00 PM CT
Name (Contact for further information)
Scott Noreuil
Phone Date
608-240-5588 June 8, 2009
Quote Price and Delivery FOB
Destination
Fax bids are not accepted
Item Quantity Price
Description
No. and Unit Per Unit Total
The Department of Corrections, Div. of Community Corrections
Requesting bids for non-residential Alcohol and Other Drug
Abuse/Post Traumatic Stress Disorder Services in
Milwaukee, WI, area per attached terms, conditions and
specifications.
1. 102 AODA/PTSD Outpatient Groups $ $
Groups (2 grps/wk x 17 wks = 34 groups x 3 cycles = 102 grps annually)
Before submitting this bid be sure to include all requirements
listed in Section 2.4 and 8.
Payment Terms Net 30 Delivery Time: per specifications
We claim minority bidder preference [Wis. Stats. s. 16.75(3m)]. Under Wisconsin Statutes, a 5% preference may be granted to CERTIFIED Minority Business Enterprises. Bidder must be
certified by the Wisconsin Department of Commerce. If you have questions concerning the certification process, contact the Wisconsin Department of Commerce, 5th Floor, 201 W. Washington
Ave., Madison, Wisconsin 53702, (608) 267-9550. Does Not Apply to Printing Bids.
We are a work center certified under Wis. Stats. s. 16.752 employing persons with severe disabilities. Questions concerning the certification process should be addressed to the Work Center
Program, State Bureau of Procurement, 6th Floor, 101 E. Wilson St., Madison, Wisconsin 53702, (608) 266-2605.
Wis. Stats. s. 16.754 directs the state to purchase materials which are manufactured to the greatest extent in the United States when all other factors are substantially equal. Materials covered in our
bid were manufactured in whole or in substantial part within the United States, or the majority of the component parts thereof were manufactured in whole or in substantial part in the United States.
Yes No Unknown
In signing this bid we also certify that we have not, either directly or indirectly, entered into any agreement or participated in any collusion or otherwise taken any action in restraint of free competition;
that no attempt has been made to induce any other person or firm to submit or not to submit a bid; that this bid has been independently arrived at without collusion with any other bidder, competitor or
potential competitor; that this bid has not been knowingly disclosed prior to the opening of bids to any other bidder or competitor; that the above statement is accurate under penalty of perjury.
We will comply with all terms, conditions and specifications required by the state in this Request for Bid and all terms of our bid.
Name of Authorized Company Representative (Type or Print) Title
Phone ( )
Fax ( )
Signature of Above Date Federal Employer Identification No.
This form can be made available in accessible formats upon request to qualified individuals with disabilities.
RFB # SN-2125 Due Date: June 26, 2009
AODA/PTSD Services in Milwaukee, WI Page 2 of 41
STATE OF WISCONSIN
REQUEST FOR BID (RFB) # SN-2125
FOR: Alcohol and Other Drug Abuse/Post Traumatic Stress Disorder
Services in Milwaukee, Wisconsin
TABLE OF CONTENTS
DEFINITIONS
1.0 INTRODUCTION, PURPOSE, AND SCOPE
2.0 BID PROCEDURE AND INSTRUCTIONS
3.0 BID ACCEPTANCE, EVALUATION AND AWARD
4.0 TECHNICAL REQUIREMENTS
5.0 PERFORMANCE REQUIREMENTS
6.0 SUPPORT REQUIREMENTS
7.0 STANDARD AND SUPPLEMENTAL TERMS AND CONDITIONS
8.0 REQUIRED FORMS AND ATTACHMENTS
ATTACHMENTS
EXHIBIT 1 ……………………………………. DCC Administrative Directive 01-10
EXHIBIT 2 ……………………………………. Referral for Services (DOC-1336)
EXHIBIT 3 ……………………………………. Offender Report - Monthly (DOC-1088)
EXHIBIT 4 ……….…………………………… Unit Service Monthly Report (DOC-1026)
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AODA/PTSD Services in Milwaukee, WI Page 3 of 41
DEFINITIONS:
The following definitions are used throughout the bid:
Bidder: Firm submitting a bid in response to this Request for Bid
Contractor: Successful vendor awarded the contract
DAI: Division of Adult Institutions, administration of all state correctional incarceration facilities except those
juvenile facilities operated by Division of Juvenile Corrections – headquartered at DOC Central
Offices, 3099 E Washington Ave., Madison, WI 53704
DCC: Division of Community Corrections, supervises offenders outside secure facilities
DJC: Division of Juvenile Corrections, operates the three correctional „schools‟ – headquartered at DOC
Central Offices, 3099 E Washington Ave., Madison, WI 53704
DOA: Department of Administration has statutory authority [WI Stats. Chapter 16] to define, regulate and
delegate all aspects of procurement of commodities and services for state agencies.
DOC: Department of Corrections, also referred to as the department or the DOC – headquartered at DOC
Central Offices, 3099 E Washington Ave., Madison, WI 53704
MBE: Minority Business Enterprise
Offender: Person under the custody or supervision of the Wisconsin Department of Corrections
P-Card: Procurement Card (State credit card)
Purchasing: Department of Corrections‟ Purchasing Services Section
RFB: Request for Bid
State: State of Wisconsin
Vendor: Firm submitting a bid in response to this Request for Bid
Must: Requirement is mandatory
Shall: Requirement is mandatory
Should: Desirable but not mandatory
Administrative and Fiscal Services: Tasks and responsibilities such as preparation and management of operational
budget; personnel management; program planning and evaluation; supervision and evaluation of staff;
labor/management relations; public relations; ensuring compliance with Affirmative Action requirements;
development, implementation, and monitoring of policies/practices for information and technology, space,
staff/offender health, safety and security.
Alcohol and Other Drug Abuse (AODA):
Aftercare or Continuing Care: Aftercare and Continuing Care are interchangeable terms and refer to treatment
provided after the offender has completed the goals of a primary care program and no longer requires counseling
at that intensity level. Aftercare is less intensive treatment that tapers the treatment process in order to sustain
and extend the offender‟s recovery by reinforcing the concepts learned in the primary program. Aftercare is
usually offered on an outpatient basis for a limited time. For example, DOC Aftercare is often twelve weeks in
length.
AODA Assessment: The process and procedures by which a counselor or service identifies and evaluates an
individual‟s strengths, weaknesses, problems and needs in order to develop the offender‟s individual treatment
plan or to make recommendations for the offender‟s continuing care.
Intake Assessment: The process by which a counselor or service contractor review and evaluates offender
history to include such data as the AODA assessment, Criminal Complaint, Judgment of Conviction, Agent‟s
Assessment and Impressions, and offender interview to determine and report appropriateness and level of group
services to be provided.
Intensive Outpatient: A structured, non-residential AODA treatment consisting of regularly scheduled sessions
of various treatment modalities such as counseling case management, group or individual therapy, medical
services, and mental health services, as indicated, by interdisciplinary contractors for a scheduled number of
sessions per day and week. This is the most intensive level of outpatient counseling.
Post Traumatic Stress Disorder (PTSD): PTSD is described in the DSM IV as “the development of
characteristic symptoms following exposure to an extreme stressor”.
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AODA/PTSD Services in Milwaukee, WI Page 4 of 41
Relapse Intervention/Prevention: AODA treatment to which an offender is referred due to exhibiting signs of
relapse/destabilization. The goal of such a “booster” form of treatment is to re-stabilize and return the offender to
community living following a structured re-exposure to program elements designed to address the issues the
offender was having difficulty within the community. Typically, this might occur through an alternative to revocation
process with the needed elements identified in the treatment plan. Relapse Prevention can also be combined with
Outpatient AODA Counseling as elements of an individual treatment plan.
Alternative to Revocation (ATR) is a written and signed agreement between DOC and the offender.
Clinical Supervision: Management of the treatment aspects of the program. Tasks and responsibilities include
development, implementation, and functional oversight of programs; maintaining current knowledge of research,
literature, evidence based practices, program theories and models relevant to target populations served by the
program; ensuring ethical and professional standards are maintained in program delivery.
It also requires the periodic direct observation and analytic review of ongoing assessment, counseling, motivational
interviewing, treatment plan development, implementation, discharge planning and case management by the
contractor staff with the purpose of evaluating and improving service delivery and assuring quality of care.
Clinical Supervisor: The person designated to be responsible for the clinical supervision of the staff delivering
clinical services in an AODA treatment program. This person is knowledgeable and experienced about the provision
of substance abuse services, the change process and working with criminal offenders.
Cognitive Interventions: A program which teaches specific strategies or techniques to enable offenders to (1)
identify for themselves the specific thoughts that support their criminal behavior (self-observation); (2) see and
appreciate the pattern and consequences of their thinking; (3) utilize reasoning and problem solving, self-talk, social
interaction skills as a means of controlling and changing their thinking; (4) recognize that they have choices and can
make a conscious decision to change or not to change. The Department stresses programming that combines two
types of cognitive interventions: cognitive restructuring (changing the thinking patterns, attitudes, and beliefs that lead
persons to offend) and cognitive skills training (teaching reasoning, problem solving, and social skills).
Correctional Client: Program participants from city, county, state or federal programs provided in a correctional
setting. The DOC will make sole determination of who meets these criteria.
Criminogenic Risk Factors: Those features that research has demonstrated are related to criminal behavior. At
least two types are recognized. Static risk factors are offender characteristics that cannot change but are predictive of
an offender‟s propensity for future criminal activity, for example, the offender‟s age at the time of first offense.
Dynamic risk factors are offender characteristics that may be altered by effective intervention. Examples of dynamic
risk factors are substance abuse; identification with criminal companions; low tolerance for frustration; impulsivity;
conflicts with authority; poor use of leisure time; conning and manipulation; thrill seeking; egocentrism; blaming others;
dissatisfaction with conventional, mainstream activities; poor skills in identifying alternative choices; etc.
Culturally Diverse Programming: Programming which accommodates the learning styles of African American,
Hispanic, American Indian, Caucasian and other ethnic backgrounds. This is accomplished through diverse staff and
program materials.
Gender Specific: Programming designed specifically to address male and female offenders‟ needs and learning
styles.
Guided Self-Discovery: This methodology proposes that to take a cognitive approach and then try to argue
offenders out of their habits of thinking is ineffective and even counterproductive. Despite the fact that cognitive
interventions involve learning new beliefs and behaviors, these are not taught through lectures or preaching. In guided
discovery, questioning and exploration are used to help participants discover what they think, guide them to pinpoint
the source of their problems, assist them in seeing new perspectives, and help them find their own solutions to their
problems. When using guided discovery, facilitators model a process that offenders can use, on their own, to explore,
evaluate and challenge their beliefs and thoughts rather than continually relying upon facilitators to pinpoint the
sources of their problems and find solutions for them. Asking questions also helps the facilitator keep track of a
participant‟s progress in understanding cognitive concepts and making cognitive changes.
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AODA/PTSD Services in Milwaukee, WI Page 5 of 41
The guided discovery approach is also used to maximize participant involvement in the group sessions. When
responding to questions, the participant is doing most of the work rather than being a passive recipient listening to
statements from the facilitator. Guiding participants to pinpoint the source of their problems and find their own
solutions also minimizes the possibility of the participant believing that the facilitator is attempting to impose his or her
own ideas on the participant. Participants often adopt new perspectives more readily when they are allowed to form
their own conclusions than when they are persuaded to adopt the facilitator‟s conclusions.
The facilitator‟s role is to work with participants to help them recognize their cognitions and other risk factors that
cause problems for them; to test the validity of the thoughts, beliefs and assumptions that prove important; and to
make changes in both cognition and behaviors. By actively collaborating with the offender, facilitators minimize the
resistance and opposition that is often elicited by taking an authoritarian role, yet they still remain in a position to
structure each session and the overall course of the program in a way that is as efficient and effective as possible.
This methodology tends to increase feelings of self-efficacy and empowerment in participants by encouraging them to
adopt an internal focus of evaluation.
Program Evaluation: The identification of quantifiable behavioral indicators of response to the planned intervention
used to determine program efficacy.
Program Statement: The written statement of a program‟s philosophy and model of treatment; the research basis for
selection of the treatment model; the problem and the population to be served; the goals, objectives, and activities to
be employed to achieve the desired outcomes; and the plan for determining the efficacy of the services provided.
Screening: The process which identifies whether an offender has an AODA problem (in this case) and if so, a
recommendation for the most appropriate type of treatment. A screening is a “first cut” done quickly, without the
detailed, in-depth, current information that would be gathered for an assessment. A screening should not be confused
with an assessment, which is a lengthier, much more definitive process.
Secular Programming: A program that is free of religious components (Exhibit 1).
Special Populations: Offenders that may present particular characteristics such as the following – cognitively
challenged (low functioning), non-English speaking, learning challenged, mentally ill or physically challenged
(hearing/visual/mobility impaired).
Urinalysis (UA): Analysis of urine, used to detect the presence of a specific substance, such as an illegal drug.
RFB # SN-2125 Due Date: June 26, 2009
AODA/PTSD Services in Milwaukee, WI Page 6 of 41
1.0 INTRODUCTION, PURPOSE, AND SCOPE
1.1 PURPOSE OF THIS REQUEST FOR BID
The Department of Corrections, hereinafter referred to as the "DOC", through its Purchasing Services
Section, hereinafter referred to as "Purchasing," on behalf of the Division of Community Corrections
hereinafter referred to as "DCC", requests bids for Non-Residential Alcohol and Other Drug Abuse
(AODA) and Post Traumatic Stress Disorder (PTSD) Secular Treatment Program(s) in the Milwaukee, WI,
area. The program must provide services to offenders convicted in adult court and under the supervision
of the Wisconsin Department of Corrections (DOC) with specified alcohol and other drug abuse treatment
services.
