GOVERNMENT OF THE DISTRICT OF COLUMBIA
Office of Contracting and Procurement
Pursuant to section 202(c) of the Procurement Practices Reform Act of 2010, as amended, D.C.
Official Code 2-352.02(c), the following contract summary is provided:
COUNCIL CONTRACT SUMMARY
(Options)
(A) Contract Number: CW63013
Proposed Contractor: Liberty Healthcare Corporation
Contract Amount (Option Period 3): Not-to-exceed (NTE) $7,016,552
Unit and Method of Compensation: Fixed Unit Prices and Firm Fixed Price components
Term of Contract: July 31, 2021 through July 30, 2022
Type of Contract: Indefinite Delivery/Indefinite Quantity (IDIQ)
(B) Identifying number of the underlying contract, including the identifiers assigned to the
underlying contract by the Council for the base period and any subsequent option periods:
Base Period Amount: NTE $7,541,177
(July 31, 2018 through July 30, 2019)
(Council Approval CA22-0645)
Option Period One Amount: NTE $6,617,972
(July 31, 2019 through July 30, 2020)
(Council Approval CA23-0158)
Option Period Two Amount: NTE $7,012,780
(July 31, 2020 through July 30, 2021)
(Council Approval CA23-0588)
Option Period Three Amount: NTE $7,016,552
(July 31, 2021 through July 30, 2022)
(C) A statement that Citywide Clean Hands database indicates that the proposed contractor is
current with its District taxes. If the Citywide Clean Hands Database indicates that the
proposed contractor is not current with its District taxes, either: (1) a certification that the
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 contractor has worked out and is current with a payment schedule approved by the District;
or (2) a certification that the contractor will be current with its District taxes after the District
recovers any outstanding debt as provided under D.C. Official Code 2-353.01(b):
On April 27, 2021, the Citywide Clean Hands database certified that the contractor is current with
its District taxes.
(D) A statement that the proposed contract is within the appropriated budget authority for the
agency for the fiscal year and is consistent with the financial plan and budget adopted in
accordance with D.C. Official Code 47-392.01 and 47-392.02:
The Department of Health Care Finance Agency Fiscal Officer certified that funding in the amount
of $7,016,552 is available to support the contract for long term care support services.
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 Government of the District of Columbia
Office of the Chief Financial Officer 1101 4th Street, SW
Office of Tax and Revenue Washington, DC 20024
Date of Notice: April 27, 2021 Notice Number: L0005453287
LIBERTY HEALTHCARE CORPORATION FEIN: **-***8586
401 E CITY AVE STE 820 Case ID: 809708
BALA CYNWYD PA 19004-1130
CERTIFICATE OF CLEAN HANDS
As reported in the Clean Hands system, the above referenced individual/entity has no outstanding
CO
liability with the District of Columbia Office of Tax and Revenue or the Department of Employment
Services. As of the date above, the individual/entity has complied with DC Code 47-2862, therefore
this Certificate of Clean Hands is issued.
TITLE 47. TAXATION, LICENSING, PERMITS, ASSESSMENTS, AND FEES
CHAPTER 28 GENERAL LICENSE
SUBCHAPTER II. CLEAN HANDS BEFORE RECEIVING A LICENSE OR PERMIT
D.C. CODE 47-2862 (2006)
PY
47-2862 PROHIBITION AGAINST ISSUANCE OF LICENSE OR PERMIT
Authorized By Marc Aronin
Chief, Collection Division
To validate this certificate, please visit MyTax.DC.gov. On the MyTax DC homepage, click the
Validate a Certificate of Clean Hands hyperlink under the Clean Hands section.
