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PCA HEALTH PLANS OF FLORIDA, INC., AND PCA FAMILY HEALTH PLANS, INC. vs BROWARD COUNTY SCHOOL BOARD, 95-004559BID (1995)

Court: Division of Administrative Hearings, Florida Number: 95-004559BID Visitors: 20
Petitioner: PCA HEALTH PLANS OF FLORIDA, INC., AND PCA FAMILY HEALTH PLANS, INC.
Respondent: BROWARD COUNTY SCHOOL BOARD
Judges: MICHAEL M. PARRISH
Agency: County School Boards
Locations: Fort Lauderdale, Florida
Filed: Sep. 15, 1995
Status: Closed
Recommended Order on Friday, December 8, 1995.

Latest Update: Jan. 05, 1996
Summary: Petitioner, PCA Health Plans of Florida, Inc. ("PCA"), has challenged The Broward County School Board's proposed award of the group health plan HMO contract pursuant to Request for Proposals 96-030S. The ultimate issue presented is whether the School Board's proposed award is fraudulent, arbitrary, dishonest, or illegal. PCA framed the following subsidiary issues in the Joint Prehearing Stipulation ("JPS"): Whether committee members were arbitrary and capricious in rating HIP and Humana Responde
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95-4559

STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS


PCA HEALTH PLANS OF FLORIDA, )

INC., a Florida corporation, )

)

Petitioner, )

)

vs. )

) THE SCHOOL BOARD OF BROWARD ) COUNTY, FLORIDA )

)

Respondent. ) CASE NO. 95-4559BID and )

)

HIP HEALTH PLAN OF FLORIDA )

INC., a Florida corporation, ) and HUMANA HEALTH INSURANCE ) CO. OF FLORIDA, INC., )

)

Intervenors. )

)


RECOMMENDED ORDER


Pursuant to notice, the Division of Administrative Hearings, by its duly designated Hearing Officer, Michael M. Parrish, held a formal hearing in the above-styled case on October 16, 17, and 18, 1995, in Fort Lauderdale, Broward County, Florida.


APPEARANCES


For Petitioner: Andrew S. Berman, Esquire

Young, Berkman, Berman & Karpf, P.A. 17071 West Dixie Highway

North Miami Beach, Florida 33160


For Respondent: Edward J. Marko, Esquire

Marko & Stephany

1401 East Broward Boulevard, Suite 201 Fort Lauderdale, Florida 33301


For Intervenor: Robert L. Shevin, Esquire HIP Richard Simring, Esquire

Strook & Strook & Lavan

200 South Biscayne Boulevard, Suite 3300 Miami, Florida, 33131

and

W. George Allen, Esquire Allen, Hursey and Lucas

305 South Andrews Avenue, Suite 701 Fort Lauderdale, Florida 33302

and

Gerald M. Cohen, Esquire

300 South Park Road Hollywood, Florida 33021


For Intervenor: Holly Skolnick, Esquire

Humana Greenberg, Traurig, Hoffman, Lipoff Rosen & Quentel, P.A.

1221 Brickell Avenue

Miami, Florida 33131 STATEMENT OF THE ISSUES

Petitioner, PCA Health Plans of Florida, Inc. ("PCA"), has challenged The Broward County School Board's proposed award of the group health plan HMO contract pursuant to Request for Proposals 96-030S. The ultimate issue presented is whether the School Board's proposed award is fraudulent, arbitrary, dishonest, or illegal.


PCA framed the following subsidiary issues in the Joint Prehearing Stipulation ("JPS"):


  1. Whether committee members were arbitrary and capricious in rating HIP and Humana Respondent, proposals as the only proposed products that exceeded current benefits (Criterion #3).

  2. Whether committee members were arbitrary and capricious by scoring PCA's mental health benefit package lower than Humana's (Criterion #5).

  3. Whether committee members were arbitrary and capricious by scoring PCA significantly lower than competitors in the area of willing- ness to comply with requested services, where PCA's proposal was either identical to or exceeded the proposal of the successful bidders (Criteria #10 and #11).

  4. Whether some of the voting was the result of bias for or against a particular proposer so as to affect the integrity of the RFP process to the damage of PCA.

  5. Whether the Board's vote on August 15, 1995 to approve the contracts with HIP and Humana, while PCA's protest was outstanding and unresolved, violated the terms of the RFP, School Board rules and Florida law, and tainted and poisoned the Board's hearing of PCA's formal protest.

  6. Whether committee members acted arbitrarily and capriciously by scoring PCA significantly lower than competitors in the M/WBE category, where the Board's own study suggested that PCA was at or near the top in this category, and was certainly superior

    to the successful bidders. One committee member gave PCA a zero.

  7. Whether some of the scoring was illegal

    because some of the insurance committee members had alternates.

  8. Whether some of the scoring was illegal because at least one of the insurance committee member's scores was collaborative.


In addition, PCA filed a memorandum of law requesting a finding of fact that the School Board's M/WBE policy is unconstitutional.


PRELIMINARY STATEMENT


This case was referred to the Division of Administrative Hearings on September 15, 1995, after PCA filed its formal written protest and petition for formal administrative hearing. By agreement of the parties, the hearing was held on October 16, 17, and 18, 1995, in Broward County, Florida.


The School Board and PCA stipulated to the intervention of HIP and Humana as parties.


At the hearing the School Board made an ore tenus motion in limine based on Section 120.53(5)(b), Florida Statutes. That section requires that a formal written protest "state with particularity the facts and law upon which the protest is based." The School Board asserted in its motion that issues (e), (g), and (h), as set forth above in the Statement of the Issues, were not properly part of this proceeding because they were not raised in PCA's formal written protest. After hearing argument from all parties, the Hearing Officer granted the School Board's motion and limited the issues to be litigated to those set forth with particularity in the formal written protest.


PCA presented the following witnesses: Walter Collymore, Stephanie Sheppa, Mary Kay Shea, and Patricia Thompson. PCA exhibits 2-5, 7, 10-13, 15, 18, 19,

23(b), and 27-34 were received in evidence. Exhibits 1, 23(a), 24, 25, 35 and

36 were rejected. Exhibit 26 was marked for identification but never introduced. (There are no exhibits 6, 8, 14, 16, 17, 20, 21 or 22.)


