General Services Agency RFP.pdfC:\Program Files\Adobe4\Acrobat 4.0\Acrobat\plug_ins\OpenAll\Transform\temp\EDIS ACMC rfp Final.doc COUNTY OF ALAMEDA REQUEST FOR PROPOSAL (RFP) NO

$Page 1: General Services Agency RFP.pdfC:\Program Files\Adobe4\Acrobat 4.0\Acrobat\plug_ins\OpenAll\Transform\temp\EDIS ACMC rfp Final.doc COUNTY OF ALAMEDA REQUEST FOR PROPOSAL (RFP) NO$
1401 Lakeside Drive, Oakland, Suite 907, California 94612Telephone (510) 208-9600 ! FAX (510) 208-9626 Printed on recycled paper

C:\Program Files\Adobe4\Acrobat 4.0\Acrobat\plug_ins\OpenAll\Transform\temp\EDIS ACMC rfp Final.doc

General Serv ices AgencyAki K. Nakao, Director

COUNTY OF ALAMEDAREQUEST FOR PROPOSAL NO. 006-1-0676

SPECIFICATIONS, TERMS & CONDITIONSfor

EMERGENCY DEPARTMENT INFORMATION SYSTEM (EDIS)for

ALAMEDA COUNTY MEDICAL CENTER (ACMC)

BIDDERS CONFERENCEat

2:00 p.m.,on

November 14, 2001at

Fairmont Hospital CampusCafeteria Conference Room

15400 Foothill Blvd. San Leandro, CA 94578

RESPONSE DUEbefore

2:00 p.m.on

December 7, 2001at

Alameda County, GSA-Purchasing Department1401 Lakeside Drive, Suite 907

Oakland, CA 94612-4305


COUNTY OF ALAMEDAREQUEST FOR PROPOSAL (RFP) NO. 006-1-0676

SPECIFICATIONS, TERMS & CONDITIONSfor

EMERGENCY DEPARTMENT INFORMATION SYSTEM (EDIS)at

ALAMEDA COUNTY MEDICAL CENTER (ACMC)

TABLE OF CONTENTSPage

STATEMENT OF WORK

1. Acronym and Term Glossary.......................................................................12. Intent.............................................................................................................13. Scope .......................................................................................................2-124. Background ...........................................................................................12-155. Specific Requirements ...............................................................................156. Deliverables/Reports..................................................................................15

INSTRUCTIONS TO BIDDERS

7. County Contacts.........................................................................................168. Calendar of Events ................................................................................16-179. Submittal of Bids...................................................................................17-1810. References ..................................................................................................1811. Financial Stability ......................................................................................1812. Response Format...................................................................................18-1913. Response Content..................................................................................19-2214. Evaluation Criteria/Selection Committee .............................................22-2415. Contract Evaluation and Assessment.........................................................24

TERMS AND CONDITIONS

16. Term / Termination / Renewal...................................................................2517. Quantities ...................................................................................................2518. Pricing ...................................................................................................25-2619. Award .........................................................................................................2620. Method of Ordering ...................................................................................2621. Invoicing................................................................................................26-2722. Other Agencies...........................................................................................2723. Funding Out Clause ...................................................................................2724. ACMC Provisions.................................................................................28-3225. Account Manager/Support Staff ................................................................3326. General Requirements...........................................................................33-35

Page 2October 31, 2001


ATTACHMENTS

Exhibit A……..– AcknowledgementExhibit B……..– Bid FormExhibit C……..– Certificate of InsuranceExhibit D1……– Current ReferencesExhibit D2……– Former ReferencesExhibit F……...– Request for Local PreferenceExhibit G……..– Exceptions, Clarifications, AmendmentsExhibit H……..– Standard Agreement Contract DraftExhibit I………– Proposal Evaluation FormExhibit K……..– Actual Project ExperienceExhibit L…….. – Emergency Department StatisticsExhibit M-1….. – Current Workflow DiagramsExhibit M-2….. – Future Workflow DiagramsExhibit N……...– Functional Requirements

Specifications, Terms & Conditionsfor Emergency Department Information System

Page 1 of 35C:\Program Files\Adobe4\Acrobat 4.0\Acrobat\plug_ins\OpenAll\Transform\temp\EDIS ACMC rfp Final.doc

STATEMENT OF WORK

1. ACRONYM AND TERM GLOSSARY

1) HIS (page 2 of 35) Hospital Information System2) HPI (page 3 of 35) History of Present Illness3) ROS (page 3 of 35) Review of Systems4) HIPAA (page 4 of 35) Healthcare Information Portability and Accountability Act5) ICD-9 (page 4 of 35) International Classification of Diseases-9th revision6) CPT (page 4 of 35) Current Procedural Terminology7) E & M (page 4 of 35) Evaluation & Management8) HCFA (page 4 of 35) Health Care Financing Administration9) ASCII (page 6 of 35) American Standard Code for Information Interchange10) SMS (page 9 of 35) Shared Medical Systems11) HL7 (page 10 of 34) Healthcare Level 712) FTP (page 10 of 34) File Transfer Protocol13) FTE (page 12 of 35) Full Time Equivalent12) ADP (page 14 of 35) Automatic Data Processing

2. INTENT

It is the intent of these Specifications, Terms and Conditions to describe the Alameda CountyMedical Center (ACMC) requirements for selecting and implementing an EmergencyDepartment Information System (EDIS).

ACMC is planning to complete a multiple phase implementation of the EDIS based on thefollowing:• Phase I – Implement Emergency Department (ED) Quick Registration, Triage, and

Patient Tracking, including interfacing to INVISION®

• Phase II – Implement advanced clinical and patient management functions such asadvanced tracking for orders, results, etc., physician and clinician documentation,medication management, disposition planning, etc.

Furthermore, the intent is to:• Interface and integrate the EDIS information management with ACMC’s core Siemens

products including INVISION®, and other key departmental systems listed above (e.g.,Laboratory, Pharmacy, Radiology)

• Replace the existing information systems and automate critical manual processes with anintegrated EDIS that will allow ACMC to operate more efficiently

• Provide the information needed to continuously improve workflow and patient caredelivery processes, while meeting state and federal regulations as they evolve

• Automate the patient tracking and triage assessment functions (this is of particularimportance)



2. INTENT (continued)

ACMC will explore implementation strategies with the selected contractor to determine howthe needs in theses areas can be met based on ACMC’s optimal timeframe.

Based on and agreed upon implementation strategy, ACMC may want to install and pilot theEDIS in the current ED and/or install the EDIS in the new ED prior to opening the ED for patientcare. ACMC would like to explore opportunities to pursue these options with the contractor ofchoice.

3. SCOPE

The objective of this RFP is to assist ACMC in identifying an EDIS contractor that offers acomprehensive suite of application modules that support ED and Urgent Care Center (UCC)patient management and clinical management information needs.

Of particular importance, the system shall assist the ED and UCC personnel in providing fast,excellent care to patients. Rapid collection of patient data, quick access to clinical historydata, and real-time dynamic patient tracking shall be supported. Standard order sets/protocolsand Triage Assessment templates shall be available. Clinical results shall be available on-lineas soon as they are entered into the system. Statistical reporting capability shall be supported.

Below is a brief description of the automation goals consisting of eight functional areas andone technical area, followed by a set of functional requirement statements that describe themost critical demands from an EDIS product. Contractors will be evaluated based on thesections of their response that address each of the functional requirement statements.

For each requirement statement listed below, Contractor shall provide a clear, concise,description statement on how its products can meet that requirement (see attached Exhibit N).In addition, Contractor shall indicate whether the functionality is in Production today, is inAlpha or Beta Test, is in Development for future release, or is Unplanned. For any function inAlpha/Beta Test or in Development, Contractor shall provide any planned release dates usingmonth or quarter, and year.

The Technology section below (Item F) describes ACMC’s requirements based on network andhardware standards currently in place throughout the Medical Center. Contractor shall providean appropriate response to each requirement statement and any visual diagram that represents itsproposed system configuration.

A. ED Registration/Quick Admission

ACMC’s goal is to significantly improve the patient flow process within the ED byquickly and efficiently registering all ED patients into an EDIS and begin the process ofelectronically tracking their locations and key patient information. The registrationprocess shall allow entry of information prior to the patient’s arrival to the ED, and also



3. SCOPE (continued)

allow for the ability to flag key information on whether a patient has been recentlyadmitted or indicates any other significant information. The system shall be compatiblewith ACMC’s core HIS Registration system (Siemens INVISION®) and allow bi-directional sharing and synchronization of information. The system shall comply withthe following requirements:

1. Provide a quick registration process for collection of minimal required patientinformation for admission and begin the patient tracking function. Contractor shalllist the minimum required fields.

2. Provide a pre-hospital (ambulance) data collection component.3. Provide visual flags/alerts regarding the admission status of a patient and any

notation of previous visit history (admission within 72 hours, drug-seeker, etc.).4. Support the ability to begin the ordering and documentation processes upon

completion of the quick admission process by issuing an account or visit number.5. Provide the ability to send or receive patient registration information to/from the

Siemens OPENlink® integration engine application.6. Support bedside registration.

B. Triage

ACMC’s goal is to more efficiently and effectively assess, prioritize, and route patients totheir appropriate location, based on their chief complaint, by using automated tools andtemplates to support the process. The system shall provide the flexibility to developautomated triage assessment templates, that when completed, will assist the triage nursein assigning the appropriate acuity. Upon completion of the assessment, the informationshall be immediately available to other caregivers on-line, and have the status of priority,location, and chief complaint visible on the tracking screen. The system shall complywith the following requirements:

1. Provide the ability to begin the triage process prior to the arrival of the patient in theED (e.g., via Ambulance/EMS).

2. Provide a user-defined ability to develop triage assessment templates and/orprotocols based on chief complaint or user-defined criteria.

3. Produce a flag/alert for relevant patient information at the time of triage(abnormalities, risk factors, etc.).

4. Provide the ability to capture or automatically generate information of patient acuityat the point of triage as an outcome of the assessment data.

5. Provide the ability to sequence or prioritize registrations based on patient acuity (attriage).

6. Provide the ability to print customizable triage forms specific to chief complaint oruser-defined category (HPI, ROS, medications, immunizations, etc.).

7. Provide the ability to enter or associate orders to a patient based on, or as part of, theoverall triage assessment.




C. ED Tracking

The most immediate need of the new ED facility at ACMC is automated patient tracking.Given the significant change in the number of beds, the size and logistics of the physicallocation and the distance between pods, it is imperative that a tracking system be in place.The tracking system shall provide a real-time dynamic view of patient activity across allED locations, including the UCC. It shall be viewable from any PC or end-user devicewithin the ED and from designated locations. The system shall comply with thefollowing requirements:

1. Provide the ability to view/know the location/status of every patient within the EDon a real-time basis.

2. Provide the ability to view the tracking information from any end-userworkstation/device and via dedicated monitors.

3. Provide user-defined views/filters of the patient tracking information by user-defined status (e.g., room/area, pod, patient name, chief complaint, physician).

4. Provide a clearly visible display of the status of patient activities such as locationchanges, orders/results statuses, abnormal or stat result statuses, waiting roompatient status, etc., via color-coding, flashing, or other easily distinguishingmethods.

5. Provide the ability to drill-down on information directly from the tracking screen foraccess to more detailed information.

6. Provide the ability to track patients based on multiple criteria, including two levelsof physician providers (e.g., attending and resident).

7. Provide the ability to track key documentation processes during the patient stay andprovide an alert for incomplete steps. (Example: medical screening needs to becompleted before patient financial registration can be finished.) (25% of patients arebeing discharged prior to this being completed.)

8. Provide the capability of placing a patient tracking monitor in the family/waitingarea that displays patient information via ID code for privacy purposes.

9. Support HIPAA privacy and security regulations associated with patient trackingand allow various filters or screen displays of the tracking information to meet thediverse needs of the ED.

D. Clinical Documentation/Order Management

ACMC’s goal for documentation is to automate and integrate the order managementprocess with clinical documentation. This goal includes order entry at the point of triage,during the patient assessment process and at the point of disposition/discharge planning.Result status, based on the tests ordered, shall be available on-line via the trackingsystem, and shall be easily accessible by physicians. Several tools and techniques fordocumentation shall be provided, including structured text charting, charting byexception, and free-text charting. The system shall be flexible enough to support




ACMC’s ED standards for charting and support multi-disciplinary documentation (e.g.,physician, nurse, therapist, technician, etc.). The system shall comply with the followingrequirements:

1. Provide the ability to order standard test batteries/order sets for all necessarydepartments based on patient class (i.e., trauma or sepsis), chief complaint, etc.,within a single screen.

2. Provide on-line access to patient results within the EDIS. contractor shall describehow its system alerts/flags the various statuses of a test order and result.

3. Provide the ability to support designation of required fields prior to completingdocumentation activity.

4. Support the need for a physician to revise documentation completed by a resident,intern, or medical student, etc.

5. Support various forms of clinical documentation, including structured charting,charting by exception (checkbox format), and free-text charting.

6. Provide incorporation of graphics or user-defined pictures as part of thedocumentation and assessment process.

7. Support the ability to user-define a patient summary worksheet, be available on-line,and provide the ability to print a summary sheet.

8. Have the ability to associate all codes (ICD-9, CPT, E & M) with documentationbased on HCFA guidelines.

9. Support the co-signature of orders.10. Provide the ability to access the patient’s lifetime clinical record (Siemens Lifetime

Clinical Record – LCR®) via the EDIS.

E. Discharge/Disposition Planning

ACMC would like to improve the efficiency and effectiveness of the discharge planningprocess, including the ability to customize discharge instructions and include allnecessary information to the patient in an efficient manner. Including medicationinformation with the discharge instructions would be critical to the process. The systemshall comply with the following requirements:

1. Support starting the discharge planning process upon ED admission.2. Support multilingual discharge instructions (at a minimum, English and Spanish). It

is desired to have the ability for multiple languages.3. Support patient-specific discharge instructions based on chief complaint, and shall

include diagnosis, medications, and follow-up instructions.4. Medication prescription writing and administration instructions shall be integrated

with discharge planning and instructions.5. Support web-enablement of discharge instructions for Intranet/Internet access.6. Contractor shall provide a set of standard discharge instructions with ability to tailor

to ACMC’s needs.




F. Medication Management

ACMC shall be able to more effectively track the patient’s medication history,medication activity while in the ED, and medications upon disposition. The goal of theEDIS would be to support all three medication management processes, and allowimmediate access to medication information for each patient. The system shall complywith the following requirements:

1. Provide the ability to enter and track the medication history of every patientadmitted to the ED.

2. Provide access to a patient’s medication history from all other visits via access tothe patient’s lifetime clinical record (Siemens Lifetime Clinical Record – LCR®).

3. Provide an on-line link to medication information, either as part of the system orintegrated with a third-party application.

4. Provide the ability to order medication prescriptions on-line and route theprescription to a user-defined location (e.g., printer, pharmacy, etc.).

