€¦ · web viewalliance behavioral healthcare is seeking a care management system comprising of...

Request for ProposalCare Management System

RFP # 17-003

Pursuant to General Statutes of North Carolina, Section 143 Article 3 subject to the conditions and specifications herein, Vendors are invited to submit Proposals for Care Management System

Responses to this Request for Proposal will be received by Alliance Behavioral Healthcare until February 1, 2017 5:00 p.m. EST

Responses shall be submitted to: [email protected]

TABLE OF CONTENTS

Title Starting Page INTRODUCTION 3QUESTIONS 3GENERAL COMMENTS 3SUBMITTAL INSTRUCTIONS 4

THE TECHNICAL PROPOSAL SECTION 1 – GENERAL RESPONSE INFORMATION

4Tab 1 - Required Forms Tab 2 - Introductory Letter and Executive SummaryTab 3 - Financial Performance Tab 4 - Qualifications and ExperienceTab 5 - Your Product and Approach Tab 6 - Conflict of InterestTab 7 - Business Continuity Plan

SECTION 2 – SOFTWARE OVERVIEW 6Tab 1 - ApplicationsTab 2 - Data Warehousing Tab 3 - User Interface Tab 4 - Documentation Tab 5 - Source Code Tab 6 - Customization Tab 7 - System InterfacesTab 8 - Installations Tab 9 - Security

SECTION 3 – APPLICATION REQUIREMENTS (Chart)8

Tab 1 - Systems Management, Security and Compliance 1-62Tab 2 - Care Management 1-110Tab 3 - Workflow 1-34Tab 4 - Product Hosting 1-24

SECTION 4 – IMPLEMENTATION 25Tab 1 - Approach Tab 2 - Data Conversion Tab 3 - Project PlanTab 4 - Education and TrainingTab 5 – Staffing

SECTION 5 – MAINTENANCE AND SUPPORT 26Tab 1 - Software Support

Tab 2 - Warranty Period

SECTION 6 - THE COST PROPOSAL 26Tab 1 - Pricing StrategyTab 2 - Software MaintenanceTab 3 - Implementation Support

SECTION 7 - EVALUATION AND AWARD CRITERIA28

Tab 1 - Evaluation ProcessTab 2 - Evaluation CriteriaTab 3 - Award of Contract

ATTACHMENTS-To be returned with SubmittalNon-Collusion Affidavit Attachment A Iran Divestment Act Certification Form Attachment BAlliance Vendor Profile Form Attachment CW-9 Form Attachment DAddendum Acknowledgement Form Attachment E

INTRODUCTIONAlliance Behavioral Healthcare, known as Alliance, operates as a public Local Management Entity (LME) and Managed Care Organization (MCO) responsible for over 200,000 Medicaid eligible North Carolinians with mental health, intellectual and developmental disability, and substance use/addiction services across Wake, Durham, Johnston and Cumberland counties in North Carolina.

Alliance Behavioral Healthcare is seeking a Care Management System comprising of the application software, hosting configuration, interoperability, consulting, project management, implementation, training, documentation, on-going hosting and customer support.

EXPECTED RFP SCHEDULERFP Posted Monday, January 9, 2017Vendor Questions Due Wednesday, January 18, 2017 5:00 pm EST

Questions/Answers Posted(As an addendum)

Wednesday, January 25, 2017 2:00 pm EST

Proposals Due Wednesday, February 1, 2017 5:00 pm EST

Evaluations of Proposals-Including any Vendor Demonstrations/Presentations

Complete by Wednesday, February 15, 2017

Tentative Award Announcement February 15, 2017

Anticipated Contract Start Date 2nd Quarter 2017

No pre-bid vendor conference will be held in conjunction with this RFP.

QUESTIONSAny Vendor requiring clarification of any section of this RFP or wishing to comment or take exception to any requirements or other portion of the RFP must submit specific questions in writing no later than January 18, 2017 5:00 p.m. EST. Questions shall be e-mailed to [email protected]. Any objection to the RFP or to any provision of the RFP that is not raised in writing on or before the last day of the question period is waived. Every effort will be made to have responses posted in the form of an addendum by January 25, 2017 5:00 p.m. EST, contingent on the number and complexity of the questions. A copy of all questions or comments and Alliances responses will be posted on the Alliance’s website: http://www.alliancebhc.org/

GENERAL COMMENTSBy submitting a proposal, vendors acknowledge that Alliance reserves the right to reconsider any proposals at any phase of this procurement process. Alliance also reserves the right to meet with select vendors at any time to gather additional information.

