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County of Santa Cruz General Services Department

Purchasing Division 701 OCEAN STREET, SUITE 330, SANTA CRUZ, CA 95060-4073 (831) 454-2210 FAX: (831) 454-2710 TDD: (831) 454-2123 ______________________________________________________________________

COUNTY of SANTA CRUZ Health Services Agency Behavioral Health Division 1080 Emeline Ave. Santa Cruz, CA 95060

REQUEST FOR PROPOSALS RFP#13P1-002

For an Integrated Behavioral Health Electronic Health Record System Due September 30, 2013 Issued by: Blanche Bettinger, C.P.M (831-) 454-2721 [email protected]

RFP#13P1-002 BH Records Mgmt Sys

TABLE OF CONTENTS: GENERAL REQUIREMENTS SECTION..................................................................................3 1.0 INTENT ................................................................................................................................3 2.0 BACKGROUND ..................................................................................................................3 3.0 CALENDAR OF EVENTS ...................................................................................................5 4.0 COUNTY POINTS OF CONTACT ......................................................................................6 5.0 SCOPE OF WORK ...............................................................................................................6 6.0 CONTRACT TERM ........................................................................................................... 94 7.0 SELECTION CRITERIA .................................................................................................... 95 8.0 BIDDERS CONFERENCE ................................................................................................. 97 9.0 SEQUENTIAL CONTRACT NEGOTIATION ................................................................... 98 GENERAL PROVISIONS SECTION GP ................................................................................. 99 GP 1.0 CONTRACT AWARDS ...............................................................................................99 GP 2.0 PROPOSAL SUBMITTALS ......................................................................................... 99 GP 3.0 PROPOSAL FORMAT AND CONTENT ................................................................... 100 GP 4.0 PROPOSAL STANDARD INSTRUCTIONS AND CONDITIONS ............................ 102 GP 5.0 AGREEMENT TO TERMS AND CONDITIONS ...................................................... 103 GP 6.0 RIGHTS AND REMEDIES OF THE COUNTY FOR DEFAULT .............................. 103 GP 7.0 INDEMNIFICATION ................................................................................................. 103 GP 8.0 INSURANCE .............................................................................................................. 104 GP 9.0 INVOICES .................................................................................................................. 106 GP 10.0 RIGHTS TO PERTINENT MATERIALS ................................................................. 106 GP 11.0 CONTRACT AUDITS .............................................................................................. 106 GP 12.0 NON-DISCRIMINATION ........................................................................................ 107 GP 13.0 INDEPENDENT CONTRACTOR ............................................................................ 107 GP 14.0 CONFLICT OF INTEREST ...................................................................................... 107 APPENDICES - LIST BELOW .............................................................................................. 112 Exhibit A REFERENCES .................................................................................................... 112 Exhibit B NON-COLLUSION DECLARATION ............................................................... 113 Exhibit C PROTEST AND APPEALS PROCEDURES ....................................................... 114

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RFP#13P1-002 BH Records Mgmt Sys

GENERAL REQUIREMENTS SECTION

1.0 INTENT 1.1

The County of Santa Cruz is requesting proposals from qualified bidders for an integrated Behavioral Health Electronic Medical Record System (System) to replace the current County Behavioral Information System. Santa Cruz County seeks an integrated solution that allows all functioning modules to efficiently interact.

1.2

Proposals will be evaluated by a selection panel to select CONTRACTOR(s) to negotiate a contract with the County.

1.3

This RFP addresses replacement and enhancement of the existing Behavioral Health Division (BHD) billing information system and those collateral systems used to manage registration, eligibility, provider or entity management, and managed care operations, and includes scheduling, claims and billing operations, and addresses the addition of an electronic medical record, based on and integrated with billing information system components, to provide a seamless, single sign-on integrated system.

1.4

The intent is to consider two options – hosting of servers on site and remote hosting with the vendor. Two cost proposals should be submitted to address these two alternatives.

2.0 BACKGROUND 2.1

The mission of the Behavioral Health Division (BHD) of the Santa Cruz County Health Services Agency is to assist Santa Cruz County citizens with mental health and addictive disorders to live in the community; and to reduce the social, legal, health, and economic consequences of mental health and addictive disorders.

2.2

BHD has multiple sites throughout Santa Cruz County, all with different equipment and hardware capabilities. There are approximately 28 behavioral health contract and civil service programs in the organizational provider network and approximately 450 individuals, groups, and facilities in the mental health provider network. All of these programs and sites provide comprehensive client services. In addition, there are community pharmacies used by behavioral health clients to fill prescriptions written by BHD physicians and nurse practitioners, and laboratories used by behavioral health clients for laboratory testing. The software must have scanless electronic capacity to order medications and lab orders.

2.3

BHD has an active unique client count of approximately 6,100 mental health clients per year and 2,500 substance abuse clients. Each year, spanning all modalities of treatment, those clients receive approximately 222,000 units of services. BHD also has a unique client count of

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RFP#13P1-002 BH Records Mgmt Sys

approximately 1,113 substance abuse treatment clients per year. These clients receive approximately 116,574 units of services per year, also spanning several modalities of treatment. 2.4

BHD programs are supported by centralized administration, quality management, claims, billing, reporting, and information technology services located at 1400 Emeline Ave, Santa Cruz, CA, 9507360.

2.5

BHD enters client registration, service, and billing information directly into separate applications in the current billing information system, Sharecare from Echo Management. Access is provided through a combination of direct LAN access using terminal emulation software on a variety of PCs. In addition, mental health civil service and contract providers at specified locations enter authorizations for care directly into the mental health managed care system.

2.6

Frequently, other divisions of Santa Cruz County Health Services Agency and the Behavioral Health Division serve the same clients. The intersection of historical and treatment issues pertinent to both physical and behavioral health makes it necessary for service providers to have access to all relevant data in order to optimize health outcomes while meeting medical information privacy requirements. It is fundamental that the software System provide the flexibility to be integrated and/or interfaced with other client services data systems within Santa Cruz County Health Services Agency. It is desirable that providers in the BHD network have access to client information and to electronic submission of claims and claims processing information. County clinics are on Epicare through OCHIN and a unique client link for shared clients is desired to make it clear when coordination of care is needed.

2.7

This RFP requests a comprehensive BHD practice management information system and those collateral systems used to manage registration, eligibility, provider or entity management, managed care operations and includes scheduling, claims and billing operations, as well as an electronic medical record, based on and integrated with billing information system components, to provide a seamless, single sign-on integrated system.

2.8

The purpose of the System is to enable effective electronic operations that facilitate provision of these services through the appropriate, cost-effective, coordinated, innovative, and useful application of information systems and Informatics within, and among, the various private and public agencies that comprise BHD.

2.9

The System will provide a true management information system to support management decisionmaking. The computer software desired will support clients as they move through registration, eligibility determination, clinical assessment and treatment. It will provide for program monitoring and business decisions by producing a comprehensive range of client, program and system information, quality management; billing; and integrated report writing.

2.10

The ultimate goal of the System is to provide a fully integrated information system that combines the functionality of the billing information system with that of an electronic medical patient record to optimize efficiency and eliminate redundancy in operations and data entry. This system should also be able to communicate to the local Health Information Exchange.

2.11

Client and service records are formatted to meet stringent State and Federal requirements then submitted as claims for reimbursement. Authorizations information is processed against claims PAGE

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received from private providers, then formatted into accounts payable and re-billed for reimbursement. The data is then formatted into an array of regulatory, fiscal, and clinical reports that provide the administrative information required for mandated reporting, and upon which Mental Health and Substance Abuse business decisions are based. 2.12

Web enabled System will provide the flexibility needed to make the system accessible across the current array of platforms. It will also provide the technological infrastructure required to make interface or integration with other Santa Cruz County Health Services Agency and State-wide data systems feasible.

2.13

Options of choosing either hosting on site or remotely with the vendor are important to the county.

2.14

The overall services and components to be acquired through this RFP encompass the following: 2.14.1 A “state-of-the-art” System that includes: practice management, appointment scheduling electronic medical records, call management, managed care, eligibility verification, electronic claims processing, Coordination of Benefits (COB)/Third Party Liability (TPL), electronic prescription and report writing components; interface capability with existing Santa Cruz County’s Financial System. 2.14.2 Automated verification to the California Medi-Cal Eligibility Data System (MEDS). 2.14.3 Electronic digital signature (client and clinical staff) functionality supporting the electronic medical record. 2.14.4 Imaging and document management services. 2.14.5 Project management, training and training documentation, data conversion and system documentation. 2.14.6 Ongoing system support and maintenance.

Bidders may, at their discretion, include in their comments more detailed components that they believe are important features of their proposed product(s). Based on an evaluation of each bidder’s response submissions, Santa Cruz County will select Bidders for further review. Bidders might be requested to participate in demonstrations. Important Note: An electronic copy of the RFP is available at: [email protected]

3.0 CALENDAR OF EVENTS 3.1

Issue RFP

August 6, 2013

3.2

Advertise the RFP

3.3

Bidders Conference:

August 23, 2013

3.4

Deadline for written questions

August 30, 2013

3.5

Proposal Submittal Deadline

3.6

Estimated Notification of Selection

August 6th & 16th 2013

2:00 p.m., Local Time, September 30, 2013 October 30, 2013 PAGE

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3.7

Estimated AGREEMENT Date

November 30, 2013

This schedule is subject to change as necessary. 4.0 COUNTY POINTS OF CONTACT 4.1

Questions and correspondence regarding this RFP shall be directed to: 4.1.1 Proposal Format and Timeline: Blanche Bettinger, C.P.M. County Purchasing 701 Ocean St. Santa Cruz, CA 95060 PHONE: (831) 454-2721 FAX: (831) 454-2710 Email: [email protected]

4.2

All questions regarding this RFP shall be submitted in writing (E-mail). The questions will be researched and the answers will be communicated to all known interested CONTRACTOR(s) after the deadline for receipt of questions.

4.3

The deadline for submitting written questions regarding this RFP is indicated in Section 3.0 CALENDAR OF EVENTS.

4.4

Questions submitted after the deadline will not be answered. communicated by formal written addenda will be binding.

4.5

Interested CONTRACTOR(s) shall not contact County officers or employees with questions or suggestions regarding this Request for Proposals without first contacting the persons listed above. Any unauthorized contact may be considered undue pressure and cause for disqualification of the CONTRACTOR.

Only answers to questions

5.0 SCOPE OF WORK 5.1

To Provide a fully integrated, flexible, comprehensive, and user-friendly Behavioral Health Information System software package that provides for registration, eligibility, provider management and scheduling, authorizations, claims and billing, placement tracking, and the development of a management information system and electronic medical record as an integrated component.

5.2

Meet all State mandated reporting requirements, including but not limited to Client Services Information (CSI), Mental Health Services Act (MHSA) Data collection and Reporting (DCR) supporting XML and California Alcohol and Drug Outcomes Measurement System (CalOMS). PAGE

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5.3

Provide a flexible and extensible Web enabled system using up to date technology.

5.4

Provide a scalable and flexible system of security on all modules that allows for client, field, and screen level security by individual, role or groups of users. Provide audit logs for each transaction.

5.5

Provide 24 hour per day/7 day per week technical support.

5.6

Provide training for appointed IS administrative staff to optimize use of in-house resources for system administration and maintenance. Provide a training version and materials of the system to facilitate training at all sites. Provide administrative level training to appointed departmental trainers.

5.7

Provide the ability to add, edit, delete data elements at the data entry forms/screens and reports levels, include the ability to add or change data field labels in the same functional areas.

5.8

Provide Billing, Eligibility, Management and Clinical modules that are compliant with HIPAA and all other applicable State and Federal security laws. As a minimum the system must meet HIPAA transaction and code set standards and include compliant security mechanisms. The System must also provide scalable end-user security levels for complete access control.

5.9

Provide suggestions for in-house staffing levels required for installation, training and maintenance of the proposed system.

5.10

Provide a training plan to include training for various roles such as Administrator, Super User, Admin. user, and clinical user. Training plan should include ‘train the trainer’ strategies.

5.11

Provide a test environment to be maintained synchronously with the production environment for use in development and testing of enhancements and upgrades to the system.

5.12

Provide a training environment to be customized and upgraded synchronously with the production environment for use in training and staff practice. (Test and training environments can be cohosted.)

5.13

Provide a replication environment to permit extensive reporting and upload tasks to various enterprise applications without impacting production environment processing.

5.14

Provide for migration or conversion of data from the legacy systems to the new system. All the data in the legacy systems is necessary for the continuation of BHD business. If such an import is not feasible, the vendor must indicate that in their proposal and provide a plan for maintaining access to the business information contained in the legacy systems. State regulations require BHD to retain and continue to use the current client identifier. The new system will have to retain and continue the current numbering system or provide an automatic crosswalk for State reporting purposes.

5.15

Provide project management support using project management methodology standards for the duration of the project.

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5.16

Place a copy of the System source code in escrow. Source code will come to the County in the event that the vendor goes out of business or declares bankruptcy.

5.17

Provide, print and on-line, a Manual of Operation for the whole system including table structure and relationship maps. One copy of your current documentation must be included with the Original proposal.

5.18

Provide an Electronic Medical Record module for Mental Health and Substance Abuse that permits each to retain individual confidentiality requirements. The Clinical Record must be available at the point of service and must contain clinical management information, including but not limited to prescription medication management, lab order capacity, and diagnostic testing information.

5.19

Provide a Behavioral Health Clinical module with the capacity for tracking services across the entire array of BHD treatment modalities, while creating customized treatment plans, managing predefined mental health and substance abuse screening assessment tools, and providing protocol based decision support.

5.20

The Clinical module must support Mental Health, Substance Abuse and Managed Care outcomes analysis, utilization review, and quality management standards. The Clinical module should feed directly into--and drive--the Billing module in order to provide accurate billing files without duplicate data entry. The clinical module must link to appropriate coding validation tables to provide accurate billing, quantifiable reporting and outcomes management.

5.21

Provide for innovations in client centric recordkeeping by providing surveys and self-assessment tools, such as symptom review and medication side effects review, that can be made available to clients to promote self-assessment, in a web based format, that can be maintained within the electronic client record and made available to clinicians at the time of client review and interview.

5.22

Provide for linkages to various community-based agencies to enable exchange of treatment related information such as prescription management and laboratory testing.

5.23

Provide a Prescription Management module capable of maintaining comprehensive client medication profiles and providing clinical decision support and alerts. This module must be capable of creating bi-lingual labels with symbols from MD orders, creating inventory control logs, and providing access to drug formulary information. This module must facilitate documentation of medication administration and dispensing at the point of service.

5.24

Provide for a Laboratory Management module capable of reporting results of laboratory tests providing clinical decision support and alerts.

5.25

Integrate the clinical record with registration, eligibility and client insurance, billing and provider management and scheduling to provide a seamless record to clinical users with the system of workflow alerts and reminders required to support and promote sound clinical recordkeeping practices.

5.26

Provide reminders of due items, e.g. pop-up of scheduled encounters with no notes after 72 hours.

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5.27

Provide To Do lists for assessments, treatment plans, notes, et al. Reminders and To Do lists should be presented in a dashboard when the user first logs in to the System.

5.28

Automated verification to the California Medi-Cal Eligibility Data System (MEDS).

5.29

Electronic digital signature (client and clinical staff) functionality supporting the electronic medical record.

5.30

Imaging and document management services.

5.31

Project Management: Training and training documentation, data conversion services and detailed system documentation so that staff understand the fundamental architecture of the data structure.

5.32

Ongoing system support and maintenance as well as an option for onsite and offsite hosting of servers and software with descriptions of each model and costs.

5.33

Functional Requirements: IMPORTANT NOTE: As you respond, please be aware that some sections contain multiple but related requirements. If you answer that you “Comply” with a given section by placing a “Y” in the column, you are answering that you comply with all aspects of that section. If there is a portion that you do not comply with, please explain that in your Response. Provide enough relevant information in the Response so that you can be fairly evaluated in all cases. Simply placing a Y in any column is not a sufficient response and will not be counted. All responses must include a description of the functionality. Wherever applicable, please reference the related section of the System documentation. Placing a Y in the Core column indicates that the functions are contained in the core system. Placing a Y in the Custom column indicates that a custom modification will be required. Placing a Y in the 3rd Party column indicates that the function(s) will be provided by 3rd Party software.

5.34

Access: Initial contact with the county systems generally happens in one of three ways: by phone; by direct contact with a county clinic; or via direct contact with a contracted provider. Clinics and providers may be office or street-based and contacts may be routine, urgent or emergent. The county desires the ability to deploy call center functionality at each of these contact points and contact types. Staff at these access points needs software that supports real-time data editing and data entry while they are on the telephone or face to face with a client, prospective client, or related party. The system supports a seamless handoff of crisis contacts to crisis workers and requests for routine care to outpatient clinics via linkages to these portions of the software. This section contains functionality related to how the “front door” needs to be managed including call logging, provider referral, crisis triage, etc.

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5.34.1 Call Logging Req #

Requirement

5.34.1.1

All calls are logged into a user-defined online form that gathers information on the nature of the call and basic caller data such as date of call, staff receiving call, name, telephone number, language requirement, referring party, etc. The system will email the person the call is directed to.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Response:

5.34.1.2

If the call is not a request for service, basic information is collected regarding the type of call and disposition. If the call is about a complaint, compliment or grievance, all relevant data is recorded on the online form. Recording and reporting of disposition is included in all cases. Call logs must be easily retrievable and sortable by client, staff member, date, call type, disposition, etc. The online form should be formatted to be used as the “official” form to be sent to the Access Team.

Response: 5.34.2 Pre-Registration Req #

5.34.2.1

Requirement Provides user-defined online pre-registration forms to gather initial client demographic, financial resources information, and the name of the program (in-house or contractor) where the client made initial contact requesting a specific service.

Response:

5.34.2.2

If the client becomes registered for service this information can be forwarded to Registration so that duplicate data entry is not required. If the client is already registered as a client in the system this should be flagged.

Response: 5.34.3 Intake Screening Req # 5.34.3.1

Requirement Provides user-defined online client screening forms to assist in the determination of whether the client requires

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services from the crisis system, hospitalization, referral for outpatient services, or referral to other community resources. Includes access needs information, presenting problems and other relevant clinical information. Response:

5.34.3.2

Intake screen must provide the ability to track referral source. Referral source, such as Courts, Probation, physician, is often tracked even if the client has not presented for services. The system must support reporting on referrals.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(b) Custom

(c) 3rd Party

Response: 5.34.4 Referral Management Req #

Requirement

(1) Comply

(a) Core

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system contains detailed provider profile information for clinicians working at county clinics, independent providers in the provider network, and at 5.34.4.1 contracted provider organizations. Clients can be matched to clinicians based on multiple variables in the Provider Registration Database. Response: Req #

5.34.4.2

Requirement This includes information about provider location, specialties, non-English language capability, whether the provider is opened/closed to new clients, etc. The system should support the issuance and tracking of service referrals by county to members of their internal and external provider networks, which are compliant with the ASC X12N 278 - Referral Certification and Authorization format.

Response:

5.34.4.3

Users should be able to customize the referral management screens, including the sort and selection criteria, as well as referral letters that can be sent to clients and providers. It should be possible to upload information electronically to the Provider Registration Database. This component is closely linked to the Authorization Management system, described in section 3, when a referral is made and the county is responsible for payment of the services associated with that referral.

