Project Information

Bid Title

RFP: Medicaid Enrollment and Renewal Work Requirements Navigation Services

Issuing Agency

City of St. Louis

Location

Missouri

Published Date

Jun 2, 2026

Closing Date

Jun 24, 2026

Government Level

State & Local

Status

Closed

Original Source

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Bid Inquiries

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Bid Documents

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Project Description

RFP: Medicaid Enrollment and Renewal Work Requirements Navigation Services

Sponsor: Department of Health

Procurement Type: Request for Information

Starting Date: 06-02-2026

Closing Date: 06-24-2026

Closing Time: 05:00 PM

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THE CITY OF ST. LOUIS

DEPARTMENT OF HEALTH

REQUEST FOR PROPOSALS

AND

APPLICATION REQUIREMENTS

MEDICAID ENROLLMENT AND RENEWAL

&

WORK REQUIREMENTS NAVIGATION SERVICES

ISSUANCE DATE: June 3, 2026

DUE DATE: June 24, 2026

City St. Louis Department of Health

1200 Market Street, Room 4051

St. Louis, MO 63103

Note: If this RFP was downloaded from the City of St. Louis Website each applicant must provide contact information to the RFP contact person in order to

be notified of any changes in this RFP document.

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TABLE OF CONTENTS

I. Purpose and Intent

3

II. Contact Person & Questions

5

III. Submission

5

IV. Required Qualifications & Certifications

6

V. Method of Compensation

6

VI. Scope of Services

7

VII. Required Application Contents

8

VIII. Program Narrative

9

IX. Application Evaluation & Selection Criteria (Scoring)

10

X. Living Wage

11

XI. Miscellaneous Terms and Conditions Applicable to RFP

12

A. Indemnification

12

B. Amendments

12

C. Right to Withdraw Application

12

D. Contents of Applications

12

E. Respondents Responsibility

12

XII. Insurance Requirements

13

XIII. Service Contract Prevailing Wage

13

XIV. Earnings Tax Requirements

13

XV. Additional Terms to be Required in Subawards

14

A. Recordkeeping & Audits

14

B. Non-Discrimination Policy

14

C. Public Records Law

15

D. Unauthorized Aliens Affidavit

15

E. Indemnification

15

F. Subject to Appropriation of Funds

15

G. Prohibition on Limitation of Liability Clauses

16

H. Termination

16

XVI. Governing Law and Venue

16

2

ESTIMATED SCHEDULE (SUBJECT TO CHANGE):

Date

June 3, 2026

June 16, 2026

June 24, 2026

August 3, 2026

September 1, 2026

August 31, 2027

Activity/Time

Issuance of Request for Proposals

Final Submission of Questions to Contact Person

Applications Due – No Later than 4:00 pm CDT

Selection by Selection Committee

Tentative Contract Start Date

Tentative 1 year completion of the Project Period, plus four 1-

year renewal options (subject to funding availability)

I. Purpose and Intent

This Request for Proposals (“RFP”) is for navigation services to assist Medicaid qualifying residents of

the City of St. Louis with enrollments, annual and semi-annual (every 6 months) renewals, and

verifications by Medicaid Expansion adult persons (ages 19-64, earning 138% or below of Federal Poverty

Level) of 80 hours per month of qualifying activities (e.g. work, education, community service, workforce

training, certain caregivers, and inmates) or exemption because of certain verified disabilities and medical

conditions that prevent compliance -- all as required by the Reconciliation Act of 2025 (a/k/a H.B. #1,

One Big Beautiful Bill) (Public Law 119–21).

The City of St. Louis Department of Health (“DOH”) is accepting applications to provide navigation

services to assist Medicaid qualifying residents of the City of St. Louis with enrollments, semi-annual

(every 6 months) renewals, and verifications by Medicaid Expansion adult persons, funded with up to

One Million Two Hundred Thousand ($1,200,000.00) from the Health Care Trust Fund (Fund 1110;

Center 700020).