Alliance will not be held responsible for the failure of any email delivery service to deliver a proposal response. It is solely the Vendor’s responsibility to: (1) ascertain that they have all required and necessary information, documents and addenda, prior to submitting a response; (2) ensure that the response is received to the correct email address on or prior to the date and time listed. Late responses, regardless of delivery means, will not be accepted. Submittals received by hand deliver, telephone, or facsimile will not be accepted. (3) Alliance Behavioral Healthcare reserves the right to reject any and all submittals or any portions thereof.

Alliance reserves the right to cancel, issue amendments or modify this RFP to correct any errors or to clarify requirements. Alliance will post all communication regarding this RFP on its website http://www.alliancebhc.org. Any changes, amendments, or clarifications will be made in the form of written responses to Vendor questions, amendments, or addenda issued by Alliance on its website. Vendors should check the website frequently for notice of matters affecting the RFP.

SUBMITTAL INSTRUCTIONSVendors interested in being considered for providing the specified software and services shall submit a response electronically to [email protected]. All submissions shall be in Adobe pdf format readable by a currently supported version of MS Office software.

Responses shall be labeled in Subject Line and in Introductory Letter as:RFP# 17-003 Care Management System

When responding to this RFP, please follow all instructions carefully. Proposals must address all the questions and requirements of the RFP in the order and format specified in each section. It is the Vendor’s responsibility to ensure its Proposal is submitted in a manner that enables the Evaluation Team to easily locate all response descriptions and any exhibits or attachments for each requirement of this RFP.

The RFP is provided to you as a word document. Responders are strongly encourage to provide information and responses directly into this document, when possible. If the Responder is providing attachments, it is important to specify the associated Section and Tab number directly on the attachment.

THE TECHNICAL PROPOSAL SECTION 1 – GENERAL RESPONSE INFORMATIONTechnical Proposal addressing all requirements specified in the RFP under the following Tabs. Proposals must include all of the information set forth and shall be organized, tabbed and submitted appropriately, responding to all information requested.

Tab 1 – Required Forms This Tab includes the following required forms and information.

a. Non-Collusion Affidavit-Attachment Ab. Iran Divestment Act Certification-Attachment Bc. Alliance Vendor Profile-Attachment Cd. W-9 Form-Attachment D

e. Addendum Acknowledgement, if any addendums are issued-Attachment E

Tab 2 – Introductory Letter and Executive SummaryProvide an informative, narrative Introductory Letter highlighting your agency’s capabilities and services, and additional information as noted here. Identify number of personnel by department (support, development, training, sales, and administration). If outside services are an integral part of the operation (i.e., contract programmers/consultants), describe their typical responsibilities and if they are outsourced outside of the United States. This is especially important relating to any support services relating to the RFP.

Submit any organization information, such as awards received, or M/WBE business information.

Submit a brief statement of history including ownership, mergers/acquisitions, business partnerships, and other significant business events. Vendors should also identify the approximate date of initiation of their performance management SaaS solution implementation and support business. (Definition-SaaS software as a service)

Tab 3 - Financial Performance Submit annual reports and financial statements for the past three (3) years. If this cannot be done, summarize highlights of financial performance over the past three years (specifically, total revenues, revenue growth and net profit). Disclose any pending acquisitions (i.e., companies being acquired, companies acquiring your organization, products being acquired, etc.).

Tab 4 - Qualifications and ExperienceUnder this tab include references of similar requested work performed by your firm over the past three (3) years. Include a client’s name, email address and telephone number.

Tab 5 - Your Product and Approach Briefly describe the main features of the product/solution that you are offering. Highlight the innovative aspects of your product. What do you consider the most important features?

Under this Tab include a description of activities, such as the project methodology and timeline for project completion, etc. The Proposer should also include its plan for managing the work requirements requested.