G. Management Reporting

ACMC’s goal is to use the information collected in the EDIS to improve the quality andefficiency of care in the ED. ACMC shall be able to easily report on the data via a user-friendly report writer, or by extracting the information to an industry standard database.The management reporting process shall support ACMC’s quality and compliancereporting needs of the ED, and support research and follow-up activities related to patientcare. Data from the patient tracking function shall allow ACMC to identify bottlenecksin the patient flow process. The system shall comply with the following requirements:

1. Produce an on-line ED log with user-defined fields.2. Provide the ability to maintain on-call lists for staffing purposes.3. Provide the ability to user-define a report on any database element. In addition,

Contractor shall describe its system’s statistical reporting capabilities (patienttracking statistics, staff productivity, etc.).

4. Support State, Federal, and other mandated reporting such as domestic violencetracking, sexual assault report, etc.

5. If the current EDIS, Logicare, is replaced as part of this process, the chosencontractor shall support the conversion of current encounter records stored in theLogicare system. Contractor shall describe the process to convert and access thesedata.

6. Contractor shall provide a list and a brief description of standard reports.7. Support the ability to export data to a standard ASCII format to be uploaded by

various registries (Trauma, etc.) or other industry standard database report writingtools.




H. Physician/Clinician Access

Physician/clinical access is critical to the success of the system. The EDIS system shallprovide a variety of methods, tools, and devices to access the data. ACMC prefers that anEDIS have web-enabled access methods that would allow increased flexibility in accessinginformation. Because of the composition of staff within the ED, including a standardrotation of residents, interns, students, etc., the system shall be intuitive and easy for staff tobe trained and begin using the system in a very short period of time. The system shallcomply with the following requirements:

1. Support single sign-on access to patient information for any physician or clinicianfrom any authorized location. In addition, Contractor shall describe its system’sremote access capabilities.

2. Be intuitive and user-friendly enough to allow rapid training and usage by residents,interns, medical students, etc. (typically on four-week rotations).

3. Support multiple user access to a single patient record. Contractor shall describe howits system supports this.

4. Support web-enabled access to patient information. Contractor shall describe itssystem’s functional and technical capabilities.

5. Provide the ability to allow access and sorting of patients by multiple providers(attending and either resident/intern/med student).

6. Support a combination of data access/entry devices, including desktop PC, mobilelaptop device, wireless notebook, or handheld device.

I. Technology

1) ACMC Information Systems Department Technical Environment Guide

This section presents a high-level description of the technical environment atACMC. These descriptions are meant to be guidelines for contractors makinginquiries about ACMC environment and to serve as parameters for the purchasing ofnew equipment and software. It is ACMC’s intent to evaluate each contractor’stechnology as to the alignment with ACMC’s technology direction. This sectioncovers guidelines for the following topics:

a) Why purchasing guidelines are importantb) Server, Desktop and Notebook approved hardwarec) Network approved printers (desktops)d) Approved Softwaree) Network Componentsf) Interfacesg) Revisions




a) Why purchasing guidelines are important

Guidelines are important for a number of reasons. They protect ACMC’sinvestment by ensuring that departments purchase high quality, appropriateproducts that have a reasonable life span. Guidelines make support easier byreducing the variety of items that need to be supported. They give direction tothe end-users and contractors as they make it possible to streamline thepurchasing process. However, the adoption of guidelines does not preclude thepossibility that individuals or departments may need to purchase hardware orsoftware that is outside of these guidelines. These exceptions will be evaluatedon an as-needed basis.

b) Server, Desktop and Notebook Approved Hardware:

The current server hardware platform deployed throughout the enterprise isHewlett-Packard (HP). Server specifications are determined depending uponthe application and load requirements. Currently, servers operating in the datacenter have a network operating system (NOS), consisting of Microsoft NT 4.0(with current service pack) or Windows 2000 server and Windows 2000Advanced server.

All desktop and notebook systems come pre-installed with Windows 2000 asthe operating system (OS) of choice. Where applicable, thin-client networkeddevices will be purchased to replace outdated personal computers and/orterminals:• Desktops:

− HP Vectra VL400 PIII/1GHZ 20GB Hard Drive with 128 MB RAM48X CD-ROM and a 17” Color Monitor

• Notebooks:− HP OmniBook 6000 PIII/1GHZ 15GB Hard Drive 128 MB Ram

with docking station (Additional expansion slots).− HP OmniBook 500 PIII/600MHZ 128 MB RAM 10 GB Hard Drive

Ultralight)

c) Network and Desktop (Approved) Printers:

It is the goal of these enterprises and departments to implement networkprinting whenever possible. For this purpose the approved printing hardware isthe following:

High volume network printing (large work-groups)• HP LaserJet 9000N• HP LaserJet 8150N




• HP LaserJet 4100N

Low volume network printing (small work-groups)• HP LaserJet 2200n• HP Inkjet Printers (Color/B&W)

High volume color LaserJet network printing (large work-groups)• Lexmark color LaserJet 720c

Low volume color LaserJet network printing (small work-groups)• Lexmark Optra c710n

Impact Network printing (forms)• Lexmark Forms Printer 2380 Plus

d) Approved software

Microsoft office and BackOffice suite software is currently the enterprisestandards. This would include the following:

MS Office Products• Word• Excel• PowerPoint• Access

MS Back-Office Products• Exchange 5.5• SQL server (7.0/2000)• MS project• Visio

Miscellaneous Software products• PC Anywhere• Rumba 2000• MS Internet Explorer

e) Network Components

The Enterprise network is composed of Cisco Routers for Wide-Areaconnectivity and a Cisco switched environment for Local-Area (LAN) networktraffic. Where applicable, VLAN’s (virtual local area networks) are




established to segment like traffic, thus reducing broadcasts and congestionthroughout the network. All network closets are equipped with uninterruptiblepower supplies (UPS) to suppress any power fluctuations and or outages.

f) Interfaces

ACMC utilizes the Siemens OPENLink v23.0 Interface engine for all of itsinterfaces. The Siemens SMS OPENLink Interface Engine delivers aprescribed interface protocol and data structure that meets ACMC Integrationstrategies and standards. The Siemens SMS OPENLink Engine providesACMC with the following capabilities:• Secure Socket Layer (SSL) with server authentication, providing

encryption of data (40 bit only), message tampering prevention and replaydetection

• Entire message encryption that allows SMS OPENLink to do SSL withany contractor

• XML, HTTP support (transmission of HTML/XML documents). SMSOPENLink is designed to be fully web-integrated including support forHTTP and HTTPS

• X12 Transactions (HIPAA mandated transactions)• Supports both fixed and delimiter-base transaction data formats.

ACMC requires its contractors to address whether or not they canaccommodate the following data format and protocol standards:• Utilization of application acknowledgment (ACK) or negative

acknowledgment (NAK). Ack/Nak shall be acted on and then be sentrather than be discarded

• Only SNA/SDLC (LU2 & LU6.2) and IP protocols are expected (theseare commonly known as routed network protocols)

• HL7 2.2 version or better is expected. This includes HL7 versions 2.3,and 3.0 (preliminary format)

• File processing via FTP

g) Revisions

Purchasing guidelines are updated annually, or as needed, to reflect changes inrecommended products, new products that have been adopted for ACMCEnterprise-wide use, or strategic alliances with certain contractors.

2) Technical Requirements:

a) Alignment with ACMC’s Information Systems Environment




ACMC is intending to award the contract to a contractor that can support andintegrate with the current and future direction of technology at ACMC.Contractor shall describe how its products software and hardware technology arein alignment with ACMC’s current technology environment.

b) Training

Specifically, the contractor shall include information referencing the followingissues:• Training strategy or methodology (i.e. train the trainers versus all end

users)• Number of training sessions, on-site and off-site for each application• Limitations on the number of people to be trained based on proposed

costs• Nature/content of course materials• Average hours to train by functional area including physicians, nurses,

clerks, etc.

c) Support

Contractor shall describe its problem reporting process, including theescalation procedure and identification of the management level within itsorganization at each stage of escalation. If Contractor’s hardware problemreporting process is different from its software problem reporting process, thenContractor shall describe each process separately. Contractor shall specifyturn around time for each level of escalation.

d) Product Vision

Contractor shall briefly describe its approach and direction to each of thefollowing:• 100% availability• 24 x 7 support• Integration across all modules• Interfacing with external systems• Alternative data collection devices (e.g., Palm Pilots, PDAs)• Use of voice recognition technology• Bar code technology – identify applications where you have implemented

bar coding as part of the workflow• Internet/Intranet use within your application modules (including remote

access)• Paper independence/Electronic forms/Workflow automation




• Remote computing options (e.g., Application Service Provider/ASP)

e) Implementation Plan• Contractor shall provide a high-level (phase and activity level only)

sample implementation project plan including Gantt chart. ACMCanticipates a two phase process: Phase I – ED Registration/QuickAdmission, Triage Assessment, Patient Tracking; Phase II –Physician/Clinician Documentation, Medication Management,Discharge/Disposition Planning

• Based on Contractor’s past experience, Contractor shall describe how longis the typical implementation by phase (see previous paragraph) for a siteof ACMC size, complexity and scope, and what are the critical successfactors for a timely and accurate implementation

• Contractor shall provide the estimated level of support (in FTEs) for bothACMC and its staff during the implementation of the system. Contractorshall list personnel by specific module.

f) System Availability (Contractor shall describe):• How are daily backups performed and whether they require the users to be

off-line

• What investment is required to specifically achieve 100% systemavailability

• What is the typical daily downtime for the system

4. BACKGROUND

The Alameda County Medical Center (ACMC) is a comprehensive system of care thatencompasses three hospital campuses (Highland, Fairmont, and John George PsychiatricPavilion), and five ambulatory care centers (Central, Eastmont, Alameda, Hayward, and NewarkHealth Centers). For addresses, site information, driving directions and campus maps,contractors can open ACMC website at http://acmedctr.org. As its core mission, the MedicalCenter provides an assured source of care for all County residents, regardless of ability to pay.

In July 1998, ACMC separated from direct County management and installed its own Board ofTrustees. This was done to assist the Medical Center in becoming more efficient in its overalloperations.

A. Critical Care and Clinics Building (CCCB)

A major building expansion is currently underway on the Highland Campus and will becompleted by mid-2002. The new five story CCCB will house Clinic services,



4. BACKGROUND (continued)

Emergency Department and Trauma services, Surgical Department services, andconsolidated outpatient clinical and ancillary services. The driving force behind thisconstruction was the need to meet Alquist seismic codes.

B. Emergency Department (ED) and Urgent Care Center (UCC)

ACMC’s ED, including the Trauma Center, and Urgent Care Center (UCC) comprise oneof the busiest and most highly respected operations in ACMC. Annual visits for the EDand UCC total 44,000 and 18,000 respectively (see Exhibit L for volume details).Completion of the new facility will allow ACMC to support its nationally recognizedservices and professionals with a state-of-the-art facility, and better serve the greaterAlameda County area population. The new ED and Trauma facility will quadrupleexisting space and double the number of beds. Table 1 (below) describes key servicesand characteristics of the current ED and future benefits of the new ED and TraumaCenter:

Table 1Current Emergency Department

CharacteristicsFuture ED and Trauma Center Benefits

The existing ED has 22 exam beds along one longhallway; sometimes patients are located in thehallways due to overcrowding.

43 exam beds that are divided into logicalgroupings, including:Resuscitation Bays (5), Critical Care (7),Observation (6), Orthopedic (3), ENT (1),Isolation (4), Seclusion (2), Pediatric (1),OB/GYN (3), Sexual Assault TreatmentCenter, Radiology (2), CT Scanner (1),UCC (8)

The ED location is too small for the presentvolume of approximately 160 patients a day;rooms intended for two patients have three andsometimes four patients.

The new ED will be able to handle currentvolumes and increased volumes based onestimations.

ED staff are sometimes forced to examine patientsin the hallways, where privacy or medical supportsystems are not easily available.

The new ED shall eliminate the privacy andsafety constraints of the existing ED.

The existing ED is located in an area of thehospital that was originally constructed for anoutpatient clinic.

The new ED was designed specifically tosupport all ED and Trauma related services.The UCC will still be located in its originallocation.

The ED location is remote from the center ofactivity of the hospital, with poorly markedsignage and inadequate parking for patients,police, and ambulance staff.

The new ED location will provide betterpatient flow in and out of the department.



Current Emergency DepartmentCharacteristics

Future ED and Trauma Center Benefits

The logistics of the department do not supportefficient patient, staff, and information flow.

The new ED is based on a series of pods orstations, each with a centralized nursingstation and larger hallways.

The ED is not effectively and efficiently located inrespect to other key services such as Surgery,Radiology, etc.

The new ED will be centrally located withclose proximity to Pharmacy, Surgery,Radiology, Laboratory, and other keyclinical services.

The ED has a UCC, which is located in anotherarea of the facility, making it difficult to managepatient flow from the ED.

The UCC will still be located in its currentlocation and will be farther from the new EDthan its current location, and will requireimproved signage and redesigned workflowprocesses to improve patient flow.

The ED lacks treatment space, and existing spaceis too small or poorly laid out.

The new ED has greatly expanded theavailability of treatment space throughoutthe ED.

Poor visibility of patient exam rooms from thenursing station; all are accessed via a narrowcorridor.

Each nursing station is centrally locatedwithin its pod or service to easily observepatient exam rooms and activity. However,there will be logistical limitations to viewingother pods from a particular nursing station.An electronic tracking system will berequired to enable optimal knowledge ofpatients’ locations and statuses.

Contractors can review workflow diagrams in Exhibits M-1 and M-2, that describe high-level current and future states workflow processes for the ED.

C. Information Technology Environment

Alameda County Medical Center (ACMC) uses Siemens applications (formerly SMS), tomeet a majority of its information processing requirements. INVISION®, in a remotecomputing environment (RCO) is used for the patient management functions ofemergency and inpatient registrations, order processing, charge capture, patient billing,and receivables management. SIGNATURE® is used in the ambulatory care settings andprovides for clinic registration, clinic billing, and receivables management.

INVISION® enterprise applications are used for a master person index (EnterpriseAccess Directory – EAD®), scheduling (Scheduling ASP), a medical record database forresults and observations (Lifetime Clinical Record – LCR®), and an image storagemanagement/distribution system (Document Imaging), and a corporate reporting system(NOVIUS® Data Warehouse).



4. BACKGROUND (continued)

For the major ancillary Siemens applications are also used in pharmacy and radiologyand MEDITECH’s Laboratory Information System (LIS) is used in laboratory.

Software from Lawson is used for the financial accounting applications of accountspayable, materials management, and general ledger. Payroll is processed by ADP.

ACMC has adopted an integration strategy that uses the Siemens OPENlink® integrationengine and all system interfaces internal and external use this integration engine thatincorporates HL7 standards as the interface protocol.

5. SPECIFIC REQUIREMENTS

A. Licensing

ACMC requires a perpetual license for an acquired product that allows use by the variouson-staff physicians, clinicians, and other designated staff. The license to use shall notrestrict the healthcare organization to using the software on specific hardware, nor shall itbe tied to licensed hospital beds or other measures of use or activity. Contractor shalldescribe how they can support this requirement.