The School Board presented the testimony of James Marshall, Jr., and Mark Seigle. School Board exhibit 1 was received in evidence.


Neither HIP nor Humana presented any witnesses. HIP exhibits 1-3 were received in evidence. Humana did not offer any exhibits.


Prior to the hearing, on October 5, 1995, Humana filed a motion to dismiss.

The arguments set forth in Humana's motion have been considered and are incorporated in the conclusions of law.


At the conclusion of the hearing the parties were allowed ten days from the filing of the transcript within which to file their proposed recommended orders. The hearing transcript was filed on October 25, 1995. On November 6, 1995, the Petitioner and the Intervenor HIP both filed proposed recommended orders containing proposed findings of fact and conclusions of law. The Petitioner also filed a separate Memorandum of Law and Intervenor HIP filed a separate Closing Argument. The Respondent and the Intervenor Humana both filed statements adopting the proposed recommended order submitted by the Intervenor HIP.

The proposals submitted by the parties have been carefully considered during the preparation of this Recommended Order. All proposed findings of fact submitted by the parties are specifically addressed in the appendix to this Recommended Order.


FINDINGS OF FACT


The Parties


  1. The School Board of Broward County, Florida is responsible for, among many other things, the purchase of group health insurance for school system employees. The Broward County School System is the second largest in Florida and the seventh largest in the United States with 21,033 eligible employees.


  2. PCA, HIP, and Humana are large managed care companies providing a wide range of health care services to the public. Each proposer submitted proposals in response to the RFP. PCA's proposal was subdivided into PCA Basic (which was designed to generally match the current benefit plan) and PCA Enhanced (which was designed to exceed the current benefit plan). HIP and Humana are interested parties, entitled to intervene, because they were jointly awarded the health insurance contract by the Board, subject to PCA's protest.


    The Insurance Consultant


  3. The Board retained the services of Siver Insurance Management Consultants ("Siver"), an independent insurance management consulting firm, to aid it and the Insurance Committee with this RFP and other matters. Siver is a group of professionals who provide advice and counsel to both public and private sector clients. The majority of its public sector work involves assisting governmental entities in purchasing their insurance programs.


  4. Siver was not retained to score the proposals or to provide a recommendation to the Insurance Committee or the School Board as to which proposal should be chosen.


  5. At one of the early Insurance Committee meetings, Siver made a presentation entitled "Insurance 101" to inform the Committee members about group health insurance and to advise them about the criteria that could be used in the evaluation process.


    The RFP


  6. On April 11, 1995 the Board issued an RFP to solicit bids for its group health program, covering eligible employees of the Broward County School System. It sought proposals on one or more of the following managed care organizations, with each organization to be evaluated on its own merit (standing alone):


    1. Health Maintenance Organization (HMO)

    2. Point-of-Service Health Maintenance Organization (POSHMO)

    3. Preferred Provider Organization (PPO)


    The contract was to begin January 1, 1996 and run through January 1, 2000 (4 years).


  7. The RFP set forth, in general terms, the criteria that would be used to evaluate the proposals. Under the category "Evaluation Criteria and Selection Factors", the RFP provided that out of a total of 100 points, 0 to 45 points

    would be allocated to projected costs and rate guarantees, 0 to 45 points would be allocated based upon the extent to which the proposers were "willing and able to provide products and services as specified in the RFP", and 0 to 10 points would be allocated for the extent to which minorities and women were to participate in the providing of services.


  8. The criteria in the RFP were further broken down for the "willing and able" and M/WBE categories. In the willing and able category (45 points maximum) the major factors which may be considered were stated to be: The degree of relevant experience of the proposer with respect to comparable clients in Florida; the degree to which the proposer matched current plan provisions, coverages and services required by the RFP; the degree to which the proposer exceeded the current plan provisions, coverages, and services required; and the capability of the network to provide proposed care and services.


  9. The M/WBE category (10 points maximum) was further broken down as follows: (a) The degree to which minorities and women participate in the services to be performed and (b) the estimated amount of remuneration to qualified M/WBE's. The M/WBE criteria also provided:


    A greater amount of evaluation credit will be given to Proposers with a Broward County office(s) whose employee composition by ethnicity and gender reflects the Broward County population as defined by the 1990 census. Less evaluation credit will be given to Proposers with administrative office(s) located outside Broward County and/or whose office(s) do not have the employee composition by ethnicity and gender that reflects the Broward County population as defined by the 1990 census.


  10. The RFP specifically provided that Proposers could protest the contents of the RFP within 72 hours of its receipt. Neither PCA, nor any other Proposer, filed a protest to the contents of the RFP. Specifically, PCA did not protest the School Board's express intention, set forth in Section II, pages 7-8 of the RFP, to use the ratio of minority and women business enterprises as one of the criteria to rate the proposals.


    The Insurance Committee


  11. The RFP was developed by an Insurance Committee of fourteen individuals chosen by the Superintendent of the School Board.


  12. The Insurance Committee was charged with responsibility for evaluating the various proposals submitted in response to the RFP and making a recommendation to the Superintendent.


  13. The fourteen Insurance Committee members, and their respective backgrounds, were as follows:


    1. Ray Adkins Executive Director

      Confidential Office Personnel Association

    2. Walter Browne Executive Director

      Federation of Public Employees

    3. James Flynn Executive Director

      Support Services Personnel Association

    4. Anthony Gentile

      President, Broward County Teachers Association

    5. Judith Hunt

      Director of Risk Management and Safety for the Broward County School Board

    6. Nona L. Jones

      Local Businesswoman with background in risk management

    7. George Latimer

      Chief Finance Officer, Broward County School Board

    8. Lisa Maxwell Executive Director,

      Broward County Principals Association

    9. Robert Parks

      School Board Member

      Professor, Nova Southeastern University

    10. William Read

      Retired Businessman

      Former Benefits Manager, Chrysler Motor Corporation

    11. Mark S. Seigle

      Associate Superintendent for Personnel of the Broward County School Board

    12. Richard Thomas

      Director of Benefits, Broward County School Board

    13. Patricia Thompson

      President, Broward County Paraprofessional Association

    14. Lois Wexler

    School Board Member


  14. Of the 14 Insurance Committee members, two were School Board members, four were high ranking employees of the School Board, six were representatives of various employee unions and associations, and two were from the Broward business community.