Other State agencies may use the resulting contract, if agreeable to both the DOC and the vendor, to obtain
the benefits of volume purchases and/or reduction in administrative expenses.
The Department of Corrections (DOC) supervises individuals with extensive AODA and PTSD treatment
needs. Non-residential or outpatient services are an integral component of the AODA treatment
continuum. It is the intent of the Division of Community Corrections (DCC) to purchase non-residential
groups for offenders who are experiencing alcohol and/or other drug abuse problems.
1.1.1 PROGRAM GOALS
The goals and objectives of the Non-Residential AODA/PTSD Treatment Programs are to:
To provide gender specific treatment to female offenders, targeting their criminogenic
needs
To provide group and/or other individual treatment for female offenders that focuses on:
1. Promoting abstinence from mood-altering chemicals and recovery from addiction.
2. Promoting positive lifestyle changes to avoid further legal difficulties.
3. Promoting independence for female offenders.
4. Assisting female offenders to develop positive self regard
To reduce jail and prison overcrowding by providing options/diversions to offenders who
are experiencing problems as a result of their alcohol and other drug abuse.
To reduce crime/recidivism by treatment for alcohol and other drug abuse/addiction.
1.1.2 Program Philosophy
Non-Residential AODA/PTSD Treatment Programs philosophy consists of the following beliefs:
An alcohol and other drug problem is an indication of a greater individual problem
Female offenders differ from male offenders in regard to their pathways into crime
Gender differences dictate a need for gender specific treatment programs
Offenders can make responsible choices to change their behaviors
Treatment must address the whole person
A cognitive-behavioral treatment approach is used because research supports this
treatment model with offenders
Treatment activities are experiential to the greatest possible degree
1.1.3 TARGET POPULATION
The program shall serve female offenders convicted in adult court as referred by the Department
of Corrections and are under DOC supervision for the duration of services. A special population
group of offenders may present particular characteristics that should be addressed by reasonable
accommodations in the program. Factors considered in referrals will include convicting offense
behavior(s), prior record, other prior history, indicators of imminent relapse, availability of
resources, or other case contingencies.
1.2 CONTRACT TERM
The contract term will be for one year, with options to extend the contract for two additional one-year
terms. Extension(s) beyond the initial contract term is contingent upon the performance of the contractor
during the contract period and upon availability of funds. These are not automatic extensions. Contracts
RFB # SN-2125 Due Date: June 26, 2009
AODA/PTSD Services in Milwaukee, WI Page 7 of 41
will be reviewed by the DOC before a decision is made. Any extension(s) must be authorized by mutual
written agreement of the vendor and the state.
1.3 EXECUTED CONTRACT TO CONSTITUTE ENTIRE AGREEMENT
In the event of contract award, the contents of this RFB (including all attachments), RFB addenda and
revisions, and the bid of the successful bidder, and additional terms agreed to, in writing, by DOC and the
contractor shall become part of the contract. Failure of the successful bidder to accept these as a
contractual agreement may result in a cancellation of award.
The following priority for contract documents will be used if there are conflicts or disputes.
State of Wisconsin standard terms and conditions
Final Signed Contract including amendments
Official State of Wisconsin Purchase Order
Bidder‟s written bid document
State of Wisconsin Request for Bid, including any amendments;
Other exhibits/attachments
Successful bidder(s) should retain a copy of this DOC Request for Bid document and their own response
to the RFB solicitation, as it becomes part of the awarded contract.
1.4 CANCELLATION AND TERMINATION
This Contract may be terminated for the following conditions:
1.4.1 The DOC may terminate the Contract at any time, with or without cause and without penalty by
delivering thirty (30) days written notice to the Contractor.
1.4.2 The DOC has a Vendor Performance Evaluation process for soliciting feed-back from contract
users about vendor performance and compliance with contract specifications. Vendor
noncompliance with the terms, conditions or specifications that is persistent and/or significantly
impacts the quality and performance provided pursuant to the contract may be considered in
breach of contract. Negative Vendor Performance Evaluation Surveys may result in non-renewal
or termination of contract.
1.4.3 If at any time the Contractor performance threatens the health and/or safety of the DOC, the DOC
has the right to cancel and terminate the Contract without notice.
1.4.4 Failure to maintain the required Certificates of Insurance, Permits and Licenses shall be cause for
Contract termination. If the Contractor fails to maintain and keep in force the insurance as
provided in #23 of the Standard Terms and Conditions, the DOC has the right to cancel and
terminate the Contract without notice.
1.4.5 If at any time a petition in bankruptcy shall be filed against the Contractor and such petition is not
dismissed within 90 calendar days, or if a receiver or trustee of Contractor's property is appointed
and such appointment is not vacated within 90 calendar days, the DOC has the right, in addition to
any other rights of whatsoever nature that it may have at law or inequity, to terminate the Contract
by giving 10 calendar days notice in writing of such termination.
1.4.6 Failure of the DOC to comply with contract terms, conditions or specifications shall provide the
sole cause for which the Contractor is entitled to terminate the contract. The Contractor shall notify
the Department in writing within thirty (30) days after the Contractor becomes aware of the alleged
noncompliance with a complete description of the same. If the DOC does not, within forty-five (45)
days after its receipt of the Contractor‟s notice, either (1) effect a cure or (2) if the noncompliance
is not one that can reasonably be cured within forty-five (45) days, develop a plan to cure the
noncompliance and diligently proceed according to that plan unto a cure is effected, then the
Contractor may terminate the Contract for cause by written notice to the DOC. The Contractor may
RFB # SN-2125 Due Date: June 26, 2009
AODA/PTSD Services in Milwaukee, WI Page 8 of 41
not terminate the Contract without cause unless express written consent to do so is provided by
the DOC.
1.5 VENDORNET REGISTRATION
Department of Administration and State Bureau of Procurement policies no longer require maintenance of
bidder‟s lists or individual notification of vendors on bidders‟ lists. In addition, there is no requirement to
post solicitations for bids/proposals in the Legal Notices of the Official State Newspaper. Vendors who fail
to register with VendorNet may not receive notification of procurement solicitations.
The State of Wisconsin‟s purchasing information and vendor notification service is available to all
businesses and organizations that want to sell to the state. Anyone may access VendorNet on the
Internet at http://vendornet.state.wi.us to get information on state purchasing practices and policies,
commodities and services that the state buys, and tips on selling to the state. Vendors may use the same
Web site address for inclusion on the bidders list for commodities and services that the organization wants
to sell to the state. A subscription with notification guarantees the organization will receive an e-mail
message each time a state agency, including any campus of the University of Wisconsin System, posts a
request for bid or a request for proposal in their designated commodity/service area(s) with an estimated
value over $25,000. Organizations without Internet access receive paper copies in the mail. Increasingly,
state agencies also are using VendorNet to post simplified bids valued at $25,000 or less. Vendors also
may receive e-mail notices of these simplified bid opportunities.
To obtain information on the state‟s bidder registration, visit the VendorNet Web site at
http://vendornet.state.wi.us or call the VendorNet Information Center (1-800-482-7813). In the Madison
area, call 608-264-7898.
Make sure to select all the appropriate NIGP (Commodity) Codes. Bid lists are generated by NIGP codes.
Consider using a generic email address that is accessed or delivered to multiple recipients (example:
bids@xyzcompany.com). This will insure that the bid notice is received.
2.0 BID PROCEDURES AND INSTRUCTIONS
2.1 REASONABLE ACCOMMODATIONS
The DOC will provide reasonable accommodations, including the provision of informational material in an
alternative format, for qualified individuals with disabilities upon request. If accommodations at a bid
opening/vendor conference are needed, contact Scott Noreuil via telephone at 608-240-5588 or email at
scott.noreuil@wisconsin.gov
2.2 BID SUBMITTAL
Bidders must submit an original, marked as such, and 3 copies of all materials required (see
section 2.4 and 8) for acceptance of their bid. Receipt of a bid by the State mail system does not
constitute receipt of a bid by the Purchasing Services Section, for purposes of this RFB. Use one
of the options below for return of the bid.
The Bid(s) must be received at the Purchasing Services Section, at the office listed below, no later than
June 26, 2009 2:00 PM Central Time. Any bids received after that time and date will be rejected.
USPS ADDRESS COMMON CARRIER ADDRESS
DEPARTMENT OF CORRECTIONS DEPARTMENT OF CORRECTIONS
SCOTT NOREUIL SCOTT NOREUIL
PURCHASING SERVICES SECTION PURCHASING SERVICES SECTION
PO BOX 7991 3099 EAST WASHINGTON AVE.
MADISON, WI 53707-7991 MADISON, WI 53704-4338
FAXING: Faxed bids are NOT accepted. E-MAILING: Emailed bids are NOT accepted.
RFB # SN-2125 Due Date: June 26, 2009
AODA/PTSD Services in Milwaukee, WI Page 9 of 41
All bids must be packaged, sealed, and show the following information on the outside of the package:
Vendor‟s Name and Address
Request for Bid Title
Request for Bid Number
Bid Due Date
2.3 CALENDAR OF EVENTS
Listed below are important dates and times by which actions related to this Request for Bid (RFB) must be
completed. In the event that the State finds it necessary to change any of these dates and times it will do
so by issuing an amendment to this RFB to be posted on VendorNet, unless the event is listed as
estimated or approximate.
DATE EVENT
June 8, 2009 RFB posting date
June 15, 2009 Last day for submitting written questions
June 19, 2009 Answers to questions posted on VendorNet (estimated)
June 26, 2009 Bids due from vendors
July 1, 2009 Estimated award date
July 1, 2009 Approximate Contract Start date
2.4 FORMAT OF BID
Responses to this RFB must comply with the following format requirements (reference Section 8).
SIGNED REQUEST FOR BID FORM DOA-3070 – Cover sheet of this RFB
Include here the signed Request for Bid form included with the bid and those certifications
required for submittal of a bid. Bids submitted in response to this RFB must be signed by the
person in the vendor's organization who is responsible for the decision as to the prices being
offered in the bid or by a person who has been authorized in writing to act as agent for the
person responsible for the decision on prices.
COST SUBMITTAL INFORMATION
Bidders must submit cost on the Request for Bid form (DOA-3070), complete and sign,
including a price per unit for each item, an extended total for each item and a total price. Cost
must include labor, travel and insurance. All costs to furnish the service(s) included in the bid,
in accordance with the terms and conditions of this RFB, must be included.
VENDOR INFORMATION DOA-3477
Provide Vendor Company contact information as requested on the form.
AFFIDAVIT DOA-3476 (MBE/AMERICAN MADE)
Indicate on Affidavit if vendor company is claiming to be certified Minority Enterprise certified
by the State of Wisconsin, Department of Commerce or a Work Center certified by the State
Use Board. Sign the non-collusion clause.
DESIGNATION OF CONFIDENTIAL AND PROPRIETARY INFORMATION DOA-3027
Information submitted as part of the bid document which is proprietary and confidential in
nature and which qualifies as a trade secret may be kept confidential under the Wisconsin
Open Records Law – Section 19.36(5), Wis. Stats. Complete and sign the attached form.
WISCONSIN’S COOPERATIVE PURCHASING SERVICE DOA-3333
Vendors are encouraged to extend the contract resulting from this RFB to local governments
in Wisconsin. Indicate your willingness to allow Wisconsin municipalities to participate in this
contract by completing Form DOA-3333, Wisconsin‟s Cooperative Purchasing Service.
RFB # SN-2125 Due Date: June 26, 2009
AODA/PTSD Services in Milwaukee, WI Page 10 of 41
2.4.7 VENDOR REFERENCE DOA-3478 Complete the Vendor Reference form with four vendors
that your company has done business with providing services. Include the company name,
address, contact person and telephone number along with a brief description of the service.
2.4.8 STATE OF WISCONSIN TERMS AND CONDITIONS
The standard (DOA-3054) and supplemental (DOA-3681) terms and conditions shall govern this RFB
and subsequent award.
Vendor must accept these terms and conditions or submit point –by-point exceptions along with
proposed alternative or additional language for each point, including any vendor contracts.
Submission of any standard vendor contracts as a substitute for language in the terms and
conditions is not a sufficient response to this requirement and may result in rejection of the
vendor‟s proposal. The state reserves the right to negotiate contractual terms and conditions
other than those in the State of Wisconsin Contract when it is in the best interest of the State to
do so.
2.5 MULTIPLE BIDS
Multiple bids from a vendor will be permissible, however each bid must conform fully to the requirements
for bid submission. Each such bid must be separately submitted and labeled as Bid #1, Bid #2, etc. on
each page included in the response. Alternate acquisition plans do not constitute multiple bids.
2.6 INCURRING COSTS
The State of Wisconsin is not liable for any cost incurred by a vendor in the process of responding to this
RFB.
2.7 QUESTIONS, CLARIFICATIONS AND/OR REVISIONS THROUGH DESIGNATED CONTACT
All communications and/or questions regarding this request must be written and submitted via FAX, e-
mail, USPS mail or hand delivery to the Purchasing Services Section.
If a Bidder discovers any significant ambiguity, error, conflict, discrepancy, omission, or other deficiency in
this RFB, they have five (5) business days after the bid posting date to notify, in writing, the Purchasing
Agent at the address shown below of such error and request clarification of the RFB document. All written
questions will be responded to in writing and provided to all bidders.
DEPARTMENT OF CORRECTIONS
SCOTT NOREUIL / PURCHASING SERVICES SECTION
PO BOX 7991
MADISON, WI 53707-7991
scott.noreuil@WISCONSIN.GOV
FAX: 608-240-3342
From the date of release of this RFB through the entire RFB process, all contacts with the DOC regarding
this RFB shall be made through the Purchasing Services Section. Violation of this condition may be
considered sufficient cause for rejection of a bid, irrespective of any other considerations.