B. Source Code (Contractor shall describe the following):

1. Its policies pertaining to source code ownership and access.

2. In which language(s) is the system written for the proposed application set.

3. Which database(s) is (are) used for the proposed application set.

C. State and Federal Regulations (Contractor shall do the following):

1. Describe in detail its plan to meet proposed HIPAA regulations for electronictransactions, security and privacy.

2. Specify the activities that Contractor has identified in its plan to support HIPAA andshall indicate which of these activities are already completed.

3. Describe the federal and state requirements supported in the current system.

6. DELIVERABLES/REPORTS

All deliverables shall be provided in hard copy and (upon request) in a format compatible withMicrosoft Word, Excel, PowerPoint or Access for Windows 98, or ACMC current application attime of request.



INSTRUCTIONS TO BIDDERS

7. COUNTY CONTACTS

All questions regarding these specifications, terms and conditions are to be submitted in writing,preferably via e-mail before noon on November 13, 2001 to:

Tudor S. Mosu, BuyerAlameda County, GSA-Purchasing Department1401 Lakeside Drive, Suite 907Oakland, CA 94612-4305E-Mail : [email protected] : 510-208-9626

The GSA Contracting Opportunities website will be the official notification posting place of allRequests for Interest, Proposals, Quotes and Addenda. Go to www.co.alameda.ca.us and clickon Contracting Opportunities for the Goods and Services table.

8. CALENDAR OF EVENTS

Event DateRequest Issued October 30, 2001Written Questions Due BEFORE 12:00 noon on November 13, 2001Bidders Conference November 14, 2001Addendum Issued November 21, 2001Response Due BEFORE 2:00 p.m. on December 7, 2001Evaluation Period December 10-19, 2001Contractor Interviews/ Selection ofDemo Finalists January 9-10, 2002On-site Demonstrations January 15-18, 2002Selection of Finalist(s) January 21, 2002Board Letter Issued January 2002Board Award Date February 2002Contract Start Date February 2002

Note: Award and start dates are approximate.

It is the responsibility of each bidder to be familiar with all of the specifications, terms andconditions and the site condition. By the submission of a bid, the bidder certifies that if awardeda contract they will make no claim against ACMC based upon ignorance of conditions ormisunderstanding of the specifications.

Failure to participate in the bidders conference will in no way relieve the successful bidder fromfurnishing materials and/or services required in accordance with these specifications, terms and

http://www.co.alameda.ca.us/



8. CALENDAR OF EVENTS (continued)

conditions. Attendance at the bidders conference is strongly encouraged and recommended but isnot mandatory.

Bidders conference will be held at:

Fairmont Hospital CampusCafeteria Conference Room15400 Foothill Blvd.San Leandro, CA 94578

9. SUBMITTAL OF BIDS

A. Sealed bids must be received at the Office of the Purchasing Agent of Alameda CountyBEFORE 2:00 p.m. on the due date specified above.

B. Bidders are to submit an original plus 5 (five) copies of their proposal. Original proposal isto be clearly marked and is to be either loose leaf or in a 3-ring binder, not bound.

C. Bids are to be addressed as follows:

Tudor S. Mosu, BuyerRFP No. 006-1-0676 / EDIS for ACMCAlameda County, GSA-Purchasing Dept.1401 Lakeside Drive, Suite 907Oakland, CA 94612-4305

D. Bidder's name and return address must also appear on the envelope.

E. Bids will be received only at the address shown above, and prior to the time indicated.Any bid received at or after said time and/or date or at a place other than the stated addresscannot be considered and will be returned to the bidder unopened.

F. No telegraphic or facsimile bids will be considered.

G. All bids, whether delivered by an employee of the bidder, US Postal Service, courier orpackage delivery service, must be received and time stamped at the stated address prior tothe time designated. The Purchasing Department's timestamp shall be considered theofficial timepiece for the purpose of establishing the actual receipt of bids.

H. Contractor agrees and acknowledges all RFP specifications, terms and conditions andindicates ability to perform by submission of a bid.

I. Submitted bids shall be valid for a minimum period of one hundred-eighty (180) days.



9. SUBMITTAL OF BIDS (continued)

J. All costs required for the preparation and submission of a bid shall be borne by theContractor.

K. Only one bid response will be accepted from any one person, partnership, corporation, orother entity; however, several alternatives may be included in one response.

L. It is the responsibility of the bidders to identify information in their bid responses thatthey consider to be confidential under the California Public Records Act. To the extentthat County/ACMC agrees with that designation, such information will be held inconfidence whenever possible. All other information will be considered public.

10. REFERENCES

A. Respondents are to provide a list of three (3) current and three (3) former clients.References shall have similar volume and requirements to those outlined in thesespecifications, terms and conditions.

B. Reference information is to include:• Company/Agency name• Contact person (name and title), contact person is to be someone directly involved

with the services.• Complete street address• Telephone number• Type of business• Dates of service

C. ACMC may contact some or all of the references provided in order to determine theproposer’s performance record on work similar to that described in this request. TheACMC reserves the right to contact references other than those provided in the responseand to use the information gained from them in the evaluation process.

11. FINANCIAL STABILITY

Responses are to include:• Company’s most recent Dun and Bradstreet Supplier Evaluation Report.

In addition, start-ups shall provide demonstrated track record in industry which indicatespotential for success.

12. RESPONSE FORMAT

A. Proposals are to be straightforward, clear, concise and specific to the informationrequested.



12. RESPONSE FORMAT (continued)

B. In order for bids to be considered complete bidders must provide all informationrequested.

13. RESPONSE CONTENT

A. Bid responses must be signed in ink as set forth in this subsection. The signatures of allpersons required under the applicable organizational documents, in order to bind theContractor, must be on the bid response.

B. Bidders shall follow the requirements set forth below. Any material deviation from theserequirements may be cause for rejection of the Proposal, as determined in ACMC’s solediscretion. All items listed below are required to be submitted in each RFP response. Thecontent and sequence of each proposal shall be as follows:

1. Title Page: Show RFP number and title, your company name and address, name ofthe contact person, telephone number and proposal date.

2. Table of Contents: Bid responses shall include a table of contents listing theindividual sections of the proposal and their corresponding page numbers. Tabsshall separate each of the individual sections.

3. Cover Letter: Bid responses shall include a cover letter describing the Contractorand include all of the following:

a) The official name of the Contractor;

b) The Contractor’s organizational structure (e.g. corporation, partnership, limitedliability company, etc.);

c) The jurisdiction in which the Contractor is organized and the date of suchorganization;

d) The address of the Contractor’s headquarters and of any local office of theContractor involved in the bid proposal;

e) The Contractor’s Federal Tax Identification Number;

f) The name, address, telephone, fax numbers and e-mail address of the person(s)who will serve as the contact(s) with ACMC, with authorization to makerepresentations on behalf of, and to bind the Contractor;

g) A representation/statement that the Contractor is in good standing in the Stateof California and has all necessary licenses, permits, certifications, approvals



13. RESPONSE CONTENT (continued)

and authorizations necessary in order to perform all of the Contractor’sobligations in connection with this RFP;

h) An acceptance of all conditions and requirements contained in this RFP.

i) Applicable documentation as required and identified above in this section.

4. Letter of Transmittal: Bid responses shall include a description of approach toservice in one or two pages stating the understanding of the work to be done and apositive commitment to perform the work as specified.

5. Executive Summary: A brief synopsis of the highlights of the proposal and overallbenefits of the proposal to ACMC. This synopsis shall not exceed three pages inlength and shall be easily understood.

6. Contractor’s Qualifications and Experience: A description of the capabilities of theContractor that pertain to this RFP. This description shall not exceed five pages andshall include a detailed summary of the Contractor’s experience relative to RFPrequirements described herein, including references.

7. Financial Statements:• Company’s most recent Dun and Bradstreet Supplier Evaluation Report

In addition, start-ups shall provide demonstrated track record in industry whichindicates potential for success.

8. Key Personnel - Qualifications and Experience: Bid responses shall include acomplete list of all key personnel associated with the proposal and their resumes.This list must include all key personnel who will provide services to ACMC staffand all key personnel who will provide maintenance and support services. For eachperson on the list, the following information shall be included:

(1) the person’s relationship with the Contractor, including job title and years ofemployment with the Contractor;

(2) the role that the person will play in connection with the proposal;(3) address, telephone, fax numbers, and e-mail address;(4) the person’s educational background;(5) the person’s relevant experience;(6) relevant awards, certificates or other achievements.

This section of the bid response shall include no more than two pages of informationfor each listed person.



13 RESPONSE CONTENT (continued)

9. Description of the Proposed System: Bid response shall include a description of theproposed system as it will be finally configured during the term of the contract. Thedescription shall specify how the proposed system will meet or exceed therequirements of ACMC and shall explain any advantages that this proposed systemwould have over other possible systems. The description shall include anydisadvantages or limitations that ACMC shall be aware of in evaluating theproposal. Bid response shall include responses to functional requirement statementsdescribed in Section 2-SCOPE, Items A through H and Item I-Technology (also seeattached Exhibit N, Functional Requirements). Finally, the description shalldescribe all system warranties provided by the Contractor.

10. Implementation Plan and Schedule: The bid response shall include animplementation plan and schedule. The plan shall include a detailed scheduleindicating how the Contractor will ensure adherence to the timetables set forthherein for the proposed system and associated services.

11. References, Exhibit D1 and D2: Complete reference information for all publicinstitutions or agencies for which the Contractor provides or has providedcomparable systems and services shall be provided on a separate sheet. Eachreference shall include the project name and location, the scope of servicesperformed and the name, address, telephone and fax numbers of the person whomay be contacted for reference information.

12. Bid Form, Exhibit B: must be completed, signed and returned with the bid response.

13. Evidence of Insurance, per Exhibit C: Certificates of insurance from a reputableinsurer evidencing all coverage required for the term of the Final StandardAgreement, and shall indicate that ACMC, its Board of Trustees, officers, agentsand employees are named as additional insureds as their interest may appear withrespect to system implementation.

14. Summary of Submittals and Exhibits:

• Exhibit A, Acknowledgement, signed• Exhibit B, Bid Form, completed and signed• Certificate of Insurance per Exhibit C, shall be attached• Exhibit D-1, Current References, completed• Exhibit D-2, Former References, completed• Exhibit F, Request for Preference for Local Products and Contractors,

completed and signed (if applicable)• Exhibit G, Exceptions, Clarifications and Amendments Form, completed and

signed (if applicable)• Exhibit I, Sample Proposal Evaluation Form, signed



13. RESPONSE CONTENT (continued)

• Exhibit K, Actual Project Experience, completed and signed• Exhibit N, Functional Requirements, completed and signed

14. EVALUATION CRITERIA/SELECTION COMMITTEE

All Proposals will be evaluated by an ACMC Selection Committee (SC). The SC will becomposed of departmental staff and other parties with expertise or experience in informationsystems. The SC will select a Contractor in accordance with the selection criteria set forth inthis RFP. The evaluation of the proposals shall be within the sole judgment and discretion ofSC.

All contacts during the evaluation phase will be through the Purchasing Department. Attemptsby the Contractor to contact members of the SC may result in disqualification of the bidder.

The SC will evaluate each proposal meeting the qualification requirements set forth in thisRFP. Contractors shall bear in mind that any proposal that is unrealistic in terms of thetechnical or schedule commitments, or unrealistically high or low in cost, will be deemedreflective of an inherent lack of technical competence or indicative of a failure to comprehendthe complexity and risk of ACMC’s requirements.

The basic information that each section shall contain is specified below. These specificationsshall be considered as minimum requirements. Much of the material needed to present acomprehensive proposal can be placed into one of the sections listed. However, if relevantinformation needs to be presented to further support the bidder's case, other appropriatesections may be added.

A. Completeness of Response……………………………………Pass/Fail

Responses to this proposal must be complete. Responses that do not address each of theitems listed below will be considered incomplete, be rated a “Fail” in the EvaluationCriteria and will receive no further consideration.

B. Financial Stability……………………………………………..Pass/Fail

The financial stability of bidders will be evaluated to determine their fiscal capability toprovide the system proposed. Bidders are to include in their responses the documentspreviously specified in Section 10.

C. Vendor's Understanding of the EDIS-RFP Requirements

This section is to serve as an introduction to the overall Emergency Department’sinformation management requirements at ACMC and what needs to be done as the



14. EVALUATION CRITERIA/SELECTION COMMITTEE (continued)

proposer sees it. It is intended as a means of presenting the proposer's understanding ofACMC-EDIS functional and technical requirements.

D. Statement of Approach, Schedule and Personnel

Explain your approach and methodology to fulfilling this RFP, including schedule andpersonnel.

E. Relevant Experience

Respondents are to provide a list of three (3) current clients and three (3) former clients.References shall have similar size and requirements to those outlined in these specifications,terms and conditions.

Reference information is to include:• Hospital name• Contact person (name and title), contact person shall be someone directly involved in

delivery of products and services• Complete street address• Telephone number• Dates of Installation

ACMC may contact some or all of the references provided in order to determine theproposers' performance record on work similar to that described in this request. ACMCreserves the right to contact references other than those provided in the response and touse the information gained from them in the evaluation process.

F. Cost

Contractor shall detail all expected costs. Fees shall include all anticipated costsincluding travel, per diem, and out-of-pocket expenses (Exhibit B, Part 1).

In addition, Contractor shall quote any other services possibly connected to the systemthat may be needed during/and as a result of the system implementation and operationand which Contractor believes that ACMC is interested in receiving (Exhibit B, Part 2).

An evaluation will be made of (a) reasonableness (i.e., does the proposed pricingaccurately reflect the Contractor's effort to meet requirements and objectives?); (b)realism (i.e., is the proposed cost appropriate to the nature of the services to beprovided?); and (c) affordability (i.e., the ability of the ACMC to finance the services.Consideration of price in terms of overall affordability may be controlling incircumstances where two or more proposals are otherwise adjudged to be equal, or whena superior proposal is at a price that ACMC cannot afford.



14. EVALUATION CRITERIA/SELECTION COMMITTEE (continued)

G. Actual Project Experience

Contractor shall provide information about actual project experience in a hospitalenvironment and years of experience performing similar services, number ofinstallations, by product/module, maturity of the products installed, origin of the productsinstalled as outlined in Exhibit K.

H. Oral Presentation/Interview

Following evaluation of the written proposals, Contractors receiving the highest scoresmay be invited to an oral presentation and interview, if CSC makes the decision to do so.The scores at that time will not be communicated to the Contractors. The invitation to anoral presentation/interview is optional and the oral presentation by each Contractor shallnot exceed sixty (60) minutes in length. The oral interview will consist of standardquestions asked of each of the Contractors and specific questions regarding the specificproposal. The proposals may then be re-evaluated and re-scored based on the oralpresentation and interview.

15. CONTRACT EVALUATION AND ASSESSMENT

During the initial sixty (60) day period of the contract, the CSC and/or other personsdesignated by ACMC, will meet with the Contractor to evaluate the system performance andto identify any issues or potential problems.