Describe future development plans and a 5 year roadmap for feature and platform upgrades of your proposed solution. Where is this product on the product lifecycle?

Tab 6 - Conflict of InterestUnder this Tab the Proposer should describe any involvement that your firm, its employees, or its owner(s) have that may constitute a conflict of interest. Note: Alliance reserves the right to approve all personnel working on Alliance projects. Key professional staff may not be removed, reassigned or replaced without prior approval from Alliance.Tab 7 - Business Continuity Plan

Under this Tab the Proposer shall provide a copy of their Business continuity plan in the event their system goes down.

SECTION 2 – SOFTWARE OVERVIEW Tab 1 - Applications If the solution allows or requires the purchase of individual modules, identify the modules currently available for installation and how often the software is upgraded.

Server Side:1. Please describe the structure of your application, specifically, describe the operating

system platform(s) supported and the database platform(s) supported.

2. List any additional 3rd party applications necessary to meet the functionality requested.

3. If the application is supported under the Microsoft platform, how quickly is the application tested against Microsoft updates, patches, hot fixes, and operating system upgrades?

4. Please describe the maintenance process for minor version releases, major version releases, patches and/or hot fix updates and the frequency of each; provide sample documentation that is included with each release, and your record of meeting scheduled release dates.

5. For cloud based or SaaS based solutions, please answer all of the above including how you solicit feedback from clients and incorporate enhancements to the solution. This should include details of the process and any user group models that are in place for this solicitation.

Client Side: 6. Describe the client application; are there independent upgrades and/or patches

separate from the server application? How does the client application connect to the Server application?

7. Describe the maintenance process for minor version releases, major version releases, patches and/or hot fix updates and the frequency of each; provide sample documentation that is included with each release, and your record of meeting scheduled release dates.

Tab 2 - Data Warehousing Describe access methods to the data for downstream applications such as a data warehouse:

1. Please specify what Application Programming Interfaces (APIs) are available and describe their supported framework.

2. If API’s are available, please provide detailed documentation for all of the functionality available through the API.

3. If this is a hosted solution Describe how we can access our data through means other than the user interface. This includes the tools used to extract data from the system for integration into other CLIENT applications or data environments.

4. Provide a detailed schema with metadata, data dictionary (indicating required vs. optional fields) and data flow diagram for the application database. We highly recommend a detailed response.

5. Describe standards, methodology (including frequency) in place for passing data to downstream reporting databases such as a data warehouse.

6. Do you provide reliable create and update dates on all tables such that incremental warehouse processing is possible. If not available, describe alternative means for downstream incremental processing.

7. Do you offer the ability to access any and all data elements for downstream processes?

8. Do you offer the ability to generate custom reporting fields that can be accessed for the data warehouse?

9. Describe methods used to provide audit information on inserted, updated and deleted records.

Tab 3 - User Interface Describe the user interface employed by the application software. Describe how users navigate through the applications: pull-down menus, standard menus, jump keys, quick commands, etc. Indicate if working in multiple sessions is allowed.

Tab 4 - Documentation Describe documentation available to users and provide relevant sample documentation.

Describe documentation available to system administrators for product support, end-user training, major and minor releases or upgrades, patch/or hot fix releases and operating system upgrades.

Indicate if documentation is integrated with your product, on-line and not integrated, or hard copy.

Tab 5 - Source Code

Will Alliance acquire source programs? If not, what arrangements have been made to supply current users with rights to software and related documentation in the event the vendor ceases business?

Tab 6 - Customization Identify your policy regarding customization of source code. If it is allowed, describe your approach including design, development, testing, upgrades, documentation, and pricing structure. Describe any features or capabilities that allow the systems to be customized without changing source code (i.e., screen designers, template builders, etc.). Tab 7 - System InterfacesThe system(s) must interface with Microsoft applications, particularly Outlook, Excel and Word. Indicate how this system interfaces with Microsoft applications.

Also, indicate if this system does not interface with Microsoft please identify compatible applications. Specify compatible versions if applicable.

Specify what Application Programming Interfaces are available and describe their supported framework.

If this is a hosted solution describe how we can access our data without using the User Interface. This includes the tools used to extract data from the system for integration into other Alliance applications or data environments.