  15. Each of the Insurance Committee members was furnished with, among other things, a copy of each of the proposals submitted in response to the RFP. These copies comprised several boxes full of documents.


  16. The Insurance Committee met a total of 11 times, beginning on February 17, 1995 and ending on July 17, 1995. Each meeting lasted between 3 and 10 hours.


  17. All the meetings of the Insurance Committee were publicly held "in the Sunshine."


    The Committee Evaluation Process


  18. The intention of the Insurance Committee in evaluating the proposals was to design evaluation criteria that afforded maximum discretion. There was no intention of making the Insurance Committee a "mathematical scoring machine."

  19. Based on consultations with Siver, and through its various meetings, the Insurance Committee adopted a scoring matrix to use in evaluating the various proposals.


  20. The scores were divided, as required by the RFP, into three categories: Ready, Willing and Able ("RWA"), Price, andMinority/Women Business Enterprise ("M/WBE").

  21. The maximum scores for each category were as follows: Price 45

    Ready and Willing 45

    M/WBE 10


    TOTAL: 100 Points


  22. The RWA category was subdivided into twelve separate criteria. The M/WBE category was subdivided into two separate criteria. The Insurance Committee thus ranked the proposals using a total of 14 separate criteria.


  23. Ultimately, the willing and able category was broken down into the following 12 "detailed categories": The number of products offered (1,2 or 3); whether the proposal matched current plan benefits or model; whether the proposal exceeds current benefits or model; allocation of premium dollars to medical services/claims; whether the proposal exceeded, equalled or provided less than the current level of mental health and substance abuse benefits; wellness program (level of services to be provided); credentials for managed care products; the extent to which the proposal exceeded, equalled, or provided less than the current provider of managed care services; the ratio of board certified providers to total network providers; comply with requested services set forth in the RFP; agree to service standards set forth in the RFP; and overall experience, specifically in Florida.


  24. The Insurance Committee then allocated maximum points to each of the

    12 "detailed categories" according to their importance. The total of the points added up to 45. The Insurance Committee created a scoring grid containing the "detailed criteria", listing the detailed criteria and maximum points to be awarded in each category on the left side of the document, along with the 12 separate proposers across the page from left to right, leaving space to score each proposer in each criterion. In assigning points to the various criteria, it was the intention of the Insurance Committee members to allow for scoring anywhere along the range of assigned points. As noted in an early draft of the scoring matrix: "Maximum Suggested Points means that points may be awarded up to the stated maximum for each criteria."


  25. As a general rule, when establishing criteria for the evaluation of competing proposals for the furnishing of services it is best to try to avoid or minimize the use of subjective criteria. However, with regard to proposals of the type involved in this case, it is difficult to make meaningful comparisons on a purely objective basis and a certain amount of subjectivity is unavoidable. Honest mistakes are to be expected in a committee evaluation of competing proposals. Although a number of the criteria adopted by the Committe in this case were largely subjective, all of the criteria were relevant to a reasonable comparison of competing proposals.


  26. The consultant for the Board, Siver, prepared an analysis and comparative study of the various proposals to assist the Insurance Committee in

    scoring the proposals. The Proposal Analysis consisted of a breakdown and comparison of those features in each proposal which were relevant to each of the

    12 RWA criteria established by the Insurance Committee. It listed each of the criteria individually and then outlined how each proposer complied or did not comply with the criteria. The analysis provided a quick reference for Insurance Committee members to use during their evaluation of the proposals, particularly given the number and size of the proposals. Each of the Insurance Committee members was provided a copy of the Siver analysis.


  27. Siver's Proposal Analysis was limited to the price/cost and "willing and able" categories. The Board utilized the resources of its own staff to assemble and compare information contained in the proposals with respect to the M/WBE category. Ultimately, the Committee decided to break down the M/WBE category into two sub-categories, to wit: workforce environment and M/WBE participation. It also decided that the workforce environment category would count for 3 points, and the M/WBE participation category for 7 total points.


  28. Shelia Dudley, the M/WBE coordinator for the Board supplied Insurance Committee members with several proposal analyses. The first was a document analyzing the percentage of minority and women employees in the proposers' regional, local, and corporate offices. The second was a proposal analysis of the extent to which the proposers committed to M/WBE participation. The document contained three columns. The first noted the firmness of any contracts with a qualified M/WBE and the dollar commitment, if provided; the second column set forth the form of minority contractor participation, viz: wellness program, printing, copying, etc., and the third column extracted general information from the proposals which might be useful to the analysis. The next document provided a breakdown of minorities/women for "physicians and others", and Dudley indicated that only Humana provided such information. PCA did supply a list of all minority physicians in Broward County with estimated capitation dollars, although without percentages.


  29. Lastly, Ms. Dudley provided Insurance Committee members with a document outlining possible evaluation considerations for the workforce environment criteria and the M/WBE participation criteria. There was no evidence in the record that Ms. Dudley's proposed evaluation considerations were ever adopted by the Committee.


    The July 13, 1995 Scoring


  30. The Insurance Committee met on July 13, 1995, to score the various proposals.


  31. Prior to the July 13, 1995, Committee meeting, all of the proposers had been given an opportunity to make an oral presentation, to hand out written presentation materials, and to participate in a question and answer session before the Committee voted. In addition, many of the Proposers, including PCA, had previously met individually with most of the Committee members for 20 or 30 minutes. The Committee members had also been lobbied by the various Proposers.


  32. Each member of the Insurance Committee scored the proposals for three different group medical products: an HMO product, a PPO product, and a Point of Service HMO product.


  33. The Insurance Committee elected not to independently score the price category, but rather to adopt Siver's price rankings based on a formula approved by the Committee.

    The July 17, 1995, Scoring


  34. The Insurance Committee reconvened on July 17, 1995, because Siver, at the request of some of the proposers, asked the Insurance Committee members to re-check some of their scores that in Siver's opinion were objectively verifiable and possibly inconsistent with the scores given by other Committee members. Siver offered its help, but left it to the individual Committee members to decide whether to rescore. Some did; some did not. (The final scores by each Insurance Committee member on each of the criteria are set forth in Petitioner Exhibit 18.)