ACMC reserves the right to determine, at its sole discretion, (a) whether the Contractor hascomplied with all terms of this RFP and (b) whether any problems or potential problems withthe proposed system have been evidenced that make it unlikely (even with possiblemodifications) to meet ACMC requirements. If, as a result of such determination ACMCconcludes that it is not satisfied with the Contractor’s performance, the Contractor will benotified of contract termination effective thirty (30) days following notice. Contractor shall beresponsible for the removal of system and shall return ACMC facilities to their pre-installationstate at no charge to ACMC. ACMC shall have the right to invite the next highest rankedContractor to enter into a contract. ACMC also reserves the right to re-bid system if it isdetermined to be in its best interest to do so.



TERMS AND CONDITIONS

16. TERM / TERMINATION / RENEWAL

A. The term of the contract will be determined throughout negotiations and mutual agreementbetween ACMC and Contractor. The contract is planned to start on approximatelyFebruary 2002. Timelines established through contract are of essence.

B. ACMC may terminate the contract at any time without written notice upon a materialbreach of contract and substandard or unsatisfactory performance by the Contractor.

C. By mutual agreement, this contract may be extended for additional terms at agreed priceswith terms and conditions remaining the same.

17. QUANTITIES

Quantities listed are annual estimates based on past usage and are not to be construed as acommitment. No minimum or maximum is guaranteed or implied.

18. PRICING

A. Prices quoted are to be firm for the period of the contract.

B. Unless otherwise stated, the Contractor agrees that, in the event of a price decline, thebenefit of such lower price shall be extended to ACMC.

C. All prices are to be F.O.B. destination. Any freight/delivery charges are to be included.

D. Any price increases or decreases for subsequent contract terms may be negotiated betweenContractor and ACMC only after completion of the initial term.

E. Contractor shall propose a “not too exceed” bid amount for the EDIS project including anestimate of necessary software, hardware, interface, implementation, training, conversion,and resource hours and hourly rates.

F. All prices quoted shall be in dollars and "whole cent," no cent fractions shall be used.There are no exceptions.

G. ACMC has the right to decline to award this contract if it is determined that proposedpricing is not competitively priced with similar sized counties or non-county agencieswithin the State of California.

H. Price quotes shall include any and all payment incentives available to ACMC.



19. AWARD

A. Proposals will be evaluated by a committee and will be ranked in accordance with the RFPsection entitled “Evaluation Criteria/Selection Committee.”

B. The committee will recommend award to the contractor who, in its opinion, has submittedthe proposal that best serves the overall interests of ACMC and attains the highest overallpoint score. Award may not necessarily be made to the Contractor with the lowest price.

C. ACMC reserves the right to reject any or all responses and to waive informalities and minorirregularities in responses received.

D. In the event of termination due to breach of contract and substandard or unsatisfactoryperformance ACMC reserves the right to contact the bidder that submitted the next tohighest ranked proposal.

E. ACMC Board of Trustees approval to award a contract is required.

F. Contractor shall sign an acceptance of award letter prior to Board approval.

G. The successful Contractor will be considered the prime contractor and hence, will be heldsolely responsible for products and services delivered in implementation of the contract byits principals, employees, or subcontractors.

20. METHOD OF ORDERING

A. A written purchase order (PO) and signed Standard Agreement contract shall be issuedupon Board of Trustees approval.

B. Standard Agreement and POs shall be the only authorization to the Contractor to do work.

C. Purchase orders and payments for products and services shall be issued only in the nameof the Contractor who is awarded a contract.

D. Contractor shall adapt to changes to the method of ordering procedures as required byACMC during the term of the contract.

E. Change orders shall be agreed upon by ACMC and Contractor and shall be issued asneeded in writing by ACMC.

21. INVOICING

A. Contractor shall invoice ACMC monthly, unless otherwise advised, upon satisfactoryreceipt of product as scheduled and performance of services.



21. INVOICING (continued)

B. Payment will be made within thirty (30) days following receipt of invoice and uponcomplete satisfactory receipt of product and performance of services.

C. ACMC shall notify contractor of any adjustments required to invoice.

D. Invoices shall contain ACMC purchase order number, invoice number, remit to address anditemized products and/or services description and price as quoted and shall be accompaniedby acceptable proof of delivery.

E. Contractor shall utilize standardized invoice upon request.

F. Invoices shall be issued and payments made only to the Contractor who is awarded acontract.

G. Payments shall be issued to and invoices must be received from the same Contractor namespecified on the purchase orders.

H. The entire County is not to be put on credit hold or penalized if ACMC is delinquent inprocessing its payments. Contractors must work with ACMC to resolve any delinquentor other payment issues. Contractors are to take collection actions if necessary, up to andincluding credit hold against ACMC, not the entire County. Failure to follow thisprocedure may result in termination of the contract.

I. ACMC will pay Contractor for products and associated services monthly or as agreed upon,within the “not to exceed” total price quoted in the bid response.

22. OTHER AGENCIES

Other tax supported agencies within the State of California who have not contracted for their ownrequirements may desire to participate in this contract. The Contractor will be requested toservice these agencies and will be given the opportunity to accept or reject the additionalrequirements. If the Contractor elects to supply other agencies, orders will be placed directly bythe agency and payments made directly by the agency.

23. FUNDING OUT CLAUSE

ACMC may, at its sole option, terminate this agreement at the end of any County Fiscal Year, forreason of non-appropriation of funds. In such event, ACMC will give Contractor at least thirty(30) days written notice that such function will not be funded for the next fiscal period. In suchevent, ACMC will return any associated equipment to the Contractor in good working order,reasonable wear and tear expected.



24. ACMC PROVISIONS

A. Preference for Local Products and Vendors: A 5% preference shall be granted to AlamedaCounty Products or vendors on all sealed bids on contracts except with respect to thosecontracts which state law requires be granted to the lowest responsible bidder. An AlamedaCounty vendor is a firm or dealer with fixed offices or distribution points located in andhaving a street address within the County and which holds a valid business license issued bythe County for a city within the County. Alameda County products are those which aregrown, mined, fabricated, manufactured, processed or produced within the County.

B. Hold Harmless: The vendor agrees to defend, indemnify and hold harmless ACMC and theCounty of Alameda, their respective officers, employees, agents and servants, for any andall liability caused by the negligence or wrongful act of the vendor arising out of theperformance of this contract, or any act or omission of vendor, its agents, employees andservants, or for product liability or breach of warranty by vendor, either expressed orimplied, and to pay all claims, damages, judgments, legal costs, adjuster fees and attorneyfees related thereto.

C. Insurance: Please refer to Exhibit C for the insurance requirements applicable to thisrequest.

D. Drug-Free Workplace: It is the policy of ACMC to maintain a drug-free workplace. Theunlawful manufacture, distribution, dispensation, possession and/or use of controlledsubstances in the workplace is prohibited. Controlled substances are those defined in 21USC Section 812 and include, but are not limited to, such substances as marijuana, heroin,cocaine and amphetamines. The workplace is presumed to include all ACMC facilities andpremises where ACMC employees may visit in the execution of their job duties such ashomes, schools, hospitals, etc. All ACMC employees are required to comply with thispolicy as an essential condition of employment. Individuals who are not considered ACMCemployees, but who perform work at ACMC worksites for ACMC’s benefit, are required tocomply with this policy. Such individuals who unlawfully manufacture, distribute,dispense, possess or use controlled substances in the ACMC workplace may be barred fromfurther work for and in ACMC’s facilities as well as from future consideration.

E. Immigration Naturalization Service Requirements: In compliance with the ImmigrationReform and Control Act of 1986, Contractor shall require all persons in its employ toprovide the necessary documentation to establish identity and employment eligibility. TheOwner requires that all personnel employed be eligible for employment in the United Statesand have substantiated their eligibility with the Contractor.

F. Equal Employment Opportunity Practices Provisions: Contractor assures that he/she/it willcomply with Title VII of the Civil Rights Act of 1964 and that no person shall, on thegrounds of race, creed, color, disability, gender, sexual orientation, national origin, age,religion, Vietnam era Veteran’s status, political affiliation, or any other non-merit factor, be



24. ACMC PROVISIONS (continued)

excluded from participation in, be denied the benefits of, or be otherwise subjected todiscrimination under this contract.

1. Contractor shall, in all solicitations or advertisements for applicants for employmentplaced as a result of this contract, state that it is an “Equal Opportunity Employer” orthat all qualified applicants will receive consideration for employment without regardto their race, creed, color, disability, gender, sexual orientation, national origin, age,religion, Vietnam era Veteran’s status, political affiliation, or any other non-meritfactor.

2. Contractor shall, if requested to so do by ACMC, certify that it has not, in theperformance of this contract, discriminated against applicants or employees because oftheir race, creed, color, disability, gender, sexual orientation, national origin, age,religion, Vietnam era Veteran’s status, political affiliation, or any other non-meritfactor.

3. If requested to do so by ACMC, Contractor shall provide ACMC with access to copiesof all of its records pertaining or relating to its employment practices, except to theextent such records or portions of such records are confidential or privileged understate or federal law.

4. Contractor shall recruit vigorously and encourage minority and women-ownedbusinesses to bid its subcontracts.

5. Nothing contained in this contract shall be construed in any manner so as to require orpermit any act that is prohibited by law.

6. Contractor shall include the provisions set forth in paragraphs numbered 1 through 5(above) in each of its subcontracts.

G. Independent Contractor Status: Contractor hereby agrees that it is engaged as anindependent contractor and not as an agent or employee of ACMC or the County; that it hasand retains the right to exercise control and supervision of the work and full control over theemployment, direction, compensation and discharge of all persons assisting in the work; thatit will be solely responsible for wages, including withholding of income taxes, socialsecurity taxes and preparation and filing of IRS Form 1099 for each individual furnished toACMC under this contract, workers' compensation premiums, compliance with OSHA andall employment-related regulations relating to its employees; and that it will be responsiblefor its own acts and those of its subordinates, employees and agents during the term of thiscontract. Contractor agrees that as an independent contractor it is solely responsible for allfederal, state and local taxes. Contractor further agrees that its officers and employees donot become employees of ACMC or the County, nor are they entitled to any ACMC orCounty employee benefits as a result of the execution of this contract.




H. Conflict of Interest: No officer, member or employee of ACMC and no member of itsgoverning bodies shall have any pecuniary interest, direct or indirect, in this contract or theproceeds thereof. No Contractor nor member of Contractor's family shall serve on anyACMC board, committee, or hold any such position which either by rule, practice or actionnominates, recommends, supervises Contractor's operations, or authorizes funding toContractor.

I. Confidentiality: Confidential information is defined as all information disclosed toContractor which relates to ACMC’s past, present and future activities, as well as activitiesunder this agreement. Contractor will hold all such information in trust and confidence.Upon cancellation or expiration of this Contract, Contractor will return to ACMC all writtenor descriptive materials that contain any such confidential information.

J. Use of ACMC Property: Contractor shall not use ACMC premises, property (includingequipment, instruments or supplies) or personnel for any purpose other than in theperformance of its obligations under this contract.

K. Alameda County Medical Center: The responsibilities, functions, objectives and terms ofagreement, including financial arrangements and charges of each such outside resource,shall be delineated in writing and signed by an authorized representative of ACMC and theperson or the agency providing the service. The agreement shall specify that ACMC retainsprofessional and administrative responsibility for the services rendered. The outsideresource, when acting as a consultant, shall appraise ***?? apprise??? the administrator ofrecommendations, plans for implementation and continuing assessment through dated andsigned reports which shall be retained by the administrator for follow-up action andevaluation of performance.

Tuberculosis: Contractor shall provide ACMC yearly with acceptable proof of Mantouxskin test for tuberculosis or chest x-ray (14 x 17) for all personnel providing on-site servicesat ACMC. Initial proof shall be provided prior to the provision of service. Acceptableproof shall be a statement signed by a physician of a negative Mantoux test or a signednegative chest X-ray. Contractor or any employees of Contractor who convert from anegative Mantoux test to a positive test must provide a signed physician’s statementindicating they are free from the presence of infectious disease.

Rubella and Rubeola Immunity: Prior to assignment, the Contractor shall provideacceptable proof of rubella and rubeola immunity and other immunities as may be requiredby law for all individuals who will be providing on-site services at ACMC. Acceptableproof of immunity (positive titer and/or vaccination) shall be a signed statement from anofficial health provider or a signed health certificate such as for marriage or internationaltravel.




Administrative Responsibilities: Consistent with Title 22, California AdministrativeCode, Section 70713, ACMC retains professional and administrative responsibility forservices rendered under this Agreement. ACMC’s retention of these responsibilities shallnot alter or modify, in any way the hold harmless, indemnification, insurance orindependent contractor provisions set forth herein.

L. Access To Records: Until the expiration of five (5) years after the furnishing of anyservices, Contractor shall make available, upon written request, to ACMC or to thefederal/state/county government, or any of their duly authorized representatives, thisAgreement, and such books, documents and records of Contractor that are necessary tocertify the nature and extent of the reasonable cost of services to ACMC. If Contractorenters into an ACMC approved agreement with any related organization to provideservices with a value or cost of $10,000 or more over a twelve-month period, suchagreement shall contain a clause to the effect that until the expiration of five years afterthe furnishing of services pursuant to such subcontract, the related organization shallmake available, upon written request, to ACMC or to the federal/state/countygovernment, or any of their duly authorized representatives, the subcontract, and books,documents and records of such organization that are necessary to verify the nature andextent of the services and costs. This paragraph shall be of no force and effect when andif it is not required by law, or if modified by law, such modification will supersede thisclause. ACMC shall have access to Contractor's financial records for purposes of audit.Such records shall be complete and available for audit 90 days after final paymenthereunder and shall be retained and available for audit purposes for five years after finalpayment hereunder.

M. Conformity with Law Standards and Safety:

1. Contractor shall observe and comply with all applicable laws, ordinances, codes andregulations of governmental agencies, including federal, state, municipal, and localgoverning bodies, having jurisdiction over the scope of services or any part hereof,including the Joint Commission on Accreditation of Healthcare Organizationsstandards for compliance and accreditation, State Department of Health requirements,as set forth in California Code of Regulations, Title 22, and all provisions of theOccupational Safety and Health Act of 1979 and all amendments thereto, and allapplicable federal, state, municipal, and local safety regulations. All servicesperformed by Contractor must be in accordance with these laws, ordinances, codes andregulations. Contractor shall indemnify and hold ACMC harmless from any and allliability, fines, penalties and consequences from any noncompliance or violations ofsuch laws, ordinances, codes and regulations.

2. ACMC is committed to monitoring performance and continually improving thequality of care delivered. Contractor and any of its subcontractors and employees,shall cooperate with and, as necessary, actively participate in the ACMC




performance improvement process. This shall include participation on performanceimprovement teams and/or committees, cooperation with sentinel eventinvestigations, participation and/or cooperation in disease and case managementprograms. Contractor will additionally participate in preparation for surveys and/oraudit by accrediting or regulatory agencies and any plan(s) of correction, which mayfollow.