Tab 8 - Installations Identify the number of installations where your solutions are operational for healthcare settings. Indicate what applications or modules are in use, and which versions.

Describe the installation process. Include the options for technical assistance and/or support.

Tab 9 - Security If the application is supported by the Microsoft Windows Operating System has it been tested to function with the High Security Template provided by Microsoft? Does the application comply with Federal privacy regulations, including HIPAA, Hi-Tech and 42 CFR Part 2 as applicable?

SECTION 3 – APPLICATION REQUIREMENTSThis Section defines the applications that Alliance expects to implement.

CHART INSTRUCTIONS The chart below profiles desired key features of the software solutions so that you may determine the compatibility of your proposed software with Alliances requirements. Use the following instructions to address each feature described in the profiles.

Place a "Y" (for yes) in the “Y/N” column of the matrix if the current release of the software can support all of the features described in the row without special customization. Expand on system capabilities in the comments section of the matrix.

If the current release of the software does not support all of the features in the row, place an “N” (for no) in the “Y/N” column and if appropriate, use the comments section to describe alternate means of providing the missing feature(s).

If customization (vs. configuration) is necessary, it should be clearly noted by indicating estimated hours to customize (EHC) in the vendor comment column. Feel free to use as much space as needed in the comments area to tell us about your functionality and how it differentiates your product from your competition’s product.

Also, feel free to add supplements to this RFP to compliment any questions you have identified that need further detail. Mark all exhibits, attachments or supplements with corresponding Tab number.

Tab 1 - Systems Management, Security and ComplianceID Sub-category Application Criteria Yes/No Vendor Comment

1. Access Controls The system should allow multiple users to edit the same client information concurrently

Click here to enter text.


2. Access Controls The system must provide protection to maintain the integrity of client health information during concurrent editing.



3. Access Controls The system must trigger alerts to simultaneous users who may be editing the same data screen.



4. Access Controls The system must be scalable to accommodate up to 200 users and up to 50 sites.



5. Access Controls The system must support and implement redundancy/ fault tolerance for 100% system availability.



6. Access Controls The system must support secure Web-based system access.



7. Access Controls The system must provide the ability for authorized system administrators to add/ delete users and assign, modify, or delete related system access restrictions or privileges.



8. Access Controls The system must have specific permission settings for viewing, entering, and modifying any and all data



9. Access Controls The system must provide the ability to define user access to the application's functions through role -based profiles rather than user-based profiles



10. Access Controls The system shall enforce the most restrictive set of rights/privileges or accesses needed by users/groups (e.g. System Administration, Clerical, Nurse, Doctor, etc.), or processes acting on behalf of users, for the performance of specified tasks.



11. Access Controls The system, prior to a user login, may display a warning notice (e.g. "The system should only be accessed by authorized users").



12. Access Controls Users without a valid account, and/or invalid login attempts receive this message



13. Access Controls The system must be able to associate permissions with a user using user-based role (access rights assigned to each user)



14. Access Controls The system must be able to associate permissions with a user using role-based (users are grouped and access rights assigned to these groups)



15. Access Controls The system should be able to associate permissions with a user using context-based (role-based with additional access rights assigned or restricted based on the context of the transaction such as time-of-day, workstation-location, emergency-mode, etc.)



16. Access Controls The system shall support removal of a user’s privileges without deleting the user from the system. The purpose of the criteria is to provide the ability to remove a user’s privileges, but maintain a history of the user in the system.



17. Access Controls The system shall be able to support role based access control that is in compliance with the HL7 Permissions Catalog.



18. Access Controls The system must be capable of operating within an RBAC infrastructure conforming to ANSI INCITS 359-2004, American National Standard for Information Technology – Role Based Access Control.



19. Passwords The system must require user login passwords be changed regularly.



20. Passwords The system must require valid and secure user login passwords.

Click here to enter


text.21. Passwords The system must provide the ability to

automatically log users out of the system after a period of inactivity (set by system admin)



22. Passwords The system must enforce a limit of consecutive invalid access attempts by a user. The system shall protect against further, possibly malicious, user authentication attempts.



