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State of Ohio - Controlling Board Request
STATE OF OHIO
CONTROLLING BOARD
30 East Broad Street, 34th Floor
Columbus, Ohio 43215-3457
(614) 466-5721 FAX:(614) 466-3813
OPERATING REQUEST Controlling Board No.
DMH0100768
Status:  Approved
Meeting Date:  2/26/2018

GENERAL INFORMATION
Agency
Department of Mental Health & Addiction Services


Division/Institution
Fiscal Administration
Waiver of Competitive Selection  (Revised Code Section 127.16B)
      No Competitive Opportunity
      Agency Released Competitive Opportunity
Agency Released Competitive Opportunity (Revised Code Section 127.162)
Other Statutory Authority/Bill Section:
Operating Transfer Request  (Revised Code Section 127.14)
      Appropriation
      Cash
      Other Statutory Authority/Bill Section:
Fiscal Year(s)
2018
Bill No.
HB 49
Eligible for OBM
Director Approval?
No

VENDOR INFORMATION
For FYAmountNameAddressCityStateCountyZip Code
DMH01 2018 $47,000.00 RIVERSIDE METHODIST HOSPITAL 3535 OLENTANGY RIVER RD COLUMBUS OH Franklin 43214
DMH01 2018 $50,000.00 DOCTORS HOSPITAL 1087 DENISON AVE COLUMBUS OH Franklin 43201

FUNDING INFORMATION
Fund GroupFund CodeAppropriation Line ItemAppropriation Line Item NameFYAmountFYAmount
GRF 334412 HOSPITAL SERVICES 2018 $97,000.00 $.00

SIGNATURES
     
Tracy Plouck 02/26/2018
   
Agency Director or Authorized Agent On The Date Of
   
02/05/2018 Christine Morrison
   
Date Controlling Board President/OBM Director
   
AGENCY CONTACT
Name:  Rosaland Gatewood-Tye Title:  Fiscal Officer
Phone:  (614) 644 - 9142 Fax:  (614) 644 - 5331 E-Mail:  Rosaland.Gatewood.Tye@mha.ohio.gov
REQUIRED EXPLANATION OF REQUEST
  The Department of Mental Health & Addiction Services respectfully requests Controlling Board approval to waive competitive selection in the amount of $97,000 for FY18 from Fund GRF, ALI 334412 (Hospital Services), to amend our services with Riverside Methodist Hospital and to contract with Doctor's Hospital to provide inpatient care and emergency medical services for patients residing at Twin Valley Behavioral Healthcare (TVBH).  
  As a state operated and funded agency of institutional care, OhioMHAS is required to cover the costs of physical health care services.

We are requesting an additional $47,000 with Riverside, for the remainder of the fiscal year, which should cover current and future medical bills. Riverside provides electro convulsive therapy for our patients. Many acute care patients have seen practitioners at this facility prior to admission and return during their admission at TVBH for continuity of care.

We are requesting $50,000 with Doctor's Hospital, which will cover current and future medical bills. Doctor's Hospital also has seen many of our acute care patients prior to admission and return during their admission at TVBH for continuity of care.
 
   
Attachments Controlling Board Request No.: DMH0100768
Attachment TypeAttachment Description
No attachments found.
 
Release and Permit Information
NameFYAmountR & P #R & P DateIssued ByComments
RIVERSIDE METHODIST HOSPITAL 2018 $47,000.00 State Purchasing
DOCTORS HOSPITAL 2018 $50,000.00 DMH 18/19

Operating Request Required Information
Contract Amendment - RIVERSIDE METHODIST HOSPITAL
Controlling Board Request No.: DMH0100768
1. Identify the contractor and provide the contractor's address of their principal place of business.
RIVERSIDE METHODIST HOSPITAL
3535 OLENTANGY RIVER RD
COLUMBUS,  OH  43214
County: Franklin
   
2. Explain why the contract is being amended and the effect on the project or program.
Change in amount of personal service required.
   
3. Specify the deliverables of this contract or describe the scope of service(s) to be performed by this contractor.
General Medical Services for patients at Twin Valley Behavioral Healthcare.
   
