Request For Proposal.doc

Request For Proposal for a

Behavioral Health Information System

July 27, 2001

Table of Contents

PageNumber

Section I. Background Information

The Santa Clara Valley Health & Hospital System (County) I-1

The Mental Health / Alcohol and Drug Services I-2

The Current Billing Information System I-5

Purpose of the Request for Proposal I-6

The Current Information Systems Environment I-8

Section II. Evaluation Criteria and Proposal Selection

Criteria for Evaluation II-1

Proposal Selection II-3

Contract Issues and Negotiations II-4

Protest Procedures II-8

Section III. Submission Requirements

Due Date, Return Addresses, Number of Copies III-1

Key Event Dates III-2

Questions Regarding the Submission III-3

Section IV. Response Requirements

Format For Response IV-1

Cover Page and Board Letter of Authorization IV-2

Table of Contents

Executive Summary and Proposed System Overview IV-2

Business Offering IV-2

Subsection One --General Description of the Vendor IV-2

Subsection Two -- Overview and Status of Proposed Application IV-3

Subsection Three -- Hardware, Interfaces, and Operating Environment IV-4

Subsection Four --Implementation Support Services IV-9

Subsection Five -- Ongoing Support Services IV-10

Subsection Six -- Client References IV-12

Subsection Seven -- Cost Summaries IV-13

Support Documents and Miscellaneous Marketing Literature IV-16

Section V. Functional Requirements (provided and to be responded to electronically)

Section VI. Forms

Exhibit I – Current SCVHHS (County) Network Environment

Exhibit II – County Mental Health/Alcohol and Drug Operational Statistics

Exhibit III – County Mental Health/Alcohol & Drug Current Interface Summary

Exhibit IV – Indemnification and Insurance examples

Exhibit V – Local Preference Policy

Exhibit VI – County Contracting Principles

Attachment A1 – RFP Proposal Cover Page

Attachment A2 – RFP Checklist

«Salutation»March 30, 2000Page 4

SECTION I

BACKGROUND INFORMATION

I. Background

Santa Clara Valley Health & Hospital System (County)

The Santa Clara Valley Health and Hospital System (County) is comprised of:

The Valley Medical Center (VMC)

Public Health Department (PH)

Alcohol and Drug Department (DADS)

Mental Health (MH)

Children's Shelter and Custody Health Service (CSCHS)

Valley Health Plan (VHP)

Community Outreach Programs

The following three County entities are pertinent to this Request for Proposal (RFP):

Valley Medical Center (VMC) is an acute care public teaching hospital affiliated with Stanford University Medical School. VMC provides a full range of inpatient, emergency and outpatient services. Inpatient services include medical/surgical care and such special services as spinal and head injury acute rehabilitation, neonatal intensive care, high-risk maternity care, pediatrics intensive care, burn intensive care, and inpatient psychiatric services.

SCVMC Statistics (for FY 1999-2000) Inpatient Days 97,356 Psychiatric Inpatient Days 1,701 Emergency Visits 60,814 Clinic Visits 472,386

Alcohol and Drug Department Services (DADS) is responsible for the development, implementation, coordination and evaluation of a continuum of alcohol and drug programs. With 77 locations across the County, these programs include preventive services, criminal justice services, treatment and recovery, family services and women’s treatment services.

Mental Health provides a broad range of mental health services through over 100 County and contract operated program located throughout the County. Over 19,000 children, adults, and older adults receive specialty mental health services, which range from early intervention, crisis intervention, outpatient, day treatment, crisis and transitional residential, 24-hour acute hospital, and long-term state hospital care.

Santa Clara Valley Health & Hospital SystemRequest for ProposalJuly 27, 2001

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I. Background

The Mental Health / Alcohol and Drug Services

Mental Health Department

The Mental Health Department of the Santa Clara Valley Health & Hospital System provides services for County residents experiencing mental illness and/or serious emotional disturbance through an array of County-operated and contracted programs. Together, these programs (ranging from case management to long term hospital care) create Systems of Care for clients of all ages. Services are provided in several languages by staff skilled at using the individual’s culture as a foundation for service delivery.

Systems of Care

The Mental Health Department is committed to providing a continuum of care for individuals experiencing serious emotional disturbance and mental illness. These Systems of Care contain specialized services developed for three age groups: 1) children, adolescents, and their families; 2) adults; and 3) older adults.

Family & Children’s Services

The Family and Children's System of Care offers a continuum of services to families and children experiencing mental illness. Services include outpatient care, with specialized programs for youth incarcerated within Juvenile Hall and the Ranches, and programs specific to the unique needs of children and adolescents placed in the County Children’s Shelter. In addition to clinic and school-based treatment, the Department offers services for children and adolescents who meet Special education eligibility criteria and are entitled for services under Special Education AB 3632 legislation (Chapter 26.5 of the Government Code).

Outpatient services are provided by a network of County and contract agencies located throughout the County. The Mental Health Clinic at Juvenile Hall provides crisis evaluation, medication and brief treatment to incarcerated youth and youth placed in the Ranch programs on a 24-hour/day basis. Specialized Services to Juvenile Probation Youth in outpatient programs serve the needs of mentally ill juvenile offenders with serious emotional disturbances via intensive case management and clinical outpatient services. The Children’s Shelter program provides mental health crisis, medication, and brief treatment services to children and youth in temporary custody. School-based services consist of intensive outpatient services located on school sites, providing over 1300 hours per week of direct service time. Wraparound Services are provided for youth at risk of or returning from out-of-home placement in mental health institutions, allowing them to remain in their natural home or foster home with services “wrapped” around the child and family. School Day Treatment Programs located in both public and non-public school settings are open to special education students in need of mental health treatment. Residential Day Treatment Services (RCL-14) are provided to seriously emotionally disturbed youth placed in group homes. Inpatient services are provided through contracts with


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I. Background

private hospitals in the bay area region. A new Community Treatment Facility (CTF) provides contained residential treatment for severely disturbed youth.

Adult and Older Adult Services

The Adult and Older Adult System of Care offers outpatient Service Teams, with special teams for mentally ill young adults, homeless individuals, and special ethnic populations. The residential continuum of care includes crisis residential services, supported board and care, Institutes of Mental Disease (IMD) and state hospitalization services for those requiring long term psychiatric care in a locked facility. Inpatient services are provided through Acute Psychiatric Services of Valley Medical Center.

Clients identified as seriously mentally ill (SMI) are geographically assigned to Service Teams that serve as the single point of responsibility for these clients. Service Teams provide outpatient mental health services such as crisis intervention; individual, group, and family therapy; assessments, evaluations, medication support services, rehabilitation; and case management and money management services. A Young Adult Transition Team has been developed to aid SMI young adults between the age of 18 and 24 with the stresses of coping with the responsibilities of life in an adult world. Vocational Services are provided to the mentally ill to rehabilitate them to learn job skills necessary to obtain gainful employment. Day Treatment Services are designed to maintain the individual in a community setting and to serve clients at risk of psychiatric hospitalization. Supported Housing programs provide long-term transitional affordable housing options to SMI individuals and the Shelter Plus and Homeless Shelter programs serve to provide shelter housing and link individuals with service providers to obtain permanent housing, and to aid mentally ill homeless persons to transition off the streets and into assisted housing. Adult Jail Services provides outpatient and inpatient mental health services to both men and women at the Main Jail and at the Elmwood facility. The Custody Intensive Alternatives Program (IAP) diverts non-violent mentally ill adults away from jail custody.

Emergency Psychiatric Services offers emergency psychiatric evaluation and short-term (up to 23-hour) crisis stabilization services to individuals experiencing acute psychiatric episodes who are gravely disabled or pose a threat to themselves or to others. Acute Psychiatric services are available at Barbara Aarons Pavilion for those requiring hospitalization beyond the 23-hour stabilization period. Both of these programs are provided through Valley Medical Center. Crisis residential and Transitional residential services provide rehabilitation services in non-institutional settings to individuals at risk of hospitalization. Institutions for Mental Disease (IMDs) programs provide locked skilled nursing care for clients requiring a longer-term program to regain stability. All clients in IMDs are placed under conservatorship, and their progress is followed by Service Teams. State Hospital placement is reserved for individuals displaying such severe symptoms of mental illness that they are unmanageable in locked IMDs. Neurobehavioral programs serve those who are disabled due to a brain injury, particularly those whose needs cannot be managed effectively in a conventional skilled nursing facility.


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I. Background

Crisis, Outreach, Referral, & Education Services (C.O.R.E.) The CORE Division serves as the entry point for the mental health system. It also manages the entry to the Department of Drug & Alcohol Services. In addition, the CORE division is responsible for mobile crisis, telephone crisis support, and emergency response to disasters and critical incidents in the community. The Mental Health Call Center and Authorization Unit provides phone response in three languages (English, Spanish, Vietnamese) 24 hours per day, and receives roughly 10,000 calls per year from members of the community, referring providers, health plans, and County agencies. The Call Center provides mental health information and community service referrals, screens for financial eligibility of Medi-Cal recipients, verifies client services information, determines urgency of mental health need and provides linkage to appropriate mental health services. Suicide & Crisis Services operates a 24-hour telephone crisis line and suicide prevention service, staffed with almost 100 highly trained volunteers, and is privately funded through a generous grant from the Morrison Trust. The Mobile Mental Health Team is a collaborative effort between San Jose Police Department and the Mental Health Department designed to provide crisis intervention response to police requests in targeted areas within San Jose, in order to provide linkage to services for clients at high risk of incarceration due to mental illness. Gateway is the point of entry into the Department of Alcohol and Drug’s system of care, and provides telephone screening and service authorization, as well as information and referral services.