In the event that it becomes necessary to provide additional clarifying data or information, or to revise any
part of this RFB, amendment(s) will be posted on VendorNet.
Each bid shall stipulate that it is predicated upon the terms and conditions of this RFB and any
amendment(s) thereof.
3.0 BID ACCEPTANCE, EVALUATION AND AWARD
3.1 BID OPENING
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AODA/PTSD Services in Milwaukee, WI Page 11 of 41
Bids will be opened on the date and time indicated on the Request for Bid Form (DOA-3070) at 3099 East
Washington Ave. Madison, WI 53704 Purchasing Services Section room. Names of the bidders shall be
read aloud at that time.
3.2 BID ACCEPTANCE
Bids which do not comply with instructions or are unable to comply with specifications contained in this
RFB may be rejected by the State. The State retains the right to accept or reject any or all bids, or accept
or reject any part of a bid deemed to be in the best interest of the State. The State shall be the sole judge
as to compliance with the instructions contained in this RFB.
3.3 BID EVALUATION
Bids will be evaluated by the DOC's purchasing agent and program manager to verify that they will meet
all specified requirements in this RFB. This verification may include requesting reports on the vendor's
financial stability, conducting demonstrations of the vendor's proposed service(s) and reviewing results of
past awards to the vendor by the State of Wisconsin.
FAILURE TO MEET A MANDATORY REQUIREMENT SHALL DISQUALIFY THE BID. However, if no
bidder is able to comply with a given specification, condition of bid or provide a specific item, Purchasing
Services reserves the right to delete that specification, condition of bid or item.
3.4 METHOD OF AWARD
Award(s) shall be made on the basis of the lowest net unit price and extended net total from a
responsive, responsible bidder meeting bid specifications and requirements, which is judged to be
in the best interest of the DOC. The DOC reserves the right to accept or reject any and all bids in whole or
in part. Bids that state the DOC shall guarantee a specific quantity or dollar amount will be disqualified.
The Department also reserves the right to negotiate price with the lowest responsive and responsible
bidder. The Department reserves the right to adjust the number of units, to add or move locations, and/or
add locations outside the designated area if in its best interest.
In the event of bidder error in calculation, unit price shall prevail in award.
If a responsive, responsible State qualified work center meets the fair market price and other work center
program criteria, the award will be made to the work center (Wisconsin State Statute 16.752).
3.5 MINORITY BUSINESS ENTERPRISE
Bids from certified Minority Business Enterprises may be provided up to a five percent (5%) bid preference
in accordance with Wis. Stats. s. 16.75(3m).
3.6 NOTIFICATION OF INTENT TO AWARD
Any vendors who respond to this RFB, with a bid, will be notified in writing of the State‟s intent to award
the contract(s) as a result of this RFB.
After notification of the intent to award is made, under the supervision of Department of Corrections,
copies of bids will be available for public inspection 8:30 a.m. to 3:30 p.m. at 3099 East Washington Ave.,
Madison WI. Vendors shall schedule reviews with purchasing agent to ensure that space is available for
the review.
3.7 APPEALS PROCESS
The appeals procedure applies to only those Requests For Bids for Services that are $25,000.00 or
greater. Notices of intent to protest and protests must be made in writing. Protesters should make their
protests as specific as possible and shall identify statutes and Wisconsin Administrative Code provisions
that are alleged to have been violated.
The written notice of intent to protest the Intent to Award a Contract must be filed with:
RICK RAEMISCH, SECRETARY, DEPARTMENT OF CORRECTIONS
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P.O. BOX 7925
MADISON, WI 53707-7925
And be received in the office above within five (5) working days after the notice of intent to award is
issued. The written protest must be received in the office above within ten (10) working days after the
notice of intent to award is issued.
Copies of the notice of intent to protest and the written protest should be sent to the Purchasing
Section Chief at the same address.
The decision of the head of the procuring agency may be appealed to the Secretary of the Department of
Administration within five (5) working days of issuance, with a copy of such appeal filed with the procuring
agency, provided the appeal alleges a violation of statute or a provision of a Wisconsin Administrative
Code.
4.0 TECHNICAL REQUIREMENTS
The following requirements are the minimum specifications of the service(s) required. Failure by a bidder to
respond to any specific requirement or question shall be the basis for elimination from consideration. However, if
no bidder is able to comply with a given specification, condition of bid or provide a specific item, Purchasing
Services reserves the right to delete that specification, condition of bid or item.
The Department reserves the right to adjust the number of units of service, to add or move locations, and/or add
locations outside the designated area if in its best interest. The number of units listed is for bidding purposes only,
the Department reserves the right to adjust units as needed.
Revisions to this bid, if any, will be made in the form of an official amendment(s) issued by the Department of
Corrections, Purchasing Services Section.
4.1 FACILITY REQUIREMENTS
Non-residential AODA/PTSD treatment services are required to be located in the Milwaukee area. DCC
office conference rooms located in Glendale, Wisconsin, at 4160 N. Port Washington Road shall be used
as the site for groups. This room along with the furniture therein will be provided at no cost to the
contractor, however this does not include access to photocopier, fax, office supplies or use of any other
areas. Awarded contractor will ensure that minimal disruption of other office staff occurs before, during
and after groups.
4.2 VENDOR AGENCY EXPERIENCE
The vendor agency shall have a minimum of two (2) years experience providing AODA/PTSD groups to
correctional clients and/or human services programs.
Vendor shall provide a list of past contracts, DOC and others, within the last three (3) years that are of a
similar size and service to this bid. Include service description, date(s) and location of service, number of
clients served, outcome evaluation, and contact person with a phone number. DOC reserves the right to
contact any or all persons listed. Past contract quality may impact this award.
The bidder shall provide documentation demonstrating that their organization meets the experience
requirements, including details of past contract information.
4.3 STAFF QUALIFICATIONS AND EXPERIENCE
All staff facilitating groups will have completed required training prior to providing specified services.
4.3.1 STAFF QUALIFICATIONS
4.3.1.1 ADMINISTRATIVE AND FISCAL: The Bidder staff responsible for providing
administrative and fiscal services for the program shall have at least a Bachelors Degree
in human services or business related field. Administrative staff must have a minimum of
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three (3) years> experience managing AODA services to correctional clients and/or
human services programs.
4.3.1.2 STAFF SUPERVISION: Person(s) providing supervision of direct-service staff under this
contract shall have a BS or BA in a human services related field or a minimum of three (3)
year(s) providing supervision to staff in a correctional or human services program.
Supervision of AODA staff requirements noted in 4.3.1.3 below.
4.3.1.3 DIRECT SERVICE: Staff providing group program services under this contract must
have minimum of a high school diploma or its equivalent in addition to the following –
4.3.1.3.1 AODA INCLUDING CLINICAL SUPERVISION: Bidder staff delivering any of
the direct AODA services is required: 1) to be certified as a Substance
Abuse Counselor or a position certified to conduct AODA treatment per
MPSW 1.09; or 2) possess a certificate as a Substance Abuse Counselor in-
Training from the Department of Regulation and Licensing (DRL).
In all instances, a staff member with supervisory designation shall provide
overall clinical supervision to insure program integrity and a professional level
of practice by treatment delivery staff per DRL regulations on Substance
Abuse Counselors.
Access to a licensed psychologist for assistance/staff consultation regarding
clinical issues shall be available as needed. All AODA staff must comply with
the Department of Regulation and Licensing Emergency Rule 167 to have
professional liability insurance as applicable.
The bidder shall provide staff resumes that identify specific dates, company (including
address and phone number), position description listing job responsibilities to verify all staff
meet the bid qualification requirements in delivering services as described in this section. The
format for this documentation also requires copies of current certification, licensing, insurance
and/or training including supervision plan, if applicable.
4.3.2 STAFF EXPERIENCE
4.3.2.1 ADMINISTRATIVE AND FISCAL: The Bidder staff for this program shall have at least
three (3) years of administrative and fiscal services.
4.3.2.2 STAFF SUPERVISION: Experience requirements as noted in 4.3.1.2.
4.3.2.3 DIRECT SERVICE:
4.3.2.3.1 All AODA staff person(s) performing individual and group program services
are required to have a minimum of : 1) Three (3) years experience providing
program services to correctional clients; and 2) knowledge of Motivational
Interviewing, and 3) the proven ability to deliver services to individuals from
various racial, religious, and ethnic backgrounds, as well as, individuals with a
disability. Proven ability may be documented by one (1) year of job or
volunteer experience and completion of eight (8) hours of cultural sensitivity
training.
A training plan must be submitted identifying hours of continued education for all staff
per DRL.
Clinical supervision experience will be in accordance with DRL regulations.
The bidder shall provide a list of program staff and documentation demonstrating that the
program staff meets the bid solicitation’s experience requirements in delivering AODA
treatment services as described in this section. The format for this documentation is to
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include name(s) of staff person(s), dates and locations of experience, and the names and
phone numbers of persons who can verify the experience.
If staff positions are pending hire, submit recruitment plan and job description of
those pending positions. NOTE: Any staff listed as pending hire will be required to
be on staff within 4 weeks from date of award unless otherwise authorized.
4.4 PROGRAM DESCRIPTION
Women now represent a significant proportion of all offenders under criminal justice supervision. The vast
majorities (85% nationally) are under community supervision. The total number of women under correctional
control increased 81% from 1990-2000, while the number of men increased 45% (see BJS statistics).
Research has found that women offenders differ from their male counterparts regarding both their personal
histories and pathways to crime. A female offender is more likely to have experienced physical and/or sexual
abuse, and domestic violence. They are also likely to have both physical and mental health needs.
Research shows that women are more likely involved in crime if they are drug abusers (see Merlo, Al, & Pollock,
J.) On every measure of drug use, women offenders in state prisons reported higher usage than male
counterparts. According to the Bureau of Justice Statistics, 89% of women report using drugs on a regular basis
compared with 76% of men. Studies indicate that trauma, particularly in the form of physical or sexual abuse, is
closely related with substance abuse in women. Integration of treatment is consistently recommended for female
offenders who present with AODA and PTSD issues (see Brady et al., Brown et al., and Najavits).
The following provisions are required for all services:
1) At the onset of offender program participation, the contractor staff shall inform offenders of the
therapist‟s duty to warn, and communication obligation to DOC. The therapist shall have the offender
sign a waiver of confidentiality to allow information to be shared with DOC or other criminal
justice/social service agencies that have a need to know.
2) The contractor staff shall be willing to address community safety issues and cooperate with DOC staff
to monitor risk. The contractor must report lapses, violations, and when the offender is in a high-risk
situation to the supervising agent within one working day.
3) The contractor staff must agree to appear at revocation and court hearings if required.
4) The contractor staff must be willing to have group treatment observed and evaluated by a DOC
representative. The staff must demonstrate and ability to be assertive, but respectful and professional
toward offenders.
5) All treatment groups shall be secular and use a cognitive behavioral model of programming,
motivational interviewing techniques, and guided self-discovery. Groups are to be experiential and,
minimally, shall include modeling, role-playing, a system of positive reinforcement, experiential
exercises, and involvement with appropriate collateral resources.
6) Contractor agrees to submit updates within 10 days for non-direct service staff changes to the
Contract Administrator during the contract period. Changes in direct service staff will be pre-approved
by Contract Administrator or designee.
7) Groups shall be composed of DCC offenders only in gender specific groups. Group size shall be no
more than 15 offenders and no less than 8 offenders.
8) Groups shall be open ended allowing for entrance into the program at various sessions.
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9) All referrals will be individually screened in collaboration with DCC staff for appropriateness of specific
group treatment. Treatment placement will be consistent with DMS IV and WI-UPC, as applicable.
Sources of information to be considered shall include offender interviews, and collateral contacts with
professional and significant others as appropriate. Treatment plan will be developed based on the
screening and written with offender input.
4.4.1 AODA/PTSD OUTPATIENT GROUPS
The primary goal of these treatment groups is to establish a pattern of abstinence from alcohol
and other drugs of abuse,” to provide an opportunity for offenders to “own” both disorders, and to
recognize their interrelationship” (see Najavits). This requires the integration of the individual into
the group, stabilization of individual functioning, and identification of long standing problems
obscured or exacerbated by substance abuse and PTSD issues. Treatment groups are also to
address denial and defense mechanisms, personal indicators of dependency and abuse, the
impact of using on major life areas, the relationship between both disorders, identifying traumatic
events and triggers that result in re-experiencing symptoms, personal belief systems/values,
recognition of the need to change, the recovery process and lifestyle changes, coping skills,
appropriate interpersonal functioning and enhancement of positive social supports
The contractor selected under this solicitation shall conduct two (2) sessions each week for
seventeen (17) weeks, each session will be ninety (90) minutes in length. Thirty-four (34) groups
x three (3) cycles for a total of one-hundred and two 102 groups will be conducted annually.
4.4.1.1 Program Content for Outpatient Groups
Within this contract period and upon approval of DOC AODA/PTSD Program
Standards, you may be required to submit a Program Abstract as a first step in the
Department‟s program approval process.
The services provided must have research support
Must target dynamic criminogenic risk factors
Gender-specific programming is required
Program materials and presentations must be culturally relevant to the population
served
Program materials must consist of an integrated model (i.e. both AODA/PTSD must be
addressed simultaneously, not sequentially
Performance measures must be established that objectively gauge offender treatment
progress
Use of self-help groups (e.g. SOS, Rational Recovery, etc.) must comply with the
requirements of Kerr v. Farrey. 95 f.3d 472 (1996). (See DCC Administrative Directive
01-10, attached as Exhibit 1.)