23. Passwords The system must prevent the reuse of passwords previously used within a specific (configurable) timeframe (i.e., within the last X days, etc. - e.g. "last 180 days"), or shall prevent the reuse of a certain (configurable) number of the most recently used passwords (e.g. "last 5 passwords).



24. Passwords The system must store encrypted passwords.



25. Passwords The system must provide system password controls to enforce minimum password length



26. Passwords The system must encrypt passwords when routed over a network



27. Passwords The system must support a minimum of two-factor authentication (i.e.: user name and password)



28. Passwords The system must not display passwords while being entered.



29. Passwords The system must provide users with the capability to change their passwords at their discretion



30. Passwords The system must support case-insensitive usernames that contain type able alpha-numeric characters in support of ISO-646/ ECMA-6 (aka US ASCII)



31. Passwords The system shall support password strength rules that allow for minimum number of characters, and inclusion of alpha-numeric complexity.



32. Passwords The system shall provide an administrative function that resets passwords.



33. Passwords The system must allow user accounts that have been reset by an administrator shall require the user to change the password at next successful logon.



34. Passwords The system shall provide only limited feedback information to the user during the authentication. Ex (invalid password)



35. Passwords The system shall use either standards-based encryption, e.g., 3DES, AES, or standards-based hashing, e.g., SHA1 to store or transport passwords.



36. Protected Health Information

The system must allow a user to mark a client's specific health information as blinded, prohibiting access to other users.




The system must support access to blinded information to a treating healthcare service clinicians, when the blinded information is necessary for managing an emergency condition if it meets consent policies.




The system must authenticate the user login before any access to Protected Resources (e.g. PHI) is allowed, including when not connected to a network e.g. mobile devices.




The system shall provide the ability to prevent specified user(s) from accessing a designated client's chart.




Ability to "lock" consumers records down per procedure.




The system shall provide the ability to identify certain information as confidential and only make that accessible by appropriately authorized users.




The system shall provide the ability to limit access to a client's chart to clinicians directly involved in treatment of the client, or clinicians involved in review of the treatment.



43. Data Security Controls

All electronic transactions and interface specifications must be HIPAA compliant




The system must provide the ability to implement Chain of Trust agreements.




The system must support protection of confidentiality of all Protected Health Information (PHI) delivered over the internet or other known open networks via encryption using triple-DES (3DES) or the Advanced Encryption Standard (AES) and an open protocol such as TLS, SSL, IPSec, XML encryptions, or S/MIME or their successors.




The system must include the capability to encrypt the data communicated over the network via SSL (HTML over HTTPS) for systems that provide access to PHI through a web browser interface (i.e. HTML over HTTP).




The system must support protection of integrity of all Protected Health Information (PHI) delivered over the internet or other known open networks via SHA 1 hashing and an open protocol such as TLS, SSL, IPSec, XML digital signature, or S/MIME or their successors.




Alliance does not allow portable/removable devices. Employees have to be approved to use these devices. When approved, the system must support use of standards based encrypted format using triple- DES (3DES0, and the Advanced Encryption Standard (AES), when storing PHI on any physical media intended to be portable/ removable (e.g. thumb-drives, CD-ROM, PDA).




The system must have security measures to protect data being transmitted via wireless networks, including data communications with portable devices.



50. Audit traceability Provide a fully auditable operational system that can track and report on ALL user activity on system



51. Audit traceability The system must store the identity of the user for every instance of: Data entry, Data modification, Exchange of data, data deleted or inactivated, Report or Query requested or executed. It should be able to audit all events and not just the last user/modification.



52. Audit traceability The system must be able to detect security-relevant events that it mediates and generate audit records for them. At a minimum the events shall include: start/ stop, user login/log out, session timeout, account lockout, client record created/ viewed/ updated/ deleted, scheduling, query, order, node-authentication failure, signature created/ validated, PHI export, PHI import, and security administration events. Note: The system is only responsible for auditing security events that it mediates. A mediated event is an event that the system has some active role in allowing or causing to happen or has



opportunity to detect.53. Audit traceability Must provide security administration

functionality including logging unauthorized access attempts by date, time, user ID, device and location



54. Audit traceability The system must provide audit trail capabilities that are compliant with regulatory guidelines, including HIPAA for all client records by a user or system



55. Audit traceability The system must provide an audit trail that is compliant with regulatory guidelines when any existing client records are read, modified or deleted by a user or the system



56. Audit traceability System shall support logging to a common audit engine using the schema and transports specified in the Audit Log specification of IHE Audit Trails and Node Authentication (ATNA) Profile.