The Crisis Management Program component of the CORE Division provides critical incident debriefings and coordinates the Mental Health response to disasters and emergencies in the community, as well as providing training, consultation, and support to the Department’s Refugee Mental Health Program.

The CORE Division also supervises the team of mental health staff who provide services to the Drug Treatment and Dual Diagnosis Treatment Court. The Division provides mental health services to CalWORKS participants and represents the Department in the CalWORKS Health Alliance, a collaboration of health, substance abuse, social services and mental health providers that service CalWORKS families.

Alcohol and Drug Department Services (DADS)

The Santa Clara Valley Health and Hospital System Department of Alcohol and Drug Services offers substance abuse prevention and treatment services to County residents. In fiscal year 1999-2000, substance abuse treatment for adults, children, adolescents, families and special populations such as HIV-positive persons, and individuals with both mental health and substance abuse problems, was provided for nearly 9,000 adult and youth clients through a network of service providers.


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I. Background

The Adult System of Care (ASC) is by far the largest component of DADS treatment services, with children and adolescent services comprising a proportionately smaller part of system. Typically, adult clients enter the ASC through Gateway, which serves as the principal entry point into the County's substance abuse treatment network. Gateway conducts preliminary screening and places clients into appropriate treatment modalities matched to the level of care they require. DADS also offers behavioral health services to County employees including substance abuse counseling through the Employee Assistance Program.

Treatment modalities include detoxification services, narcotics replacement (formerly known as Methadone services), outpatient, and perinatal and residential services. Pregnant women and recent mothers who require substance abuse treatment are referred to the perinatal program, which offers intensive outpatient treatment for women. The ASC contracts with different facilities in the County for the provision of services. Payment for services is based on client’s ability to pay, and a number of providers accept Medi-Cal clients. DADS also offers support services for recovering substance abuse clients to facilitate their reintegrationinto the family, the workplace and the community. Ancillary services include testing and counseling for HIV-positive substance abuse clients, parenting skills classes, family counseling, crisis counseling, transitional housing and job skills training for its recovering clients. As many clients also suffer from mental illness, DADS expanded its dual diagnosis capability by adding psychiatric services and case managers.

The Children, Adolescent and Families (CAF) division currently offers school-based care for children and adolescents. CAF provides assessment, intervention and treatment services at participating schools, Children’s Shelter and Juvenile Hall. Adolescents referred for drug or alcohol counseling or brief treatment by self, family, school, mental health services, social services, police or probation have access to treatment through community-based organizations, licensed practitioners and contracted private agencies in North and South County.

Together, the Mental Health Department and the Department of Alcohol & Drug Services (DADS) recognize the need for increasingly integrated collaborative, culturally competent dual diagnosis services. The two Departments have begun partnering to provide integrated collaborative services in the following programs: CalWORKs Community Health Alliance, Drug Treatment Court, integrated service team pilots via the Dual Diagnosis Collaborative, the Intensive Alternatives Program, and the Catalyst Committee. It is recognized that these are promising programs with planned growth and enhancement expected as positive outcomes are achieved.

The Current Mental Health /Alcohol and Drug Services Clinical and Billing Information System


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I. Background

The Mental Health/Alcohol and Drug Services Department’s current service and billing system, INSYST, does not adequately support the business and clinical needs that have become more sophisticated in recent years. Current needs that can not be met include the following:

Inability to adequately coordinate patient care between different providers.

Inability to offer Electronic Client Records (electronic charting).

Inability to comply with new HIPAA (Health Insurance Portability and Accountability Act) EDI, Security, and individual Privacy provisions.

Inability to utilize one system for both Managed Care and Short-Doyle clients.

Inability to capture medication data, preventing the program from medication monitoring on a real-time basis.

Inability to easily complete financial reporting and analysis of actual cost of service delivery, Incurred But Not Reported (IBNR) calculations, payments received, and other accounting requirements.

Inability to interface with other County systems.

The Systems Office has growing concerns that the older VAX/Rdb technology used in the INSYST system is weakening and quickly becoming obsolete. Technical obsolescence is causing many problems including the following:

Unacceptable downtime.

Difficulty accessing data for analytical reports.

Scarcity of adequate technical support with VAX/Rdb expertise.

General system integrity and user confidence degradation.

Purpose of the Request for Proposal (RFP)

For the noted reasons, an INSYST system review with movement to newer technology was noted in the recent SCVHHS (County) IT Strategic Plan document prepared by an outside healthcare consulting firm. The Board of Supervisors of Santa Clara County requested that proposals for a replacement behavioral health information system to evaluate the current vendor marketplace for the best possible technical and business solution.

The goal of this project is to find and implement a superior service and billing system for the Mental Health/Alcohol and Drug Departments. County is interested in improving the services provided to its clients with the application of state of the art information technology to support its


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I. Background

clinical, financial, and operational strategies. Specific areas that County desires to improve include the following:

A system based on open technology standards that will allow integration and visibility of client data across processes and systems of care.

Integration and visibility of client data is tightly controlled by security mechanisms and services to conform with client confidentiality requirements and County policy.

A stable and easy to support computing platform solution.

An Electronic Client Record (ECR) to enable a ‘capture once-share often’ model of client clinical, demographic, and financial information across processes, providers, and treatment modalities.

Real-time medication management to reduce adverse drug events, and to increase client compliance.

Support of HIPAA mandated EDI, data security, and individual privacy provisions.

The ability to capture numerous cost and payment rates.

The ability to report 'Incurred But Not Reported' calculations, actual payments received as compared to expected payments, and other financial accounting and revenue enhancement capabilities.

A steering committee has been formed to provide leadership, guidance, and definition of business requirements for the replacement of the current INSYST system. The steering committee is comprised of broad representation from the Mental Health/Alcohol and Drug Services including clinical, finance, operations, and information technology expertise.

The Health Care Consulting Group of Kurt Salmon Associates (KSA) has been engaged to assist and support County in this effort to select and plan for the implementation of a replacement behavioral health information system. This Request for Proposal is the first deliverable of the steering committee and encapsulates the requirements that County desires in a replacement service and billing information system for the Departments of Mental Health/Alcohol and Drug Services.

Specifically, the following are the applications County is seeking for current acquisition:

PATIENT/CLIENT MANAGEMENT Preadmission Registration Admission, Discharge, Transfer, Medical Records Index Enterprise Master Patient Index Census reporting


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I. Background

Medical Records Online Client Eligibility

PATIENT ACCOUNTING Grants Management Financial Analysis / Entitlement / Patient Financial Information Patient Accounting Payer Contract Management Cost Accounting

MANAGED CARE OPERATIONS Member Enrollment / Eligibility Authorizations / Referral Tracking Provider Contract Management and Negotiation Support Provider Relations Access Management: Call Logs / Client Contacts

CLINICAL OPERATIONS Electronic Medical Record Behavioral Health Assessment / Outcome Measurement Behavioral Health Treatment Plans and Notes Order Entry Management Clinical Decision Support Resource Scheduling Quality Assurance and Follow up EPrescriptions Clinician Access View Incident Reporting Clinical Pathways and Guidelines

GENERAL SYSTEM FUNCTIONS Multientity Security mechanisms and services Interface Engine Screen builder User Report Generator Intranet / Extranet user access

County currently uses the Diamond system for Managed Care Operations. County is very interested in a single vendor and information technology solution for the above functionality. The ideal product or products will provide the functionality implied by the application/module name in a fully integrated suite or set of products across the two client-care delivery systems. These products must support the direct interaction of clinician users and provide the ability to


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enhance the clinical care process regardless of the point of care within County. Although a single Vendor approach for core clinical and financial application is highly desired, County will utilize multiple products and/or Vendors if, and only if, it is determined that a single approach cannot meet its needs.

The Current Information Systems Environment

To better assist you in providing a proposal for a replacement service and billing information system, a detailed description of the current information system and technology environment is provided.

Network

SCVHHS (County) has evolved its single centralized computer network into a standardized, open architecture, enterprise system operating under multiple platforms with Windows NT as the primary platform. Multiple platforms include Novell, UNIX & VMS. The standardization initiative has interconnected several dissimilar and standalone network systems which now operate on the enterprise network. The Windows NT platform consists of PDC, redundant BDCs, DHCP, DNS, WINS & RAS servers.

IP address assignment is handled through redundant DHCP (Dynamic Host Control Protocol) servers, operating on Microsoft Windows NT servers which also support Dynamic Name Services (DNS), roving user profiles, and central administration, distribution, and enforcement of desktop configuration. Exhibit I – SCVHHS Network Environment depicts the current network environment.