4.4.1.2 Core Content Required for Outpatient Groups
“The key principle for addressing offenders issues is “show it and say it”, i.e.
o For cognitive topics have offenders say aloud how they would rethink an
issue
o For behavioral topics, have offenders outline what actions they would
take to address/solve problems
o For interpersonal topics, have offenders role play how they would
address personal issues/problems” (see Najavits)
Communication, problem solving and life skills.
o Discuss topics
o Process obstacles
o Review key points
A written, individualized treatment plan must be developed within fourteen days of
commencement of services and must be sent to the supervising agent.
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Relapse prevention planning and a detailed personal, written Relapse Prevention Plan
is required and, within 5 working days of program completion, a copy must be
submitted to the referring agent.
4.4.1.3 Program Completion Requirements for Outpatient Groups
Complete goals of the Individual Treatment Plan
Performance measures objectively gauge treatment progress and program completion
Complete assignments to an acceptable standard
Demonstrate that the skills taught have been learned
Pass Required tests to an acceptable standard
Produce an acceptable relapse prevention plan
Identify role models
Involve safe family/friends
Bidder shall provide a detailed description/curriculum of the AODA/PTSD Outpatient
Counseling Group component of their program including the test to be administered for
successful completion.
4.5 INTAKE/TREATMENT/DISCHARGE PROCEDURES
4.5.1 INTAKE PROCEDURES
The contractor staff shall develop referral/intake procedures in cooperation with DOC staff. If the
contractor rejects an offender, this must be discussed with DOC staff to determine if the program
can be modified to address the specific offender needs. The contractor staff shall send copies of
the intake summary and recommendations to the referring DOC staff person within 10 working
days of intake interview.
The contractor shall have each offender complete the necessary releases of information and
shall give each offender a copy of the program rules and expectations.
The intake assessment shall include, but is not limited to:
A. An interview focusing on recent/current offender functioning
B. The nature and severity of drug use and impact upon offender‟s life
C. Describe nature and severity of criminal history and impact upon offender‟s life (i.e. physical
health, mental health, family friends, school, work, spiritual, financial and legal)
D. Secure informed consent to treatment
E. Consider information from all sources
4.5.2 TREATMENT PLAN
The contractor shall prepare an individualized treatment plan for each offender accepted into the
program. The plan shall include measurable goals and objectives, as well as activities/services
needed to achieve successful discharge from the program.
Provide a completed ‘sample’ treatment plan.
4.5.3 TREATMENT PLAN FORMAT
Treatment plans may be reviewed and modified as needed.
A. Require offender input
B. Identify offender‟s assets/strengths
C. Identify offender‟s problem areas
D. Describe offender‟s readiness to change
Use of the Prochaska, J.O., and Diclemente, C.C., Stages of Change Model or other
Department accepted tool.
E. Identify offender‟s short/long term goals
Specify steps to be taken to achieve goal(s)
Identify time frame for each step
Identify offender responsibilities
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Identify contractor responsibilities
F. Specify next progress review date
4.5.4 DISCHARGE/TERMINATION
The contractor shall develop termination and discharge procedures in cooperation with DOC staff
for offenders completing or exiting group services. The contractor shall inform the referring DOC
staff of the intent to “unsuccessfully” terminate an offender from treatment prior to termination.
Within three (3) days of termination, the contractor shall prepare a discharge summary including
a description of offender‟s progress in programming which includes additional program
recommendations as well as recommendations to assist the agent in supervising the offender‟s
subsequent activities.
4.6 LENGTH OF PROGRAM PARTICIPATION
4.6.1 AODA /PTSD OUTPATIENT GROUPS
It is anticipated that each offender referred for evaluation will participate in no less than 34 group
sessions (2 sessions per week x 17 weeks). Participation for any longer or shorter period of time
may be negotiated with DOC staff based on treatment goals.
4.7 NUMBER OF SERVICE UNITS
Under any agreement resulting from this solicitation, units of service are defined as follows:
4.7.1 AODA/PTSD OUTPATIENT GROUPS
One 90 minute group session of direct service to DCC offenders participating in activities as
defined in 4.4.1 with documentation to referring DOC staff.
4.8 REPORTING REQUIREMENTS
4.8.1 EXPECTATIONS FOR PREPARATION, RECORD KEEPING, AND REPORTING
A. Agent of record, program liaison, and/or other designees must be included in distribution of
written reports
B. An individual intake assessment must be completed within fourteen days of referral.
C. Development of an individual treatment plan that is
1. Individualized according to assessment of each offender
2. Completed and submitted within first fourteen days of admission
3. Reviewed at least every thirty days and modified as needed
th
D. Quarterly progress reports completed and submitted by the 10 of the following month.
E. Written personal, detailed Relapse Prevention Plan completed and submitted within 5 days
of program completion.
F. Develop Aftercare Plan recommendations
G. Cooperate fully in Department efforts to evaluate and improve AODA programming (See
Program Evaluation Requirements)
H. Contractor shall provide a weekly written, legible copy or e-mail listing of the attendance for
each group within 24 hours from the start of each group.
4.8.2 REPORTING ON INDIVIDUAL OFFENDERS
4.8.2.1 PROGRESS REPORTS
The contractor shall document attendance and progress of the offender in the
AODA/PTSD groups. Documentation of offender progress will be submitted to the
referring DOC staff person on a quarterly basis.
Quarterly Progress Report Format
Progress reports must address the following areas:
1) Attendance
2) Participation
3) Homework completion
4) Demonstrate knowledge acquisition
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5) Demonstrate skill in applying knowledge
6) Performance in completing treatment plan elements
7) Drug tests administered and results in past month
8) Note progress/modifications to treatment plan in past month
The bidder shall provide a copy of the format to be used for the Progress reports.
4.8.2.2 DISCHARGE SUMMARY- The program shall provide the referring DOC staff person with
a discharge summary within ten (10) days of offenders successful and within three (3)
days of offender‟s unsuccessful discharge from the program.
PROGRAM DISCHARGE SUMMARY REPORT FORMAT
a. Discharge status
b. Program entry and discharge dates
c. Brief description of program
d. Offender‟s alcohol/drug use patterns, negative impact on life and prior treatment
history
e. Identification of offender‟s assets/strengths
f. Account of offender‟s effort and progress toward goals
g. Identification of significant problem areas not addressed in program
h. Identification of any continuing treatment needs and recommendations to address
them
i. Relapse Prevention Plan including aftercare recommendations
j. Prognosis/Risk for further use and criminality as a result of offender participation
The bidder shall provide a copy of the format to be used for the discharge summary.
4.8.3 OTHER REPORTS
4.8.3.1 LAW VIOLATIONS- The contractor shall notify the referring DOC staff or other available
DOC staff if a participant is in violation of the law. This notification shall take place as
soon as possible and no later than 24 hours, subsequent to receiving information
concerning the law violation.
4.8.3.2 SERIOUS PROGRAM VIOLATIONS- Serious program rule violations, including failure to
attend shall be reported to the referring DOC staff or other available DOC staff within
one working day.
4.8.3.3 AD HOC REPORTS- Upon request, the contractor shall provide to DOC staff reports on
offenders served in the program when needed by the courts, for revocation procedures
and/or other Departmental processes.
4.8.3.4 FEDERAL REPORTS- Resulting contracts using may use Federal Block Grant funds will
be required to complete additional state and federal reports, as necessary.
4.8.4 PROGRAM REPORTING
4.8.4.1 REFERRAL FOR SERVICES (DOC 1336) - The contractor shall submit a completed
Referral for Services form for each offender referred by DOC for service. These forms
shall be submitted with the first Offender Report Monthly (DOC 1088A) following
offender‟s rejection or acceptance into the program. A copy of the form is attached as
Exhibit 2.
4.8.4.2 OFFENDER REPORT MONTHLY (DOC 1088) - The contractor shall submit a completed
Offender Report Monthly to report data on offenders served each month. This report shall
be submitted within five (5) days of the last day of the month during which service was
provided. A copy of this form is attached as Exhibit 3.
4.8.4.3 UNIT SERVICE MONTHLY REPORT (DOC 1026) - The contractor shall submit a
completed Unit Service Monthly Report to provide data on the number of units of service
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provided each month. This report shall be submitted within five (5) working days of
the last day of the month during which service was provided. A copy of this form is
attached as Exhibit 4.
4.8.4.4 PROGRAM EVALUATION
Program evaluation is intended to return useful information to program sites for the
purpose of program improvement. Contractors delivering AODA services to offenders
shall prepare for and cooperate with evaluation efforts initiated by the Department.
Contractors will be expected to collect and maintain similar data on offenders and their
participation in the treatment process in an electronic database.
Requirements include computer capabilities with internet access, e-mail, and window‟s
applications. Data will be reviewed at the end of each year and submitted in a report
providing details to show how the program reduced recidivating. Evaluation report shall
be submitted annually, at a minimum, with a summary page explaining report outcomes.
At minimum the report will include -
Program overview including outcome goals and relationship to reducing
recidivism.
Number of offenders participated in the program.
Number of offenders completing the program - 80% completion (standard).
Offenders who do not complete the program, explain why.
Number of offenders returning to the program including the period of time
after leaving the program.
If your organization has an existing system for documenting and managing client-level
information, please provide an overview of the system and whether it is in electronic
or paper format. Provide the name of your staff person who will be the contact
person responsible for coordinating with DOC and evaluation staff.
5.0 PERFORMANCE REQUIREMENTS
5.1 FIRM PRICES
Prices must remain firm for the initial contract term.
5.2 PRICE INCREASE REQUESTS
Price increase requests proposed after the initial Contract term must be received by Purchasing in writing
90 calendar days prior to the beginning of the next contract term for acceptance or rejection. Proposed
price increases are limited to fully documented cost increases submitted with the request. If Purchasing
deems cost increases are not acceptable, it reserves the right to rebid the contract in whole or part.
Acceptance of the price increases shall be in the form of an amendment to the contract. Price increases
must be labeled with the contract number and be submitted in the same format as the original RFB. Any
price increase requested that is not submitted in the proper format may be rejected.
5.3 STAFF PERFORMANCE
The contractor shall utilize, on this contract, only workers that are skilled in the tasks to which they are
assigned. The DOC retains the right to require the reassignment of an employee or employees, as the
Department may deem necessary. Reasons for this request may be but are not limited to incompetence,
carelessness, disruptive or otherwise objectionable behavior. The request for reassignment is in no way a
call for dismissal. It is just a request for the individual to be reassigned out of the State facility.
6.0 SUPPORT REQUIREMENTS
6.1 COLLECTION OF OFFENDER FEES
The Contractor shall collect fees from program participants or via third party payments. The fee rate shall be
set on a sliding co-pay scale per offender. The amount of all fees collected will be reported on the Unit
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Service Monthly Report (DOC-1026) for the month in which the fees were collected and deducted from the
amount reimbursable to the Contractor by DCC.
NO OFFENDER WILL BE DENIED SERVICES BECAUSE OF INABILITY TO PAY.
6.2 INVOICING / PAYMENT REQUIREMENTS
Contractor must agree that all invoices and purchasing card charges shall reflect the prices and discounts
established for the items on this contract for all orders placed by the DOC even though the contract
number and/or correct prices may not be referenced on each order.
The DOC must meet a statutory mandate to pay or reject invoices within 30 days of receipt by DOC
Accounts Payable (Note exemption of aids payments to individuals and organizations). Before payment is
made, it also must verify that all invoiced charges are correct as per this Contract. Only properly
submitted invoices will be officially processed for payment. Prompt payment requires that contractor
invoices be clear and complete in conformity with the instructions below. All invoices must be itemized
showing:
Contractor name
remit to address
purchase order number
release number if given
date of order/release
item manufacturer‟s name or abbreviation (if applicable)
complete item description including catalog, model and/or stock number(s) identical to those
stated in bid
prices per the Contract
The original invoice and two copies must be sent to the DOC address listed on the Purchase Order.
Final payment may not be made until work has been accepted by the DOC.
6.3 SUBCONTRACTING
Any Contract resulting from this bid shall not be, in whole or in part, subcontracted, assigned, or otherwise
transferred to any other Contractor without prior written approval by Purchasing Services.
6.3.1 The Contractor shall be directly responsible for any subcontractor‟s performance and work quality
when used by the Contractor to carry out the scope of the job.
6.3.2 Contractor must assure subcontractors abide by all terms and conditions under this Contract.
6.3.3 If subcontractors are to be used, the Contractor must clearly explain their participation.
6.4 PRIME CONTRACTOR AND MINORITY BUSINESS SUBCONTRACTORS
The prime contractor will be responsible for contract performance when subcontractors are used.
However, when subcontractors are used, they must abide by all terms and conditions of the contract. If
subcontractors are to be used, the bidder must clearly explain their participation.
The State of Wisconsin is committed to the promotion of minority business in the state's purchasing
program and a goal of placing 5% of its total purchasing dollars with certified minority businesses.
Authority for this program is found in ss. 15.107(2), 16.75(4), 16.75(5) and 560.036(2), Wisconsin
Statutes. The contracting agency is committed to the promotion of minority business in the state's
purchasing program.
The State of Wisconsin policy provides that minority-owned business enterprises certified by the
Wisconsin Department of Commerce, Bureau of Minority Business Development should have the
maximum opportunity to participate in the performance of its contracts. The supplier/contractor is strongly
urged to use due diligence to further this policy by awarding subcontracts to minority-owned business
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enterprises or by using such enterprises to provide goods and services incidental to this agreement, with a
goal of awarding at least 5% of the contract price to such enterprises.
The supplier/contractor shall furnish appropriate quarterly information about its effort to achieve this goal,
including the identities of such enterprises certified by the Wisconsin Department of Commerce and their
contract amount.