The City of St. Louis Department of Health is seeking to contract with experienced, reputable, capable

community-based nonprofit organization(s) to support residents with all requirements of the

Reconciliation Act of 2025 (a/k/a H.B. #1, One Big Beautiful Bill) (Public Law 119–21) to provide and

document enrollments, renewals of Medicaid qualifying residents of the City of St. Louis annually and

semi-annually (every 6 months), and verifications by Medicaid Expansion persons (ages 19-64, earning

138% or below of Federal Poverty Level) of 80 hours per month of qualifying activities (e.g. work,

education, community service, workforce training, certain caregivers, and inmates) or exemption because

of certain verified disabilities and medical conditions that prevent compliance.

At the beginning of the 20th Century the City of St. Louis owned a female hospital, insane asylum,

quarantine hospital, and traditional “City Hospital” (which became Max C. Starkloff – City Hospital #1).

From 1919 to 1937 City Hospital #2 was created for treatment of African American patients. On February

22, 1937 a new African American Hospital (Homer G. Phillips – Hospital #2) was opened in The Ville

Neighborhood of North St. Louis. Homer G. Phillips closed on August 17, 1979 among much controversy;

Max C. Starkloff – City Hospital #1 closed in 1985. Collaborating with St. Louis County, the St. Louis

Regional Health Care Corporation was created (Regional Hospital), which also closed in 1997. There was

a transition to a new model of indigent healthcare in 1998, known as ConnectCare, as an urgent care center

and issuer of vouchers for care in private hospitals for primary and specialty care, with funding coming

from the State of Missouri and Disproportionate Share Hospital (DSH) funds. ConnectCare ceased

operations in November 15, 2013. In 2000 the St. Louis Regional Health Commission (RHC) was formed

to help coordinate indigent health care in the City and County. In 2010 in partnership with the State of

Missouri the RHC obtained approval of an 1115 demonstration program called Gateway to Better Health,

approved by CMS on July 28, 2010 to help to pay for outpatient care services for uninsured adults in the

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St. Louis area with Community Health Centers/Federally Qualified Health Centers providing primary care

homes.

City of St. Louis Ordinance 65609 created a health care trust fund in 2002 from use tax funding for “public

health care services within the City of St. Louis”. Those funds were used by the City of St. Louis

Department of Health & Hospitals during the existence of the Gateway to Better Health demonstration

program to help fund access to public health services through access to healthcare for the uninsured, prior

to the expansion of Medicaid. Now that expansion coverage is once again potentially threatened by the

bureaucratic hurdles of renewal and verification of work qualifying activities (e.g. work, education,

community service, workforce training, certain caregivers, and inmates) or exemption because of certain

verified disabilities and medical conditions that prevent compliance -- all as required by the Reconciliation

Act of 2025 (a/k/a H.B. #1, One Big Beautiful Bill) (Public Law 119–21).

According to the Missouri Budget Project, an estimated 177,000 eligible Medicaid recipients are

anticipated to lose coverage in Missouri as a result of bureaucratic processes from the One Big Beautiful

Bill renewal and work requirements. According to Dr. Timothy McBride and the Washington

University in St. Louis Center for Advancing Health Services, Policy & Economics Research, current

annual enrollment renewals of Medicaid coverage are resulting in one quarter losing coverage, with 90%

of those losing coverage because of procedural reasons (such as missing or lost paperwork), not because

they are ineligible. Since January 2025 there has been a reduction in children enrolled in Medicaid in

Missouri of over 27,000 (down 4.6%) even though there has been no change in eligibility criteria. It is

believed that this is as a result of disenrollment for procedural reasons. It is anticipated that doubling the

number of times for renewal to twice per year and adding verification of qualifying activities e.g. work,

education, community service, workforce training, certain caregivers, and inmates) or exemption

because of certain verified disabilities and medical conditions that prevent compliance, without

substantial upgrades to computer systems and software as well as expansion of the workforce to process

these enrollments and verifications will only exacerbate the system disfunction that is resulting in loss of

coverage for procedural reasons.

One of the core functions of a public health organization such as the City of St. Louis Department of

Health is to link people to needed personal health services and assure the provision of healthcare when

otherwise unavailable (Equitable Access). The services to be offered under this RFP should be designed

to fulfill this core public health function.