57. Audit traceability The system shall record within each audit record the following information when it is available: (1) date and time of the event; (2) the component of the system (e.g. software component, hardware component) where the event occurred; (3) type of event (including: data description and client identifier when relevant); (4) subject identity (e.g. user identity); and (5) the outcome (success or failure) of the event.



58. Audit traceability The system shall provide authorized administrators with the capability to read all audit information from the audit records in one of the following two ways: 1) The system shall provide the audit records in a manner suitable for the user to interpret the information. The system shall provide the capability to generate reports based on ranges of system date and time that audit records were collected. 2) The system shall be able to export logs into text format in such a manner as to allow correlation based on time (e.g. UTC synchronization).



59. Audit traceability The system should be able to input, modify, inactivate, update, copy, and print reasons alerts/reminders were overridden. No one should be able to delete alerts/reminders, maybe make them inactive but still have a process, based on user role to identify the inactive alerts/reminders.



60. Backup & System will support Alliance Service Level Click here Click here to

Recovery Agreements and Business Continuity Plan to enter text.

enter text.

61. Reporting & Analytics

Ability to provide operational reports Click here to enter text.


62. Personal Health Records

Ability to provide client-facing personal health records through a patient portal.



Tab 2 - Care ManagementID Sub-category Evaluation Criteria Yes/No Vendor Comment

1. Vocabulary & Taxonomy

System supports LOINC for lab tests and results



2. Vocabulary & Taxonomy

System supports both ICD9 and ICD10 diagnostic codes



3. Client Search Ability to segment and stratify members by a large number of variables and attributes including name, DOB, SS#



4. Crisis system Implement a Crisis system (not excel) that is integrated with the Care Management system



5. Advance Directives

The system shall provide the ability to indicate that a client has completed medical advance directive(s) and/or mental health advance directive(s) and whether the advance directive(s) is available in the system.




The system shall provide the ability to indicate or record the type of advance directive(s), such as living will, durable power of attorney, or a "Do Not Resuscitate" order.




The system shall provide the ability to indicate when advance directives were last reviewed.




The system must be able to input, modify, inactivate, expire, update, display, copy, and print an Advance Directives Plan.



9. Individualized Care Plan

An individualized care plan that lists specific tasks, has protocols for monitoring patients, and helps remind about pre-determined frequency of encounters is an important component of a care management information system.



10. IndividualizedCare Plan

Patients can be assigned to a Care Mgr directly even though providers change




Individualized Care Plan for each patient Click here to enter text.



Includes DX, risk status, Patient Monitoring protocol




Includes intervention tasks and activities Click here to enter text.



Includes goals Click here to enter text.


15. IndividualizedCare Plan

Includes assessment Click here to enter text.



Does the care plan help determine how frequently the patient should have an encounter or contact




Who has access to care plan - Care Mgr., PCP, patient, caregiver, hospital




Is the care plan electronic Click here to enter text.



Is the care plan printable Click here to enter text.



Can the care plan be printed at appropriate comprehension level



21. Clinical Patient Summary

A clinical patient summary that includes risk status, problems, medications, assessments and reminders, with the option of being patient friendly and printable is essential for care coordination.




What is included in the patient summary? Click here to enter text.



Risk status, Diagnoses, Medications, Allergies




Assessments (e.g. Medical, Psychosocial) Click here to enter text.



Exams/Lab results Click here to enter text.



Reminders - Follow up, Health promotions Click here to enter text.



Preventative care summary, Care recommendations




Can the clinical summary be printed at appropriate comprehension level




Patient access to summary Click here to enter text.



Summary available as CCD for interoperability




ImpactPro Score can be tracked over time Click here to enter text.