Quarterly reports shall be due fifteen (15) calendar days after the end of the quarter, 9/31, 12/31, 3/31 and
6/30. The form for submitting this information is available from the VendorNet on the Contract‟s Home
Page. http://vendornet.state.wi.us/vendornet/doaforms/doa-3234.doc.
The report shall be submitted even if there is no activity.
Submit to:
e-mail: DOCDMSPurchasing@wisconsin.gov
post: MBE PURCHASING REPORT
PO BOX 7991
MADISON, WI 53707-7991
The State reserves the right to request additional reports from the Contractor at no additional cost.
Contractor shall use every effort to provide such reports in a reasonable timeframe, but no later than thirty
(30) calendar days from the time the request was submitted. These reports shall be in a form approved in
advance in writing by the State.
A listing of certified minority businesses, as well as the services and commodities they provide, is available
from the Department of Administration, Office of the Minority Business Program, 608/267-3293. The listing
is published on the Internet at: http://www.doa.state.wi.us/mbe/minority_search.asp
6.5 AFFIRMATIVE ACTION
All contracts of more than Twenty Five Thousand Dollars ($25,000) require the submission of a written
affirmative action plan or request exemption. Contractors with an annual workforce of less than twenty-five
employees are eligible for exemption. Within fifteen (15) days after the award of the contract, the written
affirmative action plan, or statement requesting exception, shall be submitted to the Department‟s
Contract Compliance Office. Address plan to:
DEPARTMENT OF CORRECTIONS
AFFIRMATIVE ACTION MANAGER
PURCHASING SERVICES SECTION
3099 E. WASHINGTON AVE.
PO BOX 7991
MADISON, WISCONSIN 53707-7991
Contractors are encouraged to contact this office at, (608) 240-5419, for technical assistance on equal
opportunity.
"Affirmative Action Plan" is a written document that details an affirmative action program. Key parts of an affirmative action plan
are: (1) a policy statement pledging nondiscrimination and affirmative action employment, (2) internal and external dissemination of
the policy, (3) assignment of key employee as the equal opportunity officer, (4) a workforce analysis that identifies job classification
where representation of women, minorities and the disabled is deficient, (5) goals and timetables that are specific and measurable
and that are set to correct deficiencies and to reach a balance of work force, (6) revision of all employment practices to ensure that
they do not have discriminatory effects, (7) establishment of internal monitoring and reporting systems to measure progress
regularly.
Failure to comply appropriately with these requirements can lead to bidder being banned from doing
business with any agency of the State of Wisconsin. Additionally, failure to comply can result in
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AODA/PTSD Services in Milwaukee, WI Page 22 of 41
termination of this contract, or withholding of payment. On the Vendor Information Sheet provide the
requested information. For additional information see Section 19.0 of the Standard Terms and Conditions.
6.6 WISCONSIN SALES AND USE TAX REGISTRATION
The State of Wisconsin shall not enter into a contract with a vendor, and reserves the right to cancel any
existing contract if the vendor or contractor has not met or complied with the requirements of s. 77.66,
Wis. Stats., and related statutes regarding certification for collection of sales and use tax.
If you have not established a certification for Collection of Sale and Use Tax status with the Wisconsin
Department of Revenue, the DOC and any other state agency can not issue any purchase orders to your
firm. For additional information see http://www.dor.state.wi.us/html/vendlaw.html
6.7 EMPLOYEE IDENTIFICATION
All contractors‟ employees, while working on DOC property, must wear a clearly displayed photo
identification badge (provided by the Contractor at the Contractor‟s cost) showing they are employees of
the contractor. Badges must be available but will not be required to be worn when protective clothing and
respiratory protection is required.
6.8 CONFIDENTIALITY
The confidentiality of offender health information is protected by the federal Health Insurance Portability
and Accountability Act of 1996 (HIPAA) regulations (45 CFR, parts 160 & 164), federal Alcohol and Other
Drug Abuse Patient Information regulations (42 CFR Part 2), and by various Wisconsin laws governing the
confidentiality of medical, mental health, developmental disability, and alcohol and drug information. In
addition, the department considers all personally identifiable information relating to DOC employees or
offenders to be confidential, and such data is not to be released unless approved by the DOC.
6.9 LIQUIDATED DAMAGES
This shall be surety for fulfillment of the contract(s) including quality, performance and delivery under the
terms of this Request for Bid. Liquidated damages shall consist of the cost per group for failure to deliver
according to the requirements of this bid. Liquidated damages will be deducted from the invoice, if the
invoice is of sufficient amount to cover the liquidated damages. If the invoice is not of a sufficient amount
to cover the liquidated damages, the agency will request cancellation of the invoice and a credit to cover
the balance.
6.10 EMPLOYMENT OF CURRENT OFFENDERS AND EMPLOYMENT AND RETENTION OF
INDIVIDUALS ARRESTED, CHARGED OR CONVICTED OF CRIMINAL OFFENSE
6.10.1 Contractor shall not employ a person who is on probation, parole or an inmate who is supervised by
Intensive Sanctions for any position where the primary duties and responsibilities involve the
supervision or treatment of inmates, probationers or parolees or involve access to offenders' records
or funds.
6.10.2 Contractor will implement policies and procedures to ensure that:
Job applicants or current employees shall be dealt with as follows:
a) For a job applicant who has a pending criminal charge: Where the circumstances of said
criminal charge substantially relate to the circumstances of a particular job or licensed
activity, the applicant will not be hired for that job;
b) For a current employee who has a pending criminal charge: Where the circumstances of
said criminal charge substantially relate to the circumstances of the job or licensed
activity, the employee will not be continued in that particular job;
c) For a job applicant who is convicted of a criminal offense: Where the circumstances of
said conviction of a criminal or other offense that substantially relates to the
circumstances of a particular job or licensed activity, the applicant will not be hired for that
job; and
d) For a current employee who is convicted of a criminal offense: Where the circumstances
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AODA/PTSD Services in Milwaukee, WI Page 23 of 41
of said conviction of a criminal or other offense that substantially relates to the
circumstances of the current job or licensed activity, the employee will not be retained in
that particular job.
Nothing in this contract prohibits the Contractor from reassigning or suspending the employee or,
in the case of a conviction, terminating the employee.
6.10.3 In hiring and retention decisions, Contractor may consider records of pending criminal charges
and convictions when it can be demonstrated that the circumstances of the offense substantially
relate to the circumstances of the job or licensed activity. When determining whether the
circumstances of a pending charge or conviction are substantially job related, Contractor should
take into consideration elements related to the position, the offense, and the individual.
6.10.4 To make determinations on substantial relationships to the circumstances of the job, Contractor
shall have written policies on how the applicant for employment and the employee will be
reviewed. To guide the development of the policy, the Contractor may obtain a copy of Chapter
301 of the Department of Corrections Supervisor's Manual from the Contract Administrator.
6.11 FRATERNIZATION
6.11.1 Contractor agrees to have a written policy on fraternization that prohibits the forming of improper
relationships between Contractor's employees and offenders. The policy must be substantially
equivalent to the Department of Corrections' policy as expressed in Executive Directive 16, May
1991 - Revised January 1997, Further Revised August 2004. A copy of Executive Directive 16
may be obtained from the Contract Administrator.
6.11.2 Contractor shall address at the minimum the policy required in Sub. A: definitions of employee,
relationships and offender; a statement of prohibited relationships; duty of employee to inform
Contractor of unplanned contacts with offenders; a statement that Contractor-directed contacts or
those which are part of the employee's job duties are exempt from the policy; an exception
procedure which may be carried out by the Executive Director or designee; and a standard
employee statement indicating that each employee has read a copy of the Contractor's policy on
fraternization.
6.11.3 Contractor shall also agree to have a written policy which prohibits Contractor‟s employees from
engaging in any sexual contact or sexual intercourse with offenders under the custody and control of
the Department of Corrections. The policy must be substantially equivalent to the Department of
Corrections‟ policy as expressed in Executive Directive 16-A, August 2006. A copy of Executive
Directive 16-A may also be obtained from the Contractor Administrator.
6.11.4 Contractor shall maintain a copy of the signed employee statement on fraternization and sexual
contact in each employee's personnel file.
6.12 CONTRACTOR AUDIT REQUIREMENT
6.12.1 Governmental entities shall comply with the Single Audit Act of 1984, OMB Circular A-128 and the
State Single Audit Guidelines issued by the Department of Administration. They shall also comply
with the Department of Health and Family Services' Allowable Cost Policy Manual. Single audit
reports are due to the Department within 30 days from issuance of the report, but no later than
one year after the end of the audit period.
6.12.2 Non-profit agencies that have been certified under USC 501(c)(3) shall comply with OMB Circular
A-133, the Department's Contractor Agency Audit Guide, the Allowable Costs Policy Manual and
ss. 301.08. Audits are due to the Contractor within one year of the close of the contract.
6.12.3 Profit agencies shall comply with the Department's Contractor Agency Audit Guide, the Allowable
Costs Policy Manual, and ss. 301.08. Audits are due to the Contractor within one year of the
close of the contract.
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AODA/PTSD Services in Milwaukee, WI Page 24 of 41
6.12.4 If a Contractor agency's audit is based on a calendar rather than state fiscal year (July 1 through
June 30), the Contractor and/or auditor shall submit a worksheet which reconciles the
expenditures based on the state fiscal year and the relevant purchase orders within one year of
the close of the contract.
6.12.5 DOC shall notify Contractor within 90 days of receipt of the audit completed by the independent
certified auditor, whether or not the audit meets the requirements of DOC's audit guidelines. DOC
shall initiate resolution of audit findings with Contractor within 180 days following notification of the
audit's acceptance. If the audit is not complete or is acceptable only in part, DOC shall rely upon
the acceptable portion of the audit and any additional audit work shall build upon the work already
done.
6.12.6 DOC reserves the right to conduct an independent audit of Contractor if Contractor fails to secure
an audit covering all funds, or a follow-up review of selected areas is determined to be necessary.
In the event that Contractor fails to secure an audit, DOC's costs for completing an audit will be
charged back to Contractor.
6.12.7 Contractor agrees that it is responsible to assure that all purchase of service contracts of $25,000
or more meet the requirements of the Office of Management and Budget Circulars A-133 and A-
128 that pertain to sub-recipient audits.
6.13 FAITH-BASED AND CHARITABLE ORGANIZATIONS
6.13.1 A faith-based or charitable organization is eligible to be a contractor on the same basis as any
other private organization. If Contractor is a faith-based or charitable organization it shall retain its
independence from the State of Wisconsin, including without limitation Contractor‟s control over
the definition, development, practice, and expression of its charitable or religious beliefs. Except
as otherwise provided by state or federal law, Purchaser shall not interpret this Contract to require
a charitable or faith-based organization to alter its form of internal governance or remove religious
art, icons, scriptures, or other symbols.
6.13.2 A religious organization does not, by contracting with the State of Wisconsin, lose the exemption
provided under Section 702 of the Civil Rights Act (42 U.S.C. 2000e-1(a)) regarding its
employment practices. Furthermore, if a faith-based or charitable organization segregates the
government funds provided under the Contract, then only the financial assistance provided by
these funds will be subject to audit.
6.13.3 Neither Purchaser‟s selection of a charitable or faith-based contractor to provide the Services
described herein nor the expenditure of funds under this Contract is an endorsement of the
Contractor‟s charitable or religious character, practices, or expression. The purpose of this
Contract is the provision of Services; none of Purchaser‟s expenditures have as their objective the
funding of sectarian worship, instruction, or proselytization. As such, a faith-based or charitable
Contractor of Services under this Contract shall post at its place(s) of business the following
written notice and personally apprise all assisted inmates of the same:
Neither the State of Wisconsin’s selection of a Charitable or faith-based Contractor of
services or the expenditure of funds under any contract with said Contractor is an
endorsement of that Contractor’s charitable or religious character, practices, or
expression. No Contractor of services may discriminate against you on the basis of
religion, a religious belief, or your refusal to actively participate in a religious practice. If
you object to a particular Contractor because of its religious character, you may request
assignment to a different non-sectarian Contractor by contacting your Agent.
6.13.4 To ensure an inmate is informed of the foregoing, a faith-based or charitable Contractor shall
require that each inmate receiving Services under this Contract signs an acknowledgment form
prepared by the Contractor containing the aforementioned notice and verifying the offender‟s
receipt of the same. A copy of all signed acknowledgment forms shall be promptly provided to
Purchaser. Finally, Purchaser will require that each inmate sign the Purchaser‟s “Voluntary Choice
and Waiver” form, which will be provided by Purchaser, prior to receiving any Services from a
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AODA/PTSD Services in Milwaukee, WI Page 25 of 41
faith-based or charitable Contractor under this Contract. A faith-based or charitable Contractor
agrees to refrain from providing Services hereunder to an inmate until it receives a copy of a fully
executed Voluntary Choice and Waiver form from Purchaser for that respective offender.
6.14 AMERICANS WITH DISABILITY ACT
The contractor agency must complete or currently have on file a facility self-survey and a program and
policy self-evaluation to address compliance with the Americans with Disability Act. (Public Law 101-336,
July 26, 1990, 104 Stat. 327 and Title 42, U.S.C.A., ss. 12101 to 12213). During the course of the
contract, the contractor must take action to comply with the facility, program and employment provisions of
the Americans with Disability Act. Applicants may obtain information on the Americans with Disability Act
by contacting the Director of the Office of Diversity and Employee Services, Wisconsin Department of
Corrections, 3099 E. Washington Avenue, PO Box 7991, Madison, Wisconsin 53707-7925.