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I. Background

Data Communications

The communications infrastructure has also evolved from a flat Ethernet WAN to a switched Ethernet and ATM topology. The router and switch group is CISCO standardized and its main core is composed of fiber-linked CISCO 5000 series. Its current electronic capacity bandwidth is estimated to be 6 GB per second. The SCVHHS backbone infrastructure is fiber optic-based (collapsed backbone) with Category 5 twisted pair standard to the desktop. The bandwidth supply to the desktops is 10/100 MB per second to each segment. Three firewalls connect the enterprise network to Santa Clara County, State of California, and Siemens. The network supports fiber links to 20 campus buildings and communications links to 81 remote sites via T-1, Digital and Analog circuits. It provides access to 45 different systems. The network also supports Ethernet-based automated monitoring and diagnostic systems.

The infrastructure direction is to move to a fully switched edge device environment supporting VLANs. Connectivity between switched edged devices and the core matrix is generally 1000 Mbps duplex links with a design goal of no more than 48 edge devices per 1000 Mbps link.

Further enhancing the throughput of the network will be the movement toward VLAN-based broadcast domains restricted to no more than 15 switches supporting a maximum of 229 devices, thereby enabling the use of eight-bit networks.

Part of the planning for the future is to move to a pure IP-based (Internet Protocol) network using EIGRP (a proprietary Cisco) for routing. To the extent that Novell fileservers remain in use across the health system, IPX routed via RIP/EIGRP will be utilized. The other protocols currently in use (DEC-LAT, DECNET, and PCSI/AFCP) will be retired and the excessively bridged networks currently in existence will be gradually eliminated. The ability to retire these protocols and eliminate the excess bridging is dependent upon the replacement of many of the existing information systems with systems to be acquired from Siemens and thus will entail work over several years.

Dual/Redundant T1s typically support remote Clinics. Networks at clinics vary but can house older "Shared 10" equipment. T1 usage is monitored and additional T1s are added as needed. Some "priority queuing" is also used to manage telecommunications circuit bandwidth.

The County charter has strict regulations on dial-in and WAN connections from non-County Networks. Special precautions would need to be taken for connectivity to any vendor networks, including the implementation of County approved firewall and access control systems to isolate and protect the SCVHHS and County networks.

A potential separation might include the following (a specific solution would need to be reviewed and approved as required by County regulations):

Dual PIX firewalls between the Siemens and SCVHHS Networks


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I. Background

Dual PIX firewalls between the SCVHHS and County Networks (Replacing current router based ACLS)

CITRIX Array for full function Dial-in

SKEY and CRYPTOCARD for central dial-in authentication

SecureID for standalone dial-in.

Outgoing modem, fax and ISDN functions to be 100% server/router based pools. NAT (Network Address Translation) will be used in some applications as security and also resource pools.

The purpose of the County strategy of using a centralized, enterprise network system is to reduce cost, eliminate redundancy, increase productivity, provide cost-effective access to information, make communication across a distributed healthcare enterprise more accessible, and improve fault-tolerant methods to store, share, and access information.

Table 1 depicts the current and planned information technology and technical environment standards supported by the Mental Health/Alcohol and Drug Services. It would be expected that any potential BHIS technology be able to effectively operate in the current technical environment as well as be scalable to incorporate emerging technology standards of the Health & Hospital System, the County and the industry.

TECHNICAL ENVIRONMENT COMPONENT

CURRENT STANDARD

FUTURE STANDARD

Backbone Network Topology Ethernet 10/100 Ethernet 10/100

Horizontal Network Topology Ethernet 10 Ethernet 10

Network Operating System Netware 5.0 Netware

Network Communication Protocols TCP/IP, DEC LAT, DEC NET

TCP/IP, DEC LAT, DEC NET

Data Base Management System Standard Oracle Oracle

Server Operating System Windows NT Windows NT

Client Operating System Windows NT Windows 2000

Desktop Productivity Suite Office 97 Office 2000

E-mail Exchange MS Outlook Exchange MS Outlook Exchange

Web Browser MS Internet Explorer MS Internet Explorer

Table 1 - Technical Environment Standards


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Table 2 summarizes key aspects of the operational application portfolio that will need to be integrated with or replace by the new BHIS.

APPLICATION VENDORHARDWARE/

OSDBMS

FORMATUSAGE

INSYST (aka OSCAR)

Echo Management

DEC VAX 6630 Open VMS 7.1

Oracle Rdb Mental Health client demographics, episode and service tracking, billing, A/R, contract provider claims, and Federal/State reporting

Diamond 725 Siemens/SMS DEC Alpha 4100 Unix 4.0 G

BASIS Intl. BBx / ISAM

Mental health managed care billing, authorization, provider credentialing, client contact log, and state reporting

HDX Siemens/SMS RCO Malvern PA

Health Data Exchange provides real-time access to patients' MediCal beneficiary eligibility information, as well as Medicare and DIAMOND (managed care).

RX/3000 Pharmacy Computer System, Inc.

HP/3000 Public health and outpatient pharmacies. Process prescriptions, patient records, cost/pricing, check drug interactions, bill transactions and management reporting.

Invision Siemens/SMS New – acute care hospital information system, radiology, imaging, interface engine, patient accounting, contract management, and master patient index. Implementation in progress

General Accounting

Brass/Stars County financial and general accounting system


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I. Background


OSDBMS

FORMATUSAGE

General Accounting

Lawson SCVHHS (County) general ledger functionality

M4 Methadone Management System v3.25

Mallinckrodt / Creative Socio-Medics

Dell Optiplex MS Access Track dispensing and utilization of methadone to clients

Solution Plus Health Business Systems

HP Netserver E-800 Pentium III HP-UX

Progress 8.3A

Mental Health prescription tracking, inventory control, client drug profile, physician prescribing profile, drug interaction reporting, unit dose, third party billing and accounts receivable.

Appointment Processing

Internally Developed

MS Access Scheduling and tracking of client appointments

Computrust Client Trust Fund Accounting

Elite 6.0 Teleform IBM, MS Windows NT

Multiple MS Access data bases

Forms collection and scanning for patient instruments

CarePartner 2.0 PhyCom Corporation

Windows NT MS Access DADS gateway client contact tracking system. Automated support for clinical protocols, clinical notes and decision criteria, questionnaires, outcomes tracking and reports generation.

Cost Reports N/A Intel, Windows 95

Multiple MS Excel Worksheets

Contract provider monitoring performed on a quarterly basis

Mental Health Human Resource System

N/A Intel, Windows NT

MS Access Mental health provider credentialing

MEDS State of California

California MediCAL eligibility inquiry and


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OSDBMS

FORMATUSAGE

response.

CROSS University of Vermont

Intel, DOS FoxPro ACHENBACK Scoring

Table 2 - Operational Application Portfolio

Desktop Computer Platform Standard

SCVHHS (County) has standardized its computer platform. This standardization includes as a minimum: personal computer (PC) hardware, desktop operating system, office application suite, terminal emulation, and email. The main computer platform is reviewed annually and at times revised during the course of the year contingent upon technology changes. Deviation from the standard is considered on a case-by-case basis. The minimum standard for a desktop computer platform is as follows:

(a) PC Hardware:(1) Minimum:

CPU: 500 MHzRAM: 128 MBHDD: 12 GBMonitor: 17’ SVGA

(2) Special (as of December 2000)CPU: 700 MHzRAM: 128 MBHDD: 12 GBMonitor: 17’ SVGASpeakers and Microphones (on some systems)

(b) Desktop Operating System: Windows NT Workstation 4.0

(c) Office Suite: Microsoft Office 97

(d) Browser: Internet Explorer 5.5

(d) Terminal Emulator: Rumba

(e) Email: Outlook/Microsoft Exchange


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SECTION II

EVALUATION CRITERIA AND

PROPOSAL SELECTION


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II. Evaluation Criteria and Proposal Selection

Criteria for Evaluation and Proposal Selection

County has identified a number of minimum requirements that will be used to evaluate important elements of every proposal. Proposals from vendors should demonstrate a wide range of software functionality in their applications. While a high level of functionality is a necessary component of the proposal, the selected vendor must also represent an acceptable business, financial, and technical risk and be able to demonstrate a track record of successful implementations in similar public settings.

Table 3 details the minimum requirements County will consider essential for any proposal to be considered further. The satisfaction of these minimal requirements must be documented in a cover letter (Attachment A-1) accompanying the proposal.

EVALUATION CRITERIA MINIMUM REQUIREMENT

Vendor ProfileA behavioral health/ Alcohol and Drug specialty / human services vendor

Yes

Public/County operational Sites 5 or more fully implemented County clients

Software FunctionAble to support HIPAA EDI compliance Existence of a HIPAA program with a documented

action plan

Strong support of clinical functionality 50% or greater current availability of required clinical functionality as detailed in Section VI Functional Requirements

Strong support of patient management and patient accounting functionality

75% or greater current availability of required patient management and patient accounting functionality as detailed in Section VI Functional Requirements

Vendor SupportGovernment Medicaid experience Implementation experience with clients that have a

significant Medicaid client base. Preferably in the California Medi-Cal environment. Client reference list with contact information must be provided.