Response:

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5.34.5

Community Resource Database (1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system should be able to track and sort prospective clients by priority to assist in moving individuals into service in the proper order. Information on the wait list screen can be updated as additional data is gathered or 5.34.6.2 client circumstances change. It should allow userdefined reminders about Notice of Action deadlines if the request for an assessment goes beyond 14 days for both contractors and in-house staff. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system must generate Request for Service logs, which are available to the State and show the status of 5.34.6.3 clients on the wait list at a given point in time. System must have the ability to print historical wait-list reports for any period of time for which there is data. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

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Req #

Requirement

Allows for the uploading or manual entry of community 5.34.5.1 resources into a searchable database that can be filtered based on user criteria. Response: County should have the option of storing these entries in the provider referral database in ways that keep these 5.34.5.2 records separate from the listing of network providers, or in a separate table that has the same lookup and tracking capacities of the provider referral database. Response: 5.34.6 Wait List Management Req #

Requirement

The system supports the ability to enter prospective clients on a wait list if space is not available for them at a provider that can meet their clinical needs. All wait listed clients will be entered into a user-defined online 5.34.6.1 form that gathers information such as date of entry, referral type, reason for wait list, priority, expected appointment date, etc. The wait list should tell who the consumer is waiting for (multiple entries). Response:

RFP#13P1-002 BH Records Mgmt Sys

5.35

ELIGIBILITY VERIFICATION

State of California is using sophisticated, automated eligibility processes to ensure that client eligibility is current and accurate. This section describes, in some detail, the expectations that the county has for supporting the first step in the county billing cycle. Eligibility verification is an important module that is used in several other modules including Managed Care and Practice Management. 5.35.1 Insurance Eligibility Loading (1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system assures that all eligible enrollees have a new record added to the county system for Medi-Cal eligibility 5.35.1.2 each month, including all retroactive additions to MediCal. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The eligibility system should maintain eligibility records for all county "eligibles" in the state monthly download file, not just individuals who are enrolled as clients. Similar eligibility loading and processing capabilities should be available for Medicare and health plans with whom the county contracts. It is expected that prior to implementation the vendor and the State of California 5.35.1.3 will be compliant with the ASC X12N 270/271 Eligibility for a Health Plan and ASC X12N 834 Enrollment and Dis-enrollment formats.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Req #

Requirement

The system supports monthly loading of the Medi-Cal Eligibility Determination System (MEDS) files from the 5.35.1.1 state. Accounts added with retroactive eligibility should be matched with existing Treatment Authorization Requests (TARs) already in the System. Response:

The System should be able to process other payer eligibility from the Meds screen. Response: 5.35.2 Automated Insurance Eligibility Determination Req #

Requirement

Each month, or at a frequency to be determined by the county, the eligibility of registered clients should be 5.35.2.1 evaluated against the downloaded eligibility files and updated as necessary based on a matching algorithm.

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Response: When the process identifies clients where no prior eligibility had been determined or where the eligibility 5.35.2.2 status has changed, including retro-active updates for clients previously served, users will have the option of updating client insurance records automatically. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The process should include assigning or updating the cascade level of insurance plans that have been changed 5.35.2.3 for a client, identifying clients who have lost their insurance coverage, and determining how previous billings should be adjusted. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system shall also support on-line review and automatic update of insurance records for clients with various special handling conditions including: a partial eligibility match requiring investigation, Medi-Cal Share of Cost responsibility, UMDAP, CalWORKs, indigent, 5.35.2.4 other state aid codes, Medicare, private insurance, and Medi-Cal clients with a different responsible county. Changes made through the automated insurance eligibility determination process should be supported with a complete audit trail. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

5.35.3 Real-time Eligibility Verification (1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system should allow a user to poll the system and 5.35.3.2 then easily update a client’s eligibility and insurance coverage records if the coverage has changed. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

For Medi-Cal clients this includes validation of eligibility with an Eligibility Verification Code (EVC), which is maintained in the Client Payor Table. This process 5.35.3.3 should also include the capability of clearing Share of Cost via the software system and automatically updating the State MEDS file.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

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Req #

Requirement

The system should support a real-time interface to the Medi-Cal Point of Service MEDS database for viewing a 5.35.3.1 client’s current eligibility status for Medi-Cal and other included payors. Response:

RFP#13P1-002 BH Records Mgmt Sys

Response: 5.35.3.4

The system should produce an exception report of clients with Medi-Cal Aid Codes that specify limited/restricted services.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Response: 5.35.4 Eligibility Lookup Access (1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports multiple eligibility to ensure that 5.35.4.2 ineligibility for one service will not necessarily override eligibility for other services. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports client/patient eligibility for a variety of funding/plan programs including but not limited to: Medi-Cal, and Medi-Cal Share of Cost, Medicare, Medi5.35.4.3 Cal/Medicare crossover, Private Insurance, Healthy Families, UMDAP, CalWORKs, indigent, non-indigent, Child Welfare Services, and Enhanced Services. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports ability to list the services for which the client/patient is eligible and authorized, ability to indicate share-of-cost and co-pay information by plan/program, ability to indicate evidence of client/patient 5.35.4.4 income source, ability to allow a variety of client/patient income verification practices depending upon the service and ability to flag plan/program recipients services that is the responsibility of another county. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Ability to permit authorized staff to print or display language specific bi-lingual enrollment letters and provider change letters. 5.35.4.5 While this is stated as a requirement in Eligibility Lookup Access, bilingual support for printing is a System-wide requirement. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Req #

Requirement

The system supports easy access to a client’s eligibility records for eligibility lookup from various components and modules including Call Logging, Appointment 5.35.4.1 Scheduling, Registration, etc. System should match patient eligibility to possible services and programs. Response:

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Ability to indicate the current diagnosis of the 5.35.4.6 client/patient for Substance Abuse Service based on diagnosis. Response: 5.36

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

CARE MANAGEMENT

As providers of Mental Healthcare and Medicaid health plans, County has the responsibility to manage the quality, access, utilization and cost of services that are provided to eligible populations. This section describes the crisis, outpatient, and 24-hour care management requirements of the county 5.36.1 Crisis Plans Req #

Requirement

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Supports the development of a user-defined online Crisis Management Plan that is generally prepared by the client 5.36.1.1 and their coordinator. If a client goes into crisis this plan is easily accessible to provide guidance to staff on the care team and other providers who have contact Response:

5.36.2 Crisis Tracking and Management Req #

Requirement

Provides user-defined screens for tracking crisis episode data including date and time of first contact, referral source, clinical notes about the crisis including userdefined checklists and text-based crisis notes that allow 5.36.2.1 for the recording of diagnosis, level of functioning and other relevant clinical data. Also tracks and allows easy viewing of the services provided to include the amount of time spent with the client during the crisis episode Response:

5.36.3 Authorization Management Req #

Requirement

5.36.3.1

Allows for the creation, approval/deferral/denial, issuance, letter generation, tracking and closing of a variety of authorization types (e.g. acute inpatient, residential, outpatient, day treatment), which constitute

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

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16

RFP#13P1-002 BH Records Mgmt Sys

discrete episodes of care, compliant with the ASC X12N 278 - Referral Certification and Authorization format. This includes: o County-Issued Internal Authorizations for clients served at county clinics; o County-Issued External Authorizations for clients referred to providers in the provider network as part of the county’s role as a Medi-Cal mental health plan; and o Health Plan-Issued External Authorizations to the county from other health plans and managed care companies, which are approving services to be provided by county staff or contractors. The system is compatible with multiple payment methods for services provided under an authorization including fee for service, case rate, per diem, etc. Response:

5.36.3.2

The system should support several methods of setting, tracking and providing reminders of service limits for each type of authorization including number of visits or days, number of client or clinician service hours, number of days or weeks, specific service codes, service codes clusters, or specific dollar limits.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The option should exist for linking specific authorization types to insurance plans to aid in the utilization management of those authorizations. As service is provided, actual services are compared with authorized amounts and the system has multiple ways of notifying providers and utilization managers of remaining balances and impending authorization expirations, including during data entry, regular reports and various ticklers.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The authorization system supports user-defined rules for determining whether provider payment for unauthorized services will be pended or paid and whether these services will be billed to a third party payor. Linked to MEDS system for automatic updates.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

If authorizations are denied because medical necessity has not been met, or if a level of care request is reduced,

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

PAGE

17

Response:

5.36.3.3

Response:

5.36.3.4

Response: 5.36.3.5

RFP#13P1-002 BH Records Mgmt Sys

the system will generate the appropriate Notice of Action letter to the provider and client, alerting them of the denial/reduction and informing them of their due process rights. Response: The system supports Bilingual "Notice of Action" and other service denials to clients/patients based upon coded reasons and generate printed copy of the Service Authorization and/or Treatment Authorization Request (TAR)

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports verification of program/service/plan authorized, encumbered amount to responsible county, narrative comments regarding authorized treatments of services.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports service authorizations for courtordered or other Child Welfare related, mandated services that may not include specific diagnosis. Therefore, the system should permit the “diagnosis” field to be blank when Child Welfare Services (CWS) activities are authorized.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports warning messages that alert the authorizing agent when authorized services are nearly depleted, based on user-defined thresholds.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system captures patient financial liability at the time of authorization/referral and allows update of 5.36.3.10 (renewal) client/patient record and authorizes additional services or treatment when required for qualified clients/patients. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system captures service authorization for, but not limited to: indigent, non-indigent, Uniform Method of 5.36.3.11 Determining Ability to Pay (UMDAP), Medi-Cal, Medicare, Santa Cruz County Mental Health Plan (MCMHP), CalWORKs, and Healthy Families. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports a lockout of individual, organizational, and private provider services for Medi5.36.3.12 Cal/Medicare crossover cases, override of lockout by authorized staff perhaps based on the security level, and services identification that can or cannot be

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

5.36.3.6

Response: 5.36.3.7 Response:

5.36.3.8

Response: 5.36.3.9 Response:

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18

RFP#13P1-002 BH Records Mgmt Sys

reauthorized. Response: The system supports authorized staff to add, change, or delete procedure codes within an individual 5.36.3.13 authorization and look up and list those services for which the client/patient is authorized. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

5.36.4 Other Care Management Req #

Requirement

The system supports ability to allow authorized staff to print or display the Terms & Conditions of a 5.36.4.1 client's/patient's probation (common with Probation Department). This can be part of care plan or appendix. Response: List of intensive need mental health clients/patients. Ability to maintain a "Hot List" of at-risk clients/patients, which could be accessed electronically 5.36.4.2 by staff at all times, and a priority list of at-risk clients/patients Response:

5.36.5 Inpatient Tracking and Management Req #

Requirement

Provides user-defined screens that meet California CSI and County requirements for tracking key inpatient data including date of admission, referring provider, inpatient coordinator, treating psychiatrist, outpatient 5.36.5.1 authorization type, outpatient coordinator, and date of discharge, admit and discharge diagnosis, legal status, seclusion, restraint, grievances etc. Automatic link to the state’s system. Response: The system supports the entry, creation and compliance tracking of the California Treatment Authorization 5.36.5.2 Requests or similar locally defined authorization or notification forms, which are generated for inpatient admissions and submitted to the State’s inpatient fiscal

PAGE

19

RFP#13P1-002 BH Records Mgmt Sys

intermediary or similar party. Response: Ability to enter assessments and progress notes directly 5.36.5.3 into the computer and upload data into clients/patients efile using mobile computing technology. Response:

5.37

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

PAYOR/PROVIDER RELATIONS MANAGEMENT

Santa Cruz County serves as both provider and the managed care organization for the Santa Cruz County Mental Health Plan (MHP). The MHP is responsible to provide quality mental health services to Santa Cruz County Medi-Cal beneficiaries through a network of County and contract mental health providers. The objectives are to provide a choice in service providers, increase the number of Medi-Cal clients served, timely access, positive outcomes and excellent provider relations. This section describes the provider relations, process and monitor provider claims, and management functional requirements of the County. 5.37.1 Provider Registration/Enrollment Tracking and Credentialing (1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system needs to support the ability to manage both contracted clinicians who are part of the external provider network and employee clinicians who staff the county clinics, 24-hour facilities, and community-based programs.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system must establish or use (such as NPI) one unique provider identifier generated by the System or user-defined numbering methodology to identify County and contract providers. This number identifies all locations, provider types, provider specialists, licensing for services, electronic clearinghouses and other required data for that provider as a logical record.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system should support the collection of several user-defined clinician characteristics such as:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Req #

Requirement

5.37.1.1

The system must support the development of userdefined screens to register, track and report on provider organizations, individual clinicians and program staff (clinical and non-clinical) that contract with the county as required for service delivery and to monitor/track mandated training.

Response:

5.37.1.2

Response:

5.37.1.3

Response: 5.37.1.4

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20

RFP#13P1-002 BH Records Mgmt Sys

practice/geographic location, licensure, language, days and times worked, specialties, languages spoken, taxonomy code, capacity, and open/closed to new clients. It should also support the credentialing of individual clinicians (internal and external). Response: 5.37.1.5

Encourage provider self service to access and update information on-line to the greatest degree possible or execute on-line request for updates approved by designated staff.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Credentialing and certification data should include effective and expiration dates for such information as license, DMH waiver, and contracts. When provider organizations and clinicians are registered, the system supports the assignment of providers to specific fee schedules, specific health plans, specific programs, procedure codes, or groupings of these attributes in a manner that is easy to set up and manage on an ongoing basis. Findings from queries of databanks (i.e., LEIE, NPDB, EPLS, Medi-Cal Suspended and Ineligible Provider List) should be retained as data elements.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system should contain user-defined fields such as provider identifiers (NPI, UPIN, Medi-Cal provider number, PIN, DEA, etc.) and provide a tracking of changes made to provider information for both Network and County employed providers.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Response:

5.37.1.6

Response:

5.37.1.7

Response: 5.37.1.8

Ability to define procedures and diagnoses a provider is allowed to render under a provider’s license

Response: Req #

Requirement

5.37.1.9

The system should support ability to track and retain history on provider license, DEA, professional liability insurance, print expiration letter to provider (i.e. licensure, DEA, professional liability insurance), determine provider or staff eligibility for Countysponsored training, verify providers are re-credentialed by required date, track data by invoice-processing information (i.e. Tax ID/Agency/Provider Name), determine appropriate code/rate for invoice processing, determine if provider has been sent current handbooks and other materials, determine receipt of required documentation from provider handle rate differentials PAGE

21

RFP#13P1-002 BH Records Mgmt Sys

between service authorization and claims payments based on provider and plan/program, Identify and track providers authorized to perform specific services based on plan/program, service plan or payor. History should identify the staff person making such changes. Response: The system should generate a monthly or on-demand 5.37.1.10 Provider Directory for both County and contract providers to include user-requested data fields Response: The system should support verification status 5.37.1.11 (active/inactive) of providers and track type of provider (Out-of-County/Credentialed/Organizational). Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Ability to generate tickler files, flag or identify a provider and notify the Provider business unit when a 5.37.1.12 license status update has been received, license or credentialing is due to expire, mandated training not completed, etc. Response

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Expired licenses, lapses in credentialing/recredentialing, ineligible provider status, contract 5.37.1.13 termination dates, and other user-defined criteria should serve as system edits during data entry of authorizations or service data. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Ability to access all current and historical provider data on-line with inquiry capability by (but not limited to): provider ID number, name or partial name, SSN, EIN, 5.37.1.14 License No., Medicare cross-reference number and the ability to use other factors to limit the search and insure duplicate numbers are not assigned. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Ability to reactivate inactive providers, either manually or automatically

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

5.37.1.15 Response:

Ability to define types of provider contracts (i.e., 5.37.1.16 individual provider, group provider, organizational provider, other) Response: Ability to identify the type of provider ownership 5.37.1.17 arrangement and transfer provider ownership without re-entry of duplicate information Response:

PAGE

22

RFP#13P1-002 BH Records Mgmt Sys

Ability to process changes in provider ownership in which a new owner assumes liability for all activity 5.37.1.18 performed by the provider prior to the ownership change. Response: Ability to identify, cross reference, and link one provider owner to many rendering providers and one 5.37.1.19 rendering provider to many owners (i.e. licensed individuals practicing as a group) Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

5.37.2 Certification/Re-Certification of Facilities Req #

Requirement

The system must support Contract facilities to include information required for Medi-Cal site certification and 5.37.2.1 re-certification, effective/expiration dates of program services, Medi-Cal provider number tracking, etc.

5.37.3 Claims Receipt and Processing Req #

Requirement

5.37.3.1

The system supports the electronic receipt and manual entry of provider submitted ASC X12N 837 - Health Claims or Equivalent Encounter Information by contractor staff with system security safeguards and secondary review and approval for System uploads by County staff.

Response: Req #

Requirement

5.37.3.2.

The system automatically adjudicates claims on a per claim basis. Claims are adjudicated based on userdefined rules including payor eligibility, whether other insurance plans are primary, the existence of an appropriate authorization, coverage for the specific service, service by an authorized provider, covered diagnosis, etc. System-generated errors reports of charges not passing system edits should be generated on-line for correction.

Response:

PAGE

23

RFP#13P1-002 BH Records Mgmt Sys

Ability to apply service limits across different claim lines, regardless of claim form type.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Ability to audit claims based on duplicate check criteria across multiple claim lines regardless of claim form type, as defined by the user.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system generates electronic and hard copy reports using the ASC X12N 835 - Healthcare Payment and Remittance Advice format.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Most claims received for processing from providers are passed along to the system’s billing module so that the county can bill the appropriate payors, including MediCal

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system allows for pending claims for review or to deny the claims if they do not have an appropriate authorization in the system, exceed the authorized service levels or were provided before/after authorization period without manual intervention.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The user can choose to include or exclude denials and pended claims from Remittance Advice reports and other county-defined electronic transfer files that may 5.37.5.41 be necessary. All claims can be easily viewed via userdefined sort and select options (e.g. by provider, by client, by payor) and view claims display key information including claim status. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system provides appropriate operations reports to support claims receipt and processing including preadjudicated batch reports, exception reports, suspended claims, claims ready for payment reports, etc. Operation reports should retain historical record of each person who works on a claim or initiates an update to a field.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system provides reports to identify data entry staff productivity, error rates and manage staff workloads

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

5.37.3.3 Response: 5.37.3.4 Response: 5.37.3.5 Response: 5.37.3.6 Response:

5.37.3.7

Response:

5.37.3.9

Response: 5.37.3.10 Response:

PAGE

24

RFP#13P1-002 BH Records Mgmt Sys

5.37.4 Claims Payment and Adjustment (1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Ability to maintain Other Health Coverage data elements as needed to bill Medi-Cal as secondary payor.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Adjustments will be included in the Remittance Advices for specific providers/facilities. All entries, including 5.37.4.4 reversals, should be maintained in history, viewable, and reportable. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports the entry of payment and denial information from providers related to coordination of 5.37.4.5 benefits where the county is not the primary payor; in many cases, this is required prior to county payment of their secondary or tertiary responsibility. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Req #

Requirement

In some cases county will be using the claims processing module to cut checks to providers and the system should have an accounts payable module to support this 5.37.4.1 activity. In other instances Santa Cruz County will require only the generation of accounts payable invoices for entry or electronic files for transfer to the county accounting system. Response: The system should produce paper and electronic Explanation of Benefits (EOB) and offer flexibility for user-defined letters to accompany EOBs. The system supports the entry of claim adjustments where claims 5.37.4.2 that have been entered, adjudicated, deleted, approved and paid can be reversed and credit balances cleared, while retaining the historical audit trail with userdefined parameters. Response: 5.37.4.3 Response:

5.37.5 Claims Payment History Req #

Requirement

History is maintained by vendor for all claims processed through the claims processing module. Contract number 5.37.5.1 and service/dollar limits can be tracked by vendor and payor source and processed claims can be applied PAGE

25

RFP#13P1-002 BH Records Mgmt Sys

against those limits. Response: Summary level payment data which is automatically updated after each claims processing payment cycle by 5.37.5.2 calendar week-to-date, month-to-date, year-to-date and state and federal fiscal year-to-date totals by provider, group of providers, etc. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Users can view vendor summary and detail information. 5.37.5.3 Information is tracked and can be reported by date of service and claims paid date. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

5.37.6 Multiple Contracting Schemes In the roles of health plans and managed care entities, Santa Cruz County has multiple contracting schemes with organizational and individual members of their provider networks. Req #

Requirement

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system should support multiple contractor agreements that include services funded by multiple payors with differing benefit designs and multiple provider reimbursement systems such as single case 5.37.6.1 rate, fee for service, capitation, and fixed fee payments. Different benefit designs will include or exclude certain services based on diagnosis, coverage, or other attributes. Response: A single provider can have multiple fee schedules based on health plan coverage or population served, including enhanced rates for services based on county-specific 5.37.6.2 criteria such as language. Fee schedules have start and end dates, with history saved to support proper payment of late claims submitted after the end date of a given fee schedule. Response: The system should support multiple providers under a 5.37.6.3 single Master Agreement with a unique fee schedule. Response:

PAGE

26

RFP#13P1-002 BH Records Mgmt Sys

5.37.7 Provider Communication Management Req #

Requirement

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system has the ability to record and track communications with provider organizations and individual clinicians including the recording and tracking of notes related to provider requests and complaints as 5.37.7.1 well as contacts initiated by county staff. The system includes a tickler system for ensuring follow-up of outstanding items and includes data fields required for MHP reporting. Response:

5.37.8 Monitoring Business Processes Ability for user to define workflows that control who and when (sequence) business processes are performed (i.e., initial service request, assessment, authorization 5.37.8.1 requested, authorization approved/denied, treatment duration, types of service, crisis episodes, reauthorization requested, reauthorization approved/denied) Response:

5.38

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

ADMINISTRATIVE WORKFLOWS

The practice management/administrative workflow functions incorporate a variety of activities that are necessary to identify and register new clients; admit, track services and discharge clients from admissions to particular sites. In addition, this functional area includes client and resource scheduling; and gathering basic financial information needed for billing operations. It is important to recognize that these traditional “practice management” type functions vary far beyond the clinic model where clients make and keep regular appointments. Rather, services are provided in inpatient, residential, day treatment, adult and juvenile criminal justice facilities, schools, and a wide variety of community-based settings. A significant percentage of services are not delivered on a scheduled basis. The system also requires flexibility to accommodate non-traditional mental health services including services related to psycho-social rehabilitation and wraparound services. In each county there are a variety of organizational providers that deliver a wide variety of services and each county has the authority to design its systems of service delivery and care management. The majority of state and federal funds are channeled through funding streams: PAGE

27

RFP#13P1-002 BH Records Mgmt Sys

Specialty Mental Health Services (SMHS), which is managed through the California Department of Mental Health.