  35. The Insurance Committee's final aggregate scores on HIP's HMO, Humana's HMO, and PCA's two separate HMOs (referred to as "PCA Basic" and "PCA Enhanced") were as follows:


    7/17/95 Score



    HIP

    HUM

    PCA

    PCA Enh

    RWA

    1

    3.00

    3.00

    2.64

    2.69

    RWA

    2

    6.93

    7.00

    6.21

    6.77

    RWA

    3

    4.57

    3.00

    1.57

    3.46

    RWA

    4

    3.00

    0.79

    2.93

    2.92

    RWA

    5

    2.36

    2.43

    1.86

    1.92

    RWA

    6

    2.71

    2.36

    2.36

    2.31

    RWA

    7

    3.04

    -0.36

    0.29

    0.23

    RWA

    8

    1.43

    2.21

    0.93

    0.85

    RWA

    9

    2.64

    0.14

    0.07

    0.08

    RWA

    10

    2.57

    2.50

    1.93

    2.00

    RWA

    11

    2.43

    2.50

    1.79

    1.85

    RWA

    12

    2.75

    3.57

    1.57

    1.54


    RWA Subtotal


    37.43


    29.14


    24.14


    26.62

    Cost

    40.49

    41.29

    43.65

    40.42

    M/WBE 1

    2.73

    2.89

    1.07

    1.15

    M/WBE 2

    6.00

    6.43

    4.93

    5.31

    M/WBE Subtotal

    8.73

    9.32

    6.00

    6.46

    HMO TOTALS:

    86.65

    79.75

    73.79

    73.50


  36. The Insurance Committee posted the final scores for all Proposers and each of their products on July 24, 1995. HIP and Humana scored more total points than any other bidders on each of the three products. Accordingly, the Committee recommended that the School Board award the entire RFP, including the HMO contract, jointly to HIP and Humana.


    September 5, 1995 School Board Meeting


  37. On July 27, 1995, PCA filed a Notice of Protest with the Director of Purchasing of the School Board, as required by the RFP. On August 7, 1995, PCA filed a Formal Written Protest with the School Board. PCA's protest challenged

    the scoring on eight separate criteria: RWA Criteria Nos. 2, 3, 4, 5, 9, 10, and 11, and the M/WBE criteria.


  38. On September 5, 1995, the School Board met to consider PCA's protest. The School Board heard argument from PCA's attorney and from Siver.


  39. Mr. Marshall, on behalf of Siver, informed the School Board that, although some of the criteria were objectively verifiable, others had been scored on a subjective range.


  40. Following Siver's recommendation and its own evaluation of the criteria, the School Board agreed to give PCA the benefit of the doubt and to accept PCA's asserted revised scores on RWA Criteria Nos. 2, 4 and 9 because those criteria were arguably objectively verifiable. The School Board rejected PCA's arguments regarding the other criteria.


  41. Even with the School Board's willingness to give PCA the benefit of the doubt on the three criteria mentioned above, the Insurance Committee's July 17th rankings did not change. Consequently, the School Board denied PCA's protest.


  42. The revised aggregate scores agreed to by the parties for purposes of the final administrative hearing include the revised scores recommended by Siver and agreed to by the School Board on Criteria Nos. 2, 4, and 9. They are as follows:


9/5/95 Board Rescoring



HUM

PCA

PCA Enh

RWA

1

3.00

2.64

2.69

RWA

2

7.00

7.00

7.00

RWA

3

3.00

1.57

3.46

RWA

4

0.43

3.00

3.00

RWA

5

2.43

1.86

1.92

RWA

6

2.36

2.36

2.31

RWA

7

-0.36

0.29

0.23

RWA

8

2.21

0.93

0.85

RWA

9

0.00

0.00

0.00

RWA

10

2.50

1.93

2.00

RWA

11

2.50

1.79

1.85

RWA

12

3.57

1.57

1.54

RWA Subtotal 28.64


24.93


26.85



Cost 41.29

43.65

40.42



M/WBE 1 2.89

1.15

1.15



M/WBE 2 6.43

5.31

5.31



M/WBE Subtotal 9.32

6.46

6.46



HMO TOTALS: 79.25

75.04

73.73



43. On September 12, Hearing.

1995, PCA

filed a

Petition

for Formal Administrative

RWA Criterion # 3


  1. Since neither HIP, Humana, nor PCA received a perfect "5" in the aggregate on Criterion #3, the Insurance Committee members obviously viewed the scoring on this criteria as a range from 0 to 5. Criterion #3 was largely subjective and was scorable on a range based upon the Committee members' individual perspectives of the value of the enhancements.


  2. There is a reasonable factual basis in the record for the Insurance Committee members to have differentiated along a range between the proposers on this criterion. Because each proposer offered different enhancements, it was a matter of discretion for each Committee member, in his or her own judgment, to rate those enhancements based on their perceived value to the employees of the Broward County School Board. The evidence is insufficient to show that the scoring on this criterion was arbitrary to any material or quantifiable extent.


    RWA Criterion #5


  3. Since neither HIP, Humana, nor PCA received a perfect "4" in the aggregate on Criterion #5, the Insurance Committee members obviously viewed the scoring on this criteria as a range from 0 to 4. Criterion #5 was highly subjective and scorable on a range.


  4. The RFP required at section III, pages 6-8 that each provider's mental health subcontractors should "reflect the racial and ethnic composition of the School Board's employees." The Insurance Committee members could have differentiated along a range between the Proposers on this criteria. Each Proposer offered different mental health and substance abuse packages, and it was therefore a matter of wide discretion for each Committee member, in his or her own judgment, to rate those packages based on their perceived value to the employees of the Broward County School Board. The evidence is insufficient to show that the scoring on this criterion was arbitrary to any material or quantifiable extent.


    RWA Criterion #10


  5. Since neither HIP, Humana, nor PCA received a perfect "+3" in the aggregate on Criterion #10, the Insurance Committee members obviously viewed the scoring on this criteria as a range from -3 to +3.


  6. The Insurance Committee members could have differentiated along a range between the Proposers on this criteria. For example, each Proposer offered a different number of on-site customer service representatives: HIP offered 6 representatives, Humana offered 2, and PCA offered 1.