Receptivity to user requirements Existence of a formal user group. Preferably, a West Coast and/or California regional user group. Contact information for the user group chairperson must be provided.


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EVALUATION CRITERIA MINIMUM REQUIREMENT

Reputation for quality implementation support Customer testimony attesting to the vendors ability to implement the proposed system in similar large public mental health/alcohol and drug provider environments. Client reference list with contact information must be provided

Reputation for responsive customer support Pacific Coast Time customer support hours. Preferably a West Coast located support center

System TechnologyAble to support HIPAA Security Compliance Existence of a HIPAA program with a documented action

plan

Availability to interfacing to desktop applications

Open integration capabilities with standard Windows based productivity applications including Word, Excel, and Access

Compatibility to existing and future County Systems

Technology based on an open DBMS standard

Business OfferingPerformance guarantees with penalties The selected vendor will be expected to propose a

hardware and software solution that enables guaranteed performance.

The vendor is expected to back its performance warranties by providing, at no additional cost, all services and software necessary to achieve the warranted performance levels.

Acceptance criteria tied to a payment schedule Payment for software, hardware (if applicable), and services will be made according to milestones as indicated in Request for Proposal, pg. II-8. Ongoing software warranty and subsequent maintenance payment methods will not begin until the software has been accepted on a module-by-module basis.

Table 3 - Evaluation Criteria Minimum Requirements

A Steering Committee has been formed to provide guidance on the selection of a replacement information technology solution. Each proposal will be scored on a 100-point scale. While all aspects of the vendor response will be evaluated, the Steering Committee will evaluate all proposals using the following criteria. Failure to comply with any part or procedure of the Request for Proposal may be cause to eliminate a proposal from consideration.


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Software Functionality (35 Points)

Breadth and depth of software functionality for mental health and drug and alcohol requirements.

Adherence to HIPAA EDI standards.

Quality of software demonstrations.

System Technology (20 Points)

Use of open and state of the industry system technology standards.

Ability to support HIPAA Security services and mechanism guidelines.

Reputation for software stability and reliability.

Vendor Support (18 Points)

Completeness and proven track record of vendor support for both implementation and ongoing support.

Experience with County and public organizations.

Receptivity to software user requirements.

Vendor Profile (12 Points)

The ability of the vendor to serve as a long-term business partner with County.

Feedback from the vendor supplied client references.

The RFP responses and adherence to the RFP submission requirements.

Business Offering (10 Points)

The vendor’s ability to define and supply the desired business relationship contractually.

Performance guarantees with penalties.

Local Preference (5 Points)

When two or more competing vendors are equally qualified, local firms shall be given preference (Please refer to Exhibit V).


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Proposal Selection

All proposals receiving a total score of 70 points or more will be submitted to the Directors of the Mental Health and Alcohol and Drug Services departments, and to the SCVHHS CIO for final consideration. In making the final selection, the Directors and CIO will consider the selection committee’s scoring and feedback regarding all aspects of the proposal. False, unresponsive, or misleading statements made in connection with any application may be sufficient cause in and of itself to warrant rejection of a proposal. The panel’s score is but one consideration in determining whether or not a contract will be awarded to the provider. Contracts are not automatically awarded to providers simply because they may have received the highest scoring proposal.

The County reserves the right to repeal or cancel the RFP at any time, to reject any and all applications, to not award contracts if proposals are inadequate or if contract negotiations are unsatisfactory, and to waive any informality, technical defect or clerical error in any application, as the interest of the County may require.

County will not be responsible under any circumstances for any costs incurred by respondents in the generation and submission of proposals, site visits, presentations, documentation, or marketing literature. All responses to this Request For Proposal and accompanying documentation will become the property of County and will not be returned.

Contract Issues and Negotiations

After the County selects the successful vendor(s), the County will enter into contract negotiations regarding the terms and conditions of the services to be rendered by said provider. Award of the contract to successful vendor(s) will be conditional upon the negotiation of a contract in substantial conformity to the County's current boilerplate with changes per negotiation or the recommendation of the County Counsel's Office.

The resulting agreement(s) may contain various terms and conditions that include but are not limited to the following.

A. Satisfaction of evaluation criteria based on the vendor's proposal. The entire written proposal and all subsequent updates will be incorporated into the final agreement as Attachments. Acceptance of all hardware (when applicable) and software modules will be based upon representations made in the proposal.

B. Liability limitations and insurance demonstrating the vendor's confidence that there is a low risk of failure of any part of the project.

The successful vendor will be expected to meet the indemnification and insurance requirements to be determined by the monetary amount of the resulting agreement.


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Evidence that the required insurance has been obtained must be provided to the County by the vendor before work under the agreement begins.

Samples of the various indemnification and insurance provisions that may be included in the agreement are set forth in Exhibit IV. C. Term of Agreement

The Agreement will commence upon completion of necessary contract paperwork required by the County and continue through the term of the agreement, unless terminated earlier or otherwise amended by the County. The Agreement shall be for One (1) year terms, with Vendor providing County with new annual rates at least 120 days prior to the end of any annual term. Unless either party gives the other party written notice of its intent to terminate at the end of the then-current term, at least 90 prior to the end of any term, the Agreement shall automatically renew for successive one-year periods, up to three (3) additional years, on certain conditions that will be detailed in the contract. Any deficiency noted by the County must be addressed or resolved by the provider within thirty days of notification by the submission of a corrective action plan or resolution of the deficiency. This period (30 days) shall serve as the cure period for this agreement.

D. TerminationCounty may terminate this Agreement at any time, either in whole or in part, by giving thirty days written notice specifying the effective date and scope of such termination. Vendor may terminate this Agreement at any time, either in whole or in part, by giving thirty days written notice specifying the effective date and scope of such termination. However, if Vendor elects to terminate this Agreement, the County's rights under any pending matter arising from Vendor's services hereunder will not be prejudiced due to such termination. Upon date of termination, all rights, powers, privileges and authority granted to Vendor under this Agreement will cease, and Vendor will have the duties provided below in Section 3b.

Termination For Cause: County will have the right to terminate this Agreement after written notice to Vendor and after the expiration of any cure period provided for above in Section K-1, upon the occurrence of any of the following events of default:

a. Failure of Vendor to perform any covenant of obligation set forth in the Agreement or any other agreement with the County;

b. Any attempt by Vendor to assign, delegate or subcontract without County's consent as provided herein;

c. Failure by Vendor to maintain insurance as required under this Agreement;

d. Filing by or against Vendor of any petition for bankruptcy, any assignment by Vendor for the benefit of creditors, the levy of a writ of attachment or execution against Vendor's property of the appointment of a receiver for


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Vendor or Vendor’s property; or, Unauthorized or excessive billing by Vendor.

E. Duties Upon TerminationUpon termination of the Agreement, all finished or unfinished documents, data, assessments, reports, project plans and other materials (hereinafter collectively referred to as “materials”) prepared by Vendor under this Agreement will become the property of the County and will be delivered promptly to the County. Upon receipt of such materials, Vendor will be paid for services performed and reimbursable expenses incurred to the date of termination.

F. Conflict of InterestVendor promises, covenants, and warrants that the performance of its services and provision of its products and representation to County under this Agreement will not result in a conflict of interest. In the event of a conflict of interest or potential conflict, Vendor must disclose such conflict to the County and shall request the County's Board of Supervisors waive such conflict on a case-by-case basis.

G. NondiscriminationVendor will comply with all applicable federal, state, and local laws and regulations including Santa Clara County's policies concerning nondiscrimination and equal opportunity in contracting. Such laws include, but are not limited to, the following: Title VII of the Civil Rights Act of l964 as amended; Americans with Disabilities Act of l990; The Rehabilitation Act of l973 (Sections 503 and 504); California Fair Employment and Housing Act (Government Code sections 12900 et seq.); California Labor Code sections 11-1,1102, and 1102.1. Vendor will not discriminate against any subcontractor, employee or applicant for employment because of age, race, color, nation origin, ancestry, religion, sex/gender, sexual orientation, mental disability, physical disability, medical condition, political beliefs, organization affiliations, or marital status in the recruitment, selection for training, including apprenticeship, hiring, employment, utilization, promotion, layoff, rates of pay or other forms of compensation. Nor will Vendor discriminate in provision of services and products provided under this agreement because of age, race, color, national origin, ancestry, religion, sex/gender, sexual orientation, mental disability, physical disability, medical condition, political beliefs, organizational affiliations, or marital status.

H. Governing Law: VenueThis Agreement will be construed and enforced in accordance with the laws of the State of California. Proper venue for legal action regarding this Agreement will be the County of Santa Clara.


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I. Relationship of Parties: Independent ContractorVendor will perform all work and services described herein as an independent Contractor and not as an officer, agent, servant or employee of the County. None of the provisions of the Agreement is intended to create, nor shall be deemed or construed to be in a relationship of joint venture, partnership or employer-employee. Neither party will have the authority to make any statements, representation or commitments of any kind on behalf of the other party, or to use the name of the other party in any publication or advertisements, except with written consent of the other party or as explicitly provided herein. Vendor will be solely responsible for the acts and omissions of its officers, agents, employees, contractors and subcontractors, if any. No person performing the work or services described herein will be considered an officer, agent, servant or employee of the County, nor will any person be entitled to any benefits available or granted to employees of the County.