5.38.1 Client Lookup/Immediate Inquiry (1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system uses sophisticated identifier matching techniques including Soundex or similar algorithms to identify the client. If the client is new to the system, the client can be added using the registration process.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The inquiry process includes the identification of the client’s status, which is user-defined and can include values such as pre-registered, enrolled, wait-listed, discharged, etc.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The client status should be automatically updated whenever a change of status occurs. An easily accessible, user-configurable summary screen displays key “at-a-glance” information for a client including basic registration data, urgent Red Flag information, language requirements, Medi-Cal/insurance eligibility, pending appointments and dates of last service.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports the development of user-defined screens, which include federal, state, and local registration fields in addition to the core fields in the vendor’s system.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system must capture data for California-specific systems, including but not limited to: Client and Service Information (CSI) including Client Master File, Periodic, Record Control, Mental Health Services Act (MHSA) and Submission Control data elements; California Alcohol and Drug Outcomes Measurement System (CalOMS) data elements.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Req #

Requirement

5.38.1.1

The system supports rapid inquiry to determine if a client is new to the system. Inquiries may be made by name, partial name, alias, birth date, social security number, CIN, account number, ethnicity, other query criteria or any combination of criteria.

Response: 5.38.1.2 Response: 5.38.1.3 Response:

5.38.1.4

Response: 5.38.1.5 Response:

5.38.1.6

Response: PAGE

28

RFP#13P1-002 BH Records Mgmt Sys

5.38.1.7

The system must also retain the history of previous but not limited to: address, phone, eligibility, AKA (Also Known As), & record number. The system must allow look up/report access to demographic information

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system must indicate on the registration screen a prompt for data entry of missing information, allow ability to include an "alert” screen for missing or incomplete data; allow an open text section to permit staff to enter other reminder information, ability to link "clients/patients" with "cases", grouping several clients/patients, family members, etc., together; ability to identify variations in name such as: AKA (Also Known As) and Soundex (sounds like).

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Response:

5.38.1.8

Response: 5.38.1.9

The system shall track staff members assigned to case.

Response: 5.38.1.10

Ability to use a Driver's License number as a traceable field

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Response:

5.38.2 Duplicate Checking and Merge Req #

Requirement

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

When it is determined that a client has erroneously been registered with two identities the system supports a 5.38.2.1 function which will allow a system manager to merge the client data including all services, charges, payments, adjustments and accounts receivable balances. Response: A single ID number will be retained and all data from the incorrect ID number will be merged. A history of past 5.38.2.2 merged records will be retained for system manager inquiry. Response:

5.38.3 Financial Information (see Billing Requirements) Req #

Requirement

PAGE

29

RFP#13P1-002 BH Records Mgmt Sys

A financial assessment process collects all standard eligibility information from clients. Authorized users collect information required for Medi-Cal, Medicare, and Third Party Insurance. During the financial assessment 5.38.3.1 process, the system makes on-line access to Medi-Cal eligibility data to determine Medi-Cal eligibility. If the consumer is no longer Medi-Cal eligible, the system will reject the claim and move on to consider the next payor in the stream. Response: The system collects income, various categories of expense, family size, family member information, and assets to comply with the Uniform Method to Determine 5.38.3.2 Ability to Pay (UMDAP). The financial assessment process prompts for and can produce printed forms to be given to clients at the conclusion of the financial assessment. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system allows the ability to calculate differential pricing/payment based on the program/plan providing the 5.38.3.3 service. It also recommends program/plan to fund services based on client/patient needs and eligibility. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

5.38.4 Sliding Scale (see Billing Requirements) Req #

Requirement

The system can be configured to support multiple sliding scales including annual deductible, percentage allowances, etc. Financial Information collected in item 5.38.4.1 5.4 is used to place the client on the appropriate sliding scale and calculate the client and family financial responsibility. Response: Scales consistent with local requirements and California regulations can be configured including the Uniform Method to Determine Ability to Pay (UMDAP). The 5.38.4.2 system should provide the flexibility to accommodate a change in financial status and sliding scale liability with an effective date of the change. Response:

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RFP#13P1-002 BH Records Mgmt Sys

5.38.5 Medical Eligibility Referral Support Req #

Requirement

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system provides a financial assessment screening process that collects appropriate information regarding indigent clients who may be potentially Medi-Cal, or Healthy Family eligible. Potential eligibility criteria may 5.38.5.1 be configured by the system administrator in support of current California eligibility criteria. When clients match the potential criteria, the financial interviewer is advised immediately and a potential eligibility referral letter to the local Social Services Office is prepared by the system. Response:

5.38.6 Admission-Discharge-Transfer (see CSI requirements) Req #

Requirement

(1) Comply

(a) Core

(b) Custom

(a) Core

(b) Custom

(c) 3rd Party

Clients may be admitted to and discharged from organizational providers through a user-defined online admission/discharge form, which can be customized for 5.38.6.1 different types of provider organizations. Admission and discharge data will be collected and the system updated to meet the requirements of the Client and Service Information (CSI). The form will be printable. Response:

5.38.7 Intake Assessment Req #

Requirement

(1) Comply

(c) 3rd Party

The system offers various standard intake assessment 5.38.7.1 instruments including optional 3rd party licensed assessment tools. Response: The system also supports the creation of user defined intake assessment forms. The intake forms can be designed to display current data in the system, such as 5.38.7.2 demographic items. The intake form can be designed to include various types of data including: free text, multiple choice, and drop down menu items.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Response: PAGE

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RFP#13P1-002 BH Records Mgmt Sys

5.38.8 Diagnosis Management Req #

Requirement

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system accepts either DSM IV or ICD-9 diagnoses as determined by the system administrator. System 5.38.8.1 must also be maintained in order to support future standards, such as DSM V and ICD-10. Response: (1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports common inquiries such as “find first available appointment for the next Dr. X”. It will have the ability to check multiple doctors. Staff profiles of availability can easily be maintained, noting available and non-available hours. Daily rosters of appointments and “chart pull” lists can be generated on demand.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system should have the flexibility to allow appointment scheduling several months in advance to accommodate medication management and other services that are scheduled in.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system should also have the functionality to allow for entry of recurring appointments. Appointments can be made for clinicians, rooms, other facilities, vehicles, etc. Integration with commonly available appointment scheduling or calendaring software would be desirable.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports cross-walk tables to translate the diagnoses from one classification scheme to another. It 5.38.8.2 can also track multiple diagnoses based on user-defined criteria, such as admission diagnosis and discharge diagnosis. Response:

5.38.9 Appointment Scheduling Req #

Requirement

5.38.9.1

The system offers a full appointment scheduling system which allows for rapid entry and retrieval of client appointments with staff. The system is designed to support a front-desk environment that is common to busy public sector clinic settings.

Response:

5.38.9.2

Response: 5.38.9.3 Response:

5.38.9.4

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RFP#13P1-002 BH Records Mgmt Sys

Response: 5.38.9.5

The system supports ability to automatically schedule appointments integrated with client/patient service records.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system must support complex scheduling for a variety of one-on-one, co-clinician, single clinician group, and multi-clinician group appointment types.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports ability to permit different methods of appointment scheduling, not limited to: location, unit of time and service to be performed: Individual, Group, & Medication Support.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports the ability to generate: appointment list for current business day, appointment list for future business days, confirmation lists for staff to call and confirm the appointment on the business day prior to the appointment, confirmation of appointment status electronically, doctor/patient canceled, patient no show, appointments kept, ability to hide appointment for sensitive cases, master appointment calendar showing a client's/patient's other appointments for other programs within the system, waiting list of clients/patients needing to be scheduled in the next available slot. It should do this for patients who have not been registered as well. The system should prompt the scheduler for these events.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports the ability to indicate to staff the method of payment in a "drop-down" box with choices, include a text field to allow staff to enter notations and/or pertinent information to be conveyed to the client/patient, permit simultaneous appointment scheduling for multiple providers, indicate the client's/patient's special requirements prior to appointment (i.e. primary language, preferred language, hearing impaired, physically challenged) and a tickler to remind staff of follow-up appointments.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The System must support the ability schedule by providers, ability to intentionally double-book (clients/patients/provider), ability to generate notice of pre and post appointments, indicate bilingual, indicate confidentiality.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Response: 5.38.9.6 Response: 5.38.9.7 Response:

5.38.9.8

Response:

5.38.9.9

Response:

5.38.9.10

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RFP#13P1-002 BH Records Mgmt Sys

Response:

5.38.9.11

The System should have the ability to initiate electronic calls to remind client/patient of an upcoming appointment. Automatic calling must be HIPAA compliant and calls should be in the language of choice, as stored in the patient demographics.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Response:

5.38.10Service Entry (1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system must also support a variety of data entry methods that are typically performed by non-clinical support staff. This data may be entered from various 5.38.10.2 paper documents, or imported electronically. Data entry methods are designed to allow maximum efficiency for contracted services such as Inpatient Hospitals, IMDs and SNFs. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Each Direct Service should be able to use the applications 5.38.10.3 core components as defined in the RFP (Example scheduling, eligibility and authorization.) Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports ability to track and report on all county provided services to clients/patients but not limited to: demographics, programs, sub-programs, 5.38.10.4 location of service, service type, units of service, costs and other data as described in the data dictionary or by the functional requirements at the time of implementation. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Req #

Requirement

The system must be configurable to meet the California billing requirements, including collection of minutes of 5.38.10.1 service, co-clinician information, and the number in a group for outpatient services. Response:

5.38.11 Indirect Services Req #

Requirement

5.38.11.1

The system offers the ability to record a variety of staff services that are not linked to individual clients. The PAGE

34

RFP#13P1-002 BH Records Mgmt Sys

nature of such services is configurable by the system administrator. They may include education, prevention and various community services for persons who have not been registered as clients. A variety of over-head activities including administration, supervision, training, QI, MAA record keeping and other activities may be tracked by staff persons. Response:

5.38.12 Incident Tracking Req #

Requirement

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system administrator can create a variety of critical incident types that can be easily entered and retrieved. Follow-up responsibility and other configurable fields 5.38.12.1 allow local policy for incident reporting to be supported by this system feature. Administrative alerts can be configured in coordination with the incident tracking function. Response:

5.38.13 Policy and Procedure Documentation Req #

Requirement

The system includes the ability to load, search and retrieve documentation related to local policies and procedures. These policies and procedures can be linked 5.38.13.1 to the related data screen entry screens. All policy and procedure information can be edited and managed using Microsoft standard text processing capabilities. Response:

5.38.14 Alias Names Req #

Requirement

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

During the registration process, the system will cross check name inquiries to identify alias names. Clients 5.38.14.1 may have multiple alias names as well as other multiple Personal Identifiers such as Dates of Birth (DOB), Social Security Numbers, etc. PAGE

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RFP#13P1-002 BH Records Mgmt Sys

Response: 5.38.14.2

The system should allow the clinical supervisor the opportunity to read the content of the notes prior to filing.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Response:

5.39

PRACTICE MANAGEMENT BILLING AND ACCOUNTS RECEIVABLE

5.39.1 State of California Billing Structure Req #

Requirement

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(a) Core

(b) Custom

(c) 3rd Party

The system must provide a data structure to capture legal entity, mode, service function code and procedure code. 5.39.1.1 Provider code must support NPI standards. The agency may be county operated or a contract facility. All such organizations or entities will have a provider code. Response: Ability to maintain a Procedure data set which contains Local codes, HCPCS codes, CPT codes, Modifier codes, ICD-CM codes, and CA State Medi-Cal service mode and service function. Ability to maintain a historical record of all changes to any code set attribute. This includes the source of the change, date, time, data entry person and version.

(1) Comply

The procedure data set will contain, at a minimum, elements such as: 1. Procedure code data with date-specific pricing segments effective begin and end dates, and allowed amount for each segment. 2. Procedure code data with status 5.39.1.2 (active/inactive) code segments with effective begin and end dates for each segment. 3. Coding values that indicate if a procedure is covered by Medicaid or other programs. 4. Numerous parameters used in claims processing including, but not limited to: CA DMH provider type/profile, specialty, subspecialty, recipient age/gender restrictions, Prior Authorization required, once-in-alifetime indicator, two digit place of service, modifiers, EPSDT indicator, co-pay indicator, eligibility aid category, family planning indicator, emergency indicator, claim type, diagnosis, units of service. PAGE

36

RFP#13P1-002 BH Records Mgmt Sys

5. 6.

7. 8. 9. 10.

11. 12. 13.

14. 15. 16. 17. 18. 19. 20.

21. 22. 23.

CA DMH Medi-Cal service mode and service function (Stated in 5.39.1.1). CA DMH CSI (CA DMH Client Services Information) service mode and service function (Stated in 5.39.1.1). Type of Fee (fixed or unit based) Unit Definition Unit conversion/crosswalk for HIPAA 837 and CSI. Indicators associated with selected parameters to designate whether they should be included, excluded or disregarded in claims processing. Multiple modifiers and the percentage of the allowed price applicable to each modifier. Complete narrative descriptions of procedure codes. Indicator of TPL (Third Party Liability) actions, such as cost avoidance, benefit recovery or pay, by procedure code. Indication of non-coverage by managed care organizations. Procedures manually priced or manually reviewed. Limits of the procedure. (i.e. based on clinical staff discipline, CA DMH provider profile) Indication of non-coverage by third party payers. Information such as accident-related indicators for possible TPL, federal cost-sharing. Indicators, Medicare coverage and allowed amounts. Indication of when or whether claims for the procedure can be archived from on-line history (such as once-in-a-lifetime procedures). Effective dates for all items. CSI Non-reportable indicator. Type of Procedure (staff only, client only or both)

5.39.2 State of California Medi-Cal Billing Rules for MH and Substance Use Disorders Req #

Requirement

5.39.2.1

The system supports the development of a variety of billing rules for specific services and programs. A basic

(1) Comply

(a) Core

(b) Custom

PAGE

(c) 3rd Party

37

RFP#13P1-002 BH Records Mgmt Sys

California requirement is the availability of billing logic that supports the calculation of charges based on the standard rate per minute multiplied by the number of total clinician minutes (primary and co-clinician(s) totals), divided by the number in group. Response: The system also supports the entry of the Medi-Cal lockout matrix that controls what can and cannot be billed, depending on where the client has been admitted. For example, if a client is in an inpatient facility, all 5.39.2.2 outpatient services except case management under certain circumstances cannot be billed. The goal in scripting these California specific billing rules is to provide flexibility in creating the rules as they are required rather than any attempt to identify and support all current rules. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(a) Core

(b) Custom

(c) 3rd Party

(a) Core

(b) Custom

(c) 3rd Party

5.39.3 Electronic Billing and Remittance Advices Req #

Requirement

(1) Comply

The system has the capability to electronically submit claims to Medi-Cal, Medicare, major insurance carriers within the State of California utilizing the ASC X12N 837 - Health Claims or Equivalent Encounter Information and to receive payments electronically via the ASC X12N 835 - Healthcare Payment and 5.39.3.1 Remittance Advice. The system can produce paper claims for any service transaction on-demand or in a batch mode. This includes claims which are forwarded electronically to the county from contract providers for submission to payors and the corresponding forwarding of remittance advices back to the contract providers. Response: The system is required to complete a Medi-Cal certification process with Department of Mental Health utilizing the ASC X12N 837 - Health Claims or 5.39.3.2 Equivalent Encounter Information and to receive payments electronically via the ASC X12N 835 Healthcare Payment and Remittance Advice. Response:

(1) Comply

5.39.4 Manual Billing and Remittance Advices

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RFP#13P1-002 BH Records Mgmt Sys

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system also supports multiple fee schedules by payer including state-specific fee schedules such as the Medi5.39.6.2 Cal AB3632 fee for service billing for children identified with a severe emotional disorder via a separate payer source with specific billing/adjust rules for that program. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports easy updating of all clients with 5.39.6.3 coverage under a specific plan to address benefit plan changes which may occur. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Req #

Requirement

The system has the capability to generate paper-based claims in CSM-1500, UB-92 and user-defined formats. 5.39.4.1 The system can also support the manual data entry of payments that are not received electronically. Response:

5.39.5 Authorization System Linkage Req #

Requirement

The system should be user-configurable to allow certain authorization types in the Authorization Management component to control whether an entered service is billed to a third party payor. In this instance, if a provided 5.39.5.1 service does not fall within the parameters of an existing authorization for a client (e.g. date range, provider, service code) the claim will be pended and listed on an error report or tickler for follow-up. Response:

5.39.6 Multiple Payers, Fee Schedules, and Reimbursement Methods Req #

Requirement

The system supports multiple payers for a client and the tracking and management of benefit limits, deductibles, 5.39.6.1 co-pays, and covered and non-covered services for specific plans. Response:

5.39.6.4

The system also supports the management of multiple reimbursement methods including fee for service, case

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RFP#13P1-002 BH Records Mgmt Sys

rates, per diem, capitation and grant-in-aid, and the bundling of service codes by payer. Response:

5.39.7 Retroactive Medi-Cal Billing Req #

Requirement

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system utilizes retroactive enrollment data to produce Medi-Cal claims for services originally billed to other 5.39.7.1 sources that are now Medi-Cal eligible and make the proper adjustments to the relevant revenue, receivable and adjustment accounts. Response: The system uses a similar process for Medicare and 5.39.7.2 private insurance companies when coverage changes occur. Response: 5.39.7.3

The system can retroactively bill these plans based on plan-specific retroactivity dates.

Response:

5.39.8 Client Billing (1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports the adjustments to outstanding balances and the annual UMDAP liability. The system 5.39.8.2 can properly track Medi-Cal clients, who currently have share of costs. Response: The System must provide for the linking of related 5.39.8.3 accounts in order to track family status and guarantors.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The System must have the ability to generate and track 5.39.8.4 refunds to clients for credit balances for co-pays and self pays.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

PAGE

40

Req #

Requirement

The System must properly calculate bills and tracks client co-pays and deductibles based on the California 5.39.8.1 Uniform Method for Determining Ability to Pay (UMDAP) annual family deductible system. Response:

RFP#13P1-002 BH Records Mgmt Sys

Response: 5.39.8.5

The System must provide the ability to apply credit balances to future services.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Response:

5.39.9 Client Statements Req #

Requirement

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd

The system can produce user-defined client statements on demand and on a cycle basis (e.g. every month) and has the capability of disabling the production of statements 5.39.9.1 for any client and the ability to classify clients into categories for which the user will have control over the decision to print statements. Response: The system supports the identification of which party should receive statements, such as directly to the client/guarantor, the client’s conservator, or both. Client 5.39.9.2 statements production supports the entry of user-defined dunning and thank-you messages based on specific payment or non-payment rules. Statements can be printed in detail or summary format based on user-defined rules. Response:

5.39.10 Revenue Recognition and General Ledger Posting Req #

Requirement

The system generates revenue, contractual allowances and sliding scale adjustments for each service from all 5.39.10.1 sources at the time of entry based on the billing rules entered for insurance companies and self-pay clients. Response: All charges are recorded at standard fees and any contractual allowances or sliding scale discounts are recorded as adjustments to the standard fees. These 5.39.10.2 entries can be posted to the county’s general ledger via hard copy or electronic posting reports, which can be summarized based on user-defined criteria including subtotals by payor, payor class, program, location, etc. Response: The system supports the entry and proper tracking of

PAGE

41

RFP#13P1-002 BH Records Mgmt Sys

Party

multiple adjustment codes including contractual allowances, sliding scale discounts, and bad debt writeoffs. Response:

5.39.11 Payment Posting Req #

Requirement

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports point-of-service check-out whereby 5.39.11.1 payments can be posted and payment receipts can be issued. Daily report by site and user is provided. Response: Allows the posting of payments to a client account even though there are no corresponding charges and considers these payments as credit balances to be matched with 5.39.11.2 charges at a later date. Also supports easy data entry of hard copy Remittance Advices and electronic posting of the ASC X12N 835 - Healthcare Payment and Remittance Advice to client accounts. Response: 5.39.11.3

The system should have sufficient controls to support reconciliation of payments entered to cash receipts.