1101 4th Street SW, Suite W270, Washington, DC 20024/Phone: (202) 724-5045/MyTax.DC.gov
 GOVERNMENT OF THE DISTRICT OF COLUMBIA
Department of Health Care Finance
Office of the Chief Financial Officer
MEMORANDUM
TO: George A. Schutter
Chief Procurement Officer
Office of Contracting and Procurement
THRU: Delicia V. Moore
Associate Chief Financial Officer
Human Support Services Cluster
FROM: Darrin Shaffer
Agency Fiscal Officer
Department of Health Care Finance
DATE: 06/08/2021
SUBJECT: Certification of Funding for the Liberty Healthcare Corporation Contract
The Office of the Chief Financial Officer hereby certifies that the sum of $7,016,522.00 is included in the Districts
Local Budget and Financial Plan submitted to Congress by the Chairman of the Council to the Speaker of the House
of Representatives for Fiscal Year 2021 to fund the costs associated with the Department of Health Care Finances
(DHCF) contract for Liberty Healthcare. This certification supports the Liberty Healthcare Corporation Long Term
Care Support Services contract CW63013 during the period from July 31, 2021 through July 30, 2022. This funding
certification replaces the original document provided on 3/18/2021. This allocation is as follows:
Vendor: Liberty Healthcare Corporation Contract Number: CW63013
Fiscal Year 2021 Funding:
Agency Fund Program PCA Index Object Grant Amount
HT0 0100 200L L0000 LL000 0409 $643,181.18
HT0 8250 200L L0000 L00A1 0409 MMAD21/21 $526,239.15
FY21 Total $1,169,420.33
Fiscal Year 2022 Funding:
Agency Fund Program PCA Index Object Grant Amount
HT0 0100 200L L0000 LL000 0409 $3,215,905.92
HT0 8250 200L L0000 L00A2 0409 MMAD22/22 $2,631,195.75
FY22 Total $5,847,101.67
Upon approval by Congress of the Districts Local Budget and Financial Plan funds will be sufficient to pay for
fees and costs associated with the contract. There is no fiscal impact associated with the contract.
Should you have any questions, please contact me at (202) 442-9079.
441 4th Street, N.W., Suite 960N, Washington, D.C. 20001 (202) 442-5988 FAX (202) 478-1373
 1. Contract Number Page of Pages
AMENDMENT OF SOLICITATION / MODIFICATION OF CONTRACT CW63013 1 3
2. Amendment/Modification Number 3. Effective Date 4. Requisition/Purchase Request No. 5. Solicitation Caption
Long Term Care Support
M012 7/31/2021
Services
6. Issued by: Code 7. Administered by (If other than line 6)
Office of Contracting and Procurement Department of Health Care Finance
441 4th Street NW, Suite 300S 441 4th Street NW, Suite 900S
Washington, DC 20001 Washington, DC 20001
8. Name and Address of Contractor (No. street, city, county, state and zip code) 9A. Amendment of Solicitation No.
9B. Dated (See Item 11)
Liberty Healthcare Corporation
Attention: Eddy Broadway 10A. Modification of Contract/Order No.
401 East City Avenue, Suite 820
Bala Cynwyd, PA 19004 X CW63013
10B. Dated (See Item 13)
Code Facility July 31, 2018
11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS
The above numbered solicitation is amended as set forth in item 14. The hour and date specified for receipt of Offers is extended. is not extended.
Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:
(a) By completing Items 8 and 15, and returning __________ copies of the amendment: (b) By acknowledging receipt of this amendment on each copy of the offer
submitted; or (c) BY separate letter or fax which includes a reference to the solicitation and amendment number. FAILURE OF YOUR ACKNOWLEDGMENT TO
BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN REJECTION
OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such may be made by letter or fax, provided each letter or
telegram makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.
12. Accounting and Appropriation Data (If Required)
13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACT/ORDERS ,
IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14
A. This change order is issued pursuant to (Specify Authority): 27 DCMR, Chapter 36, Contract Modifications
X The changes set forth in Item 14 are made in the contract/order no. in item 10A.
B. The above numbered contract/order is modified to reflect the administrative changes (such as changes in paying office, appropriation data
etc.) set forth in item 14, pursuant to the authority of 27 DCMR, Chapter 36, Section 3601.2.