  7. Members of the Insurance Committee could have evaluated Proposers based not just on whether they would, but whether they could, provide the requested services. This inference could be drawn by a Committee member based on the Proposer's references, which demonstrated their prior ability to perform, and the number of years that the Proposer has been a health care provider. The evidence is insufficient to show that the scoring on this criterion was arbitrary to any material or quantifiable extent.

    RWA Criterion #11


  8. Since neither HIP, Humana, nor PCA received a perfect "+3" in the aggregate on Criterion #11, the Insurance Committee members obviously viewed the scoring on this criteria as a range from -3 to +3.


  9. The Insurance Committee members could have differentiated along a range between the Proposers on this criteria. Just as with Criterion #10, the Insurance Committee members could have evaluated Proposers based not just on whether they would, but whether they could, comply with the requested services. The evidence is insufficient to show that the scoring on this criterion was arbitrary to any material or quantifiable extent.


    The M/WBE Criteria


  10. The M/WBE criteria was broken down into two categories: workforce environment and vendor participation. Out of 10 possible points, the Committee decided to allow a maximum of 3 points for workforce environment and 7 points for minority participation.


  11. The RFP, however, expressly indicated that Proposers who did not have an administrative office in Broward County would be scored lower than Proposers that did. (See Paragraph 9 of these Findings of Fact.) PCA does not have an administrative office in Broward County. Both HIP and Humana do have administrative offices in Broward County. This information alone was sufficient for the Insurance Committee, in its honest discretion, to score PCA less than HIP and Humana.


  12. The M/WBE Participation Proposal Analysis prepared by the School Board's Equal Employment Opportunity Department indicated that Humana anticipated that 48 percent of its primary care physicians would be M/WBEs, that

    35 percent of its specialty physicians would be M/WBEs, and that 43.5 percent ($157,783,000) of the total dollars paid to physicians in 1994 were paid to M/WBEs.


  13. PCA did not provide a breakdown of the ratio of its M/WBE physicians to the total number of physicians. Instead, PCA indicated that it had about 378 total M/WBE physicians and that the total fees that would be paid to such physicians were estimated to be $853,944.


  14. Humana was the only Proposer to provide a breakdown of its physicians by ethnicity and gender.


  15. There was other sufficient information available to the Insurance Committee members upon which they could reasonably have scored PCA lower than HIP and Humana in their "honest exercise of discretion." The evidence is insufficient to show that the scoring of the M/WBE criteria was arbitrary to any material or quantifiable extent.


    Bias


  16. PCA did not present any evidence that any of the Insurance Committee members were biased for or against any of the Proposers.


  17. A comparison of the scores of the various Insurance Committee members indicate that they were, for the most part, in reasonably good agreement with

    respect to how they rated HIP, Humana, and PCA on each criteria. There are, however, as mentioned below, a number of scores that appear to be abberations.


    Some General Observations


  18. The evidence in this case is sufficient to show that at least one member of the Insurance Committee made at least some scoring decisions on the basis of arbitrary considerations. The evidence also establishes that another member of the Insurance Committee made all of his material scoring decisions on the basis of appropriate considerations. The evidence does not show the reasoning behind any of the scoring decisions of any of the other twelve members of the Insurance Committee. Accordingly, the evidence is insufficient to establish that any of the scoring decisions of any of the other twelve Committee members was arbitrary.


  19. The arbitrary scoring decisions of one member of the Insurance Committee have not been described in detail in these Findings of Fact because the impact of those few scores on the average scores is de minimus. If all of the average scores were to be recalculated to take into account the few arbirary scores that were proved there would be no significant change in the ranking of the parties.


  20. There were some scores by some members of the Insurance Committee that, on the record in this case, appear to be what can best be described as unexplained abberations. Because they are unexplained, the evidence is insufficient to establish that these apparent abberations were based on arbitrary considerations. It is possible they were merely honest mistakes. It is possible there is some logical explanation for some or all of the apparent abberations, which explanation is not part of the record in this case because the members who cast those votes were not called as witnesses. Unexplained abberations are an insufficient basis upon which to conclude that a bidding process is arbitrary.


    Final Rankings


  21. According to the July 17, 1995 scores, PCA's best score was 5.96 points lower than Humana's score.


  22. Using the September 5, 1995 scores (and thus giving PCA the benefit of the doubt of higher scores on those criteria that were objectively verifiable), PCA's best score is still be 4.21 points lower than Humana's score.


  23. Even if the M/WBE scores were not considered, PCA's best score using the September 5, 1995 scoring would be 1.35 points lower than Humana's.


  24. Even if PCA were given the full 10 points for the M/WBE criteria, PCA's best score using the September 5, 1995 scoring would still be .67 points lower than Humana's.


    CONCLUSIONS OF LAW


  25. The Division of Administrative Hearings has jurisdiction over the subject matter of and the parties to this proceeding pursuant to Sections 120.53(5) and 120.57(1), Florida Statutes.


  26. HIP and Humana, as the successful bidders for the RFP, are entitled to intervene as parties in this proceeding.

  27. In a bid protest such as this, the sole responsibility of the Hearing Officer is to ascertain whether the agency acted fraudulently, arbitrarily, illegally, or dishonestly. Department of Transportation v. Groves-Watkins Constructors, 530 So. 2d 912, 913(Fla. 1988); Liberty County v. Baxter's Asphalt and Concrete, Inc., 421 So. 2d 505, 507 (Fla. 1982); Blue Cross and Blue Shield of Florida, Inc v. AHCA, DOAH Case No. 95-3635BID (RO issued September 27, 1995).


  28. As the Florida Supreme Court noted in Liberty County:


    1. public body has wide discretion in soliciting and accepting bids for public improvements and its decision, when based on an honest exercise of this discretion, will not be overturned by a court even if it may appear erroneous and even if reasonable persons may disagree.


      530 So. 2d at 913 (emphasis added).


  29. In the context of an evaluating committee, such as the Insurance Committee in this case, the courts have held as follows:


    The Hearing Officer need not, in effect, second guess the members of [the] evaluation committee to determine whether [they] and/or other reasonable and well-informed persons might have reached a contrary result.


    Scientific Games, Inc. v. Dittler Bros., Inc., 568 So. 2d 1128, 1131 (Fla. 1st DCA 1991) (emphasis added).