The purpose of this RFP is to promote and ensure the fairest, most efficient means to obtain the benefits

of the most qualified, responsive, and responsible proposal. Hereinafter, organizations interested in

submitting a proposal in response to this RFP shall be referred to as “Respondents.”

The City of St. Louis is not obligated to award funds to any provider, nor is the City of St. Louis liable for

any costs incurred by the organizations in the preparation of applications. Nothing in this RFP, nor in any

application in response to this RFP, is intended to be, nor should anything be construed as, an offer of

engagement. Selection of a Respondent shall not be construed as an offer of engagement unless and until

a contract is fully negotiated and fully executed by all parties. The City retains the right to award parts of

the available funds to several Respondents, not to issue any funds, and/or to re-solicit applications.

The City reserves the right to reject any and all applications submitted and to waive any and/or all non-

material irregularities pertaining to the submission of the application. Additionally, any and all projects

elements, requirements and schedules are subject to change and modification. The City also reserves the

right to modify, suspend, or terminate at its sole discretion any and all aspect(s) of the RFP process to

obtain further information from any and all Respondents, and to waive any defects as to form or content

of the RFP or any responses by any Respondents. All submitted materials will become the property of the

4

City, may become public documents at any time during the awarding process, and will become public

documents at the conclusion of the awarding process. Any and all documents submitted by Respondents

may become public if and when they are submitted to any advisory or legislative public body, or pursuant

to the Missouri Sunshine Law. By applying to this RFP, each Respondent acknowledges having read this

RFP in its entirety and agrees to all terms and conditions set out herein.

II. Contact Person & Questions

Please direct all communications regarding this RFP with a clearly marked subject heading of “RFP –

MEDICAID RENEWAL AND WORK REQUIREMENTS NAVIGATION SERVICES” to:

Craig Schmid at the following email address: schmidc@stlouis-mo.gov

No contact with other City employees or personnel is permitted.

Questions must be submitted no later than June 16, 2026 unless the Department of Health provides an

addendum to this RFP as part of rolling acceptance of applications to expend all funding. The Department

of Health will maintain a list of all organizations or individuals requesting copies of this RFP and will

ensure that copies of all questions and responses shall be made available in writing to each organization

on such list, when requested. Answers will also be publicly posted at https://www.stlouis-

mo.gov/government/procurement/index.cfm#rfp .

Questions should be asked in consecutive order, from beginning to end, following the organization of

this RFP. Each question should begin by referencing the RFP page number and section number to which

it relates. All contacts and questions must be submitted in writing to the designated contact person by

sending an e-mail to him with a clearly marked subject heading of “RFP – MEDICAID RENEWAL

AND WORK REQUIREMENTS NAVIGATION SERVICES”.

Respondents should not otherwise contact the City directly, in person, by telephone, facsimile, or by e-

mail, concerning this RFP.

Contact with the City after the submission of an application is limited to status inquiries only and such

inquiries are to be directed only to the above-named individual by email with a clearly marked subject

heading of “RFP – MEDICAID RENEWAL AND WORK REQUIREMENTS NAVIGATION

SERVICES”. Any further unsolicited contact or information about the RFP to the City or any of its

personnel will be considered an impermissible supplementation of the Respondent’s application.

III. Submission

Respondents must submit an application via one email to schmidc@stlouis-mo.gov with a clearly marked

subject heading of “RFP – MEDICAID RENEWAL AND WORK REQUIREMENTS

NAVIGATION SERVICES” electronically timestamped no later than 4:00 p.m. (CDT) on June 24,

2026 and only in standard (8 x 11-inch letter sized) in both Microsoft Word and PDF formats. Late or

incomplete proposals will not be accepted. Applicants must adhere to the following:

● Must be in the English language.

● Page number limits as set forth below in VII. CONTENTS OF PROPOSAL.

● Double spaced with one-inch margins.

● Use 12-point Times New Roman or Calibri font.

● Number each page at the bottom, except for the cover page.

● Use 8.5 inch by 11-inch page size that can be photocopied

5

Commodity Codes

• NAICS 541511Custom Computer Programming Services
• NAICS 541519Other Computer Related Services
• NAICS 541611Administrative Management and General Management Consulting Services

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