Response:

5.39.12 Cascade Billing and Accounts Receivable Management Req #

Requirement

The system provides for open item accounting with the default of posting of payments and adjustments to specific charges/invoices. It properly handles the sequential 5.39.12.1 billing of payers ensuring that the sequence is based on both the coverage that the client has and the services that are covered by the various plans. Response: When Remittance Advices are posted, outstanding charges are automatically calculated and upon user confirmation, transferred to secondary and tertiary payers 5.39.12.2 and/or client responsibility, and the appropriate electronic and paper claim forms are produced, which include the payments received from the previous payors. Response:

PAGE

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RFP#13P1-002 BH Records Mgmt Sys

Outstanding charges not confirmed and transferred to the next sequential payor remain as an open receivable. Appropriate audit trails are kept of claims that have been 5.39.12.3 sequentially billed to multiple payors and revenue and accounts receivable balances do not overstate outstanding amounts by reporting balances for multiple payors simultaneously. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

This process includes automatically crediting contractual allowance and other adjustment accounts during payment posting based on predetermined carrier-specific criteria. 5.39.12.4 This information is tracked and reported via detailed aged accounts receivable reports with user-defined sort and subtotal criteria including payor, provider, client, program, location, etc. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

5.39.13 Collections Management Req #

Requirement

The system produces on-line ledger cards for all client accounts that show the transaction history of all charges, payments, and adjustments for all payors for a specified date range. It can be filtered to show the same 5.39.13.1 information for a single payor (including client responsibility). The system has the ability to attach notes to any transaction regarding collection calls and can generate tickler reports based on the follow-up dates entered into these notes. Response:

5.39.14 Tracking Service Costs Req #

Requirement

The system supports one or more methods of recording and tracking the costs of services, such as actual cost or California’s Schedule of Maximum Allowable (SMA), 5.39.14.1 and reporting the differences between billed amounts, received amounts, and the cost of service. Response:

PAGE

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RFP#13P1-002 BH Records Mgmt Sys

5.39.15 Medi-Cal/Medicare Cost Reporting Req #

Requirement

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system can compile service units and charges into the Medi-Cal and Medicare cost reporting categories to produce reports that will support the development of these annual cost reports. This includes capturing revenue and 5.39.15.1 services by California’s mode and service function code structure and funding categories (Medi-Cal, Medicare/Medi-Cal Crossover, Healthy Families, NonMedi-Cal). The system will properly record the funding category of claims that have been reversed and re-billed. Response: 5.39.16 Other Functions (1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports ability to list the entire history of a client's/patient's account, ability of authorized staff to 5.39.16.2 print or display, but not limited to bills and re-bills to client/patient and/or third-party payors (individually or batch). Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports the ability to make automatic 5.39.16.3 payment calculations, using appropriate cost account codes, ability for authorized staff to perform post-

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Req #

Requirement

The system supports running balances of each account, links payment source to registration data, allows adequate space to be available in designated data fields for explanations or comments regarding accounting information. It has the ability to allow client/patient payment options such as co-pays or Uniform Method Determining Ability To Pay (UMDAP) amounts, ability to immediately update and report client/patient financial 5.39.16.1 accounts to include, but not limited to: consolidated share-of-cost, and co-payment. It includes separate tables for many different service areas, including but not limited to: co-payments, share-of-cost, sliding scale, rate schedule provider internal, rate schedule provider external, historical rate information retained. It reports the total amount billed by: Case, Number of appointments, 100% appointment / billing, (exception report of appointment not billed). Response:

PAGE

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RFP#13P1-002 BH Records Mgmt Sys

payment adjustments, ability to permit electronic claims submission for all third-party billings (variable time periods) from various payors (Medicare, Medi-Cal, Electronically transfer Targeted Case Management (TCM), and 3rd party billing. Response: The system supports the ability to access accounts payable and receivable information, ability to generate totals billed in a month, ability to generate unpaid aging receivables reports (accounts not paid: 30 day, 60 day, 90 day, variable time), and has the flexibility to produce aged account report on receivables by funding source. 5.39.16.4 It also provides the ability to track Medi-Cal share of cost and other adjustments, account adjustments "therapeutic adjustments" (waiver), treatments, encounters, type of billing (Medicare, Medi-Cal, copay, private insurance, etc), billings, payments, shareof-cost adjustments, and adjustments for rate changes, date received and receipt number. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Req #

(1) Comply

(2) Core

(3) Custom

(4) 3rd Party

Requirement The system supports the ability to itemize and extract costs by, but not limited to: Location, Program, 5.39.16.5 Provider, Distribution, Service type, Case number, and Funding source. Response:

5.39.16.6

The system supports a common treatment translation code/crosswalk table from county to the State for funding (horseback riding = therapy), e.g. State wants code 701 Horseback riding = 70 and allow the ability to contain a "crosswalk" system to enable multiple types of service/procedure codes to be used for different County programs, and to translate codes from one program to another

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports the ability to track clients/patients receiving community based organizations resources Disposition Service accepted, Service denied, Active/ inactive. It has the ability for authorized staff to define and describe a program/service/plan/payor (narrative description),

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports interfaces with other software such as SAS, MS Excel, MS Access and Seagate Crystal Reports for Management Analysis.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Response:

5.39.16.7

Response: 5.39.16.8

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RFP#13P1-002 BH Records Mgmt Sys

Response: The system supports tracking and reporting of denied services that are re-billed - all payers. Also the system has the ability to track and report billed but unpaid services. Reporting is by Provider/program, Mode of Service, Service Function, services originally billed within timely filing limit where subsequent denials and rebilling would be past limit. This is to be reported by Provider, Mode of Service and Service Function.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports ability to track and report MediCal services billed but deleted/refunded (before State payment is received.) Reports are to be by Provider, Mode of Service and Service Function. The system will 5.39.16.10 have the ability to track and report Medi-Cal services that are billed, paid, deleted, and refunded via the State Disallowance System by Provider, Mode of Service and Service Function Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

A variety of pre-defined assessment forms are available including for example: psycho social assessments, intake 5.40.1.2 assessments, Addiction Severity Index (ASI), inpatient evaluations, residential placement evaluations. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

In addition, the system offers a forms development tool set designed to allow locally defined assessment forms to be created. Locally defined forms can capture data as 5.40.1.3 defined by the system administrator. Such forms may also display data collected from “non-clinical” functions (e.g. demographic data, address). The assessment function

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

5.39.16.9

Response:

5.40

ELECTRONIC MEDICAL RECORDS (EMR)

5.40.1 Clinical History Inquiry Req #

Requirement

All clinical information on the history of past diagnoses, treatment plans, services, and medications are available to authorized clinicians. Immediate inquiry of all elements 5.40.1.1 of the EMR is available. Clinical history screens may be customized to accommodate the varying needs of clinicians, coordinators and clients. All clinical inquiries are controlled through the user-definable security system Response:

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RFP#13P1-002 BH Records Mgmt Sys

may be configured to generate targeted problems for treatment and such problems can flow to the treatment planning process. Response:

5.40.2 Treatment Plans (Plan of Care) Req #

Requirement

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system would allow clinicians to build treatment plans for various populations. Using a clinical database of evidence-based practice guidelines, the clinician 5.40.2.1 moves through the diagnoses, assessment, goals, objectives and interventions definition. The data set, which prompts the user with various elements of the treatment plan, is tailored to the appropriate population. Response: The practice guidelines are fully customizable in order to respond to various theoretical approaches. Current and past authorizations as well as outcome results are available for review by clinicians. All elements of the clinical guidelines that underlie the treatment planning 5.40.2.2 module may be defined and/or modified by authorized clinical supervisors. A printable version of the treatment plan is available for clients and the system supports the process of obtaining client signatures on treatment plans. System is capable of printing forms in other languages. . Response: Authorized signature is available either by scanning or by 5.40.2.3 electronic means. Prompt for authorized signature should be based on the age of the client. Response:

5.40.3 Wellness and Recovery ACTION Plans Req #

Requirement

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports the development of client created action plans. Such plans contain information provided by the client which includes their personal strategy for 5.40.3.1 recovery. The plan may also include emergency contact information, advance medication directions, and advance directives from the client.

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RFP#13P1-002 BH Records Mgmt Sys

Response: Clients may designate other authorized individuals to 5.40.3.2 view such plans. A printable version of the plan is available for clients. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports ability to electronically route and 5.40.3.3 authorize treatment/plan/service with notification to appropriate staff Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

5.40.4 Progress Notes (1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The option is also available to generate service transactions as part of the progress note entry. While writing a progress note, clinicians have ready access to the current authorization information as well as the 5.40.4.2 treatment plan. Each progress note can be linked with key elements of the treatment plan as required by regulatory guidelines. System administrators may attach program specific fields for local data requirements. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports an ability to append previously 5.40.4.3 filed clinical documentation. The system automatically notifies the original author that the note was appended. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system allows progress notes to carry forward the client’s name, CSI number, diagnosis, current 5.40.4.4 medications, any allergies, and date of birth automatically on each new progress note. Response: The System must support the ability to develop templates for various types of notes based on industry 5.40.4.5 standard formats (FIRP, SOAP, etc.) Use of a specific template is based on system of care.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Req #

Requirement

Progress notes for individuals as well as group progress notes can be captured by the system. Clinical note entry uses standard word processing functions including spell 5.40.4.1 checking. There is a medical dictionary included for spell checking and the ability to input new words. Notes are easily accessible as part of the service entry process. Response:

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RFP#13P1-002 BH Records Mgmt Sys

Response: (1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

This process combines multiple functions to allow for 5.40.5.2 the efficient processing of clients who are opened and closed on the same day. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system is able to include external information from 5.40.5.3 other facilities, ambulance, patient transfer information, etc. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system is able to allow the user to automatically see prior crisis notes, e.g., admissions, etc.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The System must provide some means of notifying the coordinator of each crisis visit for any of their clients.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

System must allow for multiple electronic signatures for group and multi-provider sessions, and co-signs for 5.40.4.6 notes written by unlicensed providers. Notes cannot be amended without reauthorization by all signers. Response:

5.40.5 Crisis Service Entry Req #

Requirement

The system provides a data entry screen to support the 5.40.5.1 admission, discharge and recording of services for a crisis service. Response:

5.40.5.4 Response: 5.40.5.6 Response:

5.40.6 Service Record Validations Req #

Requirement

As services are entered in to the system through various 5.40.6.1 clinical screens, essential validations are immediately performed. Response: The system supports an ability to track incomplete 5.40.6.2 clinical documentation for follow-up and completion which includes clinical oversight reporting Response:

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RFP#13P1-002 BH Records Mgmt Sys

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Each service performed by an identified staff person is automatically checked to confirm the credentials are 5.40.6.4 appropriate to the service rendered. Also, services are checked to determine valid time durations and location of service. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Duplicate service entry checks are performed. Validation tables are easily maintained by staff responsible to assure compliance with local, State and Federal regulations. 5.40.6.5 Error notification is immediate at time of data entry and “batch” error listings after services have been entered are minimal. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

5.40.6.3

The system supports an ability to link clinical documentation to billable and non-billable functions.

Response:

5.40.7 Group Service Management Req #

Requirement

The system supports the efficient management of group services. Groups can easily be created, clients added and deleted from particular groups. When services are entered 5.40.7.1 for a group, all group members are displayed for rapid data entry. Clinician and co-facilitator time may be recorded. Response: In addition, it must allow for the clinician and co-clinician to have different billing times including different 5.40.7.2 documentation time per client. Participants in the group may be coordinated by several different teams within the same agency. Response:

5.40.8 Medication History Req #

Requirement

5.40.8.1

The system supports the entry and viewing, on a single screen, information about medications prescribed by the county behavioral health provider, those being taken but prescribed by another provider, drug allergies, and past PAGE

50

RFP#13P1-002 BH Records Mgmt Sys

adverse reactions to particular medications. Information is also readily available about medications that have been tried and considered ineffective and medications that are no longer being taken due to other reasons. Response: The System should provide an alert when a client’s 5.40.8.2 prescription is scheduled to run out, or if prescriptions are being refilled early. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd

5.40.9 Drug Formulary Management Req #

Requirement

The system supports the review and maintenance of a locally defined formulary and will display drugs determined to be ‘first-choice’ as defined by the medical 5.40.9.1 administrator. System must support multiple formularies that are used based on primary payer (PCN, MediCal, VA, etc.) for services being provided. Response: The system will allow for alternate formularies defined by local site to address special regulatory and county 5.40.9.2 requirements. Formularies are updated on a routine basis (indicate how often) Response:

5.40.10 Medication Prescribing Req #

Requirement

The system has the ability to electronically record a prescription and to print a legible prescription or transmit a HIPAA compliant secure prescription to internal or external pharmacies. Medication history, medication consents, treatment plans and recent progress notes can 5.40.10.1 be easily accessed and viewed during the prescriptionwriting process. Automated client consent forms are generated to support the prescribing process. Client and Provider electronic signature capacity is available. Response: 5.40.10.2 The system can support wireless prescription device

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RFP#13P1-002 BH Records Mgmt Sys

Party

solutions. Response: The System should provide the ability to complete 5.40.10.3 partially filled in TAR (demographics, etc) for Medi-Cal or Medicare scripts. Response: The System should allow the provider to authorize for 5.40.10.4 indigent (PCN) medications, send out notifications, and authorize the Short Doyle form for indigents. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

5.40.11 Medication Database Linkages Req #

Requirement

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system can interface with third party databases that support automated drug interaction checking and drug allergy checking, which can be performed during the 5.40.11.1 prescribing process. Drug specific education materials from third party databases can be easily accessed from the system. Response:

5.40.12 Medication Administration Record Req #

Requirement

The system supports medication dispensing through an electronic Medication Administration Record that tracks user-defined information for all medications that have 5.40.12.1 been dispensed to clients. The record notes drug allergies, chronic conditions, and other user-defined items. Response: T

System supports Pharmacy module complying with the laws and local requirements included but not limited to: Permit the Pharmacy to document whether a prescription was filled by the County pharmacy or by an outside 5.40.12.2 Pharmacy; track medications provided free by pharmaceutical companies Track "Top 10" most used Pharmacy medications; automatically deduct filled prescriptions from current inventory; medication Alerts regarding certain medications that have been found by

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RFP#13P1-002 BH Records Mgmt Sys

FDA and other regulatory agencies to be dangerous or ineffective; track prescriptions by authorizing staff which providers (physicians) provide medication. Response: The System supports ability to alert for drug to drug 5.40.12.3 interaction, Medication history and current status of client/patient, including dosage, type, and frequency. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

5.40.13 Pharmacy Management Req #

Requirement

The system can interface with third party pharmacy management packages for inventory control, ordering and dispensing support. If a third party system is utilized it can either integrate with the system’s internal medication 5.40.13.1 prescribing, formulary management and medication history components, or replace them with well integrated components from the third party vendor that are can also be integrated into the electronic medical record and practice management modules. Response:

5.40.14 Patient Assistance Program Support Req #

Requirement

The system supports the collection of data required for the support of various pharmaceutical company indigent patients, “Patient Assistance Programs.” The system generates drug-specific applications forms to request 5.40.14.1 medications at no cost from manufacturers. The system supports the configuration of multiple application forms that may be associated with specific medications. The system provides for the tracking of the submission of forms and the status tracking of pending applications. Response:

5.40.15 Red Flag Function

5.40.15.1

The system supports the configuration of a clinical Red Flag alert that allows urgent clinical information such as danger warnings, suicide watch or similar, drug

(1) Comply

(a) Core

(b) Custom

PAGE

(c) 3rd Party

53

RFP#13P1-002 BH Records Mgmt Sys

allergies, history of adverse reactions to specific drugs, and other urgent precautions. Red Flag warnings may be viewed at various key screens including progress notes, appointments and treatment plans. Such Red Flags are visible to all authorized users. The red flag function should be part of the Tickler Engine described in Section 5.40.8.2. Response: 5.40.16 Vital Signs Tracking Req #

Requirement

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports the recording of client vital signs based on a user-defined schedule (e.g. twice per day for 5.40.16.1 every client) Vital signs are immediately available in graphic format. Response:

5.40.17 Location Check Log Req #

Requirement

5.40.17.1

The system provides a location check log that supports the tracking of patients by location on a user-defined basis (e.g. every 5 or 10 minutes). This is important for crisis and residential settings.

Response:

5.40.18 Laboratory Orders and Results Req #

Requirement

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Provides the ability to electronically enter orders for laboratory tests and to print the order or to electronically transmit a HIPAA compliant secure order to an internal 5.40.18.1 or external laboratory. Secure results may be electronically received for immediate review. Clinical alerts are generated when laboratory results are received electronically. Response: 5.40.18.2

Ability to enter lab results with client/patient case

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RFP#13P1-002 BH Records Mgmt Sys

Response: 5.40.18.3

Ability to electronically notify that lab results are posted

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Response:

5.40.19 Outcome Measurement

Req #

Requirement

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Using the system forms development tool, a variety of outcome measurement instruments can be created within the system. In addition, third party licensed instruments can be incorporated into the system for authorized use. 5.40.19.1 Locally defined as well as third party licensed scoring protocols can be used to summarize outcome instrument data. Clinical review of outcome score trends over time is available as on-line queries for clinical decisionmaking. Response:

5.40.20 Clinical Evidence Based Practice Libraries

Req #

Requirement

Industry standard clinical libraries of evidence based practice information on treatment interventions are available for inquiry by clinicians. Clinical evidence 5.40.20.1 based practice information is available for inquiry during the clinical decision making process including progress notes, treatment planning and prescribing. Response: These libraries will be customizable and may be defined by program or site. Response:

5.40.21 Electronic and Paper Interface Req #

Requirement

5.40.21.1 Since the County will retain full or partial paper records PAGE

55

RFP#13P1-002 BH Records Mgmt Sys

for an extended time period, the system is designed to support scanning key documents from paper systems and organizing them into a logical structure that allow providers to easily view these documents. The documents scanned may include drawings, suicide notes, etc. (not OCR scanning) The County currently uses the Questys records retention system. Describe your ability to interface with Questys. Response: (1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system provides for a configurable method to 5.40.22.2 designate the need for signed consent forms. For example, the need for medication consent forms can be configured. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system will track the need for signed consent forms 5.40.22.3 and alert users when forms are required but not yet signed. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

5.40.21.2

These EMR documents should be able to cross-reference to old paper charts.