6.15 CONTRACTOR MAJOR STRUCTURAL CHANGE
The Contractor is required to provide the Department with a minimum of 90 days written advance notice of
any planned or potential structural change (merger, buyout, acquisition, consolidation, etc.). Contract may
not be automatically assigned to the new entity (since the underlying procurement may be affected).
7.0 STANDARD AND SUPPLEMENTAL TERMS AND CONDITIONS
The Standard Terms and Conditions (DOA-3054, R10/2005)) and Supplemental Standard Terms and Conditions for
Procurements for Services (DOA-3681, R01/2001) are made part of this RFB. The State of Wisconsin reserves the
right to incorporate standard State contract provisions into any contract negotiated with any bid submitted
responding to this RFB (Standard Terms and Conditions, DOA-3054). Failure of the successful bidder to accept
these obligations in a contractual agreement may result in cancellation of the award.
All AODA staff must also comply with the Department of Regulation and Licensing Emergency Rule 167 to have
professional liability insurance in the amount of at least $1,000,000 for each occurrence and $3,000,000 for all
occurrences in one year.
Wisconsin Department of Administration
Chs. 16, 19, 51
DOA-3054 (R10/2005)
Page 1 of 3
Standard Terms And Conditions
(Request For Bids / Proposals)
7.0 UNFAIR SALES ACT: Prices quoted to the State of
1.0 SPECIFICATIONS: The specifications in this request are Wisconsin are not governed by the Unfair Sales Act.
the minimum acceptable. When specific manufacturer and
model numbers are used, they are to establish a design, 8.0 ACCEPTANCE-REJECTION: The State of Wisconsin
type of construction, quality, functional capability and/or reserves the right to accept or reject any or all
performance level desired. When alternates are bids/proposals, to waive any technicality in any bid/proposal
bid/proposed, they must be identified by manufacturer, stock submitted, and to accept any part of a bid/proposal as
number, and such other information necessary to establish deemed to be in the best interests of the State of
equivalency. The State of Wisconsin shall be the sole judge Wisconsin.
of equivalency. Bidders/proposers are cautioned to avoid
bidding alternates to the specifications which may result in Bids/proposals MUST be date and time stamped by the
rejection of their bid/proposal. soliciting purchasing office on or before the date and time
that the bid/proposal is due. Bids/proposals date and time
2.0 DEVIATIONS AND EXCEPTIONS: Deviations and excep- stamped in another office will be rejected. Receipt of a
tions from original text, terms, conditions, or specifications bid/proposal by the mail system does not constitute receipt
shall be described fully, on the bidder's/proposer's letter- of a bid/proposal by the purchasing office.
head, signed, and attached to the request. In the absence
of such statement, the bid/proposal shall be accepted as in 9.0 METHOD OF AWARD: Award shall be made to the lowest
strict compliance with all terms, conditions, and specifica- responsible, responsive bidder unless otherwise specified.
tions and the bidders/proposers shall be held liable.
10.0 ORDERING: Purchase orders or releases via purchasing
3.0 QUALITY: Unless otherwise indicated in the request, all cards shall be placed directly to the contractor by an
material shall be first quality. Items which are used, authorized agency. No other purchase orders are
demonstrators, obsolete, seconds, or which have been authorized.
discontinued are unacceptable without prior written approval
by the State of Wisconsin. 11.0 PAYMENT TERMS AND INVOICING: The State of
Wisconsin normally will pay properly submitted vendor
4.0 QUANTITIES: The quantities shown on this request are invoices within thirty (30) days of receipt providing goods
based on estimated needs. The state reserves the right to and/or services have been delivered, installed (if required),
increase or decrease quantities to meet actual needs. and accepted as specified.
5.0 DELIVERY: Deliveries shall be F.O.B. destination freight Invoices presented for payment must be submitted in
prepaid and included unless otherwise specified. accordance with instructions contained on the purchase
order including reference to purchase order number and
6.0 PRICING AND DISCOUNT: The State of Wisconsin quali- submittal to the correct address for processing.
fies for governmental discounts and its educational institu-
tions also qualify for educational discounts. Unit prices shall A good faith dispute creates an exception to prompt
reflect these discounts. payment.
6.1 Unit prices shown on the bid/proposal or contract 12.0 TAXES: The State of Wisconsin and its agencies are
shall be the price per unit of sale (e.g., gal., cs., doz., exempt from payment of all federal tax and Wisconsin state
ea.) as stated on the request or contract. For any and local taxes on its purchases except Wisconsin excise
given item, the quantity multiplied by the unit price taxes as described below.
shall establish the extended price, the unit price shall
govern in the bid/proposal evaluation and contract The State of Wisconsin, including all its agencies, is
administration. required to pay the Wisconsin excise or occupation tax on
its purchase of beer, liquor, wine, cigarettes, tobacco
6.2 Prices established in continuing agreements and products, motor vehicle fuel and general aviation fuel.
term contracts may be lowered due to general market However, it is exempt from payment of Wisconsin sales or
conditions, but prices shall not be subject to increase use tax on its purchases. The State of Wisconsin may be
for ninety (90) calendar days from the date of award. subject to other states' taxes on its purchases in that state
Any increase proposed shall be submitted to the depending on the laws of that state. Contractors perform-
contracting agency thirty (30) calendar days before ing construction activities are required to pay state use tax
the proposed effective date of the price increase, and on the cost of materials.
shall be limited to fully documented cost increases to
the contractor which are demonstrated to be indus- 13.0 GUARANTEED DELIVERY: Failure of the contractor to
trywide. The conditions under which price increases adhere to delivery schedules as specified or to promptly
may be granted shall be expressed in bid/proposal replace rejected materials shall render the contractor liable
documents and contracts or agreements. for all costs in excess of the contract price when alternate
procurement is necessary. Excess costs shall include the
6.3 In determination of award, discounts for early administrative costs.
payment will only be considered when all other con-
ditions are equal and when payment terms allow at 14.0 ENTIRE AGREEMENT: These Standard Terms and
least fifteen (15) days, providing the discount terms Conditions shall apply to any contract or order awarded as
are deemed favorable. All payment terms must allow a result of this request except where special requirements
the option of net thirty (30). are stated elsewhere in the request; in such cases, the
special requirements shall apply. Further, the written
contract and/or order with referenced parts and attach-
DOA-3054
Page 2of 3
ments shall constitute the entire agreement and no other
terms and conditions in any document, acceptance, or 19.2 The contractor agrees to post in conspicuous places,
acknowledgment shall be effective or binding unless available for employees and applicants for employ-
expressly agreed to in writing by the contracting authority. ment, a notice to be provided by the contracting state
agency that sets forth the provisions of the State of
15.0 APPLICABLE LAW AND COMPLIANCE: This contract Wisconsin's nondiscrimination law.
shall be governed under the laws of the State of Wisconsin.
The contractor shall at all times comply with and observe all 19.3 Failure to comply with the conditions of this clause
federal and state laws, local laws, ordinances, and may result in the contractor's becoming declared an
regulations which are in effect during the period of this "ineligible" contractor, termination of the contract, or
contract and which in any manner affect the work or its withholding of payment.
conduct. The State of Wisconsin reserves the right to
cancel this contract if the contractor fails to follow the 20.0 PATENT INFRINGEMENT: The contractor selling to the
requirements of s. 77.66, Wis. Stats., and related statutes State of Wisconsin the articles described herein guarantees
regarding certification for collection of sales and use tax. the articles were manufactured or produced in accordance
The State of Wisconsin also reserves the right to cancel with applicable federal labor laws. Further, that the sale or
this contract with any federally debarred contractor or a use of the articles described herein will not infringe any
contractor that is presently identified on the list of parties United States patent. The contractor covenants that it will
excluded from federal procurement and non-procurement at its own expense defend every suit which shall be brought
contracts. against the State of Wisconsin (provided that such
contractor is promptly notified of such suit, and all papers
16.0 ANTITRUST ASSIGNMENT: The contractor and the State therein are delivered to it) for any alleged infringement of
of Wisconsin recognize that in actual economic practice, any patent by reason of the sale or use of such articles, and
overcharges resulting from antitrust violations are in fact agrees that it will pay all costs, damages, and profits recov-
usually borne by the State of Wisconsin (purchaser). erable in any such suit.
Therefore, the contractor hereby assigns to the State of
Wisconsin any and all claims for such overcharges as to 21.0 SAFETY REQUIREMENTS: All materials, equipment, and
goods, materials or services purchased in connection with supplies provided to the State of Wisconsin must comply
this contract. fully with all safety requirements as set forth by the
Wisconsin Administrative Code and all applicable OSHA
17.0 ASSIGNMENT: No right or duty in whole or in part of the Standards.
contractor under this contract may be assigned or dele-
gated without the prior written consent of the State of 22.0 WARRANTY: Unless otherwise specifically stated by the
Wisconsin. bidder/proposer, equipment purchased as a result of this
request shall be warranted against defects by the
18.0 WORK CENTER CRITERIA: A work center must be certi- bidder/proposer for one (1) year from date of receipt. The
fied under s. 16.752, Wis. Stats., and must ensure that equipment manufacturer's standard warranty shall apply as
when engaged in the production of materials, supplies or a minimum and must be honored by the contractor.
equipment or the performance of contractual services, not
less than seventy-five percent (75%) of the total hours of 23.0 INSURANCE RESPONSIBILITY: The contractor perform-
direct labor are performed by severely handicapped ing services for the State of Wisconsin shall:
individuals.
23.1 Maintain worker's compensation insurance as
19.0 NONDISCRIMINATION / AFFIRMATIVE ACTION: In required by Wisconsin Statutes, for all employees
connection with the performance of work under this engaged in the work.
contract, the contractor agrees not to discriminate against
any employee or applicant for employment because of age, 23.2 Maintain commercial liability, bodily injury and prop-
race, religion, color, handicap, sex, physical condition, erty damage insurance against any claim(s) which
developmental disability as defined in s. 51.01(5), Wis. might occur in carrying out this agreement/contract.
Stats., sexual orientation as defined in s. 111.32(13m), Wis. Minimum coverage shall be one million dollars
Stats., or national origin. This provision shall include, but ($1,000,000) liability for bodily injury and property
not be limited to, the following: employment, upgrading, damage including products liability and completed
demotion or transfer; recruitment or recruitment advertising; operations. Provide motor vehicle insurance for all
layoff or termination; rates of pay or other forms of owned, non-owned and hired vehicles that are used
compensation; and selection for training, including appren- in carrying out this contract. Minimum coverage shall
ticeship. Except with respect to sexual orientation, the be one million dollars ($1,000,000) per occurrence
contractor further agrees to take affirmative action to combined single limit for automobile liability and
ensure equal employment opportunities. property damage.
19.1 Contracts estimated to be over twenty-five thousand 23.3 The state reserves the right to require higher or lower
dollars ($25,000) require the submission of a written limits where warranted.
affirmative action plan by the contractor. An exemp-
tion occurs from this requirement if the contractor has 24.0 CANCELLATION: The State of Wisconsin reserves the
a workforce of less than twenty-five (25) employees. right to cancel any contract in whole or in part without
Within fifteen (15) working days after the contract is penalty due to nonappropriation of funds or for failure of the
awarded, the contractor must submit the plan to the contractor to comply with terms, conditions, and specifica-
contracting state agency for approval. Instructions tions of this contract.
on preparing the plan and technical assistance
regarding this clause are available from the
contracting state agency.
DOA-3054
Page 3of 3
25.0 VENDOR TAX DELINQUENCY: Vendors who have a 30.0 MATERIAL SAFETY DATA SHEET: If any item(s) on an
delinquent Wisconsin tax liability may have their payments order(s) resulting from this award(s) is a hazardous chemi-
offset by the State of Wisconsin. cal, as defined under 29CFR 1910.1200, provide one (1)
copy of a Material Safety Data Sheet for each item with the
26.0 PUBLIC RECORDS ACCESS: It is the intention of the shipped container(s) and one (1) copy with the invoice(s).
state to maintain an open and public process in the solicita-
tion, submission, review, and approval of procurement 31.0 PROMOTIONAL ADVERTISING / NEWS RELEASES:
activities. Reference to or use of the State of Wisconsin, any of its
departments, agencies or other subunits, or any state offi-
Bid/proposal openings are public unless otherwise speci- cial or employee for commercial promotion is prohibited.
fied. Records may not be available for public inspection News releases pertaining to this procurement shall not be
prior to issuance of the notice of intent to award or the made without prior approval of the State of Wisconsin.
award of the contract. Release of broadcast e-mails pertaining to this procurement
shall not be made without prior written authorization of the
27.0 PROPRIETARY INFORMATION: Any restrictions on the contracting agency.
use of data contained within a request, must be clearly
stated in the bid/proposal itself. Proprietary information 32.0 HOLD HARMLESS: The contractor will indemnify and
submitted in response to a request will be handled in save harmless the State of Wisconsin and all of its officers,
accordance with applicable State of Wisconsin agents and employees from all suits, actions, or claims of
procurement regulations and the Wisconsin public records any character brought for or on account of any injuries or
law. Proprietary restrictions normally are not accepted. damages received by any persons or property resulting
However, when accepted, it is the vendor's responsibility to from the operations of the contractor, or of any of its
defend the determination in the event of an appeal or contractors, in prosecuting work under this agreement.
litigation.