3. Accidents: If a death, serious personal injury or substantial property damage occursin connection with the performance of this Agreement, Contractor shall immediatelynotify ACMC and the Alameda County Administrator, Risk Manager’s Office, andthe Alameda County Contracting Officer, Health Care Services Agency Director, bytelephone. Contractor shall promptly submit to ACMC, the Alameda County RiskManager and the Alameda County Contracting Officer a written report, in such formas may be required by ACMC of all accidents that occur in connection with thisAgreement. This report must include the following information: (1) name and addressof the injured or deceased person(s); (2) name and address of Contractor’ssubcontractor, if any; (3) name and address of Contractor’s liability insurance carrier;and (4) a detailed description of accident and whether any of ACMC’s equipment,tools, material, or staff were involved.

N. Travel Expenses: Contractor shall not be allowed or paid travel expenses unless set forth inthis Agreement.

O. Work Products and Inventions: ACMC shall have a royalty-free, exclusive, and irrevocablelicense to reproduce, publish and use all original computer programs, writings, soundrecordings, pictorial reproductions, drawings and other works of similar natures produced inthe course of or under this Agreement; and Contractor shall not publish any such materialwithout prior written consent of ACMC.

P. Assignment of Contract: Nothing contained in this Agreement shall be construed to permitassignment or transfer by Contractor of any rights or delegation of any duties under thisAgreement and such assignment, transfer or delegation of duties is expressly prohibited andvoid unless otherwise approved in writing by ACMC.

Q. Subcontracting: None of the work to be performed by Contractor shall be subcontractedwithout the prior written consent of ACMC. Contractor shall be as fully responsible toACMC for the acts and omissions of any subcontractors, and of persons either directly orindirectly employed by them, as Contractor is for the acts and omissions of persons directlyemployed by Contractor.



25. ACCOUNT MANAGER/SUPPORT STAFF

A. Contractor shall provide a dedicated competent account manager who shall be responsiblefor the ACMC account. The account manager shall receive all orders from ACMC and shallbe the primary contact for all issues regarding this contract.

B. Contractor shall provide adequate, competent support staff who shall be able to service thisaccount during normal working hours, Monday through Friday. Such representatives shallbe knowledgeable about the contract, products offered and able to identify and resolvequickly any issues including but not limited to order and invoicing problems.

C. Account manager shall be familiar with ACMC requirements and standards and work withACMC delegate to ensure that established standards are adhered to.

D. Account manager shall keep ACMC representative (Bob Woods, CIO or designateddelegate) informed of the status of project implementation on a periodic basis as agreed:daily, weekly, monthly, verbally or in writing.

26. GENERAL REQUIREMENTS

A. The successful contractor shall be of preference regularly and continuously engaged in thebusiness of providing information systems for at least three (3) years.

B. The successful Contractor shall possess all permits, licenses and professional credentialsnecessary to supply system and perform services as specified under this contract.

C. Proper conduct is expected of Contractor’s personnel when on ACMC premises. Thisincludes adhering to no-smoking ordinances, the drug-free work place policy, not usingalcoholic beverages and treating employees courteously.

D. ACMC has the right to request removal of any Contractor employee who does not properlyconduct himself/herself or perform quality work.

E. Contractor personnel shall be easily identifiable as non-ACMC employees (i.e. workuniforms, badges, etc.).

F. Contractor shall be responsible for any and all damage to ACMC facilities or equipmentas a result of an act or omission arising out of the performance under this contract.

G. All work shall be performed in a professional manner according to generally acceptedindustry standards and manufacturers instructions.

H. Contractor shall not assign or transfer this agreement, any interest therein or claimthereunder without the prior written approval of ACMC.



26. GENERAL REQUIREMENTS (continued)

I. Time is of the essence in each and all the provisions of this agreement.

J. No alteration or variation of the terms of this agreement shall be valid unless made inwriting and signed by the parties hereto.

K. Warranty: Contractor expressly warrants that all goods and services to be furnishedpursuant to this contract conform to the descriptions and specifications contained herein andin Contractor catalogs, product brochures and other representations, depictions or models,and will be free from defects, of merchantable quality, good material and workmanship.Contractor expressly warrants that all goods and services to be furnished pursuant to thiscontract will be fit and sufficient for purposes intended. This warranty shall survive anyinspections, delivery, acceptance or payment by ACMC. Contractor warrants that all workand services furnished hereunder shall be guaranteed for a period of minimum one (1) yearfrom the date of acceptance by the ACMC.

L. Title: Contractor warrants and represents that Contractor has absolute and good title to andfull right to dispose of goods and services, and that there are no security interests, liens,claims or encumbrances of any kind against the goods or work.

M. Remedies: In addition to other remedies afforded by law or in equity for breach of warrantyor otherwise, any goods or work found to be defective within 30 days after acceptancethereof by ACMC shall be repaired or replaced by Contractor free of all charges, includingtransportation. Contractor agrees to indemnify ACMC against all liability, loss and damage,including reasonable attorney’s fees, sustained by ACMC because of the failure of thegoods or services to conform to any express or implied warranty. All warranties containedherein shall survive the termination or expiration of this contract. If any of the goods orservices are purchased by ACMC for resale, the time limitation on the duration of thewarranties applicable to such goods or services shall begin to run on the date of such resale.

N. Third Party Beneficiaries: Contractor’s warranties extend to any person who mayreasonably be expected to use, consume or be affected by the goods and services, and anysuch person shall be entitled to bring an action directly against Contractor for damages orinjuries sustained in the result of any breach of warranty by Contractor.

O. Force Majeure: Upon award of a contract, should Contractor or ACMC be prevented fromperforming its obligations as specified herein by a cause or cause outside of and/or beyondtheir control, including but not limited to, acts of God, acts of civil or military authorities,government priorities, unavailability of transport, fire, strikes, floods, earthquakes,hurricanes, epidemics, tornadoes, wars, or riots, which makes performance not feasible andwhich by the exercise of due diligence Contractor or ACMC is unable to overcome, thenthey will be excused from performance to the extent such performance is prevented, but notto exceed the duration such Force Majeure affects Contractor or ACMC.



26. GENERAL REQUIREMENTS (continued)

Payment of money for delivered and accepted goods or work is not excused by ForceMajeure.

If Contractor or ACMC invokes these Force Majeure conditions, they shall give writtennotice to the other Party of the existence of a Force Majeure conditions and shalldemonstrate that all reasonable steps to minimize the consequences of the conditions havebeen taken. As continuity of contract performance is essential, Contractor and ACMC shallcooperate with the other in actions reasonably necessary to minimize the consequences of aForce Majeure. Such action shall include, but not be limited to, assisting and makingarrangements for replacement of the performance required hereunder.

In the event of reduced performance due to Contractor’s or ACMC’s partial Force Majeure,the other Party has the option to accept pro rata performance or refuse reduced performance.For any duration that Contractor or ACMC enforces Force Majeure provisions, the otherParty may, at its option, purchase from a third party all or part of the performance requiredhereunder.

If Contractor’s or ACMC’s Force Majeure or partial Force Majeure lasts for more than three(3) months, the other Party may, at its option, terminate the contract.

EXHIBIT A – BID ACKNOWLEDGEMENTALAMEDA COUNTY MEDICAL CENTER (ACMC)

RFP No. 006-1-0676for

EMERGENCY DEPARTMENT INFORMATION SYSTEM (EDIS)

Alameda County Medical Center (ACMC) is soliciting bids from qualified vendors to furnish its requirements per the specifications, terms and conditionscontained in the above referenced RFP/Q number. This Bid Acknowledgement must be completed, signed by a responsible officer or employee, dated andsubmitted with the bid response. Obligations assumed by such signature must be fulfilled.1. Preparation of bids: (a) All prices and notations must be printed in ink or typewritten. No erasures permitted. Errors may be crossed out and corrections

printed in ink or typewritten adjacent and must be initialed in ink by person signing bid. (b) Quote price as specified in RFP/Q. No alterations or changes ofany kind shall be permitted to Exhibit B, Bid Form. Responses that do not comply shall be subject to rejection in total.

2. Failure to bid: If you are not submitting a bid but want to remain on the mailing list and receive future bids, complete, sign and return this BidAcknowledgement and state the reason you are not bidding.

3. Taxes and freight charges: (a) Unless otherwise required and specified in the RFP/Q, the prices quoted herein do not include Sales, Use or othertaxes. (b) No charge for delivery, drayage***???, express, parcel post packing, cartage***???, insurance, license fees, permits, costs of bonds, or forany other purpose, except taxes legally payable by Alameda County Medical Center (ACMC), will be paid by the ACMC unless expressly included anditemized in the bid. (c) Amount paid for transportation of property to ACMC is exempt from Federal Transportation Tax. An exemption certificate isnot required where the shipping papers show the consignee as ACMC, as such papers may be accepted by the carrier as proof of the exempt character ofthe shipment. (d) Articles sold to the ACMC are exempt from certain Federal excise taxes. ACMC will furnish an exemption certificate.

4. Award: (a) Unless otherwise specified by the bidder or the RFP/Q gives notice of an all-or-none award, the ACMC may accept any item or group ofitems of any bid. (b) Bids are subject to acceptance at any time within thirty (30) days of opening, unless otherwise specified in the RFP/Q. (c) Avalid, written purchase order mailed, or otherwise furnished, to the successful bidder within the time for acceptance specified results in a bindingcontract without further action by either party. The contract shall be interpreted, construed and given effect in all respects according to the laws of theState of California.

5. Patent indemnity: Vendors who do business with ACMC shall hold ACMC, its officers, agents and employees, harmless from liability of an nature orkind, including cost and expenses, for infringement or use of any patent, copyright or other proprietary right, secret process, patented or unpatentedinvention, article or appliance furnished or used in connection with the contract or purchase order.

6. Samples: Samples of items, when required, shall be furnished free of expense to ACMC and if not destroyed by test may upon request (made when thesample is furnished), be returned at the bidder’s expense.

7. Rights and remedies of ACMC for default: (a) In the event any item furnished by vendor in the performance of the contract or purchase order shallfail to conform to the specifications therefore or to the sample submitted by vendor with its bid, ACMC may reject the same, and it shall thereuponbecome the duty of vendor to reclaim and remove the same forthwith, without expense to ACMC, and immediately to replace all such rejected itemswith others conforming to such specifications or samples; provided that shall vendor fail, neglect or refuse so to do ACMC shall thereupon have theright purchase in the open market, in lieu thereof, a corresponding quantity of any such items and to deduct from any moneys due or that may there aftercome due to vendor the difference between the prices named in the contract or purchase order and the actual cost thereof to ACMC. In the event thatvendor fails to make prompt delivery as specified for any item, the same conditions as to the rights of ACMC to purchase in the open market and toreimbursement set forth above shall apply, except when delivery is delayed by fire, strike, freight embargo, or Act of God or the government. (b)Costof inspection or deliveries or offers for delivery, which do not meet specifications, will be borne by the vendor. (c) The rights and remedies of ACMCprovided above shall not be exclusive and are in addition to any other rights and remedies provided by law or under the contract.

8. Discounts: (a) Terms of less than ten (10) days for cash discount will considered as net. (b) In connection with any discount offered, time will becomputed from date of complete, satisfactory delivery of the supplies, equipment or services specified in the RFP/Q, or from date correct invoices arereceived by ACMC at the billing address specified, if the latter date is later than the date of delivery. Payment is deemed to be made, for the purposeof earning the discount, on the date of mailing ACMC warrant check.

9. California Government Code Section 4552: In submitting a bid to a public purchasing body, the bidder offers and agrees that if the bid is accepted, itwill assign to the purchasing body all rights, title, and interest in and to all causes of action it may have under Section 4 of the Clayton Act (15 U.S.C.Sec. 15) or under the Cartwright Act (Chapter 2, commencing with Section 16700, of Part 2 of Division 7 of the Business and Professions Code),arising from purchases of goods, materials, or services by the bidder for sale to the purchasing body pursuant to the bid. Such assignment shall be madeand become effective at the time the purchasing body tenders final payment to the bidder.

10. No guarantee or warranty: ACMC makes no guarantee or warranty as to the condition, completeness or safety of any material or equipment that maybe traded in on this order.

THE undersigned acknowledges receipt of above referenced RFP/Q and/or Addenda and offers and agrees to furnish the articles and/or servicesspecified on behalf of the vendor indicated below, in accordance with the specifications, terms and conditions of this RFP and Bid Acknowledgement.

Firm:Address:State/ZipWhat advertising source(s) made you aware of this RFP?

By:______________________________________________________________ Date____________________ Phone _________________________

Printed Name Signed Above:________________________________________________________________________________________________

Title:___________________________________________________________________________________________________________________

Company name:

EXHIBIT B

ALAMEDA COUNTY MEDICAL CENTER (ACMC)RFP No. 006-1-0676

forEMERGENCY DEPARTMENT INFORMATION SYSTEM (EDIS)

BID FORM

DESCRIPTION COST

Part 1. EDIS Implementation:Phase I – Implement ED Quick Registration, Triage and Patient Tracking $Phase II – Implement advanced clinical and patient management functions. $Interface and integrate the EDIS with Siemens cores $Replace existing information systems and automate critical manualprocesses with integrated EDIS

$

Improve workflow and patient care delivery processes $Automate the patient tracking and triage assessment functions $Tax $Total Part 1. $

Part 2. Connected Services Offered (please describe):• $• $• $• $• $• $• $• $• $• $• $Tax $Total Part 2. $Grand Total (Part 1. + Part 2. “not to exceed” bid amount per section 16.Pricing of the RFP)

$

Exhibit C (Page 1 of 2)

Insurance Requirements for Construction, Contractors, Lease AgreementsContractor: You are required to provide evidence of insurance shown for the category selected below. Please provide a copyof this form to your Insurance Agent(s).

This section for County use only" Special Services, Contractors, Maintenance-Under $10,000 & minimal exposure to risk of loss

- No Insurance Required

" Construction, Maintenance, Other Contractors (no employees) - Use Category A

X Construction, Maintenance, Other Contractors (w/employees) –Use Category B

" Lease Agreements-Use Category C

" Miscellaneous Agreements-Use of Premises, Right of Way, etc. (Contact Risk Management)

CATEGORY A MINIMUM REQUIREMENTS (NoEmployees) CATEGORY B MINIMUM REQUIREMENTS

Commercial General LiabilityMinimum Limit $1,000,000 CSLProducts/Completed OperationsUnderground, Explosion and Collapse("X,C,U") as applicable for projects involvingunderground construction (2)

Blanket ContractualOwner’s & Contractor’s ProtectiveAdditional Insured Endorsement

Automobile LiabilityMinimum Limit $1,000,000 CSL(1)

Any Auto or Non-owned or Hired

Commercial General LiabilityMinimum Limit $1,000,000 CSLProducts/Completed OperationsUnderground, Explosion and Collapse ("X,C,U") asapplicable for projects involving undergroundconstruction (2)

Blanket ContractualOwner’s & Contractor’s ProtectiveAdditional Insured Endorsement

Automobile LiabilityMinimum Limit $1,000,000 CSL(1)

Any Auto or Non-owned or Hired

Workers’ Compensation Statutory or $1,000,000 Employers’ Liability Min. $100,000

CATEGORY C MINIMUM REQUIREMENTS(Lease of County Premise Only)

MISCELLANEOUS REQUIREMENTS(May apply to any category)

Contact Risk Management for Assistance

Commercial General LiabilityMinimum Limit $1,000,000 CSLAdditional Insured EndorsementBlanket ContractualGaragekeepers Liability(3), withMinimum Limit $1,000,000 CSL

" All Risk Builder’s Risk (4)$ _____________

" Performance Bond $ ___________________

" Construction Bond $ ___________________

" Other $______________________________

Workers’ CompensationStatutory or $1,000,000Employers’ Liability Min. $100,000

See Attached Additional Requirements and/or Conditions.