Response:

5.40.22 Client Consent Tracking Req #

Requirement

At various user defined points during service delivery, clients are required to sign various types of consent 5.40.22.1 documents. These forms are available in various languages. Response:

5.40.23 Quality Management Tracking Req #

Requirement

The system supports the development of user-defined screens for gathering data related to the quality 5.40.23.1 management process. This includes user-defined customer satisfaction surveys, customer complaint and compliment forms, provider satisfaction surveys, etc. Response: 5.40.23.2

This also includes support for the California-mandates Client Services Information (CSI) and Performance

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RFP#13P1-002 BH Records Mgmt Sys

Outcome System (POQI) client outcome and satisfaction reports. Response:

5.40.24 General – EMR (1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Documents are indexed/organized, and system provides selection of client file documents to be viewed from a 5.40.24.3 chronological listing, or by type of document, i.e., assessment, plan of care, progress note, etc. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports the ability to interface/import other source documents to system client file, i.e., cold-feed 5.40.24.4 Microsoft Word document (PHF Discharge Summary, etc.), or scanned documents Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports the ability to fax or e-mail documents from system through HIPAA compliant link.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports system monitoring to provide 5.40.24.6 staff/user access trail to specific client files for security integrity. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system administrator process corrects errors in the indexing/organizing of documents to client file, with 5.40.24.7 ability to move documents from the wrong client's file to correct client file Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

5.40.24.1 The system supports electronic signature capability Response: 5.40.24.2

The system supports the ability for authorized staff to easily/readily view electronic documents

Response:

5.40.24.5 Response:

5.41

DATA MANAGEMENT AND REPORTING

5.41.1 Standard Operational Reports Req #

Requirement

5.41.1.1 The system has standard operational reports to support PAGE

57

RFP#13P1-002 BH Records Mgmt Sys

each functional area in this document. The reports allow users to select and filter data by variables such as date range, department, clinician, etc. Response: (1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The key aspect of these reports is that they provide 5.41.2.2 summarized management-related data that support tactical and strategic decision-making. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The user has the option of outputting reports to the screen, printer, standard ASCII file format and PC application 5.41.2.3 formats such as XLS, CSV, PDF, MDB, TXT, DIF, XML, etc. Standard reports can be copied, edited and added to the reports menu with a new report name. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The user has the option of outputting reports to the screen, printer, standard ASCII file format and PC application 5.41.1.2 formats such as XLS, CSV, PDF, MDB, XML, TXT, DIF, etc. Standard reports can be copied, edited and added to the reports menu with a new report name. Response:

5.41.2 Standard Management Reports Req #

Requirement

The system has standard management reports that provide 5.41.2.1 a variety of views of county operations such as monthly trend reports, clinician comparison reports, etc. Response:

5.41.3 California-Mandated System Reporting Interfaces -California-Mandated Client Services Information (CSI) Req #

Requirement

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

PAGE

58

The system supports the collection, compilation, reporting and analysis of the California-mandated Client Services Information. The system supports bi-directional 5.41.3.1 exchange of data with the California CSI system including transmission of client, periodic and services data, receipt of errors reports, and processing and submission of corrections and updates. Response:

RFP#13P1-002 BH Records Mgmt Sys

The system is required to complete a CSI certification process with Department of Mental Health to transmit 5.41.3.2 client, periodic and services data, receipt of errors reports, and processing and submission of corrections and updates. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

5.41.4 California-Mandated Alcohol and Drug Outcomes Measurement System (CalOMS) & CaliforniaMandated Performance Outcome System Reports (POQI) (1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system is required to complete a CalOMS certification process with Department of Alcohol and 5.41.4.2 Drug Programs to transmit client admission and discharge data, receipt of errors reports, and processing and submission of corrections and updates. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports the collection, compilation, reporting and analysis of the California-mandated 5.41.4.3 Performance Outcome System (POQI) client outcome and satisfaction reports. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Req #

Requirement

The system supports the collection, compilation, reporting and analysis of the California-mandated 5.41.4.1 Alcohol and Drug Outcomes Measurement Systems (CalOMS). Response:

5.41.4.4

The system supports California DMH Adult & Children's Outcomes Reporting Requirements.

Response:

5.41.5 California-Mandated Cost Report Functionality for Mental Health & Substance Abuse Req #

Requirement

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports a compilation of services units and charges into the Medi-Cal cost reporting categories. The 5.41.5.1 system properly calculates retroactive billing activity, and produces reports to support the development of the annual cost reports. Response:

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RFP#13P1-002 BH Records Mgmt Sys

5.41.6 California-Mandated Mental Health Service (MHSA) Act Data Collection Req #

Requirement

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports the collection, compilation, reporting 5.41.6.1 and analysis of the California-mandated MHSA Data Collection Reporting (DCR). Response:

5.41.7 Quality Management Reports (1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Quality Assurance: The development and production of reports based on payor and county identified performance and outcome measures for access, assessment, treatment planning, service delivery, etc. Also aids random chart sampling and review processes.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Quality Improvement: The development and production of reports that track and trend quality measures over time and can support the identification of variation that is material and statistically significant.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Utilization Review: The System must provide the ability to produce reports that track utilization by visits and timeframes (days, months, years) and geographic distribution of clients, clinicians, services, and/or programs and secondary criteria such as userdesignated trigger thresholds.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Case cost information by, but not limited to: individual client/patient (listed from high to low cost), individual provider (both contract Network private providers and County employees), Stratified case type (e.g. less intensive or more intensive), Service type (procedure code or other service categories, e.g. inpatient, out-patient, etc.).

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Req #

Requirement

5.41.7.1

The system supports the reporting and data analysis of the county’s quality management program.

Response:

5.41.7.2

Response:

5.41.7.3

Response:

5.41.7.4

Response:

5.41.7.5

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RFP#13P1-002 BH Records Mgmt Sys

Response: Services Report by, but not limited to: Number of encounters/units of service by provider, when exam (core) and ambulatory services provided (x-ray, lab Pharmacy) and per sub program.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Cases Report listed the number of open cases that are, but not limited to: Active, Inactive, Distribution, and Open by length of time and Unduplicated clients.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Number of Calls Received report by time frame by Adult Child and Community Emergency Services System (ACCESS) by, but not limited to: Type of crisis service requested, Non-crisis support, Requests for 5150's, Assessments (child and adult), In-patient admissions (child or adult; category of admission), Insurance coverage, including Medi-Cal and Medicare, Referrals to community resources, Adult or child, Calls by: Gender, Ethnicity, Age and Location.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

List of client/patient demographic by, but not limited to: ZIP code, Census tract, list of clients/patients who have not received services for a specific date range, list of clients/patients currently receiving services from Social Security Advocacy Team, Track & report clients/patients currently receiving services in Mental Health, list of clients/patients currently in Children's System of Care receiving services from other County departments, and list of clients/patients currently in our systems of care.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Service Report to summarize by provider, by staff, and by service, but not limited to: Location, 5.41.7.10 Date/Time, Treatment code, Diagnoses, Clinician and Non-billable activities. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Clients/patients by housing arrangement, but not limited to: Assisted living, Board and care, Transitional housing, State private hospital, Institutes of Mental Disease (IMD)'s, Group Homes by Level, 5.41.7.11 by: Number of cases by diagnosis: Primary, Secondary, Tertiary Axis I-V, Identification of aid code(s) by client/patient, Record of each client/patient who has been evaluated for 5150 status and disposition of each evaluation.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

5.41.7.6 Response: 5.41.7.7 Response:

5.41.7.8

Response:

5.41.7.9

Response:

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RFP#13P1-002 BH Records Mgmt Sys

Response: Unduplicated client/patient count, linked to unduplicated family count, location, active cases by funding source, authorization (not limited to: Medi-cal inpatient/outpatient, Client/patient name, Provider 5.41.7.12 number, Clinician number.) Ability to generate claims report that itemizes: Claims paid, Claims denied, Claims suspended, reasons, and allow users to set criteria based on provider and/or service date range. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

State-required reports to provide quantitative measures used by County to assess performance and identify and prioritize areas for improvement using prescribed data elements, formats, and frequencies such as service delivery capacity, timeliness of routine mental 5.41.7.13 health appointments, timeliness of services for urgent conditions, access to after-hours care and penetration rates. Error reports to detect missing or incomplete data elements prior to electronic transmittal to State, i.e. null fields. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Utilization of services and costs for inpatient and outpatient specialty mental health services associated with specific following funding/plans/contracts, including but not limited to: Medi-Cal, Medicare, 5.41.7.14 Private pay, Healthy Families, UMDAP, CalWORKs, indigent, Private insurance, Provider, Service Location, Program, Service Type, Case number, Funding source, units and charges,. Response:

(1) Comply

(a) Core

System capability to monitor beneficiary satisfaction to 5.41.7.15 include surveys, grievances, appeals and fair hearings and service provider change requests. Response: 5.41.7.16

Ability to monitor and report medication practices per client, provider, program, etc.

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

PAGE

62

Response: Incident tracking and reporting of peer review activities, charts reviews and associated impact on 5.41.7.17 billing/collections for services (i.e. adjustments, deletions, refunds, etc.) Response: 5.41.7.18

Ability to pull reports on inpatient admissions and discharges within a specified time period by client,

RFP#13P1-002 BH Records Mgmt Sys

program, facility, age group, contract and payor type and include number of approved/denied days and the associated cost for services. Reports must also include information on whether seclusion and/or restraints were necessary. Response: (1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The report writer generates both ad hoc query-type results and formatted reports whose production can be 5.41.8.2 scheduled, produced and distributed electronically on an ongoing basis. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The report writer is integrated such that the running of reports against the production database will not create noticeable degradation in the response time of staff that is entering transactions and using the system’s various 5.41.8.3 lookup features. The user has the option of outputting results to the screen, printer, standard ASCII file format and PC application formats such as XLS, CSV, PDF, MDB, TXT, DIF, XML etc. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Monitor and evaluate the continuity and coordination of 5.41.7.19 care with physical health care providers and other human services agencies. Response: Provide reports on grievances and fair hearings by 5.41.7.20 timeframe, client, or system of care. Response:

5.41.8 Integrated Report Writer Req #

Requirement

The system includes an integrated, user-friendly report writer that has the capability of reporting on any combination of data fields in the entire system including 5.41.8.1 user-defined fields; can perform multi-layered sorts and selects; has the ability to utilize wild cards in any data position of a field to select items; has the ability to compute on any field or combination of fields. Response:

Ability to offer ad-hoc and query reporting as well as to allow authorized staff to download aggregate data into 5.41.8.4 spreadsheet and database applications (e.g. Microsoft Excel and Access)

(1) Comply

(a) Core

(b) Custom

PAGE

(c) 3rd Party

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RFP#13P1-002 BH Records Mgmt Sys

Response:

5.41.9 Alternative Report Writers Req #

Requirement

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The vendor has experience interfacing other SQLcompliant third-party report writer applications such as Crystal Reports and Microsoft Access with the system such that the tool can report on any combination of data fields in the entire system including user-defined fields. For example: (1) Number of cases assigned to provider by service program, active, inactive, open by length of time: monthly number of events (visits or encounters) by 5.41.9.1 provider/program: Performance Outcome report, client and service Information (CSI) report. (2) List of all clients/patients by service program, List of homeless clients/patients, At imminent risk of becoming homeless, (3) List of clients/patients (and aggregate data) using Homeless Vouchers, (4) List of how and where client/patient was transported to the admitting facility, Law enforcement, System of Care staff, Ambulance, referred by organization or Self. Response:

5.41.10 Letter Writing/Mail Merge Req #

Requirement

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports a letter writing/mail merge function where third party word processing programs such as 5.41.10.1 Microsoft Word can be integrated with the system to produce letters to clients, clinicians and other parties. Response: Letter templates can be added to system menus and automatically generated based on rules in the Tickler Engine and the Workflow Management component. 5.41.10.2 Examples include the generation of a referral letter to clinician and client when a referral is created, and generation of a follow-up letter when an appointment is recorded as a missed appointment. Response:

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RFP#13P1-002 BH Records Mgmt Sys

5.41.11 Data Rectangle Exports Req #

Requirement

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system supports the development of standard data rectangles based on predefined views that can be exported 5.41.11.1 to common third party products such as Microsoft Excel and Microsoft Access. Response:

5.41.12 Mirrored Database Support Req #

Requirement

The vendor has experience and supports the mirroring of the production database to a reporting server, which uses 5.41.12.1 the Integrated Report Writer and/or an Alternative Report Writer to produce user-developed reports and ad hoc queries. Response:

5.41.13 Req #

Data Warehouse/Mart Support Requirement

The vendor supports the extraction, transformation, and loading of all data from the system into a Data Store containing de-normalized and summarized data, which is used for data analysis and reporting. Trained county staff 5.41.13.1 will have the ability to maintain and manage the extraction, transformation and loading processes and obtain timely and accurate information from the vendor when they make changes to the system’s data dictionary. Response:

5.41.14 Data Dictionary Req #

Requirement

Documentation for the system includes a complete data 5.41.14.1 dictionary and Entity Relationship Diagram of all of the tables, table relationships, fields, and field attributes. PAGE

65

RFP#13P1-002 BH Records Mgmt Sys

Response:

5.41.15 Drill Down Capabilities Req #

Requirement

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The internal or alternative report writer supports the 5.41.15.1 development of drill-down reports that allow users to examine the underlying data behind figures on the report. Response:

5.41.16 Report Scheduling Req #

Requirement

The system allows users to schedule report production requests for regular periodic processing according to specified criteria such as one or more times per day, 5.41.16.1 weekly on specified day, monthly on first day of month and fiscal period, etc. Specification of data ranges to be included in reports may differ from the scheduled date/time of the execution of the report. Response: 5.41.17 Predefined Data Views Req #

Requirement

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system provides predefined views of data sets that combine files from multiple tables into logical reporting groupings to assist non-technical users in creating new 5.41.17.1 standard, management, and ad hoc reports. Example views include Clients, Clinicians, Services, and Authorizations. Response: The system supports the development of views based on groupings of client attributes such as user-defined population cohorts, geographic clusters of zip codes, 5.41.17.2 groupings of client eligibilities, etc. Views can include core fields as well as any user-defined field added to the system. Response: 5.41.17.3 Ability to include all those data elements currently used

(1) Comply

(a) Core

(b) Custom

PAGE

(c) 3rd

66

RFP#13P1-002 BH Records Mgmt Sys

Party

in the existing Behavioral Health Managed Care Access Databases (see data dictionaries) Response: (1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Ability to have on-line Help support (i.e. vendor support web site)

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Archival process should be sufficiently flexible to enable setting variable time parameters and limits

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Ability to maintain a client/patient index and retrieve records from archive automatically. Searches to be done 5.41.18.3 by Name, Birth Date, Social Security Number, CIN, or account number. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Ability to download/upload information to reduce data reentry – for contractors. 5.41.17.4 CPT data ICD-9 and ICD-10 HIPAA standardized data Response:

5.41.18 Data Archiving 5.41.18.1 Response: 5.41.18.2 Response:

5.42

SYSTEM INTERFACES

5.42.1 Interface Engine (1) Comply

(a) Core

(b) Custom

The system has an interface engine that supports the bi5.42.1.1 directional transfer of data with state and county systems as well as with other business associates. Response:

(1) Comply

(a) Core

(b) Custom

The interface engine: supports healthcare applicationlevel transaction standards including, but not limited to HL-7, ASC X12N and XML; supports the translation of 5.42.1.2 data sets based on pre-defined translation code tables; supports the development of error-checking routines, flagging via error reports, and the ability to readily resolve non-matching data.

(1) Comply

(a) Core

(b) Custom

Req #

Requirement

PAGE

(c) 3rd Party (c) 3rd Party

(c) 3rd Party

67

RFP#13P1-002 BH Records Mgmt Sys

Response: The interface engine allows trained county staff to maintain and modify these interfaces in response to 5.42.1.3 specification changes from payors and business associates. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

5.42.2 California Medi-Cal Eligibility Determination System (MEDS) Req #

Requirement

The interface engine will be configured to interface with the monthly download of the Medi-Cal Eligibility Determination System eligibility file, the MEDS Point of 5.42.2.1 Service system managed by EDS and the California Department of Health Services (DHS) Eligibility Systems. Response:

5.42.3 California Client and Service Information (CSI) System Req #

Requirement

5.42.3.1

The interface engine will be configured to interface with the Client and Service Information (CSI) System.

Response:

5.42.4 Financial Accounting System Interface Req #

Requirement

The interface engine can be used to generate generally accepted accounting standards GAAP-compliant, doubleentry uploads of billing and claims transactions into the 5.42.4.1 county’s general ledger and accounts payable systems. The file structure of the data coming out of the system supports a variety of general ledger coding schemes. Response:

5.42.5 Interfaces with Other Practice Management Systems

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RFP#13P1-002 BH Records Mgmt Sys

Req #

Requirement

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The interface engine can be used to receive and upload, with proper edit checking, client registration, episode, 5.42.5.1 admission, discharge, authorization, and service data from contract providers that may utilize a different practice management system. Response:

5.42.6 Pharmacy Benefits Management Company Interface Req #

Requirement

The interface engine can be used to export daily eligibility files and import explanation of benefits (EOB/835) files to and from pharmacy benefits management companies 5.42.6.1 that contract with the county. The EOB files can be imported as charges which can be billed to Medi-Cal and other insurance companies for Santa Cruz County that have assumed risk for pharmacy benefits. Response:

5.42.7 Data Entry Alternative Interfaces Req #

Requirement

The system supports data entry alternative interfaces for items such as encounter forms, customer satisfaction surveys, and performance outcome instruments. Methods 5.42.7.1 include scanning, optical character recognition, and intelligent character recognition. Efficient data entry is important to Santa Cruz County Behavioral Health. Response:

5.43

SYSTEM AND DATA SECURITY

This section describes the requirements for securing protected health information in accordance with the HIPAA Final Security Rules published February 20, 2003, as well as other county and regulatory body security requirements.

5.43.1 Security System

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RFP#13P1-002 BH Records Mgmt Sys

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The security system shall use a combination of user names and strong password support. Security is rolebased where user groups are created with access levels and individuals are assigned to those groups. It would be preferable that the system interface with the County Active Directory.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Security features are available such as: file and directory read/write/execute/delete authorizations; automatic logoff after a predetermined period of activity; login restrictions (days, time and workstation, hard-wired and dial-up); process initiation restrictions (e.g. month end closing); device access restrictions (e.g. access to the high speed production printer); application menu selection restrictions; and database restrictions. Authorization levels should be implemented at the data base record level and the screen field level. Logs of unauthorized attempts at access should be maintained and available for review.

(1) Compl y

(a) Core

(b) Custom

(c) 3rd Party

(1) Compl y

(a) Core

(b) Custo m

Req #

Requirement

5.43.1.1

The system shall have an operating system and/or application-level security system, which will prevent unauthorized access to and manipulation of the system, directories, files and programs

Response:

5.43.1.2

Response:

5.43.1.3

Response: Req #

Requirement

5.43.1.4

Ability to restrict access by type of case, as well as security: Service changes Payment approvals Case closures Physician's orders

(c) 3rd Party

Response: 5.43.1.5

Ability to allow for historical audit trail on record of all changes, such as additions and deletions, by user

(1) Compl y

(a) Core

(b) Custo m

(c) 3rd Party

Ability for adequate security to only permit authorized users to make changes, additions, or deletions

(1) Compl y

(a) Core

(b) Custo m

(c) 3rd Party

Maintain a separate database sub-schema / area for sensitive cases so information can only be input, viewed, or extracted by authorized staff. ( i.e. Cases

(1) Compl y

(a) Core

(b) Custo m

(c) 3rd Party

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70

Response: 5.43.1.6 Response: 5.43.1.7

RFP#13P1-002 BH Records Mgmt Sys

have unique identifiers but contain all the same data elements as the regular database) Response:

5.43.1.8

Ability to download information from the Internet, and upload data to specific, prescribed Internet sites, while still maintaining strict safeguards regarding client/patient and provider confidentiality (e.g. firewalls)

(1) Compl y

(a) Core

(b) Custo m

(c) 3rd Party

Bidders must provide a high level description of their proposed Security offering. Include unique or innovative features and advantages/benefits

(1) Compl y

(a) Core

(b) Custo m

(c) 3rd Party

Ability to define levels of security (read only, read and write, etc.).

(1) Compl y

(a) Core

(b) Custo m

(c) 3rd Party

Ability to define security at the data element/field, individual, user group or user role level.

(1) Compl y

(a) Core

(b) Custo m

(c) 3rd Party

Response: 5.43.1.9 Response: 5.43.1.10 Response: 5.43.1.11 Response: (1) Comply

(a) Core

(b) Custom

Req #

Requirement

5.43.1.12

Ability for a user to be assigned to one or more roles or groups.

(1) Compl y

(a) Core

(b) Custom

Ability to control access to system resources based upon security rights.

(1) Compl y

(a) Core

(b) Custo m

(c) 3rd Party (c) 3rd Party

Response: 5.43.1.13

(c) 3rd Party

Response: 5.43.1.14

Ability to control performance of system functions based upon security rights.

(1) Compl y

(a) Core

(b) Custo m

(c) 3rd Party

Ability to automatically log-off user if inactivity exceeds defined time-out period

(1) Compl y

(a) Core

(b) Custo m

(c) 3rd Party

Ability for each user to have a unique user ID and password.

(1) Compl y

(a) Core

(b) Custo m

(c) 3rd Party

Bidders must provide a high level description of their proposed System Auditing offering. Include unique or innovative features and advantages/benefits.

(1) Compl y

(a) Core

(b) Custo m

(c) 3rd Party

Ability to maintain a historical record of all changes made to any item within the system (e.g. data element, business rule, process control, software program), the ID

(1) Compl y

(a) Core

(b) Custo m

(c) 3rd Party

Response: 5.43.1.15 Response: 5.43.1.16 Response: 5.43.1.17 Response: 5.43.1.18

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of the person or process that made the change, before and after images of the affected data records and the date and time the change was made. Response: 5.43.1.19

Ability to trace HIPAA transactions from the receipt of the transaction through final disposition and response delivery.

(1) Compl y

(a) Core

(b) Custo m

(c) 3rd Party

Ability to trace all processing and business rules applied to an individual claim (e.g. track data changes to all reference tables that affected the claim, all edits/audits encountered, resolved overridden or adjustments to a claim).