33.0 FOREIGN CORPORATION: A foreign corporation (any
27.1 Data contained in a bid/proposal, all documentation corporation other than a Wisconsin corporation) which
provided therein, and innovations developed as a becomes a party to this Agreement is required to conform
result of the contracted commodities or services to all the requirements of Chapter 180, Wis. Stats., relating
cannot be copyrighted or patented. All data, docu- to a foreign corporation and must possess a certificate of
mentation, and innovations become the property of authority from the Wisconsin Department of Financial
the State of Wisconsin. Institutions, unless the corporation is transacting business
in interstate commerce or is otherwise exempt from the
27.2 Any material submitted by the vendor in response to requirement of obtaining a certificate of authority. Any
this request that the vendor considers confidential foreign corporation which desires to apply for a certificate of
and proprietary information and which qualifies as a authority should contact the Department of Financial
trade secret, as provided in s. 19.36(5), Wis. Stats., Institutions, Division of Corporation, P. O. Box 7846,
or material which can be kept confidential under the Madison, WI 53707-7846; telephone (608) 261-7577.
Wisconsin public records law, must be identified on a
Designation of Confidential and Proprietary Informa- 34.0 WORK CENTER PROGRAM: The successful
tion form (DOA-3027). Bidders/proposers may bidder/proposer shall agree to implement processes that
request the form if it is not part of the Request for allow the State agencies, including the University of
Bid/Request for Proposal package. Bid/proposal Wisconsin System, to satisfy the State's obligation to
prices cannot be held confidential. purchase goods and services produced by work centers
certified under the State Use Law, s.16.752, Wis. Stat.
28.0 DISCLOSURE: If a state public official (s. 19.42, Wis. This shall result in requiring the successful bidder/proposer
Stats.), a member of a state public official's immediate to include products provided by work centers in its catalog
family, or any organization in which a state public official or for State agencies and campuses or to block the sale of
a member of the official's immediate family owns or controls comparable items to State agencies and campuses.
a ten percent (10%) interest, is a party to this agreement,
and if this agreement involves payment of more than three 35.0 FORCE MAJEURE: Neither party shall be in default by
thousand dollars ($3,000) within a twelve (12) month reason of any failure in performance of this Agreement in
period, this contract is voidable by the state unless appro- accordance with reasonable control and without fault or
priate disclosure is made according to s. 19.45(6), Wis. negligence on their part. Such causes may include, but are
Stats., before signing the contract. Disclosure must be not restricted to, acts of nature or the public enemy, acts of
made to the State of Wisconsin Ethics Board, 44 East the government in either its sovereign or contractual
Mifflin Street, Suite 601, Madison, Wisconsin 53703 capacity, fires, floods, epidemics, quarantine restrictions,
(Telephone 608-266-8123). strikes, freight embargoes and unusually severe weather,
but in every case the failure to perform such must be
State classified and former employees and certain beyond the reasonable control and without the fault or
University of Wisconsin faculty/staff are subject to separate negligence of the party.
disclosure requirements, s. 16.417, Wis. Stats.
29.0 RECYCLED MATERIALS: The State of Wisconsin is
required to purchase products incorporating recycled mate-
rials whenever technically and economically feasible.
Bidders are encouraged to bid products with recycled
content which meet specifications.
State of Wisconsin Division of Agency Services
Department of Administration Bureau of Procurement
DOA-3681 (01/2001)
ss. 16, 19 and 51, Wis. Stats.
Supplemental Standard Terms and Conditions
For Procurements for Services
1.0 ACCEPTANCE OF BID/PROPOSAL CONTENT: The con- 3.2 Contractors shall agree as part of the contract for
tents of the bid/proposal of the successful contractor will services that during performance of the contract, the
become contractual obligations if procurement action ensues. contractor will neither provide contractual services nor
enter into any agreement to provide services to a
2.0 CERTIFICATION OF INDEPENDENT PRICE person or organization that is regulated or funded by
DETERMINATION: By signing this bid/proposal, the the contracting agency or has interests that are
bidder/proposer certifies, and in the case of a joint adverse to the contracting agency. The Department
bid/proposal, each party thereto certifies as to its own organi- of Administration may waive this provision, in writing,
zation, that in connection with this procurement: if those activities of the contractor will not be adverse
to the interests of the state.
2.1 The prices in this bid/proposal have been arrived at
independently, without consultation, communication, 4.0 DUAL EMPLOYMENT: Section 16.417, Wis. Stats.,
or agreement, for the purpose of restricting competi- prohibits an individual who is a State of Wisconsin employee
tion, as to any matter relating to such prices with any or who is retained as a contractor full-time by a State of
other bidder/proposer or with any competitor; Wisconsin agency from being retained as a contractor by the
same or another State of Wisconsin agency where the
2.2 Unless otherwise required by law, the prices which individual receives more than $12,000 as compensation for
have been quoted in this bid/proposal have not been the individual‟s services during the same year. This
knowingly disclosed by the bidder/proposer and will prohibition does not apply to individuals who have full-time
not knowingly be disclosed by the bidder/proposer appointments for less than twelve (12) months during any
prior to opening in the case of an advertised procure- period of time that is not included in the appointment. It does
ment or prior to award in the case of a negotiated not include corporations or partnerships.
procurement, directly or indirectly to any other
bidder/proposer or to any competitor; and 5.0 EMPLOYMENT: The contractor will not engage the services
of any person or persons now employed by the State of
2.3 No attempt has been made or will be made by the Wisconsin, including any department, commission or board
bidder/proposer to induce any other person or firm to thereof, to provide services relating to this agreement without
submit or not to submit a bid/proposal for the purpose the written consent of the employing agency of such person
of restricting competition. or persons and of the contracting agency.
2.4 Each person signing this bid/proposal certifies that: 6.0 CONFLICT OF INTEREST: Private and non-profit corpora-
He/she is the person in the bidder's/proposer's organi- tions are bound by ss. 180.0831, 180.1911(1), and 181.0831
zation responsible within that organization for the Wis. Stats., regarding conflicts of interests by directors in the
decision as to the prices being offered herein and that conduct of state contracts.
he/she has not participated, and will not participate, in
any action contrary to 2.1 through 2.3 above; (or) 7.0 RECORDKEEPING AND RECORD RETENTION: The
contractor shall establish and maintain adequate records of
He/she is not the person in the bidder's/proposer's all expenditures incurred under the contract. All records must
organization responsible within that organization for be kept in accordance with generally accepted accounting
the decision as to the prices being offered herein, but procedures. All procedures must be in accordance with
that he/she has been authorized in writing to act as federal, state and local ordinances.
agent for the persons responsible for such decisions
in certifying that such persons have not participated, The contracting agency shall have the right to audit, review,
and will not participate in any action contrary to 2.1 examine, copy, and transcribe any pertinent records or
through 2.3 above, and as their agent does hereby so documents relating to any contract resulting from this
certify; and he/she has not participated, and will not bid/proposal held by the contractor. The contractor will retain
participate, in any action contrary to 2.1 through 2.3 all documents applicable to the contract for a period of not
above. less than three (3) years after final payment is made.
3.0 DISCLOSURE OF INDEPENDENCE AND RELATIONSHIP: 8.0 INDEPENDENT CAPACITY OF CONTRACTOR: The
parties hereto agree that the contractor, its officers, agents,
3.1 Prior to award of any contract, a potential contractor and employees, in the performance of this agreement shall
shall certify in writing to the procuring agency that no act in the capacity of an independent contractor and not as
relationship exists between the potential contractor an officer, employee, or agent of the state. The contractor
and the procuring or contracting agency that interferes agrees to take such steps as may be necessary to ensure
with fair competition or is a conflict of interest, and no that each subcontractor of the contractor will be deemed to
relationship exists between the contractor and another be an independent contractor and will not be considered or
person or organization that constitutes a conflict of permitted to be an agent, servant, joint venturer, or partner of
interest with respect to a state contract. The the state.
Department of Administration may waive this provi-
sion, in writing, if those activities of the potential con-
tractor will not be adverse to the interests of the state.
RFB # SN-2125 Due Date: June 26, 2009
AODA/PTSD Services in Milwaukee, WI Page 25 of 41
8.0 REQUIRED FORMS AND ATTACHMENTS
The following forms must be completed and submitted with the bid response.
FORMS:
Request for Bid Form (DOA-3070) - cover sheet, first page of this RFB
Vendor Information Form (DOA-3477 1/08)
MBE/ American Made Affidavit Form (DOA-3476)
Designation of Confidential and Proprietary Information Form (DOA-3027), if applicable.
Wisconsin‟s Cooperative Purchasing Service Form (DOA-3333)
Vendor Reference Form (DOA-3478)
ADDITIONAL REQUIRED INFORMATION:
Documentation of vendor experience requirements with past contracts and references as specified in
4.2.
Documentation of staff qualifications requirements and references as specified in 4.3.1.
Documentation of staff experience with references as specified in 4.3.2. If staff positions are pending
hire, submit recruitment plan and job description of those pending positions.
A detailed description of the AODA/PTSD Outpatient Group component to be delivered by the bidder in
accordance with specifications described in 4.4.1.
A completed sample treatment plan as specified in 4.5.2.
Copy of format used for the Progress Reports in 4.8.2.1.
Copy of format used for Discharge Summary in 4.8.2.2.
Overview of current Program Evaluation, if applicable, per 4.8.4.4.
STATE OF WISCONSIN
DEPARTMENT OF ADMINISTRATION Bid / Proposal # SN-2125
DIVISION OF ENTERPRISE OPERATIONS
BUREAU OF PROCUREMENT
S. 16.765, WIS. STATS.
DOA-3477 (R01/08) Commodity / Service
Vendor Information
1. BIDDING / PROPOSING COMPANY NAME
Phone ( ) Toll Free Phone ( )
FAX ( ) E-Mail Address
Address
City State Zip + 4
2. Name the person to contact for questions concerning this bid / proposal.
Name Title
Phone ( ) Toll Free Phone ( )
FAX ( ) E-Mail Address
Address
City State Zip + 4
Any vendor awarded over $25,000 on this contract must submit affirmative action information to the
department. Please name the Personnel / Human Resource and Development or other person responsible
3. for affirmative action in the company to contact about this plan.
Name Title
Phone ( ) Toll Free Phone ( )
FAX ( ) E-Mail Address
Address
City State Zip + 4
Mailing address to which state purchase orders are mailed and person the department may contact
4. concerning orders and billings.
Name Title
Phone ( ) Toll Free Phone ( )
FAX ( ) E-Mail Address
Address
City State Zip + 4
5. CEO / President Name
This document can be made available in accessible formats to qualified individuals with disabilities.
State of Wisconsin Bid / Proposal # SN-2125
Department of Administration
DOA-3476 (R01/2000) Commodity AODA Milwaukee
S. 16.75(3m) Wis. Stats.; s. 16.752
Wis. Stats.
Affidavit
This completed affidavit must be submitted with the bid/proposal.
Proposer Preference: Please indicate below if claiming a proposer preference.
Minority Business Preference (s. 16.75(3m), Wis. Stats.) - Must be certified by the Wisconsin
Department of Commerce. If you have questions concerning the certification process, contact the
Wisconsin Department of Commerce, 8th Floor, 123 W. Washington Ave., P.O. Box 7970, Madison,
Wisconsin 53707-7970,
(608) 267-9550.
Work Center Preference (s 16.752, Wis Stats.) - Must be certified by the State of Wisconsin Use
Board. If you have questions concerning the certification process, contact the Wisconsin State Use
Board, 101 East Wilson Street, 6th Floor, PO Box 7867, Madison, Wisconsin 53707-7867 or 608/266-
2553.
American-Made Materials: The materials covered in our proposal were manufactured in whole or in substantial part
within the United States, or the majority of the component parts thereof were manufactured in whole or in substantial
part in the United States.
Yes No Unknown
Non-Collusion: In signing this proposal we also certify that we have not, either directly or indirectly, entered into any
agreement or participated in any collusion or otherwise taken any action in restraint of free trade; that no attempt
has been made to induce any other person or firm to submit or not to submit a proposal; that this proposal has been
independently arrived at without collusion with any other proposer competitor or potential competitor; that this
proposal has not been knowingly disclosed prior to opening of proposals to any other proposer or competitor; that
the above statement is accurate under penalty of perjury.
We will comply with all terms, conditions, and specifications required by the State of Wisconsin in this
Announcement of Bid/Proposal and the terms of our bid/proposal.
Authorized Title
Representative
Type or Print
Authorized Date (m/dd/ccyy)
Representative
Signature
Company Telephone ( )
Name
This document can be made available in accessible formats to qualified individuals with disabilities.
STATE OF WISCONSIN
DOA-3027 (R01/98)
DESIGNATION OF CONFIDENTIAL AND PROPRIETARY INFORMATION
The attached material submitted in response to Bid/Proposal # SN-2125 AODA PTSD Milwaukee
includes proprietary and confidential information which qualifies as a trade secret, as provided in s.
19.36(5), Wis. Stats., or is otherwise material that can be kept confidential under the Wisconsin Open
Records Law. As such, we ask that certain pages, as indicated below, of this bid/proposal response be
treated as confidential material and not be released without our written approval.
Prices always become public information when bids/proposals are opened, and therefore
cannot be kept confidential.
Other information cannot be kept confidential unless it is a trade secret. Trade secret is defined in s.
134.90(1)(c), Wis. Stats. as follows: "Trade secret" means information, including a formula, pattern,
compilation, program, device, method, technique or process to which all of the following apply:
1. The information derives independent economic value, actual or potential, from not being generally
known to, and not being readily ascertainable by proper means by, other persons who can obtain
economic value from its disclosure or use.
2. The information is the subject of efforts to maintain its secrecy that are reasonable under the
circumstances.
We request that the following pages not be released
Section Page # Topic
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
IN THE EVENT THE DESIGNATION OF CONFIDENTIALITY OF THIS INFORMATION IS CHALLENGED, THE
UNDERSIGNED HEREBY AGREES TO PROVIDE LEGAL COUNSEL OR OTHER NECESSARY ASSISTANCE
TO DEFEND THE DESIGNATION OF CONFIDENTIALITY AND AGREES TO HOLD THE STATE HARMLESS
FOR ANY COSTS OR DAMAGES ARISING OUT OF THE STATE'S AGREEING TO WITHHOLD THE
MATERIALS.