  30. This more restrictive standard of review for competitive bidding cases is consistent with the limited remedy available to a successful bid challenger. If a public bid process is declared arbitrary, a Hearing Officer does not have authority, even if the parties so stipulate, to make a de novo evaluation of the bids or to award the contract to a different bidder. The Hearing Officer only has jurisdiction to remand the entire matter to the agency for further action. Procacci v. Department of Health & Rehabilitative Services, 603 So. 2d 1299, 1300-01 (Fla. 1st DCA 1992); Moore v. Department of Health & Rehabilitative Services, 596 So. 2d 759, 761 (Fla. 1st DCA 1992).


  31. Substantial disagreement among the members of an evaluation committee is not unusual in cases of this nature. See, for example, Blue Cross and Blue Shield of Florida, Inc. v. AHCA, DOAH Case No. 95-3635BID (RO issued September 27, 1995), which involved the "use of 24 evaluators with diverse backgrounds and perspectives; use of questions involving the application of judgement and subjective standards; and use of the 0-10 scoring scale without any exact or true score for any questions."


  32. The Petitioner in this case has not contended that the School Board's action is fraudulent or dishonest. The Petitioner's primary contention is that the School Board's action is arbitrary and, by reason of being arbitrary is, therefore, also illegal. There is no assertion by the Petitioner of any illegal conduct by the School Board other than the allegedly arbitrary conduct in awarding the subject contract.

  33. Based on the agreement of the parties resulting from the September 5, 1995, School Board Meeting, PCA is challenging only the Board's scores on the following five criteria:


    RWA Criterion #3: Whether the proposal exceeds current benefits or model;

    RWA Criterion #5: Mental Health and Substance Abuse; RWA Criterion #10: Whether the proposal complies with requested services;

    RWA Criterion #11: Whether the Proposer agrees to service standards; and

    The M/WBE criteria.


  34. PCA only challenges the School Board's award of the HMO product, not its award of the PPO or the POSHMO. PCA is not contesting the price rankings. PCA is not challenging HIP's first place ranking; it only challenges Humana's second-place ranking over PCA's third-place ranking.


  35. On all of the contested criteria, there was information made available to the Insurance Committee upon which it could, within the exercise of a reasonable discretion, reasonably score Humana higher than PCA.


  36. While it is possible that some of the scoring decisions of the twelve Committee members who did not testify may have been arbitrary, there is no persuasive competent substantial evidence in the record of this case to establish that such is the case. Further, on the record in this case there is no way in which the impact of any such possible arbitrary scoring can be quantified. Absent quantification it cannot be shown that any such possible arbitrary scoring resulted in any substantial injury to the Petitioner's interests.


  37. A great deal of the Petitioner's argument is based on the notion that an unexplained deviation from an expected scoring result constitutes proof that the unexpected result was the result of some arbitrary action by one or more Committee members. Such is not the case. Deviations from expectations can result from any number of different reasons. In order to demonstrate entitlement to relief from unexpected results, the Petitioner must present evidence of the reason for the results and must prove that the reason constituted an arbitrary, illegal, fraudulent, or dishonest act. Absent such proof, relief must be denied.


  38. The Division of Administrative Hearings does not have jurisdiction to address PCA's claim that the M/WBE criteria utilized by the School Board in scoring the RFP was unconstitutional. See, e.g., Myers v. Hawkins, 362 So. 2d 926, 928 (Fla. 1978). PCA's attempt in its memorandum to recharacterize the issue as factual rather than legal is unavailing.


  39. Even if PCA had a valid constitutional claim, PCA waived its right to contest the School Board's use of the M/WBE criteria because it did not contest the relevant portion of the RFP within 72 hours as required by the RFP itself.


  40. In brief conclusion, the evidence in this case is an insufficient basis for granting the relief sought by the Petitioner. The few instances of arbitrary scoring that were actually proved were too few in number to have any

material impact on the average scores. Accordingly, the Petition and Formal Protest should be dismissed and all relief requested in the Petition should be denied.


RECOMMENDATION


On the basis of all of the foregoing, it is RECOMMENDED that the School Board of Broward County issue a final order in this case dismissing the Petition and Formal Protest filed by the Petitioner and denying all relief requested by the Petitioner.


DONE and ENTERED this 8th day of December, 1995, at Tallahassee, Leon County, Florida.



MICHAEL M. PARRISH

Hearing Officer

Division of Administrative Hearings The DeSoto Building

1230 Apalachee Parkway

Tallahassee, Florida 32399-1550

(904) 488-9675


Filed with the Clerk of the Division of Administrative Hearings this 8th day of December, 1995.


APPENDIX


The following are the specific rulings on all proposed findings of fact submitted by all parties.


Proposed findings submitted by Petitioner: Paragraphs 1 and 2: Accepted.

Paragraph 3: Accepted in substance, but with a large number of argumentative or editorial details omitted.


Paragraph 4: First two sentences accepted in substance. The remainder of this paragraph is rejected as subordinate and unnecessary details, or as irrelevant.


Paragraph 5: Rejected as consisting primarily of quotations of testimony and of subordinate and unnecessary details.


Paragraph 6: Rejected as subordinate and unnecessary details. Paragraphs 7 through 10: Accepted in substance.

Paragraph 12: Rejected as subordinate and unnecessary details that are not entirely accurate.


Paragraph 13: Accepted in substance.

Paragraph 14: Most of this paragraph has been rejected as consisting of subordinate and unnecessary details and of quotations of testimony; portions also rejected as irrelevant.


Paragraphs 15 through 21: Accepted in substance, but with some argumentative and editorial language omitted.


Paragraph 22: First two sentences accepted in substance. The remainder is rejected as consisting primarily of argument, of summaries of testimony, and of subordinate and unnecessary details.


Paragraph 23: Accepted in substance.


Paragraph 24: The basic substance of this paragraph has been accepted, but the majority of the details have been omitted as subordinate and unnecessary or as quotations rather than proposed findings of fact.


Paragraph 25: Rejected as subordinate and unnecessary details or as irrelevant.


Paragraph 26: Rejected as comprised primarily of argument and proposed legal conclusions, rather than proposed findings of fact.


Paragraphs 27 through 31: Accepted in substance, but with a number of argumentative, subordinate, and unnecessary details omitted.