J. Assignment: SubcontractingVendor is prohibited from: (1) assigning or subcontracting this Agreement; or (2) delegating any duties or obligations hereunder in any manner whatsoever, either voluntarily or by operation of law, unless County first approves in writing such assignment, subcontract or delegation by written instrument executed and approved in the same manner as this Agreement. County may give or withhold such approval in its sole and absolute discretion. Any purported assignment or subcontract by Vendor in violation of these restrictions will confer no rights on any other party and will, at County's sole option, be void.

K. Invoicing and Payment SchedulesCounty will be obligated to compensate the Vendor pursuant to the terms and conditions of this Agreement only for the performance, to the reasonable satisfaction of the County, of those products and services that take place during the term of this Agreement. County will not be obligated to compensate Vendor for any work, services, or products performed by Vendor which do not arise directly from the performance of tasks and provision of products relating to the terms of the agreement.

Payment for software, hardware (if applicable), and services will be made according to milestones as indicated below:

1. Hardware (if applicable):

Ten percent at contract signing. Ninety percent when the installed hardware passes the manufacturer's

certification. If hardware is provided by the software vendor, County expects that the

hardware can be returned to that vendor, with a full refund of all hardware payments to date, if software acceptance cannot be achieved.


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2. Out-of-pocket expenses as incurred, up to a project cap, which is to be negotiated.

3. Software license and implementation support payments for each module:

Twenty percent at contract signing. Twenty percent upon successful integrated acceptance testing. Twenty percent at live date, with live defined as the point at which the

software is utilized as the primary tool for processing real data. The remaining 40 percent will be paid when the system passes final

acceptance testing as measured against the vendor's response to the RFP requirements, system documentation, and custom programming specifications.

Ongoing software warranty and subsequent maintenance payment periods will not begin until the software has been accepted on a module-by-module basis.

Protest Procedures

On January 31, 2002, the Department will send letters to applicants advising of the Department Director’s and CIO’s decision. Applicants who have not received a letter by January 31, 2002 may call the Department at (408) 885-6490. Applicants whose proposals are not selected may file a written appeal no later than February 28, 2002. The written appeal should clearly state the regulatory, legal or review process violation that is grounds for the appeal or the Board Principles that have been violated.

Protests must be in writing and should be addressed to:

Santa Clara Valley Health & Hospital System Attention: CIO, Information Systems2325 Enborg Lane, Suite 240San Jose, CA 95128

After review of the appeal, the CIO will issue a written response. Applicants not satisfied with the CIO's response may request that their appeal be forwarded to the County Board of Supervisors.


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SECTION III

SUBMISSION REQUIREMENTS

III. Submission Requirements

Due Date, Return Addresses and Number of Copies

The vendor must send a letter of intent to bid at the address provided below to Ms. Cheri Silveira-Moliere. The letter must be received by August 8, 2001. Revised date is September 10, 2001. Indicate in the letter of intent the following:

The system(s) that will be proposed.

The primary contact person will be for all matters related to the proposal.

A complete listing of all clients using the proposed products to facilitate preliminary reference checking logistics.

The vendor must send the Proposal at the address provided below to Ms. Cheri Silveira-Moliere. To assure that all vendor proposals receive a fair and complete evaluation, County requires that vendors answer all questions completely without any deviation from the instructions in this RFP. Proposals that deviate from the required format and content without advance permission from County will not be considered. The original response, with signatures of corporate officers binding the firm and indicating concurrence with all aspects of the bid, and five (5) copies must be received by September 04, 2001 Revised date is 9/24/01 at 12:00 p.m., Pacific Standard Time.

All letters of intent and proposal packages will be time/date stamped by the County at the time of receipt. This stamp will serve as the only acceptable evidence to establish whether a receipt was timely.


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Use of the U.S. Mail will be at the prospective provider’s own risk. Late proposals will not be considered unless it is determined by the County that the late receipt was due to mishandling by the County after receipt at the above address. Proposals delivered after this date and time will not be accepted. Postmarks will not be accepted in lieu of the actual receipt of the proposal package. No extensions will be given beyond the response deadline.

The delivery point for the five (5) copies and the original will be:

Ms. Cheri Silveira-MoliereManager Systems OfficeSanta Clara Valley Health and Hospitals System (County)2325 Enborg Lane, Suite 240San Jose, CA 95128

Key Event Dates

Request for Proposal Issued – July 27, 2001

Letter of Intent Due – August 08, 2001 Revised date 9/10/01

Final date for questions – August 17 , 2001

Final date for Responses to RFP – September 04, 2001 Revised date 9/24/01

RFP evaluation – September 04 through September 24, 2001 Revised date 9/25-10/19/01

Reference checking – September/October 2001 Revised October/November 2001

County onsite presentations and demonstrations – October 2001 Revised November 2001

Site visits to operational sites – October/November 2001 Revised November/December 2001

Identification of finalist Vendors – October/November 2001 Revised November/December 2001

Contract negotiation -- November /December 2001 Revised December 2001/Jan-uary 2002

Contract award – January 2001 Revised February 2002

All dates are subject to change as County needs may require.


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Adjustments to the proposal package will not be accepted after the proposal deadline, unless the County determines additional information is needed from prospective contractors to evaluate the proposals. Such information will be requested within 14 days following the proposal deadline and must be received within three (3) working days following the date requested.

Proposal Opening:

Cheri Silveira-Moliere or the Department’s designee will open and record all proposals in SCVHHS IS Department, located at 2325 Enborg Lane, Suite 240, San Jose, CA 95128 on September 04, 2001 at 5:00 P.M Revised 9/24/01 5:00pm PST

Proposals become the property of the County and shall not be returned.

The California Public Records Act set forth in Government Code sections 6250 et seq. governs access to public records. The act provides that access to information concerning the conduct of the public’s business is a fundamental and necessary right of a person in the state. Consequently, all proposals, attachments, and other materials submitted in response to this RFP shall be considered public information (except as provided herein) and the exclusive property of the County. As such, proposals will not be returned to their respective applicants.

(a) In the event the County receives a request for inspection of any Proposals submitted pursuant to the RFP following the public release date, it is a responsibility of the organization that submitted the proposal to assert confidentiality rights, if any exist. The County is not responsible for and will not make objections to disclosure or assert privacy rights on behalf of the contractor. Proposal materials will be subject to public inspection absent a judicial determination that they are exempt from disclosure. Contractor’s submission of proposal materials shall be deemed a complete waiver of any claims whatsoever against the County and its agents, officers and employees that the County has violated any right to privacy, disclosed confidential proprietary and or trade secret information or has caused any damage by allowing such inspection or disclosure.

(b) Notwithstanding the foregoing, no proposal materials shall be released to the public nor shall the public have access to such proposal materials during the RFP process until such time as the Board of Supervisors awards the contract. Thereafter, the public will have access to the proposal materials, as provided in this RFP.

(c) In the event that any contractor deems any portion of their proposal confidential or proprietary or otherwise contains business or trade secrets, then those specific sections must be plainly marked as “confidential,” “proprietary,” or “trade secrets.” The County shall notify Contractor is disclosure of these materials is sought. It shall be the Contractors obligation to seek a protective order. County shall not be liable or in any way responsible for the disclosure of any such information including, but not limited to, disclosures required or permitted under the California Public Records Act or otherwise by law.


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Questions Regarding the Submission

The vendor is encouraged to seek further information and clarification by submitting questions to Cheri Silveira-Moliere. All questions regarding this submission must be made in writing. Electronic mail is the preferred medium.

All questions and the respective answers will be shared with competing vendors. The vendor must pay careful attention to the requirement that it may only contact Cheri Silveira-Moliere at County during the system selection process. Vendors that are currently doing business with the institution must limit their contacts to those necessary to support existing operations. Although the vendor may be referred to other personnel, any vendor that initially contacts other County personnel in person, in writing, or by telephone, without previous notification and approval, may be disqualified from consideration.

Questions must be received by August 17 and shall be sent to:

Mrs. Cheri Silveira-MoliereManager Systems OfficeSanta Clara Valley Health and Hospitals System2325 Enborg LaneSan Jose, CA 95128Transmissions may be made via email to [email protected] or FAX to (408) 885-2036


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mailto:[email protected]

mailto:[email protected]


SECTION IV

RESPONSE REQUIREMENTSSanta Clara Valley Health & Hospital SystemRequest for ProposalJuly 27, 2001

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IV. Response Requirements

Format For Response

The business and technical proposal will consist of three or four sections, assembled in a loose-leaf notebook to allow for easier distribution of material. Depending on the size of the submission, each section may occupy a separate notebook.