4.
Cite the account category of expense being used for this purchase of service(s).
Account CategorySubobjectAmountNon-Exempt Amount
521058 $47,000.00 $47,000.00
Total Amounts $47,000.00 $47,000.00
   
5.
Provide the dates of previous Controlling Board approvals for this contract. Indicate whether the approvals were for the initial contract, amendments to this contract, or previous renewals for this contract. In addition to the
date(s) of Controlling Board approval, provide the following information depending upon the type of contract previously approved by the Controlling Board.
Initial Contract - Total amount of the initial contract or number of hours and the rate per hour.
Amendment - Total amount of the amended contract (initial + amendment) or total number of hours (initial + amendment) and the total rate per hour (initial contract + contract amendment + contract renewals within the biennium).
Renewal - Total amount of the renewed contract or the total number of hours and the total rate per hour.
CB Approval DateType of ContractAmount per FY# of HoursRate per Hour per FY
05/22/2017 Initial $100,000.00 0.00 $0.00
   
6. If this contract amendment affects the total amount of the contract or the total number of hours and total rate
per hour, provide the new rate information.
Total Contract Amount Total Number of Hours Total Rate per Hour FY

  $147,000.00

  0

  $0.00

18

7. Duration of this contract (beginning and ending dates) within the fiscal biennium, including amendment.
Beginning Date Ending Date  
07/01/2017 06/30/2018
8. Provide all subsequent renewal schedules (beginning and ending dates) and amounts associated with this contract.
Beginning DateEnding DateTotal Lease AmountFY2
  Explain contract provisions. 
9.
Provide the following employee information: Nationwide Ohio
Total Number of Employees 0    0   
Percentage of Women 0% 0%
Percentage of Minorities 0% 0%

Operating Request Required Information
New Contract - DOCTORS HOSPITAL
Controlling Board Request No.: DMH0100768
1. Selection Process: Was this contract subject to selection by a Request for Proposal (RFP),
Request for Qualification (RFQ), Request for Information (RFI) process? No
Explain why this contract was not subject to an RFP, RFQ or RFI process
Hospital services are not subject to a RFP process.
 
2. Provide the following selected contractor information:
DOCTORS HOSPITAL
1087 DENISON AVE
COLUMBUS,   OH  43201
County: Franklin
 
3. Contractor's location from which all or most of the contract work will be performed, if different from the
location of principal place of business. (For institutional agencies, cite the location of the institution,
including the city and county, where services are to be performed.)


   
4. Institutional agencies only: Is the contractor currently performing services at the institution listed above?
5. Specify the deliverables of this contract or describe the scope of service(s) to be performed by this contractor.
General medical services for patients.
6. Cite the account category of expense being used for this purchase of service(s).
Account CategorySubobjectAmountNon-Exempt Amount
521058 $50,000.00 $50,000.00

 
Total Amounts $50,000.00 $50,000.00
7.
Duration of this contract (beginning and ending dates) within the fiscal biennium.
Beginning Date Ending Date
02/27/2018 06/30/2018
8. Is the contractor already performing work under this contract? No
   
9. Identify all state contracts which the selected contractor has had approved by the Controlling Board
since the beginning of the last fiscal year through this fiscal year to date. Also include contracts approved
for this agency or institutions of higher education.
a. Total number of contracts. 0
b. For each contract list the state agency and the contract amount.
AgencyContract/Agreement AmountFY
10. Contractor Procurement Compliance:
a. Is this contractor in compliance with Buy America? Yes
  Explain: The contractor is located in Columbus, OH.
   
b. Is this contractor in compliance with Buy Ohio? Yes
Explain: The contractor is located in Columbus, OH.
11.
Provide the following employee information: Nationwide Ohio
Total Number of Employees 0    0   
Percentage of Women 0% 0%
Percentage of Minorities 0% 0%
12. What percent of the work will be done by subcontractors?  0
  If more than 50%, provide the same information for each subcontractor as requested in number 11 above for the contractor.
SubcontractorNationwide
# of Employees
Nationwide
% of Women
Nationwide
% of Minorities
Ohio
# of Employees
Ohio
% of Women
Ohio
% of Minorities
13.  Provide all subsequent renewal schedules (beginning and ending dates) and amounts associated with this contract.

A contract renewal is the exercise of an option to enter into a subsequent contract with a vendor in accordance with renewal provisions specified in a preceding contract.
Beginning DateEnding DateTotal Lease Amount
Explain contract provisions.