Paragraph 32: Rejected as comprised primarily of argument and proposed legal conclusions, rather than proposed findings of fact.


Paragraph 33: Rejected as comprised primarily of a statement of another party's position, rather than proposed findings of fact.


Paragraphs 34 and 35: Rejected as comprised primarily of argument and proposed legal conclusions, rather than proposed findings of fact. Also rejected as irrelevant, inasmuch as the School Board has agreed that PCA should receive full credit on the subject criterion.


Paragraph 36: Rejected as irrelevant, inasmuch as the School Board has agreed that PCA should receive full credit on the subject criterion.


Paragraph 37: Most of this paragraph has been rejected as being argumentative, as consisting of subordinate and unnecessary details, or as irrelevant. A few facts from this paragraph have been accepted.


Paragraph 38: Most of this paragraph has been rejected as subordinate and unnecessary details, or as irrelevant because, even if accepted, evidence of improper voting by one of fourteen members would not be a sufficient basis upon which to conclude that the Petitioner was entitled to any relief. The last sentence of this paragraph has been rejected as too vague to be meaningful and as not fully supported by the persuasive competent substantial evidence.


Paragraph 39: Rejected as subordinate and unnecessary details.


Paragraphs 40 through 44: Rejected as consisting primarily of argument and legal conclusions, rather than proposed findings of fact.

Paragraphs 45 through 58: These paragraphs are, for the most part, rejected for several reasons. They include many subordinate and unnecessary details. They are comprised extensively of argument, much of which argument is predicated on theories which are not persuasive to the Hearing Officer.


Paragraph 59: Rejected as subordinate and unnecessary details.


Paragraph 60: Rejected as a combination of argument and subordinate and unnecessary details.


Paragraphs 61 and 62: These paragraphs are, for the most part, rejected for several reasons. They include many subordinate and unnecessary details. They are comprised extensively of argument, much of which argument is predicated on theories which are not persuasive to the Hearing Officer.


Paragraph 63 through 65: First three sentences of paragraph 63 are accepted in substance. The remainder of these three paragraphs is rejected as irrelevant because they deal with an issue not properly raised in this case.


Paragraph 66: Rejected as consisting primarily of argument with subordinate and unnecessary details.


Paragraph 67: First sentence is accepted in substance. The remainder of this paragraph is rejected as argument.


Proposed findings submitted by Respondent:


(None submitted; Respondent adopted the findings proposed by Intervenor HIP.)


Proposed findings submitted by Intervenor HIP:


Paragraphs 1 through 9: Accepted in whole or in substance.


Paragraph 10: Rejected as subordinate and unnecessary details not relevant to the disposition of this case.


Paragraphs 11 through 40: Accepted in whole or in substance.


Paragraphs 41 through 45: These paragraphs consist of descriptions of a party's positions or arguments; they belong more appropriately in the conclusions of law than in the findings of fact.


Paragraphs 46 and 47: Rejected as subordinate and unnecessary details.


Paragraphs 48 and 49: The form of these paragraphs is rejected as constituting summaries or quotations of testimony, rather than proposed findings of fact. The underlying essence has been accepted in substance.


Paragraph 50: Accepted.


Paragraphs 51: Accepted in substance.


Paragraphs 52 and 53: Rejected as summaries of testimony, rather than proposed findings of fact. Also rejected as subordinate and unnecessary details.

Paragraph 54: Accepted in substance.


through 54: The form of these paragraphs is rejected as constituting summaries or quotations of testimony, rather than proposed findings of fact. The underlying essence has been accepted in substance.


Paragraphs 55 and 56: Rejected as summaries of testimony, rather than proposed findings of fact. Also rejected as subordinate and unnecessary details.


Paragraph 57: This paragraph consists of descriptions of a party's positions or arguments; it belongs more appropriately in the conclusions of law than in the findings of fact.


Paragraph 58: Rejected as subordinate and unnecessary details. Paragraph 59: Accepted.

Paragraphs 60 through 62: Rejected as summaries or quotations of testimony, or as subordinate and unnecessary details.


Paragraph 63: Rejected as a statement of a party's position, rather than a finding of fact based on the evidence.


Paragraphs 64 and 65: Rejected as summaries or quotations of testimony, or as subordinate and unnecessary details.


Paragraph 66: The first sentence of this paragraph is accepted in substance. Most of the details in the several subparagraphs of paragraph 66 are rejected as subordinate and unnecessary details.


Paragraph 67: This paragraph consists of descriptions of a party's positions or arguments; it belongs more appropriately in the conclusions of law than in the findings of fact.


Paragraphs 68 through 72: Accepted in substance with a large number of subordinate and unnecessary details omitted.


Paragraph 73: This paragraph consists of descriptions of a party's positions or arguments; it belongs more appropriately in the conclusions of law than in the findings of fact.


Paragraphs 74 through 77: Accepted in substance with a large number of subordinate and unnecessary details omitted.


Paragraph 78: This paragraph consists of descriptions of a party's positions or arguments; it belongs more appropriately in the conclusions of law than in the findings of fact.


Paragraphs 79 through 81: Accepted in substance with a large number of subordinate and unnecessary details omitted.


Paragraph 82: Accepted.


Paragraph 83: This paragraph consists of descriptions of a party's positions or arguments; it belongs more appropriately in the conclusions of law than in the findings of fact.

Paragraphs 84 through 86: Accepted.


Paragraph 87: Rejected as subordinate and unnecessary details.


Paragraph 88: Rejected as consisting of a summary of testimony, rather than proposed findings of fact. Also rejected as subordinate and unnecessary details.


Paragraph 89: Accepted in substance.


Paragraph 90: This paragraph consists of descriptions of a party's positions or arguments; it belongs more appropriately in the conclusions of law than in the findings of fact.


Paragraph 91: This paragraph is rejected as consisting primarily of argument about the weight of the evidence, rather than consisting of proposed findings of fact.


Paragraphs 92 through 94: Rejected as subordinate and unnecessary details. Paragraphs 95 through 97: Accepted.

Paragraph 98: Rejected as subordinate and unnecessary details. Paragraph 99: Accepted.

Paragraph 100: First sentence rejected as constituting primarily argument about the weight to be given to the evidence. Second sentence accepted in substance.