Section One - Cover Page and Board Letter of Authorization

Section Two - RFP Checklist

Section Three – Executive Summary and Proposed System Overview

Section Four – Business Offering

Subsection One -- General Description of the Vendor Subsection Two -- Overview and Status of Proposed Applications Subsection Three-- Hardware, Interfaces, and Operating Environment Subsection Four -- Implementation Support Services Subsection Five -- Ongoing Support Services Subsection Six -- Client References Subsection Seven -- Cost Summaries

Section Five – Functional Offering of Software Applications

Section Six – Support Documents and Miscellaneous Marketing Literature

Guidelines for preparing each specific section are as follows:

Each section must have its own table of contents indicating all subsections and page numbers.

Each page must be uniquely numbered within each section at the same location on each page.

Labeled tabs must separate subsections within each section.

The date of the submission must be placed on each page in the same location, thus enabling County to differentiate among the original and updated versions the vendor may be asked to provide.

Unbound sets of forms and functional specifications to be used in the vendor's response are enclosed with the RFP. Also forwarded via email to the vendor are electronic versions (Word 97 and Excel 97) of the said forms and functional specifications.


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Cover Page and Board Letter of Authorization

An authorized officer or employee of the organization submitting the proposal must sign all proposals. If an administering board or board of directors is required to authorize submission of the proposal, a minute order or memorandum shall be attached to the proposal on behalf of the organization; otherwise, all members of the governing board for the organization must sign the proposal. (Attachment A-1)

RFP Checklist

A checklist has been included to ensure that all required documents and attachments are included. Incomplete proposals will not be reviewed. (Attachment A-2)

Executive Summary and Proposed System Overview

1. Provide a condensed version of the highlights and contents of the proposal. The purpose is to provide County with a broad understanding of the entire proposal.

2. Provide an overview of the features and capabilities of the proposed applications and the relationships among applications and among product lines.

3. Identify those overall and application-specific features and capabilities that differentiate the proposed product(s) from competing products.

4. Describe how you feel the proposed product offering will add value to County.

Business Offering

Please provide a narrative response to all questions, and where requested, complete the appropriate Form as indicated. Forms are located in Section IV of this document and are also provided electronically.

(1) Subsection One – General Description Of The Vendor

This subsection describes the vendor's organization and operations, as well as provides a brief overview of the product(s) bid.

A. General Description of the Vendor - Use Form 1. Provide the corporate profile data.

B. Describe the Vendor's Mission


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C. Attach the vendor's most recent annual report including audited financial statements.

D. Description of Subcontractor - Form 2. Complete form if subcontractors are used in the context of the proposed products.

E. Provide an overview of the operating structure of the firm. Define the relationship between the parent company and subsidiaries, if applicable. Describe the history of recent acquisitions and mergers, if applicable.


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(2) Subsection Two – Overview and Status of Proposed Applications

This subsection describes and reviews the status of the proposed product applications. Responses to detailed functional specifications will be solicited in the Functional Requirements section of this RFP. The vendor is required to:

A. Provide an overview of the features and capabilities of each of the proposed applications as well as the relationship and level of integration among applications and among product lines.

B. Product Information - Form 3. Use form to describe product history and system release information for each product. Be sure to complete a copy of this form for each product family. Include the year each application was generally available to the marketplace as well as the number of clients live with the application. (Note that a client may have several sites, but should be counted as one “client”.) Also, indicate the status of applications in the same product family that are not being bid.

C. Applications Bid - Form 4. Use form to clarify the names of the vendor's applications and corresponding modules being bid, relative to the RFP designations for required functions.

D. Applications Not Bid - Form 5. Use form to indicate the status of applications in the same product family that are not being proposed. Use the status designations defined below:

1. Fully Operational -- Has been in use on a non-test-site (non-pilot, non-alpha, non-beta) basis by at least two clients for at least six months.

2. Not Fully Operational -- Currently is under field test or under preliminary internal development.

E. Describe how the system or each product, if different, stores the century, year, month and date.

F. To allow County to assess the firm's development success, list initially planned and actual dates for major development projects for the current and two previous years.

G. Identify those overall and application-specific features and capabilities that differentiate the proposed product(s) from competing products.

H. System Architectural Design-Form 6. Use form to indicate the presence (yes) or absence (no) of the architectural tools and capabilities listed. Also, indicate whether or not each architectural tool is included in the bid. Use the "Notes" column to make any comments, notes, or exclusions.


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I. Provide an example of standard screen formats that are representative of the ‘look-and-feel’ of the application(s). Are the users able to change or modify the screen formats? If so, how? What are the tools provided to customize screens?

J. Identify current and future plans for utilization of each software product on an intranet and/or extranet. If applicable, state those applications or products, technology, and status (i.e., available, in development, future). Can the user utilize a Web Browser front-end to access the system?

K. Describe additional service offerings that may be relevant or useful to County. For instance, does your company offer customer relationship management (CRM) solutions for operational client contact management?

(3) Subsection Three – Hardware, Interfaces, and Operating Environment Specifications

This subsection reviews the hardware requirements and other technical aspects of the system being proposed. Exhibit II provides some key statistics provided by County to assist the Vendor in sizing its hardware offering properly. The vendor is required to conform to the following guidelines when sizing its proposed solution:

The total number of recommended peripheral devices (e.g., workstations, net computers, hand held devices, printers, microcomputers, modems, and interface ports) must be adequate to support the applications proposed based on experience with similar clients.

The recommended server(s) must be of sufficient capacity on delivery to accommodate a 25 percent growth in transaction volumes (see current statistics in Exhibit II), as well as a 25 percent growth in number of users.

The disk storage capacity of the system must, upon delivery, be sufficient to accommodate 25 percent growth. The vendor should assume an unlimited data retention period when determining the amount of disk storage. The vendor should also assume three-years of historical client and financial data will need to be migrated to the new proposed system environment.

Fault-tolerance and full redundancy is a County computing platform requirement.

Recommended networking requirements to support the system configuration must be described. In particular, specify the types of network protocols, network topologies, and communication interfaces supported by the system. Please refer to Table 1 of Section 1. - Background for specifics of the current SCVHHS (County) network infrastructure.

The vendor must be willing to provide guarantees that the proposed configuration will meet the criteria defined above upon delivery.


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A. Describe your system architecture in terms of e.g., client server (two-tier, three tier, N-tier). In general, would you describe your system to be decentralized or centralized, or a flexible hybrid?

B. County requires the ability to communicate and share information between systems in an open and integrated environment. Describe the system's ability to extract data and share with report writing/other applications.

C. Describe the computing platform architecture that you have proposed. For example, is it Massively Parallel Processing (MPP), Symmetrical Multi Processing (SMP), Non Uniform Memory Architecture (NUMA), etc.

D. Attach a comprehensive and detailed parts breakdown (formal quote from the hardware manufacturer is preferred) which highlights each component of the configuration, unit cost, suggested quantity, total purchase price, unit maintenance cost, total maintenance cost, freight and shipping cost, and shipping insurance cost. Hardware costs can be summarized in Subsection 7 of Section III – Response Requirements. All recommended hardware required to operate the system(s) must be included in the configuration, including, but not limited to the following components:

1. Server platform

2. Disk Drives

3. Tape Drives

4. Jukeboxes

5. CD-ROM systems

6. Device Controllers

7. Printers

8. Workstations

9. Bar code or hand held devices

10. Multiplexors or other Remote Communication Devices

11. Shipping and Insurance

12. Freight and Delivery

13. Hardware Installation


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E. A schematic that describes the interconnections among components.

F. Describe your strategy for integrating the proposed computing infrastructure into the current County infrastructure.

G. Based on the configuration and volumes proposed in Part A above, identify the guaranteed maximum response time, the measurement period, and the functions excluded. At a minimum, the hardware proposal should meet the following performance levels:

1. Response time of two seconds or less for at least 95 percent of all activities during any single hour of the day (excluding downtime).

2. Response time of five seconds or less for the remaining five percent of all activities.

H. The system should be available 24 hours per day, seven days per week. Describe the reasons the proposed system would not be available to the users. Address the following issues related to scheduled downtime and partial system availability:

1. Delineate which applications are not accessible to the users, and for how long, during nightly and weekly downtime.

2. Identify other types of processing that restrict or limit user access to the system.

3. Describe the impact of periodic system updates/back-ups on the availability of the system to the users.

4. Describe the normal production turnover procedure for the proposed products. Is the system operation interrupted to bring online screens or programs into production? Is system operation interrupted to bring batch programs into production? Is system operation interrupted to make changes in the communications environment?

5. Please explain the approach utilized to ensure the desired 24 X 7-system availability. Describe any additional hardware and/or software costs required to assure 24 X 7 availability.

I. Hardware Upgrade Path - Form 7. Use form to describe the upgrade path for the hardware configuration included in your proposal. Note that the first column for Form 7 should be completed using the configuration proposed that will accommodate 25 percent growth. The ability to expand the hardware configuration on a field-upgradeable basis is of primary concern to County.


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J. List all specific supported devices including, but not limited to, workstations, wireless devices, and network computers. Please provide the following information for each device supported.

1. The recommended configuration including optimal RAM, hard disk space, CD-Rom, etc. If different categories of end-user require a different device configuration, please make that delineation.

2. What operating systems are compatible to the proposed system?

3. In proposing recommended devices, is any feature or functionality gained or lost by utilizing one device over another? For example, a network PC over a desktop workstation.