C. This supplemental agreement is entered into pursuant to authority of:
D. Other (Specify type of modification and authority)
E. IMPORTANT: Contractor is not is required to sign this document ____0____ original copies to the issuing office.
14. Description of Amendment/Modification
Contract No. CW63013 is hereby as follows:
1. Pursuant to Section F.2 of the contract, the Contracting Officer, hereby exercises option period three,
extending the term of the contract for a period of 12 months commencing on July 31, 2021 through July 30,
2022 in the not-to-exceed amount of $7,016,522.00
2. Attachment A: Price Schedule B.3.3 is hereby incorporated and made a part of this contract.
All other terms and conditions remain unchanged
Except as provided herein, all terms and conditions of the document is referenced in Item 9A or 10A remain unchanged and in full force and effect.
15A. Name and Title of Signer (Type or print) 16A. Name of Contracting Officer
Helena Barbour
15B. Name of Contractor 15C. Date Signed 16B. District of Columbia 16C. Date Signed
(Signature of person authorized to sign) (Signature of Contracting Officer)
 ATTACHMENT A
Long Term Care Support Services/
Liberty Healthcare Corporation
Modification M012
B.3.3 OPTION YEAR THREE (July 31, 2021 through July 30, 2022)
Contract Line Item Description Price Per Unit Quantity Minimum Quantity Maximum
Item No. (CLIN) Minimu Total Price Maximum Total Price
m (Unit price (Unit price
x minimum x Maximum
quantity) quantity)
3001D $65.74 per
Intake Services 600 $39,444 10,000 $657,400.00
Section C.5.8 referral
Assess Applicant
3002D $3,070,300.
Programmatic (non- $307.03 per 600 $184,218 10,000
Section C.5.9 00
financial) eligibility assessment
3003D $87.97 per
Referral to Providers 600 $52,782 8,000 $703,760.00
Section C.5.10 referral
3004D Review of Person- $61.87per
600 $37,122 3,200 $197,984.00
Section C.5.12 Centered Service Plans assessment
Minimum Total NTE Maximum Total
Total Estimated Price for CLINs 3001D-3004D $269,733 $4,629,444.00
Contract Line
Item Description Quantity Total Price
Item No. (CLIN)
3005D
Establish and implement a Quality Improvement and Integrity Program 1 $541,101
Section C.5.13
3006D Establish and implement a Medicaid Beneficiary and Provider Customer
1 $758,576
Section C.5.14 Support Service
3007D Provide related administrative functions including the participation in
1 $1,087,401
Section C.5.15 administrative hearings
Total Price for CLINs 3005D 3007D $2,387,078
Option Period Two Grand Total NTE $7,016,522
Page 2 of 3
 LONG TERM CARE SUPPORT SERVICES
Liberty Healthcare Corporation CW63013
RECAP
Action Period of Performance Amount
Base Year POP: July 31, 2019 thru July 30, 2020 $7,541,177.00
Modification M001 Administrative Change - eInvoicing No Cost
Modification M001A Administrative Change CW Number No Cost
Modification M002 Administrative Change BAA HIPPA No Cost
Modification M003 Administrative Change Living Wage Adjustment No cost
Modification M004 Unilateral Change - Executed to exercise Option $6,617,972.00
Period One
Modification M005 Bilateral Change Funding Reallocation Between No Cost
CLINs
Modification M006 Administrative Change CA No Cost
Modification M007 Administrative Change - Living Wage Adjustment No Cost
Modification M007A Bilateral Change Funding Reallocation Between $142,780.00
CLINs and Additional Funding added to CLINs
1001B and 1002B
Modification M008 Unilateral Change - Executed to exercise Option $7,012,780.00
Period Two
Modification M009 Administrative Change Living Wage Adjustment No Cost
Modification M010 Administrative Change CA No Cost
Modification M011 Bilateral Change Language change throughout $129,475.47
Section C. Funding Reallocation across CLIN lines
and an increase in contract amount. Revised amount
$7,142,255.47. This equates to a 1.85% increase.
Modification M012 Unilateral Change - Executed to exercise Option $7,016,522.00
Period Three
Total Contract Value: $28,460,706.47
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