Exhibit C (Page 2 of 2)

Additional Requirements and/or Conditions

1. If contractor (1) is providing transportation services (e.g. transporting goods or hauling), $1,000,000 automobile liabilityand an additional insured endorsement is required. This requirement is automatic if the transportation condition applies.

2. If Contractor(2) is required to excavate, use explosives or dig underground then “Underground, Explosion and Collapse”Coverage ("X,C,U") is required.

3. Required(3) if lessee has parking facilities.

4. All Risk Builders’ Risk Coverage(4) is required in the construction, remodel, and/or renovation, of any building orstructure. Deductibles over $5,000 are subject to approval.

5. All Insurance Certificates showing proof of insurance must include a 30-day notice of Cancellation. (Except PersonalAutomobile may show a minimum of 10 days).

6. Additional Insured Endorsement shall name Alameda County, * its Board of Supervisors, officers, agents andemployees as Additional Insureds with respect to services being provided. Additionalinsured endorsement shall be equivalent to ISO form CG 20 09 10 93.

*Certificates of insurance may indicate: “County of Alameda as Additional Insured”. This is acceptable provided thatthe actual endorsement to the policy is worded correctly. This is also encouraged if you have contracts with otherCounty Departments.

7. Commercial General Liability coverage shall be equivalent to ISO form CG 01 01 96.

8. All Commercial General Liability policies must include Personal Injury coverage.

9. Commercial/Business Automobile Liability shall be equivalent to ISO form CA 00 01 06 92

10. Contractors that hire vehicles or have employees or volunteers that use their personal vehicles shall provide non-ownedand hired automobile liability coverage.

11. For Contracts over $25,000 insurance companies shall have a minimum Best Rating of A- VII or subject to approval byRisk Management. Risk Management must review all contracts over $100,000.

12. If contractor is self-insured for any of the required coverages, contractor must submit evidence satisfactory to ACMC ofcontractor’s financial ability to respond to losses or claims for each self-insured coverage. Governmental Agencies mayprovide a letter of self-insurance.

13. Contractors are responsible for payment of all insurance deductibles.

14. Contractor’s insurance must be primary to any other insurance available to ACMC with respect to any claim arising out ofthis contract or agreement.

Address Certificate of Insurance to: A. Alameda CountyAttention: Tudor S. MosuGSA, Purchasing Department1401 Lakeside Dr, Suite 907Oakland, CA 94541-4305

and

B. Alameda County Medical CenterAttention: Denise T. Rodrigues1411 East 31st StreetOakland, CA 94602

EXHIBIT D-1ALAMEDA COUNTY MEDICAL CENTER (ACMC)

RFP No. 006-1-0676for


CURRENT REFERENCESRespondents are to provide a list of three (3) current clients in the area provided below. References shall be provided as requiredper the RFP specifications, terms and conditions. References shall have similar volume and requirements to those outlined inthese specifications, terms and conditions.

ACMC may contact some or all of the references provided in order to determine the proposer’s performance record on worksimilar to that described in this request. ACMC reserves the right to contact references other than those provided in theresponse and to use the information gained from them in the evaluation process.

Company Name:

Address:

City, State, Zip Code:

Contact Person:

Telephone Number:

Type of Business:

Dates of Service:

Company Name:

Address:


Contact Person:

Telephone Number:

Type of Business:

Dates of Service:

Company Name:

Address:


Contact Person:

Telephone Number:

Type of Business:

Dates of Service:

Company Name:

EXHIBIT D-2ALAMEDA COUNTY MEDICAL CENTER (ACMC)

RFP No. 006-1-0676for


FORMER REFERENCESRespondents are to provide a list of three (3) former clients in the area provided below. References shall be provided as requiredper the RFP specifications, terms and conditions. References shall have similar volume and requirements to those outlined inthese specifications, terms and conditions.

ACMC may contact some or all of the references provided in order to determine the proposer’s performance record on worksimilar to that described in this request. ACMC reserves the right to contact references other than those provided in theresponse and to use the information gained from them in the evaluation process.

Company Name:

Address:


Contact Person:

Telephone Number:

Type of Business:

Dates of Service:

Company Name:

Address:


Contact Person:

Telephone Number:

Type of Business:

Dates of Service:

Company Name:

Address:


Contact Person:

Telephone Number:

Type of Business:

Dates of Service:

Company Name:

EXHIBIT F



REQUEST FOR PREFERENCEfor

LOCAL PRODUCTS AND CONTRACTORS

IF YOU WOULD LIKE TO REQUEST THE LOCAL PREFERENCECOMPLETE THIS FORM AND RETURN IT WITH YOUR BID

A five-percent (5%) preference shall be granted to Alameda County products or contractors on all sealed bidson contracts except with respect to those contracts which State law requires be granted to the lowestresponsible bidder. An Alameda County contractor is a firm or dealer with fixed offices or distributionpoints located in and having a street address within ACMC and which holds a valid business license issuedby ACMC or a city with ACMC. Alameda County products are those which are grown, mined, fabricated,manufactured, processed or produced within ACMC.

Company Name:

Street Address:

Telephone Number:

Business License Number:

The Undersigned declares that the foregoing information is true and correct:

Print/Type Name:

Title:

Signature:

Date:

EXHIBIT G



Exceptions, Clarifications, AmendmentsList below requests for RFP clarifications and exceptions below, if any, and submit with your bid response.

Reference To:ItemNo. Page

No.ParagraphNo.

Description

Company name:

EXHIBIT H -- STANDARD AGREEMENT CONTRACT


P.O./Contract #:_________________________



STANDARD AGREEMENT

THIS AGREEMENT is made and entered into this day of , 2001 by and between theAlameda County Medical Center, a Public Hospital Authority organized and existing under the laws ofthe State of California, hereinafter called the "ACMC", and ____________, hereafter called the"Contractor".

WITNESSETH: That the Contractor for and in consideration of the covenants, conditions, agreements,and stipulations of the ACMC hereinafter expressed, does hereby agree to furnish the ACMC servicesand materials, as follows, and/or as described on exhibits attached to and incorporated herein.

Contractor shall furnish services as described in EXHIBIT A of this Agreement. Contractor shall at alltimes during the term of the Contract with the ACMC maintain in force those insurance policies asdesignated in the attached EXHIBIT C and will comply with all those requirements as stated herein.

CONTRACT PERIOD will be from __________ through __________.

COMPENSATION: ACMC agrees to pay Contractor for services performed hereunder as specified inEXHIBIT B.

The total amount paid by ACMC to Contractor under this Agreement shall not exceed the sum of$________.

ADDITIONAL PROVISIONS attached hereto constitute a part of this Agreement.


IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the day and yearfirst above written.

CONTRACTOR ALAMEDA COUNTY MEDICAL CENTERA PUBLIC HOSPITAL AUTHORITY

______________________________________ BY___________________________________Contractor Name Roger A. Peeks, M.D.

Interim Chief Executive Officer

______________________________________ ______________________________________Street Address Date

______________________________________City, State, Zip Code Approved as to form

Phone Number: ( ) _________________ By:_________________________________

Tax I.D. Number: Richard R. KarlssonGeneral Counsel, ACMC

____________________________________Date



ADDITIONAL PROVISIONS

1. CONTRACTUAL RELATIONSHIPNo relationship of employer and employee is created by this Agreement, it beingunderstood that Contractor shall act hereunder as an independent contractor; thatContractor, its officers and employees do not become employees of ACMC or theCounty of Alameda and shall not have any claim under this Agreement or otherwiseagainst ACMC or the County of Alameda for seniority, vacation time, vacation pay,sick leave, personal time off, overtime, health insurance, medical care, hospital care,retirement benefits, Social Security, Workers' Compensation, disability orunemployment insurance benefits, civil service protection, or employee benefits of anykind. Contractor shall be solely liable for and obligated to pay directly all applicabletaxes, including, but not limited to, federal and state income taxes and Social Securitytaxes, and in connection therewith Contractor shall indemnify and hold ACMC andthe County of Alameda harmless from any and all liability which ACMC or the Countyof Alameda may incur because of Contractor’s failure to pay such taxes.

Contractor does, by this Agreement, agree to perform said work and functions at alltimes in strict accordance with currently approved methods and practices and that thesole interest of ACMC is to ensure that said service shall be performed and rendered ina competent, efficient, timely and satisfactory manner and in accordance with thestandards required by ACMC.

Notwithstanding the foregoing, if ACMC determines that pursuant to state and federallaw Contractor is an employee for purposes of income tax withholding, ACMC shallwithhold from the payments to Contractor hereunder federal and state income taxesand Social Security taxes and pay said sums over to the federal and state governments.

2. HOLD HARMLESS/INDEMNIFICATIONTo the fullest extent permitted by Law, Contractor shall hold harmless, defend andindemnify ACMC and the County of Alameda, their respective officers, employees andagents (collectively “Indemnitees”) from and against any and all claims, losses,damages, liabilities or expenses, including reasonable attorney fees, incurred in thedefense thereof, for the death or injury to any person or persons (including employeesof Contractor, ACMC or County of Alameda) or damage to any property or propertyright (including property or property right of Contractor, ACMC or County of



Alameda) which arises out of or is any way connected with the performance of thisAgreement (collectively “Liabilities”) except where such Liabilities are proximatelycaused solely by the negligence or misconduct of any Indemnitee.

3. INSURANCEContractor shall at all times during the term of this Agreement with ACMC maintainin force those insurance policies as designated in the attached Exhibit C, “InsuranceRequirements for Professional Services Contracts”, and will comply with its applicable“Additional Requirements and/or Conditions”.

4. WORKERS' COMPENSATIONContractor shall provide Workers' Compensation insurance at Contractor’s own costand expense and further, neither Contractor nor its carrier shall be entitled to recoverany costs, settlements, or expenses of Workers' Compensation claims arising out of thisAgreement.

5. CONFORMITY WITH LAW, STANDARDS AND SAFETYa. Contractor shall observe and comply with all applicable laws, ordinances, codes

and regulations of governmental agencies, including federal, state, municipal, andlocal governing bodies, having jurisdiction over the scope of services or any parthereof, including the Joint Commission on Accreditation of HealthcareOrganizations standards for compliance and accreditation, State Department ofHealth requirements, as set forth in California Code of Regulations, Title 22, andall provisions of the Occupational Safety and Health Act of 1979 and allamendments thereto, and all applicable federal, state, municipal, and local safetyregulations. Contractor shall furnish services that permit ACMC to comply withall applicable Health Care Financing Administration (HCFA) conditions ofparticipation and standards of contracted services. All services performed byContractor must be in accordance with these laws, ordinances, codes andregulations. Contractor shall indemnify and hold ACMC harmless from any andall liability, fines, penalties and consequences from any noncompliance orviolations of such laws, ordinances, codes and regulations.

b. ACMC is committed to monitoring performance and continually improving thequality of care delivered. Contractor, and any of its subcontractors andemployees, shall cooperate with and, as necessary, actively participate in theACMC performance improvement process. This shall include participation on



performance improvement teams and/or committees, cooperation with sentinelevent investigations, participation and/or cooperation in disease and casemanagement programs. Contractor will additionally participate in preparation forsurveys and/or audits by accrediting or regulatory agencies and any plan(s) ofcorrection which may follow.

c. Accidents: If a death, serious personal injury or substantial property damageoccurs in connection with the performance of this Agreement, Contractor shallimmediately notify ACMC and the Alameda County Administrator, RiskManager's Office, and the Alameda County Contracting Officer, Health CareServices Agency Director, by telephone. Contractor shall promptly submit toACMC, the Alameda County Risk Manager and the Alameda County ContractingOfficer a written report, in such form as may be required by ACMC of allaccidents which occur in connection with this Agreement. This report mustinclude the following information: (1) name and address of the injured ordeceased person(s); (2) name and address of Contractor’s subcontractor, if any;(3) name and address of Contractor’s liability insurance carrier; and (4) a detaileddescription of accident and whether any of ACMC’s equipment, tools, material, orstaff were involved.

6. PAYMENTa) Payment to Contractor will be made only upon presentation of proper claim by

Contractor subject to the approval of ACMC.b) Contractor agrees that ACMC may at its sole option withhold fifteen percent

(15%) of the funds awarded under this Agreement until such time as all goods andservices are received in a manner and form acceptable to ACMC.

7. TRAVEL EXPENSESContractor shall not be allowed or paid travel expenses unless set forth in thisAgreement.

8. WORK PRODUCTS AND INVENTIONSACMC shall have a royalty-free, exclusive, and irrevocable license to reproduce,publish and use all original computer programs, writings, sound recordings, pictorialreproductions, drawings and other works of similar natures produced in the course of orunder this Agreement; and Contractor shall not publish any such material withoutprior written consent of ACMC.



9. CONFIDENTIALITY OF INFORMATIONConfidential information is defined as all information disclosed to Contractor which isprotected from unauthorized disclosure under applicable law. Contractor will hold allsuch information in trust and confidence. Upon cancellation or expiration of thisAgreement, Contractor will return to ACMC all written or descriptive matter whichcontain any such confidential information.

10. CONFLICT OF INTERESTNo officer, member, or employee of ACMC and no member of their governing bodiesshall have any pecuniary interest, direct or indirect, in this Agreement or the proceedsthereof. No Contractor nor any member of Contractor’s family shall serve on anyACMC board, committee, or hold any such position which either by rule, practice oraction nominates, recommends, supervises Contractor’s operations, or authorizesfunding to Contractor.

11. USE OF ACMC PROPERTYContractor shall not use ACMC premises or property (including equipment,instruments and supplies) or personnel for any purpose other than in the performance ofhis/her obligations under this Agreement.