Failure to include this form in the bid/proposal response may mean that all information provided as part of the
bid/proposal response will be open to examination and copying. The state considers other markings of confidential
in the bid/proposal document to be insufficient. The undersigned agrees to hold the state harmless for any
damages arising out of the release of any materials unless they are specifically identified above.
Company Name ___________________________________________
Authorized Representative ___________________________________________
Signature
Authorized Representative ___________________________________________
Type or Print
Date ___________________________________________
This document can be made available in accessible formats to qualified individuals with disabilities.
State of Wisconsin Division of State Agency Services
Department of Administration State Bureau of Procurement
DOA-3333 (R03/2004)
Vendor Agreement
Wisconsin’s Cooperative Purchasing Service
Wisconsin statutes (s. 16.73, Wis. Stats.) establish authority to allow Wisconsin municipalities to purchase from state
contracts. Participating in the service gives vendors opportunities for additional sales without additional bidding.
Municipalities use the service to expedite purchases. A "municipality" is defined as any county, city, village, town, school
district, board of school directors, sewer district, drainage district, vocational, technical and adult education district, or any
other public body having the authority to award public contracts (s. 16.70(8), Wis. Stats.). Federally recognized Indian tribes
and bands in this state may participate in cooperative purchasing with the state or any municipality under ss. 66.0301(1) and
(2), Wis.Stats.
Interested municipalities:
will contact the contractor directly to place orders referencing the state agency contract number; and
are responsible for receipt, acceptance, inspection of commodities directly from the contractor, and making
payment directly to the contractor.
The State of Wisconsin is not a party to these purchases or any dispute arising from these purchases and is not liable for
delivery or payment of any of these purchases.
The State of Wisconsin will determine the contractor‟s participation by checking a box below.
MANDATORY: Bidders/Proposers must agree to furnish the commodities or services of this bid/proposal to
Wisconsin municipalities. Vendors should note any special conditions below.
OPTIONAL: Bidders/Proposers may or may not agree to furnish the commodities or services of this bid/proposal to
Wisconsin municipalities. A vendor‟s decision on participating in this service has no effect on awarding this
contract.
A vendor in the service may specify minimum order sizes by volume or dollar amount, additional charges beyond
normal delivery areas, or other minimal changes for municipalities.
Vendor: please check one of the following boxes in response.
I Agree to furnish the commodities or services of this bid/proposal to Wisconsin municipalities with any
special conditions noted below.
I Do Not Agree to furnish the commodities or services to Wisconsin municipalities.
Special Conditions (if applicable):
Signature Date (mm/dd/ccyy)
Name (Type or Print) Title
Company Telephone
( )
Address (Street) City State ZIP + 4
Commodity/Service Request for Bid/Proposal Number
AODA Milwaukee SN-2125
This form can be made available in accessible formats upon request to qualified individuals with disabilities.
RFB # SN-2125 Due Date: June 26, 2009
AODA/PTSD Services in Milwaukee, WI Page 25 of 41
STATE OF WISCONSIN Bid / Proposal # SN-2125
DOA-3478 (R12/96) AODA Milwaukee
VENDOR REFERENCE
FOR VENDOR:
Provide company name, address, contact person, telephone number, and appropriate information on the
product(s) and/or service(s) used for four (4) or more installations with requirements similar to those included in this
solicitation document. If vendor is proposing any arrangement involving a third party, the named references should
also be involved in a similar arrangement.
Company Name
Address (include Zip + 4)
Contact Person Phone No.
Product(s) and/or Service(s) Used
Company Name
Address (include Zip + 4)
Contact Person Phone No.
Product(s) and/or Service(s) Used
Company Name
Address (include Zip + 4)
Contact Person Phone No
Product(s) and/or Service(s) Used
Company Name
Address (include Zip + 4)
Contact Person Phone No.
Product(s) and/or Service(s) Used
This document can be made available in accessible formats to qualified individuals with disabilities.
EXHIBIT 1
WISCONSIN EFFECTIVE DATE
DEPARTMENT OF CORRECTIONS
Division of Community Corrections July
DOC-1356 (Rev. 05/96)
2001 PAGE 1 OF 1
MANUAL REFERENCE
New x Revision
Administrative Directive 01-10 ORIGINATED BY William J. Grosshans,
Replaces 99-15 Administrator
SUBJECT: Kerr v. Farrey
DISSEMINATION PRIORITY
X All Staff X Supervisory Staff Only X Policy / Directive Information
Discuss at Staff Meeting Read / Route / Post
The purpose of this directive is to ensure the Division of Community Corrections'
procedures comply with the decision of the United States 7t' Circuit Court of Appeals in
Kerr v. Farrey. 95 F.3d 472 (1996). In that decision, the court ruled that it was a violation
of the 1St Amendment of the United States Constitution to order an offender to attend a
treatment program with religious components. The court considered Alcoholics
Anonymous, for example, to be a program with a religious component since the program
refers to a "higher being" and to "God as we understand him."
An agent may order an offender to attend a specific secular (non-religious) treatment or
support program. An agent may not order an offender to attend a specific program with a
religious component. An offender may voluntarily participate in a treatment or
support program with a religious component as long as a non-religious program is
offered.
An agent may write a rule requiring an offender to attend and complete AODA treatment
without naming a specific program. An agent may also provide an offender with a list of
acceptable programs, as long as both secular and non-secular options are clearly
identified. If an offender chooses to participate in a program having a religious
component, the agent should document in the Chronological Log that a secular program
was offered.
________________________________
William J. Grosshans
Administrator
cc - DCC Administrative Directive Group
Executive Staff
EXHIBIT 2
DEPARTMENT OF CORRECTIONS WISCONSIN
Division of Community Corrections
DOC-1336 (Rev. 11/2006)
REFERRAL FOR SERVICES
PART A REFERRAL FOR SERVICES To be Completed by Referral Agent
PROGRAM NAME PROGRAM LOCATION
REFERRAL DATE (Month/Day/Year) PROJECTED ELIGIBILITY DATE FOR SERVICES (Month/Day/Year)
AGENT NAME AGENT ADDRESS
AGENT TELEPHONE NUMBER (Include Area Code) AGENT AREA NUMBER
REFERRAL TYPE
ALTERNATIVE TO REVOCATION (ATR) RESPONSE TO VIOLATION (NOT AN ATR)
COURT-ORDERED CONDITION PAROLE/ES CONDITION OTHER - SPECIFY:
SERVICES REQUEST (Check All That Apply)
Anger Management Domestic Violence Services Sex Offender Treatment Group
AODA Group Services Education Services Transitional Living Program
AODA Aftercare Services Emergency Housing Other (Specify)
AODA Assessment/Evaluation Employment Services
AODA Intensive Nonresidential Groups Family/Parenting Services
AODA Relapse Prevention/Aftercare Halfway House (CBRF)
Case Management Sex Offender Assessment/Evaluation
Cognitive Interventions Groups Sex Offender Denial Focus Group
Crisis Intervention Sex Offender Education Group
Day Report Services Sex Offender Relapse Prevention/Aftercare
OFFENDER LAST NAME (As Shown on Court Order) FIRST MI DOC NUMBER
DOB SEX RACE
Male Female
OFFENDER CURRENT ADDRESS
OFFENDER TELEPHONE NUMBER (Include Area Code)
MARITAL STATUS
Single, never married Married Separated Widow/Widower Divorced
OFFENDER STATUS AT TIME OF REFERRAL
Probation Parole Extended Supervision 980 Case NGI
Felony Misdemeanor SUPERVISION DISCHARGE DATE
Habitual Deferred Prosecution One Year or Less Probation
Reentry from Jail Reentry from Prison Reentry from DAI ATR
DOES INDIVIDUAL HAVE OUTSTANDING WARRANT OR PENDING CHARGES?
Yes No - If Yes, Explain:
REASON FOR REFERRAL (List Problems Behaviors Evidenced By Offender And Specific Services Requested)
SPECIAL NEEDS (Check All Relevant Categories)
Yes No Yes No
Alcohol Problems History of Violence, attach description.
Drug Problems (Specify) History of Committing Sexual Assaults
Health Problems (Specify) Mental Health Problems (Specify)
Pregnant Relationship Problems
Developmental or Learning Disabilities OTHER (Specify)
Financial Management Problems
EXHIBIT 2
IS OFFENDER TAKING MEDICATION?
Yes No - If Yes , List Reason: Prescription Self-Pay Insurance
EDUCATIONAL ACHIEVEMENT
Highest Grade Level Achieved
THIS REFERRAL MUST INCLUDE THE FOLLOWING INFORMATION:
Authorization for Use and Disclosure of Protected Health Information (DOC-1163A)
Only required for information that involves personal health information, medical, mental health, AODA, or other confidential or services.
Court Order, Criminal Complaint and Prior Record
Social Information (DOC-179)
Violation Report(s), if applicable.
Information in Regard to Alcohol, other Drug Problems and Prior Treatment Experience, if applicable.
INSTRUCTIONS: Attach Part A and Part B to your agency‟s “Offender Report Form Monthly" (DOC-386, DOC-1088A and DOC-1088) for each new intake
and each offender who re-enters your program.
PART B INTAKE DECISION
To Be Completed by Provider Agency for Offender Entering or Re-entering The Program
OFFENDER ACCEPTANCE / PROGRAM RETURN (Check Appropriate Box, Enter Appropriate Data)
Offender accepted as new intake
Offender returned to enter program
RECOMMENDED PROGRAM
START DATE PROJECTED DISCHARGE DATE
REJECTION
OFFENDER REJECTED - FOR WHAT REASON (Specify):
EXHIBIT 3
DEPARTMENT OF CORRECTIONS WISCONSIN
Division of Community Corrections
DOC1088 (Rev. 2/97)
OFFENDER REPORT – MONTHLY
COMMUNITY - BASED PROGRAMS and SERVICES
AGENCY NAME TELEPHONE NUMBER PURCHASE ORDER NUMBER
PROGRAM NAME FEDERAL FUNDS
Yes No
REPORT COMPLETED BY (Signature / Title) DATE SIGNED REPORT REVIEWED BY DPP STAFF (Signature) DATE SIGNED
INSTRUCTIONS: Use this form for all Community-based programs and services except Halfway House, use DOC-386 and Day Treatment, use DOC-1088A. Letters A through F must be completed; all other columns REPORTING PERIOD
may be required in accordance with the agency‟s contract/grant agreement or at the direction of the Contract Administrator. All columns which require a code are noted by an asterisk. All codes for the completion of this form
are listed on the back of the form. If the Region needs assistance in developing the code for additional items, please contact the Adult Services Specialist at (608) 266-3989. (Month/Year)
A B C D E* F G* H
OFFENDER AGENT ADMISSION TYPE OF STATUS OFFENDER
I J K L
OFFENDER NAME NUMBER AREA NO. DATE SERVICE SERVICE DATE OR DATES Discharge FEES
Date Code COLLECTED
THIS MONTH
M Total Number of Offenders N Total Units Provided* O Are Alcohol and Other Drug Abuse Services Provided Under This Contract/Grant YES
NO
P Other Information
EXHIBIT 3
Discharge Codes
Used For All
These codes are used in column “G” STATUS Discharge Date / Code of all billing forms including the TLP
Billing.
(01) Continues in Program.
(02) Completed Service: Significant improvement in most or all areas has occurred and
the offender is approaching or has attained full recovery (Good).
(03) Completed Service: Improvement in some areas has occurred but the degree of
improvement is minimal (Fair).
(04) Completed Service: No positive change has occurred (Poor).
(05) Referred to another agency.
(06) Behavioral Termination: Staff / Program decision to terminate due to breaking
internal program rules.
(07) Withdrew against staff advice.
(08) Funding / Authorization Expired (service not completed).
(09) Program Hold: When offender is temporarily not involved in service. Each
program hold incident must be 30 days or less.
(10) Positive urinalysis screen, positive breathalyzer test or other indication of drugs.
(11) Absconding
(12) Rules Violation: Other than drug / alcohol or absconding.
(13) New Offense
(14) Hospitalized
(15) Death
(16) Other (specify in Field P “Other Information” at bottom of form.
EXHIBIT 4
DEPARTMENT OF CORRECTIONS WISCONSIN
Division of Community Corrections Wisconsin Statutes
DOC-1026 (Rev. 2/97) Section 301.08
UNIT SERVICE
MONTHLY REPORT
AGENCY NAME VENDOR ID NUMBER PURCHASE ORDER NUMBER
PROGRAM NAME TELEPHONE NUMBER
DOC CONTACT SIGNATURE REPORTING PERIOD (Month / Year)
As the authorized representative of the above named agency, I request that my
agency is reimbursed for units of service provided to eligible Correctional offenders.
UNIT OF SERVICE(S) PROVIDED
UNIT NUMBER OF COST PER TOTAL
DESCRIPTION UNITS UNIT
Less Billing to Other Agencies -
Less Offender Fees Collected -
NET REIMBURSABLE =
I understand that my agency is required to submit a Offender Monthly Report within
30 days after the final day of the month for which this Unit Service Report is due.
I certify that the unit of services indicated for claiming State reimbursement are just, true and
correct in the amount stated and have not been reimbursed, and represent actual services
delivered and reimbursable under the laws, rules and regulation of the Wisconsin Department
of Corrections.
CONTRACTOR AGENCY CONTACT SIGNATURE DATE SIGNED
DISTRIBUTION: Submit original and 2 copies to Grant/Contract Administrator
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