(1) Compl y

(a) Core

(b) Custo m

(c) 3rd Party

(1) Compl y

(a) Core

(b) Custo m

(c) 3rd Party

Response:

5.43.1.20

Response: 5.43.1.21

Ability to view, filter and sort the system audit trail.

Response:

5.43.2 Transmission Security Req #

Requirement

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The vendor has implemented technical security measures to guard against unauthorized access to electronic protected health information that is being transmitted over 5.43.2.1 an electronic communications network including the ability to encrypt and decrypt protected health information. Response:

5.43.3 Protected Health Information Authentication Req #

Requirement

The vendor has implemented electronic mechanisms to corroborate that electronic protected health information 5.43.3.1 has not been altered or destroyed in an unauthorized manner. Response: 5.43.4 Electronic Signatures

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RFP#13P1-002 BH Records Mgmt Sys

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

All steps in the clinical documentation process are date and time stamped. Signed documentation may not be 5.43.4.2 modified, in keeping with medical record standards. The system is flexible enough to support emerging electronic signature technologies. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Clients are required to sign the Wellness and Recovery 5.43.4.3 Action Plan (Plan of Care). The system supports electronic client signatures of clinical documentation. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Req #

Requirement

The system supports electronic signatures of clinical documentation. The system supports a process whereby a 5.43.4.1 clinical document can be saved but not completed, and completed, signed and finalized. Finalized clinical documents can be appended under separate signature. Response:

5.43.5 Wireless Security Req #

Requirement

The vendor has implemented security measures to project 5.43.5.1 data being transmitted via wireless networks, including data communications with portable devices. Response:

5.43.6 Access Audit Controls Req #

Requirement

The system tracks and can produce a failed-access report of every transaction initiated on the system, identifying the user, location, date, time, function, file accessed, 5.43.6.1 record accessed. There will be sufficient capacity to archive this information for 7 years. Transactions include read, write, execute, and delete. Response: The system will support internal audit and review by the local Privacy and Security Officer. System administrators 5.43.6.2 have control over which system components will have audit controls in place and what types of audit trails are

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RFP#13P1-002 BH Records Mgmt Sys

utilized (e.g. tracking record additions, edits, and deletions, but not record lookups). Response:

5.43.7 Single-Sign On Support Req #

Requirement

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd

The vendor supports the integration of the system with 5.43.7.1 single sign-on software products, while maintaining internal security controls. Response:

5.43.8 Backup System Req #

Requirement

5.43.8.1

The system’s data and program files are capable of being backed up by common third party backup tools.

Response:

5.43.9 Data Archiving System Req #

Requirement

The system shall provide for the purging and storage of 5.43.9.1 data that is no longer needed on a real-time basis by county staff. Response: The system shall provide for: User defined archiving of data (based on service date, date of last activity, or other user-defined characteristics); Printed reports of data being 5.43.9.2 archived; ability to selectively restore archived data; proper control over archiving of data where a patient has an outstanding balance; archiving data to disk, tape or other storage media. Response:

5.43.10 Disaster Recovery Req #

Requirement

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RFP#13P1-002 BH Records Mgmt Sys

Party

The vendor has experience developing disaster recovery plans based on the system’s capability to recover from an interruption in the power supply both during business 5.43.10.1 hours and after hours when no staff are on-site, or in other situations where user data has been lost or otherwise compromised. Response:

5.43.11 System Interruption Recovery Req #

Requirement

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

The system architecture allows the system to recover from service interruptions with no or minimal loss of data, as well as minimal level of effort to return the 5.43.11.1 system to the pre-interruption state. Methods are in place to ensure that any data initially lost during a system interruption is readily recoverable. Response:

5.43.12 Vendor Access for Maintenance & description of two options for hosting – onsite and offsite with vendor, make sure the two options are reflected in bidding documents Vendor access to the servers and support systems must be done through a secure method such as VPN. Dial-up is 5.43.12.1 not acceptable. Access to be limited to that needed for the vendor to perform necessary maintenance. Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

5.43.13 HIPAA Vendor employees supporting the system for Santa Cruz 5.43.13.1 County are to have had current HIPAA Training and a program to maintain currency. Response:

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RFP#13P1-002 BH Records Mgmt Sys

5.44 Vendor Corporate Capacity 5.44.1 Corporate Information 5.44.1.1 Prime Contractor & Sub-Contractors In the table below, please note the prime contractor for this proposal. List all other companies who may serve as sub-contractors during the course of the proposed system implementation. For each listed company, please note the associated products which are proposed to address the functional requirements. Prime Contractor Corporate Name: Proposed Product(s): Contact Name: Contact Address: Contact Email: Contact Telephone:

5.44.2 Prime Contractor Years in Business State the number of years that the Prime Contractor has been in business ________.

5.44.3 Prime Contractor Type of Company Software Manufacturer: Value-Added Reseller: Consulting Firm/System Integrator: Other (Specify):

5.44.4 Prime Contractor Legal and Ownership Structure Provide information about the Prime Contractor’s Legal and Ownership Structure (e.g. 5.44.4.1 Public Company, Privately Held Corporation, Stock Exchange Symbol, Dun & Bradstreet number). Response: 5.44.4.2 Name of individuals (if any) owning 25% or more in the prime contractor. Response: 5.44.4.3 Number and locations of prime contractor’s corporate offices. Response:

5.44.5 Prime Contractor’s Installations and Contracts PAGE

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RFP#13P1-002 BH Records Mgmt Sys

A. Please provide the total number of active Installations by Market Segment: Product Line

5.44.5.1

Market Category

Active Installs

California Installs

Behavioral Health Medicine/Surgery Public Health Mental Retardation/Developmental Disabilities Social Services Other Total B. Please provide the number of active Government Contracts (City, County, State or Federal)

Response:

5.44.6 Prime Contractor’s Source of Revenue Please provide the source of revenue for the prime contractor as indicated below. Last Year’s Revenue Ratios (a. – h. should equal 100%): Revenue Category Percentage of Total Revenue (Column should total 100%) a. Software Licenses/Fees _________________ b. Custom Programming, Configuration Data Conversion_______________ 5.44.6.1 c. Implementation and Training ____________________ d. Hardware Sales ________________ e. Software Maintenance ___________________ f. Hosting/ASP Fees __________________ g. Consulting Fees (not included above) ____________________ h. Other Revenue ______________________ i. Total _________________________

5.44.7 Prime Contractor’s Financing - Revenue and Sales Volume A. Please provide the prime contractor revenue for each of the past 3 years: 5.44.7.1

Year 2010: 2011:

Total Revenue

Behavioral Health Revenue

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RFP#13P1-002 BH Records Mgmt Sys

2012: B. What is the size of the Largest Contract (Dollars) in Last 3 Years? All Contracts Behavioral Health Contracts Dollars Response:

5.45

LEADERSHIP, STAFFING, AND INFRASTRUCTURE

5.45.1 Prime Contractor’s Leadership Please provide a brief biographic summary for each of the following positions in the Prime Contractor’s organization: 5.45.1.1

Chief Executive Officer: Chief Financial Officer: Product Development Executive responsible for the behavioral health product line: Implementation Executive responsible for the behavioral health product line: Customer Service Executive responsible for the behavioral health product line:

Response:

5.45.2 Prime Contractor’s Strategic Plan

5.45.2.1

Please describe your strategic plan to develop and sell information systems in the public sector behavioral health area. Using today as a base point, where do you expect your company to be in the next 5 years? How does your plan address the national economic situation? Please take care to address your strategy for the public sector.

Response:

5.45.3 Prime Contractor’s Mergers, Acquisitions, and Partnerships

5.45.3.1

Please describe any current or recent (previous 24 months) mergers or acquisitions by your company. Please note the name of any company relevant to such corporate activity and the dates of acquisition or merger. Please explain how these actions will benefit your corporation’s capacity.

Response: 5.45.4 Prime Contractor’s Termination History PAGE

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RFP#13P1-002 BH Records Mgmt Sys

During the past 24 months, please note by organization name, any customer that initiated contract terminations for the proposed system. Cite the date of termination, the customer contract manager, and the listed contact information.

5.45.4.1

Organization Termination Date Name of Customer Contract Manager E-mail Telephone

Response:

5.45.5 Prime Contractor’s Human Resource Allocation Please provide the following information regarding your current staffing. Indicate the percentage of staff that are currently sub-contractors.

5.45.5.1

Type of Employee Full Time Equivalent (FTE) Percent Sub-Contractor Administration Sales and Marketing Research & Development Implementation & Training Hardware/Network/Telecommunications Help Desk/Support Other Total

Response:

5.45.6 Capacity and Strategy for Human Resource Growth

5.45.6.1

Assume that your company is awarded several contracts with Santa Cruz County. Drawing on this hypothetical (but possible) scenario, please describe your human resource strategy.

Response:

5.46

ABILITY TO SERVICE CALIFORNIA – SANTA CRUZ COUNTY

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5.46.1 Current California County Behavioral Health Operations Please note the indicated information for each of your current behavioral health California County contracts.

5.46.1.1

County Name Date of Original Contract Status: (I)Implementation (O)Operational Primary County Contact (Name and Phone No.) Product Name Please discuss briefly why you consider the above noted current customers are relevant to our county.

Response:

5.46.2 Current California non-County Behavioral Health Contracts

Please note the indicated information for your current California Behavioral Health (non-County) contracts. Include non-profit and for profit behavioral health organizations.

5.46.2.1

Organization Name Date of Original Contract Status: (I)Implementation (O)Operational Primary Contact at that organization: Product Name

Please discuss briefly why you consider the above noted current customers are relevant to our county. Response:

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5.46.3 National Customer Contracts National Customer contracts Please indicate the 10 active customer sites outside of California that you believe are most relevant to California county behavioral health requirements.

5.46.3.1

Organization Name Primary Contact State Date of Original Contract Organization Type (e.g. behavioral health, healthcare) Please discuss briefly why you consider the above noted current customers are relevant to our county.

Response:

5.46.4.1 Relevant Experience

5.46.4.1

Briefly describe how your past work with customers has prepared your organization to provide service to California county customers. In particular, indicate two key recent contracts in which you have provided services to a customer base with a similar multi-disciplinary, wide area ambulatory and inpatient service delivery system. Note how you have worked to assist your customers with governmental regulations relevant to your system.

Response:

5.46.5 Plan for Content Expertise in the California Regulatory Environment

5.46.5.1

As in many States, California has a demanding and dynamic set of regulations which effect the operation of key elements of county behavioral health programs. How will your organization secure and retain personnel with content expertise regarding California requirements?

Response:

5.46.6.1 Regulatory Change Example

5.46.6.1

Please provide an example of how your company recently made a significant regulatory change to your product. Note how you became aware of the change and modified your product. Provide a short description of the regulation, your modification and the time cycle from initiation to installation.

Response:

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5.47

QUALITY ASSURANCE

5.47.1 Product Development Overview

5.47.1.1

Please provide a brief descriptive summary of your software development methodology for product enhancements. Explain your testing process prior to release.

Response:

5.47.2 Product Development California Strategy

5.47.2.1

What is your product development strategy for California regulatory product changes? How does your strategy allow for the maintenance of your other State customers while simultaneously developing products for California customers?

Response:

5.47.3 Product Development Illustrative Case Example

5.47.3.1

Please provide one brief case example of a recent software enhancement to your core product. Please note the development cycle dates from initiation to completion and the testing and release process.

Response:

5.47.4 Product Releases

5.47.4.1

Please note the release frequency during last 12 months for each product in your proposal. Product Name # of Releases past 12 months

Response:

5.47.5 User Group Involvement

5.47.5.1

Please explain how your company works with a user group. Indicate the size and nature of such a group and how the group is involved in your product development process

Response:

5.48

IMPLEMENTATION SUPPORT

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5.48.1 Implementation Model Plan – All Modules

5.48.1.1

Please provide a sample implementation plan for a single customer that indicates major tasks from contract signing until the ‘go live” date of the system. The presentation of this sample plan should indicate, by task, a sample start and end date. Provide a Gantt chart to illustrate your plan. Please begin this sample plan with a November 2013 start date.

Response:

5.48.2 Configuration Training and Set-Up Provided by Vendor During the initial implementation of your system, new customers (e.g. system administrators) will be trained to perform various set-up tasks and vendor based on experience with State will complete initial set up with intense coordination with County staff. Please indicate by topic, an estimate of the duration of customer training that supports the initial set-up of the proposed new system. Your estimate is for a single county installation. Please note the number of hours each trainee will require by topic.

5.48.2.1

Configuration (Set-Up) Training Topic Training Hours Needed Per Trainee Table Set-up for Validations Form Development Report Development Billing Rules Workflow Management Tickler Engine Interface Engine User Authorization Security Set-Up Other (specify)

Response:

5.48.3 Implementation Lessons Learned – Customer Focus

5.48.3.1

Drawing on your experience installing behavioral health information systems, what have you identified as the most common customer problem areas? That is what areas have your learned to watch most carefully during an implementation? How have you helped other Counties with successful and timely launch of management and EMR components?

Response:

5.48.4 Implementation Lessons Learned – Vendor Focus PAGE

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5.48.4.1

Drawing on your experience installing behavioral health information systems, what mistakes have you made from which you have learned. (This is not a trick question.) Please demonstrate your experience by noting your mistakes and experiences with other counties and the State.

Response:

5.48.5 Implementation Project Manager

5.48.5.1

Please provide a representative biographical summary of the staff person that you would assign to be the project manager of a new installation of your proposed system in California.

Response:

5.48.6 Implementation History Please provide a listing of each implementation of your proposed system during the past 12 months. If you are proposing a new system, list past implementations which you consider comparable. If there are more than 10 implementations, please list the 5 most relevant projects. 5.48.6.1

Customer Name Mental Health(Yes/No) Implementation Status: Pending/Active/ Completed Start Date of Contract Vendor Project Manager Name

Response: 5.49

DATA CONVERSION

5.49.1 Data Conversion Process

5.49.1.1

Extensive amounts of claim data and historical account information are currently accessible from the legacy system. Santa Cruz County prefers to convert as much historical data as possible (Registration, Financial, client services, staff services, Diagnosis data, CSI periodic, Managed Care Provider Registration and Credential, Managed Care authorization, Provider and client services) Currently Santa Cruz County is using ECHO Management’s INSYST Information System to track Mental Health Programs and Substance Abuse Programs. Additionally, Santa Cruz County is using InfoMc’s eCura Information System (version 4.5.50a) to track Managed Care Program. Please briefly describe your strategy for moving data from both legacy systems to your new system. Please include your assessment, development and testing process. PAGE

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Response:

5.49.2 Conversion Experience 5.49.2.1

Based on your past data conversion experience, describe the top 3 keys to successful data conversion.

Response:

5.50

TRAINING

5.50.1 Training Strategy Please provide your training strategy for the following situation: A single medium size county with 300 users spread across an extensive geographic area. 5.50.1.1 Each functional area within this proposal will be implemented. Please give a brief overview of your training strategy for this example. Response:

5.50.2 Training by Vendor Vendors will be expected to provide a variety of training. Please indicate for the following topics, the estimated hours for each topic area and the method of training.

5.50.2.1

Major Training Topics Hours of Training Performed by Vendor Train the Trainer Method? Yes/No Will a sub-contractor do the training? Yes/No System Administration Managed Care Electronic Client Records Practice Management Billing Operations (Bill generation, receipt of payments Report Writing Form Development Other: Specify

Response:

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5.50.3 Configuration Training Provided by Vendor

5.50.3.1

During the initial implementation of your system, new customers (e.g. system administrators) will be trained to perform various set-up tasks. Please indicate by topic, an estimate of the duration of customer training that supports the initial set-up of the proposed new system. Your estimate is for a single county installation. Please note the number of hours each trainee will require by topic. Configuration (Set-Up) Training Topic Training Hours Needed Per Trainee Table Set-up for Validations Form Development Report Development Billing Rules Tickler Engine Interface Engine User Authorization Security Set-Up

Response:

5.50.4 Electronic Medical Record Training

5.50.4.1

Please describe your approach to training clinicians including physicians who have only previously worked with paper charts. Explain how your training approach supports a successful implementation of your EMR.

Response:

5.50.5 Trainer Qualifications

5.50.5.1

Please provide a brief biographic description of a representative vendor trainer for each of the following areas: Practice Management Billing Operations Electronic medical Records Managed Care

Response:

5.50.6 Training Services – Location and Format

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5.50.6.1

Please describe the location and setting of your proposed training facilities. If you offer various educational methodologies for training, please describe how you offer to deliver training to your customers. The location of your training facilities proposed for California: The format, media and methodologies used for your training courses:

Response:

5.51

TECHNICAL SUPPORT

5.51.1 Support Process Tracking

5.51.1.1

When the vendor is contacted by a customer, how is the reported problem tracked? Please describe your customer support flow from problem report to resolution. Include measures, such as time-to-resolution statistics which you currently monitor. Describe your problem escalation procedure.

Response:

5.51.2 Support Features Please complete the following table to describe your current support offerings.

5.51.2.1

Support Features Do You Provide this Support? (Yes/No) Software Support • 8:00 - 5:00 PST, Monday through Friday • 24 Hours/Day, 7 Days/Week Customized Workshop/Educational Programs (Yes/No) Electronic Documentation on Updates (Yes/No) Training on System Software Upgrades (Yes/No) Training on New Releases (Yes/No) Operational Audit/System Performance Evaluation (Yes/No) Vendor Sponsored User Group Membership (Yes/No) Web based customer support with FAQ, Searchable Knowledgebase (Yes/No) Web based problem reporting and customer inquiry on problem status (Yes/No)

Response:

5.51.3 Problem Resolution and Escalation Procedure 5.51.3.1

Please describe your proposed software problem reporting and escalation procedure. Indicate your severity classification system.

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5.51.3.2 Ability to have on-line Help support (i.e. vendor support web site) Response:

5.52

DOCUMENTATION

5.52.1 Documentation Features

5.52.1.1

Documentation Features Do you Provide this Feature? (Yes/No) All user functions are documented in on-line form All user functions are documented in printed form The system has context sensitive, user definable field level help Local policy and procedure documentation may be incorporated into the system’s on-line help function Electronic documentation includes search and index features Database documentation includes a detailed data dictionary System documentation includes entity-relationship diagrams indicating relationships among tables, including primary and secondary keys.