4. Identify any environmental constraints or requirements of the proposed devices.

5. What is the maximum number of devices that can be supported by the proposed hardware configuration within the required response time?

6. What are the system’s capabilities for downloading and uploading data or reports between PCs and the host computers? How are current clients doing this? Does any third-party software facilitate this? Describe the system’s ability to download information into a database for comparison against other submitted data.

K. State the specific reasons for recommending the proposed configuration and manufacturers over other available hardware options.

L. Systems Software - Form 8. Use form to provide a listing of all systems software required to run the proposed application(s).

M. Interface Experience - Form 9. Use form to provide a listing of the other financial and clinical systems to which the proposed system has previously been interfaced and that are applicable to this RFP. Be sure to include interface experience with the following applications (and state experience with the specified vendors, if any):

1. General Financials – PeopleSoft2. Siemens Invision – Patient Management / Patient Accounting3. Diamond – Managed Care4. WebMD (previously MEDEAmerica Solution Plus) – Pharmacy5. CompuTrust – Client Trust Fund Accounting6. ePhysician – Prescriptions7. CSM M4 - Methodone Management System 8. Echo Management Clinician Desktop - Patient Management / Patient Accounting

N. Are interfaces custom developed or are they generated using an interface engine? Is the interface engine available to County to maintain the interface(s)?


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O. HIPAA mandates the use of standard transaction sets for a number of healthcare electronic data interchanges. Please provide detail information on how the proposed system will generate and/or receive the following ANSI ASC X12 4010 transaction standards:

1. Eligibility inquiry/response (270 / 271)

2. Health Claim Status inquiry / response (276 / 277)

3. Health care services review - referral certification and authorization (278)

4. Benefit Enrollment and Maintenance - enrollment/disenrollment in a health plan (834)

5. Health Claims/COB/Encounters (837)

6. Claims payment and remittance advice (835)

P. HIPAA provisions for data confidentiality, integrity, and availability are of critical concern to County. Describe the features offered by the proposed system that support the following security features:

1. Controls that restrict access to resources and allow access only to privileged entities using one or more of the following: context based, user based, role based, terminal location, time of day, and emergency access.

2. Audit control mechanisms to record and examine system access activity.

3. Entity authentication mechanisms to corroborate that an entity provided access to resources is who it says it claims to be. Possible authentication mechanisms could include but are not limited to the following: biometrics, password, telephone callback, and token system.

4. Automatic signoff

5. Data encryption

6. Digital signature

Q. Describe your recommended file backup procedures, including time requirements and archiving capabilities. Also, describe preventative maintenance for application software, systems software, and hardware.

R. Does the system have the ability to have different business rule preferences per practice/location? Please describe how the proposed product could handle multiple practices, and the ability to maintain separate, but integrated, databases if requested.

S. Performance guarantees – System performance is considered to be a critical technical issue for a successful implementation of these applications. It is required that the selected software and hardware solution perform according to its required


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specifications. The selected vendor will be expected to propose a hardware and software solution that enables guaranteed performance.

The vendor is expected to back its performance warranties by providing, at no additional cost, all services and software necessary to achieve the warranted performance levels.

(4) Subsection Four – Implementation Support Services

This subsection details how the vendor plans to assist County to implement the proposed application(s). The vendor should include a realistic workplan that minimizes risks and takes into account the needs of County.

All required implementation support and training must be clearly described and associated costs included in Subsection Seven. Identify any optional implementation services that are available.

A. Implementation Support Proposed - Form 10. Use form to describe the vendor's implementation support proposed.

B. Provide an overview of the implementation schedule, indicating when each application function will become available. Justify the sequencing decision and describe other feasible alternatives and the pros and cons of each.

C. Show a task level implementation plan and indicate for each task:

1. Output or result2. Estimated elapsed timeframe 3. Estimated County person-hours required by title/role 4. Estimated Vendor person-hours required by title 5. Interdependencies

D. Recommended County Staffing Requirements - Form 11. Use form to indicate the recommended staff requirements necessary to install and operate the product(s). Differentiate between Systems Office and departmental staffing needs.

E. Implementation Support Description - Form 12. Use form to summarize the allocation of vendor-provided support proposed for project management, training, and implementation support, by application.

F. Describe the proposed approach to provide tailoring and design assistance for the applications. Such support would include screen design, report design, profile and table building, historical data migration, and other options available to County.


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G. Describe the Vendor’s role in interface development. In particular, address the responsibilities and resources required from County in interface analysis, specifications, and testing.

H. Does your methodology include process improvement? If so, describe the process. What is the Vendor’s responsibility versus County responsibility? Provide examples of Vendor’s role in previous sites where process improvement was performed as part of the implementation.

I. Describe the availability of hardware-related implementation support. Include the following services:

1. Workstation placement and environmental assessment.

2. Computer room environmental assessment with recommendations for space, power, cooling, and all other necessary environmental considerations.

3. Installation of hardware in the computer room.

4. Hardware testing.

5. Loading and testing of operating system and utilities.

J. Describe post implementation follow-up activities that will be provided by the vendor. Specifically address the following tasks:

1. Post live system debugging to bring application function into full conformance with documentation, proposal, and modification specifications.

2. Six-month and 12-month post live operational (non-technical) audits to review County utilization of the software and to provide recommendations for optimizing benefits.

K. Describe the training materials and user technical documentation and updates provided by the vendor.

L. Describe support provided for system conversion. Identify files commonly converted by clients and provide estimated cost of conversion in Subsection Seven.

(5) Subsection Five – Ongoing Support Services

This Subsection details the level of ongoing support provided by the Vendor after implementation.


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A. Ongoing Support Description - Form 13. Use form to describe the ongoing system support and customer support options offered by the Vendor. The forms provide for descriptions of two distinct levels of support. Form 13 is for Basic support and Form 13(2) is for a Premium level of support. If more than two support levels are offered, add additional copies of the form as needed. Note the level of service at the top of the page and respond to the questions accordingly.

B. Clearly state any other features that distinguish the levels of ongoing support offered other than the issues covered on Form 13.

C. Describe the types of services for each level of support that are covered on a 24-hour basis, such as:

1. User hotline or problem line.

2. Remote problem diagnostic services.

3. Software and any Vendor-supplied hardware.

4. Hardware maintenance services for any Vendor-supplied hardware.

5. Hardware and software maintenance expected from third parties.

D. Describe the Vendor's response time to requests for assistance. Indicate the time period in which a knowledgeable person will respond to the request for assistance and the timeframe in which work will begin to correct the identified system problem. Delineate timeframes for different categories of problems (e.g., critical, major, and minor) and describe each category. Describe the problem tracking system and methodology used.

E. Describe the Vendor's policies regarding escalation of unresolved support issues to a higher level:

1. What are the Vendor-established criteria for escalation?

2. What are the timing criteria to escalate?


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3. To what party does this issue escalate?

4. If satisfaction is still not received, what are the subsequent procedures?

F. Describe your policies regarding response to changes in federal, California, Santa Clara County, JCAHO, HIPAA, and third-party payor regulatory requirements or changes in standard industry practices.

G. If your software conforms to all California State regulations, provide the names of ALL California sites where this is being provided, and state exactly to which “State regulations” the software conforms.

H. Software Change Policy - Form 14. Use form to address issues such as training requirements and estimated cost. Using the Vendor's own terminology, identify and define each category of enhancement that a client will encounter. For example, "Version" (or "Release", "Upgrade", etc.) is defined as a significant rewrite of the software. It may require conversion to a new hardware platform or database management system and typically includes significant new function”. "Enhancement" is defined as ... "Fix " is defined as..., etc.

I. Does the Vendor provide ongoing modification assistance, and if so, which of the following components are included and at what cost?

1. Specification writing2. Coding3. Installation and testing

J. Does the Vendor have active national and regional user groups? If so, describe the functions of the user groups and the frequency of their meetings. What kind of ongoing educational services are provided? How are these educational services accessible (e.g. the web, self-study courses, etc.)?

(6) Subsection Six – Client References

This subsection identifies an appropriate subset of the Vendor's client base, which County can contact to discuss the product, support, and performance.

A. Provide a list of all clients utilizing the proposed products.

B. Provide a list of clients who have deinstalled the proposed products in the last 18 months.


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C. Client Base Overview - Form 15. Use form to summarize the extent of client experience with the system(s) proposed. Of interest is the number of implementation sites, number of live operational sites, number of de-installed sites, and the number of sites in California.

D. Client References - Form 16. Use form to list at least ten current clients that are utilizing the proposed software and that meet at least one of the criteria listed below. Include at least one reference for each criterion.

1. Public mental health service providers, preferably operating in the state of California

2. Public alcohol and drug service providers, preferably operating in the state of California

3. Multientity organizations, with five or more owned and/or contracted provider locations.

E. Interface History - Form 16(2). Use form to describe interface experience of the client reference sites.

(7) Subsection Seven – Cost Summaries

This subsection asks the Vendor is asked to provide a complete description of all one-time and ongoing costs associated with the proposal. The cost proposal should be submitted on Forms 17 through 23. Costs must be described at the level of detail specified in the forms. Please include all costs that will be required to make the proposed application fully operational.