12. EQUAL EMPLOYMENT OPPORTUNITY PRACTICES PROVISIONSContractor assures that he/she/it will comply with Title VII of the Civil Rights Act of1964 and that no person shall, on the grounds of race, creed, color, disability, sex,sexual orientation, national origin, age, religion, Vietnam era Veteran’s status, politicalaffiliation, or any other non-merit factor, be excluded from participation in, be deniedthe benefits of, or be otherwise subjected to discrimination under this contract.a. Contractor shall, in all solicitations or advertisements for applicants for

employment placed as a result of this contract, state that it is an “EqualOpportunity Employer” or that all qualified applicants will receive considerationfor employment without regard to their race, creed, color, disability, sex, sexualorientation, national origin, age, religion, Vietnam era Veteran’s status, politicalaffiliation, or any other non-merit factor.

b. Contractor shall, if requested to so do by ACMC, certify that it has not, in theperformance of this contract, discriminated against applicants or employeesbecause of their race, creed, color, disability, sex, sexual orientation, national



origin, age, religion, Vietnam era Veteran’s status, political affiliation, or anyother non-merit factor.

c. If requested to do so by ACMC, Contractor shall provide ACMC with access tocopies of all of its records pertaining or relating to its employment practices,except to the extent such records or portions of such records are confidential orprivileged under state and federal law.

d. Contractor shall recruit vigorously and encourage minority- and women-ownedbusinesses to bid its subcontracts.

e. Nothing contained in this contract shall be construed in any manner so as torequire or permit any act which is prohibited by law.

f. Contractor shall include the provisions set forth in paragraphs numbered 12.a.through 12.e. (above) in each of its subcontracts.

13. ASSIGNMENT OF CONTRACTNothing contained in this Agreement shall be construed to permit assignment ortransfer by Contractor of any rights or delegation of any duties under this Agreementand such assignment, transfer or delegation of duties is expressly prohibited and voidunless otherwise approved in writing by ACMC.

14. SUBCONTRACTINGNone of the work to be performed by Contractor shall be subcontracted without theprior written consent of ACMC. Contractor shall be as fully responsible to ACMCfor the acts and omissions of any subcontractors, and of persons either directly orindirectly employed by them, as Contractor is for the acts and omissions of personsdirectly employed by Contractor.

15. DRUG-FREE WORKPLACEContractor and Contractor’s employees shall comply with ACMC’s policy ofmaintaining a drug-free workplace. Neither Contractor nor Contractor’s employeesshall unlawfully manufacture, distribute, dispense, possess or use controlled substances,as defined in 21 U.S. Code Section 812, including marijuana, heroin, cocaine, andamphetamines, at any ACMC facility or work site. If Contractor or any employee ofContractor is convicted or pleads nolo contendere to a criminal drug statute violationoccurring at an ACMC facility or work site, the Contractor, within five daysthereafter, shall notify the head of the ACMC department for which the contract



services are performed. Violation of this provision shall constitute a material breach ofthis Agreement.

16. ACCESS TO RECORDSUntil the expiration of five years after the furnishing of any services pursuant to thisAgreement, Contractor shall make available, upon written request, to ACMC or to thefederal/state/county government, or any of their duly authorized representatives, thisAgreement, and such books, documents and records of Contractor that are necessaryto certify the nature and extent of the reasonable cost of services to ACMC. IfContractor enters into an ACMC approved agreement with any related organization toprovide services pursuant to this Agreement with a value or cost of $10,000 or moreover a twelve-month period, such agreement shall contain a clause to the effect thatuntil the expiration of five years after the furnishing of services pursuant to suchsubcontract, the related organization shall make available, upon written request, toACMC or to the federal/state/county government, or any of their duly authorizedrepresentatives, the subcontract, and books, documents and records of such organizationthat are necessary to verify the nature and extent of the services and costs. Thisparagraph shall be of no force and effect when and if it is not required by law, or ifmodified by law, such modification will supersede this clause. ACMC shall haveaccess to Contractor’s financial records for purposes of audit. Such records shall becomplete and available for audit 90 days after final payment hereunder and shall beretained and available for audit purposes for five years after final payment hereunder.

17. EMPLOYMENT ELIGIBILITYPersons providing services under this Agreement will be required to provide ACMCthe necessary documentation to establish identity and employment eligibility asrequired by the Immigration Reform and Control Act of 1986. Contractor shall ensurethat its employees providing services under this Agreement are eligible for employmentas required by the Immigration Reform and Control Act of 1986. Failure to provide thenecessary documentation will result in the termination of the contract as required by theImmigration Reform and Control Act of 1986.

18. RUBELLA AND RUBEOLA IMMUNITYContractor shall provide ACMC acceptable proof of rubella and rubeola immunityand other immunities as may be required by law for all individuals providing on siteservice at ACMC prior to their providing services under this Agreement. Acceptable



proof of immunity (positive titer and/or vaccination) shall be a signed statement froman official health provider or a signed health certificate such as for marriage orinternational travel.

19. TUBERCULOSISContractor shall provide ACMC yearly acceptable proof of Mantoux skin test fortuberculosis or chest x-ray (14 x 17) for all personnel providing on site services atACMC under this Agreement. Initial proof shall be provided prior to the provision ofservice. Acceptable proof shall be a statement signed by a physician of a negativeMantoux test or a signed negative chest x-ray. Contractor or any employees ofContractor who convert from a negative Mantoux test to a positive test must provide asigned physician's statement indicating they are free from the presence of infectiousdisease.

20. ADMINISTRATIVE RESPONSIBILITIESConsistent with Title 22, California Administrative Code, Section 70713, ACMCretains professional and administrative responsibility for services rendered under thisAgreement. ACMC’s retention of these responsibilities shall not alter or modify in anyway the hold harmless, indemnification, insurance or independent contractor provisionsset forth herein.

21. TIME OF ESSENCETime is of the essence in each and all the provisions of this Agreement.

22. TERMINATIONEither party may terminate this Agreement with or without cause by providingTHIRTY (30) days' notice, in writing, to the other party. With the exception ofprovisions 1, 2, 5, 8, 9, and 16, upon the expiration of said notice, this Agreement shallbecome of no further force or effect whatsoever and each of the parties hereto shall berelieved and discharged herefrom. ACMC may terminate at any time without noticeupon a material breach of the terms of this Agreement and/or in the event that ACMCdetermines that Contractor’s performance is substandard or unsatisfactory.

23. COMPLETE AGREEMENTThis Agreement supersedes any and all other agreements, either oral or written,between the parties hereto and contains all the covenants and agreements between the



parties with respect to the rendering of such services under this Agreement. Each partyto this Agreement acknowledges that no representations, inducements, promises,agreements, orally or otherwise, have been made by any party, or anyone acting onbehalf of any party, which are not embodied herein, and that no other agreement,statement, or promise not contained in this Agreement shall be valid and binding. Noalteration or variation of the terms of this Agreement shall be valid unless made inwriting and signed by the parties hereto.

24. NOTICESAll notices to the parties under the terms of this Agreement shall be sent to:

Alameda County Medical Center15400 Foothill Blvd.San Leandro, CA 94578Attention: Chief Financial Officer

Contractor NameStreet Address



Exhibit A

Definition Of Services

Name of Contractor

I. Services to be Provided

II. Schedule of Services

III. Reporting Relationships



Exhibit B

Terms and Conditions for Payment

Name of Contractor

1. ACMC will pay Contractor $___________ per hour, per month, upon submissionof a completed statement for each month four week period (quadri-weekly) thatservices are performed pursuant to this Agreement and certified by _________________or designee.

2. Payment under the terms of this Agreement will not exceed the total amount of$___________ for the period of the contract.

3. The term of this Agreement is _____________through _______________.

QUESTIONNAIRE FOR DETERMINING THE WITHHOLDING STATUSOF INDEPENDENT CONTRACTORS

INSTRUCTIONS: This questionnaire is to be completed for every personal services contract andmust be included as part of the contract package submitted to either the Board of Supervisors or thePurchasing Agent. Be sure to answer all of the questions in Sections I and II and to complete thecertifications on page 2. Sections III and IV contain supplemental questions to be answered forcontractors in certain service categories.

CONTRACTOR NAME: DEPT #:

TITLE/SERVICE:

DEPT. CONTACT: PHONE:

YES NOI. 1. Is the independent contractor a corporation or partnership? ( ) ( )

2. Does the contractor have the right per the contract to hireothers to do the work agreed to in the contract? ( ) ( )

If the answer to BOTH questions is YES, provide the employer ID number here: .No other questions need to be answered. Withholding is not required.

If the answer to question I.1 is NO and I.2 is YES, provide the individual social securitynumber here: .

No other questions need to be answered. Withholding is not required.

If the answer to question I.2 is NO, continue to Section II.

YES NOII. 1. Does ACMC have the right to control the way in which

the work will be done, i.e. will ACMC be able to specifythe sequence of steps or the processes to be followed if itchooses to do so? ( ) ( )

2. Will ACMC provide or pay for “how-to” training forthe contractor? ( ) ( )

3. Will the contractor be responsible for making decisions tohire or fire County employees? ( ) ( )

4. Will ACMC supply assistants to the contractor?(includes clerical, technical or professional help) ( ) ( )

5. Is the contractor doing work that would otherwise be doneby a County employee, i.e. are there County positions withthe same or similar duties? ( ) ( )

6. Is the contractor restricted from performing similar servicesfor other businesses while he is working for ACMC? ( ) ( )

QUESTIONNAIRE - Page 2

SECTION II - CONTINUED

YES NO7. Will the contractor be working more than 50% of the time

for ACMC (50% = 20 hrs/wk; 80 hrs/mo)? ( ) ( )

8. Is the relationship between ACMC and the contractorintended to be ongoing? ( ) ( )

III. For CONSULTANTS, PROJECT MANAGERS, PROJECT COORDINATORS

1. Is the contractor being hired for a period of time ratherthan for a specific project? ( ) ( )

2. Will payment be based on a wage or salary (as opposed toa commission or lump sum)? ( ) ( )

IV. For PHYSICIANS, PSYCHIATRISTS, DENTISTS, PSYCHOLOGISTS

1. Will the agreement be with an individual who does not havean outside practice? ( ) ( )

1.a Will the contractor work more than an average often hours per week? YES ( ) NO ( )

IF THE ANSWER TO 1.a IS YES, ANSWER QUESTION 1.b.

1.b Will ACMC provide more than 20% of thecontractor’s income? YES ( ) NO ( )(If NO, provide proof of income.)

2. If the answer to either question 1.a or, if required, question1.b is NO, the entire answer is NO. ( ) ( )

A “yes” answer to any of the questions in Section II, or, if applicable, Sections III or IV constitutesjustification for paying the contractor through the payroll system as an“employee for withholding purposes.”

CERTIFICATIONS:

I hereby certify that the answers to the above questions accurately reflect the anticipated workingrelationship for this contract.

Contractor Agency/Department Head or Designee

Date Date

PERSONNEL DEPARTMENT APPROVAL (REQUIRED FOR CONTRACTORS SUBJECT TO WITHHOLD):

Signature: Date:

Title:

Company name:

EXHIBIT I



PROPOSAL EVALUATION FORM

Contractor Name:

Evaluated By:

A. Completeness of Response Pass/Fail

B. Financial Stability Pass/Fail

Weight X Rating * = Points

C. Vendor’s Understanding of the EDIS-RFPRequirements

D. Statement of Approach, Schedule andPersonnel

E. Relevant Experience

F. Cost

G. Actual experience

H. Oral Presentation/Interview

Sub-Total

Plus 5% Local Preference

Evaluation Total

* 5 = Excellent 4 = Above Average 3 = Average 2 = Fair 1 = Poor

Company name:

EXHIBIT K



ACTUAL PROJECT EXPERIENCE(Please complete the following table for each product/module)

History of Selected SoftwareApplications

ApplicationDeveloped or

Acquired?

Totalnumber ofInstalled

Sites

Totalnumber inInstalledQueue

YearOriginallyDeveloped

Most CurrentRelease/Version

Number

ED Registration/QuickAdmissionTriage Assessment

ED Tracking

Clinical Documentation/OrderManagementDischarge/Disposition Planning

Medication Management

Management Reporting

Physician/Clinician Access

EXHIBIT L



Emergency Department Statistics

Emergency Department Volumes

44,163

18,125

62,288

44,977

17,681

62,658

43,191

17,391

60,582

-

10,000

20,000

30,000

40,000

50,000

60,000

70,000

ER Urgent Care Combined

98-9999-0000-01

EXHIBIT M-1ALAMEDA COUNTY MEDICAL CENTER (ACMC)

RFP No. 006-1-0676for


Current Workflow Diagrams

ACMC Emergency Department Current-State Workflow Model

Patient walks inthe ED receptionarea

Patient stands inline at check-indesk

Triage Clerkwrites time, date,name, chiefComplaint, onTriage slip

Clerk directspatient to have aseat

Clerk sees nextpatient in line.

Triage Nurse (2RNs) receives slipsand continuouslychecks for mostcritical patient

Triage nursecalls for thepatient

Triage nurseassesses patientand sends patientto waiting area,UCC, or ED

Front area:Patient goes tofront and iscalled forregistration

Back Hall towait: Patient isthen registered

Clerk passesTriage Slip toTriage Nurse

Patient isregistered andsent to UCCwaiting or EDwaiting

Patient returns toWaiting area orto ED (if not full)

Patient in UCCWaiting area

Called to UCC

ED waiting (infront) and calledto ED

Lab labels comeout; labelspecimen, enterorder

TransportSpecimen to Lab

Nurse takespatient to a bed;puts paper in slot

Nurse recordspatientinformation onBed/Greaseboard

Clerk recordsinformation intoLogicare System

Back Hall Nursetakes notes fromparamedics

Nurse takespatient into theED

Patient isregistered in theED

Ambulance

EXHIBIT M-2ALAMEDA COUNTY MEDICAL CENTER (ACMC)

RFP No. 006-1-0676for


Future Workflow Diagrams

ACMC Emergency Department Future-State Optimal Workflow Model

Patient presentsat ED reception

Patient is “quick-registered” intothe EDIS.

Patientinformation isimmediatelyavailable on-lineand on electronictracking screen

Triage nursecompletesassessment on-line

Patient escortedto Bed

Patient arrives viaAmbulance. (Priorto arrival, patientinformation enteredinto EDIS)

Patient taken toTreatment Areabased on need

BedsideRegistration iscompleted

Nurse completesassessment anddocuments vitalsignselectronically

Status of test resultsare tracked;physician notifiedof results arrival

Triage nursereceives patient Physician

completesassessment andorders testselectronically

Physician ordersdisposition andelectronically ordersmedicationprescriptions

Nurse providespatient withpersonalizeddischargeinstructions

• Auto printoutof Triage forms,barcode labels,etc.

• Use of TriageAssessmentforms based onchief complaint,patient type, etc.