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Response:

5.52.2 Project Plan

5.52.2.1

Provide a sample project plan that delineates the typical tasks employed by you when conducting an upgrade to the system after the system is in production use. The project plan should include any hardware, 3rd party software, application software, security, network downtime, or database requirements

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Response:

5.53

MAINTENANCE AND UPGRADES

5.53.1 Maintenance and Upgrade Features Maintenance & Upgrade Features 5.53.1.1 Is This a Standard Maintenance /Upgrade Feature? (Yes/No)

(1) Comply

(a) Core

(b) Custom

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Error reports to vendor are tracked and reported back to customer Bug-fixes and corrections are included in upgrades Upgrades are applied to a test environment Software upgrades includes all enhancements Source code in escrow Conformance to Federal Regulations Conformance to California Regulations Conformance to HIPAA Requirements Response:

5.54

GENERAL FEATURES

5.54.1 Application should have user friendly data entry features such

Req #

Requirement

as:

(1) (a) (b) (c) Comply Core Custom 3rd Party

5.54.1.1 Highlighted data fields Response: 5.54.1.2

Warning messages should appear for essential missing data

Response: 5.54.1.3

Ability to move within the application without entering data

Response: Req #

Requirement

5.54.1.4

Ability to allow future upgrades to be transparent to the user

(1) (a) (b) (c) Comply Core Custom 3rd Party

Response: 5.54.1.5

Ability of the data to be entered and used instantly, rather than having to wait until the following business day

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Ability of templates for all existing forms to be available for electronic entry, so that "hardcopies" can be minimized

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Response: 5.54.1.6 Response: 5.54.1.7

Ability to have field specific help information

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Response: Ability to include the option to print or not print screens

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Ability to have on-line Help support (i.e. vendor support web site)

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Ability to have the Intake process on the computer replace the current paper process

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Ability to print pertinent information on forms 5.54.1.12 and reports (I.e. Unified Service Plan, assessments) Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

All required paper based forms (whose requirement was not satisfied by the automated 5.54.1.13 system) shall be made available electronically by the application in a form library Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

Required forms should be available in the appropriate component of the application so that 5.54.1.14 they can be filled out electronically for printing or electronic routing (i.e. service plan, progress notes) Response:

(1) Comply

(a) Core

(b) Custom

(c) 3rd Party

5.54.1.8 Response: 5.54.1.9 Response: 5.54.1.10 Response:

Ability to synchronize mobile and remote users 5.54.1.11 with host access Response:

5.55

HARDWARE

Vendor must provide a complete and itemized hardware configuration and cost which is sufficient to efficiently operate the proposed application at indicated levels for 60 months after installation and successful acceptance testing. Santa Cruz County may opt to procure the hardware and support of the hardware. It is required that the following conditions be included in all software agreements and be met for applications running on the County network, and on County supported servers. The application must run on an operating system that is consistently and currently supported by the operating system vendor. Applications under maintenance are expected

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to always be current in regards to the O/S. Outdated or unsupported O/S will not be implemented on the production network. The Santa Cruz County will apply patches to both the operating system, and security subsystems as releases are available from operating system vendors. The application is expected to perform in this environment. The application vendor is expected to keep their software current in order to operate in this environment. These patches include critical O/S updates and security patches. Should the patches cause an issue with the application, the application vendor is expected to immediately work on the issue, and provide application fixes to ensure it will operate successfully in the patched environment. The Santa Cruz County will actively run anti-virus management, where appropriate, on all application servers. The application is expected to perform adequately while anti-virus management is active. It is expected that the vendor’s application will run harmoniously with the Santa Cruz County’s backup agent. The Santa Cruz County runs a variety of proactive monitoring tools to ascertain the health and performance of the application server, associated network connections, power, etc. It is expected that the application software will run while these monitoring tools are actively running. For applications that will be maintained by the Vendor, it is expected that the vendor will access the Santa Cruz County network via a secured virtual private networking client (VPN). The vendor must contact County IT Security to have access enabled prior to connecting to the application for support. All application services must run as a true Service and not require a user to be logged-in at the console. The Santa Cruz County will provide an account with the appropriate security level to logon as a service. The County will provide the vendor with an account with appropriate administrative rights to administer the application. The account password is expected to periodically expire. In order for the application to run on County supported servers, the application must not require the users to have administrative rights on the servers. For vendor supported applications, all application updates must be presented to Change Management prior to being installed in the production environment. Implementation Time Required Include an estimated implementation time from the signing of the contract to implementation of the new system. 5.56

SUPPORT 5.56.1 Support Hours (Pacific Time, Standard and Daylight Savings): Location(s) Standard work hours (8:00 a.m. to 5:00 p.m., Monday through Friday, except for County holidays). Off-Hours – Only if project is scheduled (database upgrade, application upgrade, etc.). 5.56.2 Response to Problems: Critical (causes users to stop working) – A telephone response within 4 hours from when problem is reported. PAGE

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Non-Critical – require response within one business day from when problem is reported. 5.56.3 Cost for Annual Maintenance – for up to 5 years: Identify the average lifespan of a system version Define how frequently your firm provides new releases, upgrades, and/or patches to the software Provide cost for annual maintenance (include price for each year for up to 5 years) Annual maintenance cost must include the following: o Unlimited upgrades/patches/releases/versions to the application and database o Unlimited support for problems, questions, issues, assistance with using the system, etc. 5.56.4 Vendor References Vendor must submit at least five references from the United States. It is desirable that they be from government agencies in California. 5.57

COST PROPOSAL 5.57.1 Total All –Inclusive Maximum Price The cost proposal should contain all pricing information with detail cost breakdown relative to implementing the Behavioral Health Electronic Health Records System as described in this request for proposal. The total all-inclusive maximum price to be bid is to contain all direct and indirect costs including all out-of-pocket expenses. The Santa Cruz County will not be responsible for expenses incurred in preparing and submitting the technical proposal or the cost proposal. Such costs should not be included in the proposal. The first page of the cost proposal should include the following information: o Name of firm o Certification that the person signing the proposal is entitled to represent the firm empowered to submit the bid and authorized to sign a contract with the Santa Cruz County. 5.57.2 Rates and Hours by the Partner, Specialist, Supervisory and Staff Level Times Hours Anticipated for Each The cost bid should indicate a schedule of professional fees, hours and expenses that supports the total all-inclusive maximum price. Bidders’ response should indicate professional fees for each phase of the project. 5.57.3 Out-of-pocket Expenses Included in the Total All-Inclusive Maximum Price and Reimbursement Rates Out-of-pocket expenses for firm personnel (e.g., travel, lodging and subsistence) will be reimbursed at the rates used by the Santa Cruz County for its employees as directed by the IRS Publication 1542 and CAO Management Directive 500. (See Exhibit 2, Travel Reimbursement Rates). All estimated out-of-pocket expenses to be reimbursed should be presented in the cost proposal. All expense reimbursement will be charged against the total all-inclusive maximum price submitted by the firm. PAGE

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In addition, a statement must be included in the cost proposal stating the firm will accept reimbursement for travel, lodging and subsistence at the prevailing Santa Cruz County rates for its employees. Refer to Exhibit 2, Travel Reimbursement Rates. 5.57.4 Rates for Additional Professional Services If it should be necessary for the Santa Cruz County to request the Contractor to render any additional services to either supplement the services requested in this request for proposal or to perform additional work as a result of the specific recommendations included in any report issued on this engagement, then such additional work shall be performed only if set forth in an addendum to the contract between the Santa Cruz County and the firm. The addendum must be approved by the Board of Supervisors. Any such additional work agreed to between the Santa Cruz County and the firm shall be performed at the same rates set forth in the schedule of fees and expenses included in the cost bid. 5.57.5 Manner of Payment Progress payments may be made on the basis of milestones accepted and completed during the course of the contract and any out-of-pocket expenses incurred in accordance with the firm’s dollar cost bid proposal. Interim billings shall cover a period of not less than a calendar month. 5.57.6 Hardware, Software Licensing and Maintenance The cost proposal should include the software license cost per workstation and hardware cost per workstation and maintenance (Five Years Payable Annually). If any software volume licensing is available, please specify the volume breakdown. Discuss differences in pricing between offsite and onsite server support.

5.58

COST SHEET – Complete for 2 hosting options-onsite and offsite with vendor

Please complete the following cost sheet. The price sheet must include unit price, quantity, and total price for each item listed if applicable. Add any additional lines as needed. UNIT ITEM UNITS PRICE TOTAL

SOFTWARE / INSTALLATION / TRAINING/HARDWARE Software (Application) Cost: Workstation Licenses Server License List and Specify any 3rd Party Software required for system Total Software Cost

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Data Conversion/System Migration Costs Installation Specify the installation Fees Project Management Fees Travel Expenses Total Installation Cost Training at Santa Cruz County Location Train the Trainer – Admin/Supervisor Train the Trainer – Data Entry Clerk Training Cost per Day Estimated Travel Expenses Total Training Cost Hardware List and Specify Hardware required for system Total Hardware Cost Total System Cost

Cost of Future Software Enhancements Government Mandated Local Requests MAINTENANCE COST – ANNUAL Maintenance (to be paid annually) Discounts (indicate discount type, % as well as $ amount) Total Annual Maintenance Cost – Year 1 Total Annual Maintenance Cost – Year 2 Total Annual Maintenance Cost – Year 3 Total Annual Maintenance Cost – Year 4 Total Annual Maintenance Cost – Year 5

6.0 CONTRACT TERM 6.1

The term of the AGREEMENT(s) will be for a period of three (3) years with the option to extend the AGREEMENT for two (2) additional one (1) year periods.

6.2

The County reserves the right to cancel this AGREEMENT, or any extension of this AGREEMENT, without cause, with a thirty day (30) written notice, or immediately with cause.

6.3

If this RFP includes options for renewal or extension, CONTRACTOR must commence negotiations for rate changes a minimum of ninety days (90) prior to the expiration of the AGREEMENT. Both parties shall agree upon rate extension(s) or changes in writing. The County does not have to give a reason if it elects not to renew.

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7.0 SELECTION CRITERIA 7.1

The selection of CONTRACTOR(s) and subsequent contract award(s) will be based on the criteria contained in this Request for Proposals, as demonstrated in the submitted proposal and references from customers. CONTRACTOR(s) should submit information sufficient for the County to easily evaluate proposals with respect to the selection criteria. The absence of required information may cause the Proposal to be deemed non-responsive and may be cause for rejection.

Global RFP Evaluation and Scoring Criteria: Total potential points 100% (1) Practice Management Functionality (eligibility, billing, accounts management, scheduling, registration, phone logging, management information data reports for decisions) Up to 25 points – score _______ (2) Electronic Medical Records (EMR) Functionality for clinical documentation, pharmacy, lab orders, hospital reports, HIPAA, etc. Up to 20 points – score _______ (3) Price one time and ongoing with and without local servers Up to 20 points – score _______ (4) Interface capacity with local HIE and Health software for primary care clinics (Epic) and State systems for CSI, CalOMS, MEDS, etc Up to 10 points – score _______ (5) Installation and training plan Up to 15 points – score _______ (6) Quality Management Reports to meet CA requirements and local QA activities Up to 10 points- score ______ TOTAL POINTS: ______ The County will evaluate and select the Respondent that best meets the needs set forth in this RFP, is the best qualified and is able to provide the requested services. The evaluation of the proposals shall be within the sole judgment and discretion of the County. The County reserves the right to

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reject any or all RFPs. Award of contract is contingent upon approval from the Santa Cruz County Board of Supervisors and funding availability. 7.2

Any qualified bidder must meet all requirements set by the California State Department of Mental Health’s Request for Information (RFI)and offer excellent functionality of the components identified in the functional requirements, demonstrate a corporate capacity to install, perform required services, train, and maintain the proposed product in the California regulatory environment. All modules in the proposed product must be operational and have been successfully installed in California, preferably in a California county government organization. This RFP process not only emphasizes the functionality of potential systems, but also focuses on the capacity of a bidder to perform required services.

7.3

The System must be CCHIT 2006 certified; preferably CCHIT 2007 certified. Vendor should indicate their intent to attain and maintain CCHIT certification to ensure BHD that the System will meet the evolving EMR/HER standards.

7.4

Review of the proposals will be based on a points system. There are a total of 2450 points available in this RFP. Each of the functional requirements will be scored up to 5 points. Company profile and references, implementation plan and schedule, and price will be scored at up to 10% of the total value, or 245 points, each. Each response will be reviewed by the selection committee, which is made up of representatives from across the Behavioral Health Division and Health Information Technology. An average of all scores will be used as the final score for each RFP. Selection Committee may conduct site visits and request demonstrations as well as specific county research references to determine final score.

7.5

The selection criteria include, but are not limited to, the following: Capability and Qualifications: Do the service descriptions address all the areas identified in the RFP? Will the proposed services satisfy County’s needs and to what degree? Functionality as described in the Scope of Work: Product must be a behavioral health software application. Product must, at a minimum, meet Functional Requirements. Preferred to be a system that caters to the needs of government agencies meeting California specific requirements. Santa Cruz County will not consider being a beta tester (the product must be in full production use). It is required that product is installed and in use in other similar California agencies. Profile of the Respondent:

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The responder (vendor) must provide amount of demonstrated experience in providing the services desired in a government agency mental health and substance abuse. Please include the following information in your bid: Corporate name Date incorporated/organized Total number of employees involved in product development and sales. Total number of support staff that would be available to Santa Cruz County Total number of years your business has been providing this product and services. 7.3

REFERENCE LIST

Provide a list of at least five references by filling out the attached ‘Reference List’ form (EXHIBIT A). These references must be from your current client base. They must be currently using your software application. It is desirable that they be from government agencies within California. 7.4

COST PROPOSAL

Please complete the attached ‘Cost Proposal’ form. Prices must be quoted and firm for a period of at least one year. Any discounts must be included and noted on the price sheet In regards to the annual maintenance fees, state how much prior notice the vendor will provide to the County for any increase in annual warranty/maintenance fees. CONTRACTOR is required to submit a bid bond, or equivalent surety, in the amount of fifty thousand dollars, $50,000. All unforfeited bonds will be released upon successful negotiation of an agreement with the selected vendor.

A bid bond will be forfeit to the County by a vendor if a mutually acceptable agreement is not reached within 60 days of a notice of intent to award to that vendor. The County may, at its sole discretion, extend that period if it is determined that the vendor is negotiating in good faith and/or the delays are the completely the result of actions or inaction by the County. 7.5

INSURANCE REQUIREMENT

Responses submitted are under the assumption that there may be NO EXCEPTIIONS to the County’s insurance or bond requirement.

8.0 BIDDERS CONFERENCE MANDATORY pre-proposal meeting will be held on August 23, 2013 at 1:30pm at the Santa Cruz County Mental Health, 1400 Emeline Ave, Santa Cruz, room 207. No presentations are required. No notes from this meeting will be made available to non attendees. Those interested in submitting a proposal are highly encouraged to attend this meeting. The purpose of this meeting is to EXPLAIN and answer questions. No presentations are required. Please indicate your intent to attend this meeting by PAGE

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sending a response to Balvina Collazo, 831-454-4519. Conference call capacity will be provided. No addendum will result from this meeting.

9.0 CONTRACT NEGOTIATION The County will pursue contract negotiations with the CONTRACTOR(s) who submit(s) the best Proposal(s), in the sole opinion of the County, and which is in accordance with the criteria as described within this RFP. If the contract negotiations are unsuccessful, in the opinion of either the County or the CONTRACTOR(s), the County may pursue contract negotiations with the company which submitted a Proposal which the County deems to be the next best qualified to provide the services, or the County may issue a new RFP or take any other action which it deems to be in its best interest.

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GENERAL PROVISIONS SECTION GP

GP 1.0 CONTRACT AWARDS GP 1.1

Multiple Award(s): The County has the option to award a portion or portions of this contract to multiple successful CONTRACTOR(s) at the sole discretion of and benefit to the County.

GP 1.2

The award(s) made from this solicitation may be subject to approval by the County Board of Supervisors.

GP 1.3

Interview: the County reserves the right to interview selected CONTRACTOR(s) before a contract is awarded. The costs of attending any interview are the CONTRACTOR’S responsibility.

GP 1.4

Incurred Costs: The County is not liable for any cost incurred by CONTRACTOR(s) in response to this solicitation.

GP 1.5

Unsuccessful CONTRACTORS who have submitted a Proposal will be notified of the final decision.

GP 1.6

The award(s) resulting from this solicitation will be made to the CONTRACTOR(s) that submit(s) a response that, in the sole opinion of the County, best serves the overall interest of the County. Awards will not be based on cost alone.

GP 1.7

Prices are to remain firm for the initial term of the AGREEMENT and, thereafter, may be adjusted according to the terms and conditions of the AGREEMENT. County does not guarantee a minimum or maximum dollar value for any agreement or agreements resulting from this solicitation.

GP 2.0 PROPOSAL SUBMITTALS GP 2.1

All submittals in response to this solicitation become the property of the Santa Cruz County. If a CONTRACTOR does not wish to submit a Proposal but wishes to acknowledge the receipt of the request, the reply envelope shall be marked “No Bid.”

GP 2.2

Santa Cruz County reserves the right to reject any and all Proposals, or part of any Proposal, to postpone the scheduled Proposal deadline date(s), to make an award in its own best interest, and to waive any informalities or technicalities that do not significantly affect or alter the substance of an otherwise responsible Proposal and that would not affect a CONTRACTOR’S ability to perform the work adequately as specified.

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GP 2.3

Proposals must be received BEFORE the time and date specified, at the location and to the person specified on the SIGNATURE PAGE.

GP 2.4

ALL PROPOSALS MUST BE SUBMITTED IN A SEALED ENVELOPE BEARING ON THE OUTSIDE, PROMINENTLY DISPLAYED IN THE LOWER LEFT CORNER OF THE ENVELOPE, the CONTRACTOR’S name and address, the solicitation number, and the name of the person specified on the SIGNATURE PAGE.

GP 2.5

It is the sole responsibility of the CONTRACTOR to ensure that the Proposal is received at or before the specified time. Postmarks and facsimiles are not acceptable. Proposals received after the deadline shall be rejected and returned unopened.

GP 5.39

Submit any and all exceptions to this solicitation on separate pages, and clearly identify the top of each page with “EXCEPTION TO SANTA CRUZ COUNTY SOLICITATION #” (indicate the applicable solicitation number).

GP 5.40

Each EXCEPTION shall include the page number, section number, and referenced item number as appropriate.

GP 5.41

Failure to comply with GP 2.3 – 5.40 may result in a Proposal being declared as “non-responsive”.

GP 3.0 PROPOSAL FORMAT AND CONTENT GP 3.1

All proposals received by the County shall be considered "Public Record" as defined by Section 6252 of the California Government Code. This definition reads as follows: "...Public records" includes any writing containing information relating to the conduct of the public's business prepared, owned, used or retained by any state or local agency regardless of physical form or characteristics "Public records" in the custody of, or maintained by, the Governor's office means any writing prepared on or after January 6, 1975." 3.1.1 Each proposal submitted is Public record and is therefore subject to inspection by the public per Section 6253 of the California Government Code. This section states that "every citizen has a right to inspect any public record". 3.1.2 The County will not exclude any proposal or portion of a proposal from treatment as a public record except in the instance that it is submitted as a trade secret as defined by the California Government Code. Information submitted as proprietary, confidential or under any other such terms that might suggest restricted public access will not be excluded from treatment as public record. 3.1.3 "Trade secrets" as defined by Section 6254.7 of the California Government Code are deemed not to be public record. This section defines trade secrets as: 3.1.4 "...Trade secrets," as used in this section, may include, but are not limited to, any formula, plan, pattern, process, tool, mechanism, compound, procedure, production data or compilation of information that is not patented, which is known only to certain individuals within a commercial concern who are using it to fabricate, produce, or compound an article of trade or a service having commercial value and which gives its user an opportunity to obtain a business advantage over competitors who do not know or use it."

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3.1.5 Information identified by bidder as "trade secret" will be reviewed by Santa Cruz County's legal counsel to determine conformance or non-conformance to this definition. Examples of material not considered to be trade secrets are pricing, cover letter, promotional materials, etc. 3.1.6 Any page of the CONTRACTOR’S response package that is deemed to be a trade secret by the CONTRACTOR shall be clearly marked “PROPRIETARY INFORMATION” at the top of the page in at least one-half inch (1/2”) size letters. INFORMATION THAT IS PROPERLY IDENTIFIED AS TRADE SECRET AND CONFORMS TO THE ABOVE DEFINITION WILL NOT BECOME PUBLIC RECORD. COUNTY WILL SAFEGUARD THIS INFORMATION IN AN APPROPRIATE MANNER. 3.1.7 Information identified by bidder as trade secret and determined not to be in conformance with the California Government Code definition shall be excluded from the proposal. Such information will be returned to the bidder at bidder's expense upon written request. 3.1.8 Trade secrets must be submitted in a separate binder that is plainly marked "Trade Secrets." 3.1.9 The County shall not in any way be liable or responsible for the disclosure of any proposals or portions thereof, if they are not (1) submitted in a separate binder that is plainly marked "Trade Secret" on the outside; and (2) if disclosure is required under the provision of law or by order of Court. 3.1.10 Vendors are advised that the County does not wish to receive trade secrets and that vendors are not to supply trade secrets unless they are absolutely necessary. GP 3.2

To be considered “responsive,” submitted Proposals should adhere to the following guidelines: GP 3.2.1 Proposals should be prepared on 8-1/2” x 11” paper and bound with front and back covers. Fold out charts, tables, spreadsheets, brochures, pamphlets and other pertinent information or work product examples may be included as Appendices. GP 3.2.2 Reproductions of the Santa Cruz County Seal should not be used in any documents submitted in response to this solicitation. GP 3.2.3 Indicate the name and title of the CONTRACTOR’S primary contact person. Also, include their mailing address, telephone number and fax number, along with their Email address, if any. GP 3.2.4 A copy of any agreement proposed by the CONTRACTOR(s) as part of their response to this solicitation must be submitted along with their Proposal. These agreements will be considered as part of the bid package prior to an award selection being made. THE INCLUSION OF A PROPOSED AGREEMENT DOES NOT GUARANTEE ACCEPTANCE OF THAT AGREEMENT BY THE COUNTY. Therefore, CONTRACTOR’S Proposal must specify what, if any, terms of their Proposal would be different if the County does not accept the proposed agreement, in whole or in part. CONTRACTOR agreements will not be considered if submitted after the Deadline for Proposals. (Refer to Section GP 5.0 AGREEMENT TO TERMS AND CONDITIONS.) GP 3.2.5 Submit complete documentation as listed in Section 7.0 SELECTION CRITERIA. GP 3.5.39 To validate your Proposal, submit the SIGNATURE PAGE with your proposal. Proposals submitted without this page will be deemed non-responsive. Proposal signatures must be manual and in ink. All prices and notations must be typed or

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written in ink. Errors may be crossed out and corrections printed in ink or typed adjacent, and must be initialed in ink by the person signing the proposal. GP 3.3

Submit one (1) single-sided original Proposal and three (203) single or double-sided copies of the CONTRACTOR’S proposed responses, with one (1) clearly marked “Original.” (Total of four proposal packets)

GP 4.0 PROPOSAL STANDARD INSTRUCTIONS AND CONDITIONS GP 4.1

Propose on each item separately. Prices shall be quoted in units specified. If total extended price differs from unit price, the unit price shall prevail.