Paragraph 101: First sentence accepted in substance. Second sentence rejected as subordinate and unnecessary details.


Paragraphs 102 through 104: Rejected as subordinate and unnecessary details.


Paragraphs 105 through 107: Rejected as irrelevant or as subordinate and unnecessary details.


Paragraph 108: Accepted in substance.


Paragraphs 109 through 111: Rejected as subordinate and unnecessary details.


Paragraphs 112 and 113: Rejected as comprised primarily of arguments, rather than proposed findings of fact. Also rejected as subordinate and unnecessary details.


Paragraphs 114 through 117: Accepted.


Proposed findings submitted by Intervenor Humana:


(None submitted; Intervenor Humana adopted the findings proposed by Intervenor HIP.)

COPIES FURNISHED:


Andrew S. Berman, Esquire

Young, Berkman, Berman & Karpf, P.A. 17071 West Dixie Highway

North Miami Beach, Florida 33160


Edward J. Marko, Esquire Marko & Stephany

1401 East Broward Blvd, Ste. 201 Fort Lauderdale, Florida 33301


Robert L. Shevin, Esquire Richard Simring, Esquire Strook & Strook & Lavan

200 South Biscayne Boulevard Suite 3300

Miami, Florida, 33131


W. George Allen, Esquire Allen, Hursey and Lucas

305 South Andrews Avenue Suite 701

Fort Lauderdale, Florida 33302


Gerald M. Cohen, Esquire

300 South Park Road Hollywood, Florida 33021


Holly Skolnick, Esquire

Greenberg, Traurig, Hoffman, Lipoff Rosen & Quentel, P.A.

1221 Brickell Avenue

Miami, Florida 33131


Dr. Frank R. Petruzielo Superintendent of Schools Broward County School District 600 S. E. Third Avenue

Fort Lauderdale, Florida 33301-3125


NOTICE OF RIGHT TO FILE EXCEPTIONS


All parties have the right to submit written exceptions to this recommended order. All agencies allow each party at least ten days in which to submit written exceptions. Some agencies allow a larger period within which to submit written exceptions. You should contact the agency that will issue the final order in this case concerning agency rules on the deadline for filing exceptions to this recommended order. Any exceptions to this recommended order should be filed with the agency that will issue the final order in this case.


Docket for Case No: 95-004559BID
Issue Date Proceedings
Jan. 05, 1996 Letter to E. Marko & CC: Parties of Record from MMP (re: & enclosed Petitioner`s exhibit #19(a)) sent out.
Dec. 08, 1995 Recommended Order sent out. CASE CLOSED. Hearing held 10/16-18/95.
Nov. 08, 1995 Letter to Hearing Officer from Robert L. Shevin Re: Correcting caption in Recommended Order filed.
Nov. 06, 1995 PCA`s Post Hearing Memorandum of Law; Disk (Recommended Order) ; Recommended Order (for Hearing Officer Signature) w/cover letter filed.
Nov. 06, 1995 Humana`s Notice of Adopting HIP`s Proposed Findings of Fact, Conclusions of Law and Recommended Order; Closing Argument of The School Board of Broward County, Florida filed.
Nov. 06, 1995 HIP`s Proposed Findings of Fact, Conclusions of Law and Recommended Order (for Hearing Officer signature W/computer disk, Hearing Officer has disk); HIP`s Closing Argument filed.
Oct. 25, 1995 Memorandum to counsel for all parties from MMP sent out. (deadline for filing proposed recommended orders will be 11/6/95)
Oct. 25, 1995 Letter to Hearing Officer from Andrew S. Berman Re: Reconstructed exhibit 19a filed.
Oct. 25, 1995 Volume I through III (Transcript) filed.
Oct. 23, 1995 Exhibits (3 boxes, tagged) filed.
Oct. 16, 1995 PCA`s Trial Memorandum; PCA`s Memorandum of Law On Constitutional Issue; (Respondent) Notice of Compliance; Joint Prehearing Stipulation (filed W/Hearing Officer at hearing) filed.
Oct. 16, 1995 CASE STATUS: Hearing Held.
Oct. 13, 1995 (Petitioner) Notice of Intent to Rely Upon Summaries filed.
Oct. 10, 1995 (Petitioner) Request to Take Judicial Notice filed.
Oct. 06, 1995 Order Granting Party Status sent out. (for Humana Health Insurance Co)
Oct. 05, 1995 Petition to Intervene of Humana Health Insurance Company of Florida, Inc. filed.
Oct. 05, 1995 (Hilarie Bass) Intervenor's Motion to Dismiss ortions of Petition forLack of Subject Matter Jurisdiction and for More Definite Statement; Intervenor's Memorandum of Law in Support of Motions to Dismiss Portions of Petition for Lac k of Subject Matter Juri
Oct. 05, 1995 (Petitioner) Second Request for Production filed.
Oct. 03, 1995 HIP`s Witness List; HIP`s First Request for Production of Documents to the School Board of Broward County; HIP`s First Set of Interrogatories to PCA; HIP`s First Request for Production of Documents to PCA filed.
Oct. 02, 1995 (Petitioner) Request for Production filed.
Sep. 26, 1995 Notice of Hearing Location sent out. (hearing set for October 16, 17 and 18, 1995; 8:45 a.m.; Ft. Lauderdale)
Sep. 22, 1995 Order Granting Party Status sent out. (by: HIP Health Plan of Fl., Inc.)
Sep. 22, 1995 Notice of Hearing sent out. (hearing set for Oct. 16-18, 1995; 8:45am; Ft. Laud)
Sep. 22, 1995 Prehearing Order sent out.
Sep. 20, 1995 (HIP Health Plan of Fl., Inc.) Petition to Intervene filed.
Sep. 15, 1995 Agency referral letter; (Exhibit A-H); Summary Of Opinion, From Jim Marshall (2); Agenda Request Form; Petition for Formal Administrative Hearing; Agency Action letter filed.

Orders for Case No: 95-004559BID
Issue Date Document Summary
Dec. 08, 1995 Recommended Order Evidence in bid protest proceeding was insufficient to prove that agency action was illegal, dishonest, fraudulent or arbitrary.
Source:  Florida - Division of Administrative Hearings

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