• Triagetemplates toassist inprioritizingpatients based onacuity

• Registerwith minimalinfo

• Integratedwith HISRegistration

• Producepatient IDband

• Ability to capturepatient informationprior to arrival

• Ability to begintracking processimmediately

• Decrease waittime for patients

• Improve patientregistration process

• On-lineAssessments anddocumentation

• Immediate on-lineaccess to TriageAssessment

• On-line access tohistory data

• Streamline methods forcharting and ordering

• Intuitive screen-flow

• Eliminateneed for“grease board”

• Ability tosee all patientactivity acrossall ED areas

• Ability toimmediatelyenter patientinformation online

• Flags variousorder statuses

• Ability to reviewresults on line

• Easy method forordering prescriptions online

• Linkage betweendisposition and

• Improves quality ofpatient discharge process

• Improved patientsatisfaction withpersonalized instructions

• Ability to report onpatient flow process during

• Patientpresents withID Card thatcan be scanned

Company Name:


EXHIBIT N



FUNCTIONAL REQUIREMENTS

2.A. ED Registration/Quick Admission (description):

In Production Today:In Alpha or Beta Test – planned release date:In Development – planned release date:Unplanned:

2.B. Triage (description):


2.C. ED Tracking (description):


EXHIBIT N

Company Name:


2.D. Clinical Documentation/Order Management (description):


2.E. Discharge/Disposition Planning (description):


2.F. Medication Management (description):


EXHIBIT N

Company Name:


2.G. Management Reporting (description):


2.H. Physician/Clinician Access (description):


2.I. Technology (description):

C:\Program Files\Adobe\Acrobat 4.0\Acrobat\plug_ins\OpenAll\Transform\temp\EDIS Addendum 1.doc

General Serv ices Agency

Aki K. Nakao, Director

ADDENDUM NO. 1

REQUEST FOR PROPOSAL (RFP) NO. 006-1-0676

for EMERGENCY DEPARTMENT INFORMATION SYSTEM (EDIS)

at ALAMEDA COUNTY MEDICAL CENTER (ACMC)

Specification Clarification/Modification, Response to Written Questions, Recap of Bidders Conference Held on November 14, 2001, at 2:00 p.m.

at Fairmont Hospital Campus

Cafeteria Conference Room 15400 Foothill Blvd

San Leandro, CA 94578 ________________________________________________________________________________ Attached Exhibit A, Bid Acknowledgement Addendum No. 1, must be completed, signed and returned with the bid response. The following sections have been modified to read:

8. CALENDAR OF EVENTS

Event Date Request Issued October 30, 2001 Written Questions Due BEFORE 12:00 noon on November 13, 2001 Bidders Conference November 14, 2001 Addendum Issued November 30, 2001 Response Due BEFORE 2:00 p.m. on December 14, 2001 Evaluation Period December 17-26, 2001 Contractor Interviews/ Selection of Demo Finalists

January 9-10, 2002

On-site Demonstrations January 15-18, 2002 Selection of Finalist(s) January 21, 2002 Board Letter Issued January 2002 Board Award Date February 2002 Contract Start Date February 2002

Page 2 of 2 November 27, 2001


Response to written questions: Section 2. Intent: The section “Intent” describes interfaces to INVISION for registration, orders and results including interfaces to Lab, Pharmacy and Radiology. Q: What standards are these systems using to communicate? A: HL7. Q: What are the data expected to be displayed in the EDIS system: text or text and image

information? A: Text is required; image information is desired. Q: With graphics or image information, what is the expected output from the ancillary device? A: None at this time. Q: How is each of these interfaces to be anticipated in the pricing portion of the RFP? A: For purposes of submitting cost, each bidder’s anticipated interface concerns should be

included in Exhibit B. Section 2. Intent: Under the section of intent it is suggested that ACMC is considering two possible scenarios for implementation: one install into the existing ED and migrate to the new ED once complete, the other install directly into the new ED. Q. Due to the added costs of moving and training additional staff, the cost of moving may be

higher than implementation a single time. How should a vendor address these costs in their bid?

A: Identify additional costs, if any, in Part 2. of the Exhibit B bid form. Q: What are the changes to the floor plans and hardware specifications between the old care areas

and the new facilities? Are floor plans available to assess needed quantities of workstations/ printers/tracking boards/pen-tablets/PDA’s/network drops/etc.?

A: If needed, a basic floor diagram can be procured directly from ACMC. Note however, ACMC does not expect the successful contractor to provide workstations or other furnishings.

Section 3.A.1: Contractor shall list the minimum required fields. Q: Can ACMC provide a list of the minimum required fields for the INVISION system? A: No. However, if this information is needed, use the minimum fields used by the vendor’s

systems to establish a patient record.



Section 3.A.4: Support the ability to begin the ordering and documentation processes upon completion of the quick admission process by issuing an account or visit number. Q: Does this account or visit number come from INVISION? A: Yes Q: What is the resolution/merge process between INVISION and the EDIS? A: An ACMC-supplied interface engine will transmit and manage all transactions between

the EDIS system and INVISION. Section 3.A.6: Support bedside registration. Q. What devices are anticipated at each bedside for “bedside registration”? A: Terminals will be used for all of the functions of the tracking system. Q: Should we anticipate the need to add hardware to support “bedside registration”? A: No. Section 3.D.7: Support the ability to user-define a patient summary worksheet be available on-line and provide the ability to print a summary sheet. Q. Please define a “user-defined” patient summary worksheet. A: It is a customized report (medical chart) for a specific diagnosis or a combination of

diagnosis. Q: Is this a one-time definition when the system is configured or is this expected to be a real time

tool where users can adjust the output on the fly? A: Users can adjust. Q: What does the report need to encompass? A: A combination of data fields. Section 3.E.1: Support starting the discharge planning process upon ED admission. Q: Please clarify: what information is to be collected at this point to aid in discharge planning? A: We cannot provide a comprehensive all-inclusive list, however, it should include but not

be limited to, medication allergies, current medication, follow up, problems with diagnosis.

Section 3.E.2: Multiple language support. Q. What other languages are to be supported? A: At a minimum, the supported languages should be English and Spanish. It would be a

desirable feature to support as many languages as possible. Bidders should list as many other languages as can be supported by their program under Part 2. of Exhibit B.



Q: How are bidders to reflect costs of additional language support in the bid response? A: English and Spanish language support shall be included in the bid response. Additional

languages may be indicated as optional services offered by bidder under Part 2., Connected Services of Exhibit B.

Section 3.E.5: Support web-enablement of discharge instructions for Internet/Intranet access. Q: What expected security measures will be required for Internet/Intranet access? A: ACMC will provide Internet/Intranet security. Q. Who supplies the ongoing security support? A: ACMC is responsible for supporting the network security. Section 3.I.1: Technology/Purchasing Guidelines Hardware specifications versus cost. Q. Does the project assume that vendor is going to supply all the hardware? A: No. Q. Can we submit two prices based on hospital supplying hardware versus bidder’s proposal? A: Yes, however, one cost including any proprietary equipment required to operate the

system shall be included in the price quoted in Part 1. of Exhibit B. Any other optional hardware and associated costs shall be included in Part 2. of Exhibit B for ACMC to consider.

Q. If one bidder’s hardware is more expensive than the hardware proposed by other large

companies, which criterion carries more weight in the final evaluation: cost or compatibility to stated standards?

A: Weight has not yet been assigned to any particular aspect of the evaluation criteria. Q. If using existing equipment currently installed in ED, is there an inventory of equipment,

networking and any plans for expansion beyond EDIS scope? A: No. Q. Who is responsible for power receptacles for devices? A: ACMC. Q. If ACMC supplies hardware, will it also supply the licenses for Oracle, Workstation OS,

Crystal Reports and/or other licenses? A: No. These are to be included in your bid response. Section 3.I.1.f: Technology/Scope/Interfaces HL7 Interface Example messaging? Q. Is there a way to get sample files of the HL7 message formats for all expected transactions:

Meditech Lab Transactions, OPENlink transactions or other ancillary systems expected to connect to EDIS system?

A: No.



Section 3.I.2.d: Product Vision. Q. In pricing the system, how should we anticipate the 100% availability need? This could

significantly increase the cost of hardware/software and support costs. Should the added costs be included in the price for the initial bid?

A: Yes. Section 3.I.2.f: System Availability. Q: Is it based on 100% availability named previously or some lower level of uptime? A: It is based upon 100% availability. Q: On the question of what is required to achieve 100% availability, is this to be a dollar figure or

a technical discussion? A: Technical discussion. Q. Is online off-site storage part of this requirement? A: No. Q. Do you have a disaster recovery plan we can base our assumptions on? A: No. Section 4: Background. Q: What is the anticipated number of users who will access the system from outside the ED or

UCC areas? A: Unknown. Q: Are ED and UCC the only areas where users will need direct access to the EDIS system? If

not, please list other areas and number of anticipated workstations or access points. A: A comprehensive list has not been determined but shall include, and not be limited to,

primary meeting room, ICU, laboratory, operating room, inside clinics, offsite clinics, Fairmont Campus.

Response to verbal questions: Q. Will the oral presentation be distinct from demonstrations on-site? A: Yes. Q: How far along is the HIPAA project? A: ACMC has an open RFP to assist with HIPAA. Q: Based on Pricing, how many workstations would be accessed in the Emergency Department? A: It is estimated that between 50 to 99 workstations would be accessed.



Q: How many personnel can access this system at one time (offsite Highland Campus)? A: Approximately twelve (12) outside personnel will be required to access the system at any

given time. Q: Did the bid include hardware in the pricing? A: No. As previously stated above, only proprietary hardware required to operate the

bidder’s system shall be included in the pricing. Otherwise, the Alameda County Medical Center (ACMC) will provide its own hardware.

Q: Is installation of the network already taken care of? A: Yes. The following representatives attended the bidders conference: Name Firm Gboyega Aladegbami AEKO Consulting Howie Nelsen Logicare Mark Fledderjohann Emergisoft Michael K. Sato Micon Telecom O.J. Catbagan USM Dist. Phil Eucker A4 Health Systems Roger Esparza Micon Telecom Sheryl Cass Aric Associates, Inc. Douglas Christensen Superior Consultant Company Jerry Widmer ACMC, Emergency Department Aisha McElroy GSA, Purchasing Tudor Mosu GSA, Purchasing


EXHIBIT A-BID ACKONWLEDGEMENT RFP No. 006-1-0676, Emergency Department Information System (EDIS), Addendum No. 1

The County of Alameda is soliciting bids from qualified vendors to furnish its requirements per the specifications, terms and conditions contained in the above referenced RFP number. This Bid Acknowledgement must be completed, signed by a responsible officer or employee, dated and submitted with the bid response. Obligations assumed by such signature must be fulfilled. 1. Preparation of bids: (a) All prices and notations must be printed in ink or typewritten. No erasures permitted. Errors may be crossed out and

corrections printed in ink or typewritten adjacent and must be initialed in ink by person signing bid. (b) Quote price as specified in RFP. No alterations or changes or any kind shall be permitted to Exhibit B, Bid Form. Responses that do not comply shall be subject to rejection in total.

2. Failure to bid: If you are not submitting a bid but want to remain on the mailing list and receive future bids, complete, sign and return this Bid Acknowledgement and state the reason you are not bidding.

3. Taxes and freight charges: (a) Unless otherwise required and specified in the RFP, the prices quoted herein do not include Sales, Use or other taxes. (b) No charge for delivery, drayage, express, parcel post packing, cartage, insurance, license fees, permits, costs of bonds, or for any other purpose, except taxes legally payable by County, will be paid by the County unless expressly included and itemized in the bid. (c) Amount paid for transportation of property to the County of Alameda is exempt from Federal Transportation Tax. An exemption certificate is not required where the shipping papers show the consignee as Alameda County, as such papers may be accepted by the carrier as proof of the exempt character of the shipment. (d) Articles sold to the County of Alameda are exempt from certain Federal excise taxes. The County will furnish an exemption certificate.

4. Award: (a) Unless otherwise specified by the bidder or the RFP gives notice of an all-or-none award, the County may accept any item or group of items of any bid. (b) Bids are subject to acceptance at any time within thirty (30) days of opening, unless otherwise specified in the RFP. (c) A valid, written purchase order mailed, or otherwise furnished, to the successful bidder within the time for acceptance specified results in a binding contract without further action by either party. The contract shall be interpreted, construed and given effect in all respects according to the laws of the State of California.

5. Patent indemnity: Vendors who do business with the County shall hold the County of Alameda, its officers, agents and employees, harmless from liability of an nature or kind, including cost and expenses, for infringement or use of any patent, copyright or other proprietary right, secret process, patented or unpatented invention, article or appliance furnished or used in connection with the contract or purchase order.

6. Samples: Samples of items, when required, shall be furnished free of expense to the County and if not destroyed by test may upon request (made when the sample is furnished), be returned at the bidder’s expense.

7. Rights and remedies of County for default: (a) In the event any item furnished by vendor in the performance of the contract or purchase order should fail to conform to the specifications therefore or to the sample submitted by vendor with its bid, the County may reject the same, and it shall thereupon become the duty of vendor to reclaim and remove the same forthwith, without expense to the County, and immediately to replace all such rejected items with others conforming to such specifications or samples; provided that should vendor fail, neglect or refuse so to do the County shall thereupon have the right purchase in the open market, in lieu thereof, a corresponding quantity of any such items and to deduct from any moneys due or that may there after come due to vendor the difference between the prices named in the contract or purchase order and the actual cost thereof to the County. In the event that vendor fails to make prompt delivery as specified for any item, the same conditions as to the rights of the County to purchase in the open market and to reimbursement set forth above shall apply, except when delivery is delayed by fire, strike, freight embargo, or Act of God or the government. (b)Cost of inspection or deliveries or offers for delivery, which do not meet specifications, will be borne by the vendor. (c) The rights and remedies of the County provided above shall not be exclusive and are in addition to any other rights and remedies provided by law or under the contract.

8. Discounts: (a) Terms of less than ten (10) days for cash discount will considered as net. (b) In connection with any discount offered, time will be computed from date of complete, satisfactory delivery of the supplies, equipment or services specified in the RFP, or from date correct invoices are received by the County at the billing address specified, if the latter date is later than the date of delivery. Payment is deemed to be made, for the purpose of earning the discount, on the date of mailing the County warrant check.

9. California Government Code Section 4552: In submitting a bid to a public purchasing body, the bidder offers and agrees that if the bid is accepted, it will assign to the purchasing body all rights, title, and interest in and to all causes of action it may have under Section 4 of the Clayton Act (15 U.S.C. Sec. 15) or under the Cartwright Act (Chapter 2, commencing with Section 16700, of Part 2 of Division 7 of the Business and Professions Code), arising from purchases of goods, materials, or services by the bidder for sale to the purchasing body pursuant to the bid. Such assignment shall be made and become effective at the time the purchasing body tenders final payment to the bidder.

10. No guarantee or warranty: The County of Alameda makes no guarantee or warranty as to the condition, completeness or safety of any material or equipment that may be traded in on this order.

THE undersigned acknowledges receipt of above referenced RFP and/or Addenda and offers and agrees to furnish the articles and/or services specified on behalf of the vendor indicated below, in accordance with the specifications, terms and conditions of this RFP and Bid Acknowledgement.

Firm: Address: State/Zip

By:_______________ _______________________________________________ Date___________________ Phone_______________________

Printed Name Signed Above:______________________________________________________________________________________________ Title:_________________________________________________________________________________________________________________

Documents

General Services Agency RFP.pdfC:\Program Files\Adobe4\Acrobat 4.0\Acrobat\plug_ins\OpenAll\Transform\temp\EDIS ACMC rfp Final.doc COUNTY OF ALAMEDA REQUEST FOR PROPOSAL (RFP) NO