A. Recommended Hardware Costs - Form 17. Use form to specify all hardware costs. Costs must be included for each item shown on the schematic developed for your response to Subsection Three -- Hardware, Interfaces, and Operating Environment. A detailed price quotation from the hardware manufacturer can be substituted for Form 17. However, every item must be clearly labeled with its corresponding part number, suggested quantity, unit cost, total purchase price, unit annual maintenance, and total annual maintenance. For purposes of calculating annual maintenance costs, assume that 24-hour, seven-day onsite service is required. If the Vendor or hardware manufacturer offers extended maintenance (e.g., a lump sum up-front payment for multiple years of hardware support), include this cost as an option.

All recommended hardware required to operate the system(s) as identified in the Vendor's schematic must be included in the pricing proposal, including but not limited, to the following:


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1. CPU2. Disk Drives3. Tape Drives4. Jukeboxes5. CD-ROM systems6. Device Controllers7. Printers8. Workstations9. Bar code or hand held devices10. Cabling11. Emulation or Network Cards12. Multiplexors or other Remote Communication Devices13. Shipping and Insurance14. Freight and Delivery15. Hardware Installation

Please note: In the case of desktop devices (e.g. workstations, local printers), the Vendors should include a recommendation of total devices required and a per unit cost. However, the bid should not include the total cost of purchasing all recommended devices.

B. Provide a description of the hardware warranty included with the initial purchase price. Specifically address the following questions in your response:

1. When does the warranty begin?

2. What is the duration of the warranty?

3. Which components of the configuration are covered by this warranty?

4. Does the warranty cover onsite service or is County required to drop off parts for service?

5. For which parts are drop-off service required?

6. What is the guaranteed turnaround time for repairs for both onsite service and drop-off service?

C. Application Software Costs - Form 18. Use form to describe all costs associated with the proposed application software. Pricing should be provided on a module-by-module basis. Columns are provided on this form to describe one-time, annual, implementation and training costs, which also must be listed by module. In addition, license, implementation, and ongoing fees for all custom software must be included on this form. Fixed fee proposals that cap implementation fees are required. Describe in detail all charges that are included and excluded from the fixed price umbrella. During the drafting of the contract, the selected Vendor will be required to warrant that all costs are included as described in the proposal.


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D. If the fixed price is tied to assumptions about size or volumes, then these assumptions must be stated. Specify price increases or discounts that will occur if County falls above or below these assumptions.

E. If the Vendor offers extended maintenance (e.g., a lump sum up-front payment for multiple years of support), include this cost as an option.

F. Other Software Costs - Form 19. Use form to identify one-time license fees and annual maintenance fees for all pre-requisite system software, including operating systems, database management system, utilities, form builders, etc.

G. Interface Costs - Form 20. Use form to specify costs for providing interfaces to external or other foreign systems. You should describe the Direction (one-way or two-way), Mode (online or batch) and Type (HL-7, X12, or custom) as well as the one-time and annual costs associated with each interface, separately priced. A column is provided to describe any additional implementation costs associated with the interface. It is expected that the functional interface specifications will be jointly developed with the vendor and priced on a fixed or not-to-exceed basis prior to contract signing. Refer to Exhibit III-Current Interface Summary for current inbound/outbound interfaces that will need to be created.

H. Conversion Costs - Form 21. Use form to describe data conversion costs. County assumes Vendors are responsible for conversion of data from County current file format into proposed system format for any conversions proposed. If cost estimates are made on any other assumptions please provide detailed information such as:

1. What files will be converted from the existing BHIS (i.e., Echo INSYST/OSCAR)?

2. What files will be converted from the existing managed care operations information system (i.e., DIAMOND)?

3. What are the conversion assumptions?

4. Specify Vendor's format for the conversion file

I. Additional Costs - Form 22. Use form to itemize any costs that cannot be placed in any of the categories above.

J. Cost Notes and Assumptions - Form 23. Use form to describe any assumptions, limitations, or clarifications required to understand the proposal.

K. Workplan including major milestones and identification of the responsible parties.


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It is expected that the proposal will include a list of important implementation milestones. Additionally, it is expected that the selected vendor will provide a detailed implementation workplan for all phases of the project. This workplan will be incorporated in the agreement. Information to be included in the workplan consists of the following:

1. Detailed activities.

2. Responsible parties (both vendor and County).

3. Person-hours required for responsible parties to accomplish each detailed task.

4. Elapsed times (i.e., start and completion dates).

L. Cost Summary - Form 24. Use form to summarize any and all specified costs.

Support Documents And Miscellaneous Marketing Literature

Include a second section that contains sample standard reports, marketing literature, and other back-up documentation or optional submissions.


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SECTION V

FUNCTIONAL REQUIREMENTS

V. Functional Requirements

The functional specifications included in this Section provide detailed information system requirements for the application(s) to be acquired. Each requirement has been given a unique mnemonic and number that will be used for reference purposes. In order to complete this section, the vendor must respond to each requirement according to the directions below.

In the ‘Source’ worksheet, please enter the Vendor’s name, and each of the application names and tools/utilities that are being bid and are needed to satisfy each requirement. These are labeled "A," "B," "C," "D," and "E." For the purpose of clarity, County expects that an application is a set of features and functions which can be brought live without IS/user/vendor programming or intervention, only with master file and parameter/profile building. If screen building, report writing, inquiry writing, or data manipulation coding is to be done by IS/user/vendor, then a vendor or third-party tool/utility is being utilized.

To complete each functional specification response on Functional Requirements - Form A the vendor must indicate "STATUS," "SOURCE," and "COMMENTS" as shown below. Each comment should be succinct and discretely numbered.

STATUS COMMENTS REQUIRED

NOW Available and fully operational in the field on a nontest site basis. No user tools/utilities are required to achieve this feature other than the use of the application(s) indicated in the "Source" response.

Any exclusions.

SOON Available and under field test at a client site. No user tools/utilities are required to achieve this feature other than the use of the application(s) in the "Source" response.

Any exclusions. One-time or ongoing costs incremental to those bid for "A" through "E." Availability date for code load. Current status.

Santa Clara Valley Health & Hospital SystemRequest for ProposalJuly 27, 2001document.doc


STATUS COMMENTS REQUIRED

FUTURE This feature or function is not currently available, nor is it in field-testing. However, if client licenses the application(s) listed in the "Sources" response and/or the user tools/utilities specified in the "Source" response, then client will receive it with a future release of the system.

Any exclusions. One-time or ongoing costs incremental to those bid for "A" through "E." Availability date for code load. Current status.

USER MODIFIES

This feature or function is not standard to the system; however, it is available if the client licenses the application(s) listed in the "Source" response or the user tool/utility specified in the "Source" response is deployed by the client.

Any exclusions. One-time or ongoing costs incremental to those bid for "A" through "E." Estimated number of hours it would take the vendor to complete, at a fee, if client were to request this work be done by the vendor.

CUSTOM This feature or function is not standard to the system; however, if the client licenses the application(s) listed in the "Source" response, then the vendor will provide the modification. Alternatively, the vendor will make a source code change to provide the function.

Any exclusions. One-time or ongoing costs incremental to those bid for "A" through "E." Description of how the work would be done (tool/utility or source code change). Availability date for code load.

WON'T PROVIDE

This feature or function is not available, in testing, or planned for future development.

None.

The following specifies all functional requirement categories included in Section VI. Each functional requirement is assigned a mnemonic for future ease of reference.

PATIENT/CLIENT MANAGEMENT Intake / Preadmission / Preregistration (PRE) Registration (REG) Admission, Discharge, Transfer, Medical Records Index (ADT) Enterprise Master Patient Index (MPI) Census Report (CEN) Medical Records (MED) Online Client Eligibility (OCE)



PATIENT ACCOUNTING Grants Management (GRM) Financial Analysis / Entitlement / PFI (PFI) Patient Accounting: Billing / Claims / Remittance processing / A/R (PAM) Payer Contract Management and Negotiation Support (PCM) Cost Accounting (CAM)

MANAGED CARE OPERATIONS Member Enrollment / Eligibility (MEE) Authorizations / Referral Tracking (ART) Claims Processing/Adjudication (CPA) Provide Contract Management and Negotiation Support (CMN) Provider Relations (PRM) Access Management: Call Logs / Client Contacts (ACM)

CLINICAL OPERATIONS Electronic Medical Record (EMR) Behavioral Health Assessment and Outcomes Measurement (BHA) Behavioral Health Treatment Plans and Notes (BHT) Order Entry (OEM) Clinical Decision Support (CDS) Resource Scheduling (RES) Quality Assurance and Followup (QAF) Clinician Access View (CAV) Incident Reporting (INC) Clinical Pathways and Guidelines (CLP) Eprescriptions (ERX)



GENERAL SYSTEM FUNCTIONS Multientity (MEN) Security mechanisms and services (SEC) Interface Engine (IEN) Screen builder (SCR) User Report Generator (URG) Intranet / Extranet user access (WEB)


SECTION VI

FORMS