GP 4.2

Brand names and numbers when cited are informational unless stipulated otherwise. Proposals for equal items will be considered, provided the proposal clearly describes the article offered and its proposed equal in quality, utility and/or performance. Proposals not indicating otherwise will be considered to be for the exact item specified.

GP 4.3

Delivery time shall be a part of the consideration of proposal submissions. Specify delivery time in days after receipt of order (ARO).

GP 4.4

Unless stated otherwise, the F.O.B. for receivables shall be destination. Charges for transportation, containers, packaging and other related shipping costs shall be borne by the shipper.

GP 4.5

ACCEPTANCE TIME: Proposals are subject to acceptance at any time within 90 days after opening.

GP 4.6

TAXES: Do not include sales or use tax in proposal responses. The County shall pay such applicable taxes. Do not include Federal Excise Tax. The County is registered with the Internal Revenue Service, San Francisco office, registration number 94730022K. The County is exempt from Federal Transportation Tax; an exemption certificate is not required where shipping documents show Santa Cruz County as consignee.

GP 4.7

CAL-OSHA: The items proposed shall conform to all applicable requirements of the California Occupational Safety and Health Administration Act of 1973 (CAL-OSHA).

GP 4.8

HAZARDOUS MATERIALS: Transportation of any hazardous materials to the Santa Cruz County must be done so in conformance with SARA Title 3 as amended. Appropriate documentation must be provided in a Material Safety Data Sheet (MSDS) and other documentation as necessary relating to the traits, characteristics, and pervasive properties of any hazardous materials shipped to the Santa Cruz County. The shipper understands that the Santa Cruz County shall not accept any shipment of hazardous materials without complete documentation and safety information as required by law. The Santa Cruz County shall not take responsibility for the accidental or purposeful discharge or release of any hazardous material. The Santa Cruz County does not take responsibility for the improper packaging

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and/or transportation of any hazardous materials ordered by the County while in transit or storage prior to delivery and acceptance by the County. GP 4.9

WARRANTY: The CONTRACTOR shall specify the warranty period for the materials and guarantee the workmanship of all items proposed. After the award, the CONTRACTOR shall promptly remedy all defects without cost to the County that may appear within this period.

GP 4.10

Any discount offered by the CONTRACTOR(s) must allow for payment after receipt and acceptance of services, material or equipment and correct invoice, whichever is later. In no case, in the evaluation of Proposals, will a discount be considered that requires payment in less than 30 days.

GP 4.11

PROTESTS AND APPEALS: Refer to Exhibit C for information on the County’s Protest procedures.

GP 4.12

NON-COLLUSION DECLARATION: Contractor must complete and return with their response, the form labeled Exhibit B.

GP 5.0 AGREEMENT TO TERMS AND CONDITIONS CONTRACTOR(s) selected through the solicitation process will be expected to execute a formal agreement with the County for the provision of the requested service. The agreement will be written by the County in a standard format approved by County Counsel, similar to the “SAMPLE AGREEMENT” enclosed herewith. Submission of a signed bid/proposal and the SIGNATURE PAGE will be interpreted to mean CONTRACTOR HAS AGREED TO ALL THE TERMS AND CONDITIONS set forth in the pages of this request and the standard provisions of the SAMPLE AGREEMENT. The County may consider including language from the CONTRACTOR’S proposed agreement if submitted following the procedures identified in Section GP 3.0 PROPOSAL FORMAT AND CONTENT.

GP 6.0 RIGHTS AND REMEDIES OF THE COUNTY FOR DEFAULT In the case of default by the CONTRACTOR, the County may procure the articles or services from other sources and may recover the loss occasioned thereby from any unpaid balance due the CONTRACTOR or by proceeding against any performance bond of the CONTRACTOR, if any, or by suit against the CONTRACTOR. The prices paid by the County shall be considered the prevailing market price at the time such purchase(s) may be made. Inspections of deliveries or offers for deliveries that do not meet specifications shall be made at the expense of the CONTRACTOR.

GP 7.0 INDEMNIFICATION CONTRACTOR shall indemnify, defend, and hold harmless the County, its officers, agents, and employees, from and against any and all claims, liabilities, and losses whatsoever (including damages to property and injuries to or death of persons, court costs, and reasonable attorneys’ fees) occurring or resulting to any and all persons, firms or corporations furnishing or supplying work, services, materials, or PAGE

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supplies in connection with the performance of this Agreement, and from any and all claims liabilities, and losses occurring or resulting to any person, firm or corporation for damage, injury, or death arising out of or connected with the Contractor’s performance of this Agreement, unless such claims liabilities, or losses arise out of the comparative basis of fault, comparative negligence or willful misconduct of the County. “CONTRACTOR’S performance” includes CONTRACTOR’S action or inaction and the action or inaction of CONTRACTOR’S officers, employees, agents and subcontractors. CONTRACTOR agrees to the fullest extent permitted by law, including *California Civil Code, Section 2782.8, that the CONTRACTOR is responsible for any and all damages, liabilities and cost on a comparative basis of fault between the CONTRACTOR and the Santa Cruz County. Neither the CONTRACTOR nor the County shall be responsible for the other party’s negligence.

GP 8.0 INSURANCE GP 8.1

Evidence of Coverage: Prior to commencement of this AGREEMENT, the CONTRACTOR shall provide a “Certificate of Insurance” certifying that coverage as required herein has been obtained. Individual endorsements executed by the insurance carrier shall accompany the certificate. In addition, the CONTRACTOR upon request shall provide a certified copy of the policy or policies. This verification of coverage shall be sent to the County’s Contracts/Purchasing Department, unless otherwise directed. The CONTRACTOR shall not receive a “Notice to Proceed” with the work under this AGREEMENT until it has obtained all insurance required and the County has approved such insurance. This approval of insurance shall neither relieve nor decrease the liability of the CONTRACTOR.

GP 8.2

Qualifying Insurers: All coverage, except surety, shall be issued by companies which hold a current policy holder’s alphabetic and financial size category rating of not less than A- VII, according to the current Best’s Key Rating Guide or a company of equal financial stability that is approved by the County’s Risk Manager.

GP 8.3

Insurance Coverage Requirements: Without limiting CONTRACTOR’S duty to indemnify, CONTRACTOR shall maintain in effect throughout the term of this AGREEMENT a policy or policies of insurance with the following minimum limits of liability: GP 8.3.1 Commercial general liability insurance, including but not limited to premises and operations, including coverage for Bodily Injury and Property Damage, Personal Injury, Contractual Liability, Broad form Property Damage, Independent Contractors, Products and Completed Operations, with a combined single limit for Bodily Injury and Property Damage of not less than $1,000,000 per occurrence.

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GP 8.3.2 Business automobile liability insurance, covering all motor vehicles, including owned, leased, non-owned, and hired vehicles, used in providing services under this AGREEMENT, with a combined single limit for Bodily Injury and Property Damage of not less than $500,000 per occurrence. GP 8.3.3 Workers’ Compensation Insurance, if CONTRACTOR employs others in the performance of this AGREEMENT, in accordance with California Labor Code section 3700 and with Employer’s Liability limits not less than $1,000,000 each person, $1,000,000 each accident and $1,000,000 each disease. GP 8.3.4 Professional liability insurance, if required for the professional services being provided, (e.g., those persons authorized by a license to engage in a business or profession regulated by the California Business and Professions Code), in the amount of not less than $1,000,000 per claim and $2,000,000 in the aggregate, to cover liability for malpractice or errors or omissions made in the course of rendering professional services. If professional liability insurance is written on a “claims-made” basis rather than an occurrence basis, the CONTRACTOR shall, upon the expiration or earlier termination of this AGREEMENT, obtain extended reporting coverage (“tail coverage”) with the same liability limits. Any such tail coverage shall continue for at least three years following the expiration or earlier termination of this AGREEMENT. GP 8.4

Other Insurance Requirements: All insurance required by this AGREEMENT shall be with a company acceptable to the County and issued and executed by an admitted insurer authorized to transact Insurance business in the State of California. Unless otherwise specified by this AGREEMENT, all such insurance shall be written on an occurrence basis, or, if the policy is not written on an occurrence basis, such policy with the coverage required herein shall continue in effect for a period of three years following the date CONTRACTOR completes its performance of services under this AGREEMENT.

GP 8.5

Each liability policy shall provide that the County shall be given notice in writing at least thirty days in advance of any endorsed reduction in coverage or limit, cancellation, or intended nonrenewal thereof. Each policy shall provide coverage for CONTRACTOR and additional insureds with respect to claims arising from each subcontractor, if any, performing work under this AGREEMENT, or be accompanied by a certificate of insurance from each subcontractor showing each subcontractor has identical insurance coverage to the above requirements.

GP 8.6

Commercial general liability and automobile liability policies shall provide an endorsement naming the Santa Cruz County, its officers, agents, and employees as Additional Insureds with respect to liability arising out of the CONTRACTOR’S work, including ongoing and completed operations, and shall further provide that such insurance is primary insurance to any insurance or self-insurance maintained by the County and that the insurance of the Additional Insureds shall not be called upon to contribute to a loss covered by the CONTRACTOR’S insurance

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GP 8.7

Prior to the execution of this AGREEMENT by the County, CONTRACTOR shall file certificates of insurance with the County’s contract administrator and County’s Contracts/Health Services Agency, showing that the CONTRACTOR has in effect the insurance required by this AGREEMENT. The CONTRACTOR shall file a new or amended certificate of insurance within five calendar days after any change is made in any insurance policy, which would alter the information on the certificate then on file. Acceptance or approval of insurance shall in no way modify or change the indemnification clause in this AGREEMENT, which shall continue in full force and effect.

GP 8.8

CONTRACTOR shall at all times during the term of this AGREEMENT maintain in force the insurance coverage required under this AGREEMENT and shall send, without demand by County, annual certificates to County’s Contract Administrator and County’s Contracts/Purchasing Division. If the certificate is not received by the expiration date, County shall notify CONTRACTOR and CONTRACTOR shall have five calendar days to send in the certificate, evidencing no lapse in coverage during the interim. Failure by CONTRACTOR to maintain such insurance is a default of this AGREEMENT, which entitles County, at its sole discretion, to terminate this AGREEMENT immediately.

GP 9.0 INVOICES CONTRACTOR shall reference the AGREEMENT number and solicitation number on all invoices submitted to the County. CONTRACTOR shall submit such invoices periodically or at the completion of services, but in any event, not later than 30 days after completion of services. The invoice shall set forth the amounts claimed by CONTRACTOR for the previous period, together with an itemized basis for the amounts claimed, and such other information pertinent to the invoice. The County shall certify the invoice, either in the requested amount or in such other amount as the County approves in conformity with this AGREEMENT, and shall promptly submit such invoice to the County Auditor-Controller for payment. The County Auditor-Controller shall pay the amount certified within 30 days of receiving the certified invoice.

GP 10.0 RIGHTS TO PERTINENT MATERIALS All responses, inquiries, and correspondence related to this solicitation and all reports, charts, displays, schedules, exhibits, and other documentation produced by the CONTRACTOR that are submitted as part of the submittal will become the property of the County when received by the County and may be considered public information under applicable law. Any proprietary information in the submittal must be identified as such and marked “CONFIDENTIAL”. The County will not disclose proprietary information to the public, unless required by law; however, the County cannot guarantee that such information will be held confidential.

GP 11.0 CONTRACT AUDITS CONTRACTOR agrees that Santa Cruz County or its designee will have the right to review, obtain and copy all records pertaining to performance of the contract. CONTRACTOR agrees to provide Santa Cruz PAGE

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County or its designee with any relevant information requested, and shall permit Santa Cruz County or its designee access to its premises, upon reasonable notice, during normal business hours for the purpose of interviewing employees and inspecting and copying such books, records, accounts and other material that may be relevant to a matter under investigation for the purpose of determining compliance with this requirement. CONTRACTOR further agrees to maintain such records for a period of five (5) years after final payment under the contract.

GP 12.0 NON-DISCRIMINATION GP 12.1 During the performance of this contract, the CONTRACTOR shall not unlawfully discriminate against any employee or applicant for employment because of race, religious creed, color, national origin, ancestry, physical disability, mental disability, medical condition, marital status, age (over 40), sex, or sexual orientation. The CONTRACTOR(s) shall ensure that the evaluation and treatment of its employees and applicants for employment are free of such discrimination. The CONTRACTOR shall comply with the provisions of the Fair Employment and Housing Act (Government Code, §12900, et seq.) and the applicable regulations promulgated thereunder (California Code of Regulations, Title 2, §7285.0, et seq.). GP 12.2

The applicable regulations of the Fair Employment and Housing Commission implementing Government Code, §12990, et seq., set forth in Chapter 5 of Division 4 of Title 2 of the California Code of Regulations are incorporated into this AGREEMENT by reference and made a part hereof as if set forth in full.

GP 12.3

The successful CONTRACTOR(s) shall include the non-discrimination and compliance provisions of the clause in all agreements with subcontractors to perform work under the contract.

GP 13.0 INDEPENDENT CONTRACTOR GP 13.1

The CONTRACTOR shall be an independent contractor and shall not be an employee of Santa Cruz County, nor immediate family of an employee of the County. CONTRACTOR shall be responsible for all insurance (General Liability, Automobile, Workers’ Compensation, unemployment, etc,) and all payroll-related taxes. CONTRACTOR shall not be entitled to any employee benefits. The CONTRACTOR shall control the manner and means of accomplishing the result contracted for herein.

GP 13.2

Non-Assignment: CONTRACTOR shall not assign this contract without the prior written consent of the County.

GP 14.0 CONFLICT OF INTEREST The CONTRACTOR covenants that the CONTRACTOR, its responsible officers, and its employees having major responsibilities for the performance of work under the AGREEMENT, presently have no interest and during the term of the AGREEMENT will not acquire any interests, direct or indirect, which PAGE

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might conflict in any manner or degree with the performance of the CONTRACTOR’S services under the AGREEMENT.

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SIGNATURE PAGE SANTA CRUZ COUNTY CONTRACTS/Health Services Agency

RFP ISSUE DATE: August 6, 2013

RFP TITLE: Integrated Behavioral Health Electronic Health Record System PROPOSALS ARE DUE IN THE OFFICE OF Blanche Bettinger, Purchasing Manager, On September 30, 2013 by 2pm

ADDRESS:

SANTA CRUZ COUNTY 701 Ocean St. Room 330 Santa Cruz CA 95060

QUESTIONS ABOUT THIS RFP SHOULD BE DIRECTED TO Blanche Bettinger at [email protected]

This Signature Page must be included with your submittal in order to validate your proposal. Proposals submitted without this page will be deemed non-responsive.

CHECK HERE IF YOU HAVE ANY EXCEPTIONS TO THIS RFP. BIDDERS MUST COMPLETE THE FOLLOWING TO VALIDATE PROPOSAL I hereby agree to furnish the articles and/or services stipulated in my proposal at the price quoted, subject to the instructions and conditions in the Request for Proposal package. I further attest that I am an official officer representing my firm and authorized with signatory authority to present this proposal package. Company Date: Name:

Signature:

Printed Name:

Phone:

Title:

Street Address/PO Box: _______________________________________

Fax:

E-mail:

City: ______________

State ______________

ZIP: ______________

License No. (if applicable):

License Classification (if applicable):

___________________________________________

___________________________________________

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Intentionally blank

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EXHIBIT A REFERENCES

Firm:

Provide a list of at least five (5) customers for whom you have recently provided similar services (preferably California State or local government agencies). Be sure to include addresses and phone numbers. Reference Name: Contact Date: Service Provided:

City: Phone No.:

(

)

Reference Name: Contact Date: Service Provided:

City: Phone No.:

(

)

Reference Name: Contact Date: Service Provided:

City: Phone No.:

(

)

Reference Name: Contact Date: Service Provided:

City: Phone No.:

(

)

Reference Name: Contact Date: Service Provided:

City: Phone No.:

(

)

Failure to provide a list of at least five (5) customers may be cause for rejection of this RFP.

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Exhibit “B” COUNTY OF SANTA CRUZ NON-COLLUSION DECLARATION TO BE EXECUTED BY RESPONDENT AND SUBMITTED WITH RFP

I,_____________________________________________________________, am the (Name) _________________________________ of _________________________________, (Position/Title) (Company) the party making the foregoing RFP that the RFP is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the RFP is genuine and not collusive or sham; that the respondent has not directly or indirectly induced or solicited any other respondent to put in a false or sham RFP; and has not directly or indirectly colluded, conspired, connived, or agreed with any respondent or anyone else to put in a sham RFP, or that anyone shall refrain from bidding; that the respondent has not in any manner directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the respondent or any other respondent, or to fix any overhead, profit, or cost element of the bid price, or of that of any other respondent, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the RFP are true; and, further, that the respondent has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid.

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct:

(Date)

(Signature)

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EXHIBIT “C” PROTESTS AND APPEALS PROCEDURES 1.

Protests to the General Services Director Any actual or prospective bidder, offeror or contractor who is allegedly aggrieved in connection with the solicitation or award of a contract, other than a bid protest, may protest to the General Services Director. The protest shall be submitted in writing to the General Services Director (Purchasing Agent) within five (5) working days after notification of the recommendation of award.

2.

Decision of the General Services Director The General Services Director shall issue a written decision within ten (10) working days after receipt of the protest. The decision shall: (a) (b)

State the reason for the action taken; Inform the protestant that a request for further administrative appeal of an adverse decision must be submitted in writing to the Clerk of the Board of Supervisors within seven (7) working days after receipt of the decision made by the General Services Director. However, if the underlying protested award is not subject to approval by the Board of Supervisors (contracts for services for up to $15,000), then the General Services Director’s decision shall be final.

The General Services Director shall discuss with County Counsel all protests prior to issuing a written decision. 3.

Protests and Appeals to the Board of Supervisors (a) If permitted under Section 2(b) above, the decision of the General Services Director may be appealed to the Board of Supervisors. (b) Any actual or prospective bidder, offeror or contractor who is allegedly aggrieved may protest a bid to the Board of Supervisors.

4.

Time Limits for Filing Protests and Appeals to the Board of Supervisors Protests and appeals to the Board of Supervisors must be filed no later than ten days after the date of the decision being protested or appealed. The County shall be considered an interested party. When the appeal period ends on a day when the County offices are not open to the public for business, the time limits shall be extended to the next full working day.

5.

Content of Protest and Appeal; Stay of Award Any appeal or protest shall be filed in writing with the Clerk of the Board of Supervisors and shall state, as appropriate, any of the following: A determination or interpretation is not in accord with the purpose of these procedures or County Code; There was an error or abuse of discretion; The record includes inaccurate information; or A decision is not supported by the record. In the event of a timely appeal before the Board of Supervisors under this Section, the County shall not proceed further with the solicitation or with the award of the contract until the appeal is resolved, unless the County Administrative Officer, in consultation with County Counsel, the General Services Director, and the using department, makes a written determination that the award of the contract without delay is necessary to protect a substantial interest of the County.

6.

Protest and Appeal Procedure (a) Hearing Date. A hearing before the Board shall be scheduled within thirty days of the County’s receipt of a protest or appeal unless the protestor and County both consent to a later date. (b) Notice and Public Hearing. The hearing shall be a public hearing. Notice shall be mailed or delivered to the protestor not later than ten days before the scheduled hearing date. (c) Hearing. At the hearing, the Board shall review the record of the process or decision, and hear oral explanations from the protestor and any other interested party. (d) Decision and Notice. After the hearing, the Board shall affirm, modify or revise the original decision. When a decision is modified or reversed, the Board shall state the specific reasons for modification or reversal. The Clerk of the Board of Supervisors shall mail notice of the Board decision. Such notice shall be mailed to the protestor within five working days after the date of the decision, and to any other party requesting such notice. (e) A decision by the Board shall become final on the date the decision is announced to the public.

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