32. Patient ProfileAlerts

Configurable alerts based on patient gaps in care, lack of contact




Allow entry of alerts for potential patient risks




Display patient profile alerts in Call Center application




Alert on Main screen if consumer is currently at a Crisis or inpatient Facility




Alert on Main screen that indicates if consumer has a ProActive Crisis Plan, Hospital Destination Plan or Advanced Directive in place




An indicator that identifies people who are IDD eligible and on the Innovations waitlist



38. ClinicalPatientSummary

Information that indicates how many crisis/input events have occurred within last year to help quickly identify criteria for CC assignment




Ability to drill down to identify information regarding each hospitalization event (admit/dc dates and hospital location)




Easily identifiable information related to aftercare appointments (Date/Time/Attended /Missed)



41. Claims Integration

Ability to load pharmacy claims, behavioral claims, facility claims, professional claims and electronic health record encounters into patient history



42. Claims Ability to load pharmacy claims, behavioral claims, facility claims, professional claims and electronic health record encounters into patient history daily



43. Integration Ability to load pharmacy claims, behavioral claims, facility claims, professional claims and electronic health record encounters into patient history daily in real time



44. Clinical Pathways Pre-configured evidence-based care pathways for mental health, substance



abuse and IDD.45. Clinical Pathways Care pathways include behavioral health

guidelines Click here to enter text.


46. Clinical Pathways Care pathways include level of care guidelines



47. Clinical Pathways Care pathways include therapeutic and testing procedures



48. Clinical Pathways Care pathways include detailed discharge criteria



49. Clinical Pathways Care pathways include flexible recovery courses



50. Clinical Pathways Care pathways include alternative care planning



51. Clinical Pathways Pre-configured evidence-based care pathways for acute and chronic medical conditions.



52. Patient Portal An easy to use patient portal that allows patients to access patient information, view reminders, ask questions, and leave comments



53. Patient Portal Does the portal provide patients with electronic access to their care plan?



54. Patient Portal Offer reminders and updates to patients? Click here to enter text.


55. Patient Portal Allow the patient to update and create reminders? (Must be as an addition. No original documents can be removed/deleted.)



56. Patient Portal Wellness/ Disease Management education module that contains educational information that can be shared with people being served through Care Coordination



57. Patient Portal “Medication” module (Medication Education information related to each person’s current medication)



58. Patient Portal Ability for Client to request Accounting of Disclosures



59. Patient Portal Ability to provide login credentials for patients and to verify identity



60. Provider Portal Ability for a provider to access their patient's alerts via a provider portal



61. Provider Portal Deploy a Provider Portal integrated with the Care Management and Claims/Benefit system



62. Provider Portal Limit data in client history accessible to providers on provider portal



63. Provider Portal Ability to provide login credentials for providers and to verify identity



64. Quality Reporting Does the system provide quality reports for different national, state and custom measures? (e.g. % of diabetics with hemoglobin A1C measured in the past 6 months)



65. Quality Reporting How many measures - URAC, NCQA, SAMHSA, NQF, DHHS



66. Quality Reporting How often are the measures updated Click here to enter text.


67. Quality Reporting Granularity of measure drill down - agency, provider, clinic, practitioner



68. Quality Reporting Interactive risk stratification by diagnosis cost, in-patient cost, outpatient cost, gaps-in-care, adherence, assessments, and risk scores.



69. Quality Reporting Risk adjusted cost reporting at agency and provider level



70. Quality Reporting Ability to retrieve patient history (provider NPI, last claim, metabolic screening data) by combinations of diagnosis and medication type



71. MedicationManagement

Medication management: identifying barriers to medication adherence, generating a comprehensive medication list, tracking encounters with pharmacists, tracking prescription refills for patients with difficulty in medication adherence, and providing reconciliation metrics is a core component of care coordination.




Do you have an electronic comprehensive medication list for each patient?




Track prescription refill dates? Click here to enter text.



Track when prescriptions have been filled-picked up? For at least 6 months



75. Medication Management

Medication Administration, Drug Interactions,




Medication Possession Ratio (MPR) & Proportion of Days Covered (PDC) adherence metrics



77. Medication Ability to drill down to identify prescriber Click here to Click here to enter

Management information (name and office phone number)

enter text. text.


Ability to drill down to identify pharmacy information (name and phone number)




Provide evidence-based, best practice prescribing guidelines for psychotropic medications.




Configurable pharmacy alerts based on high/low dose, metabolic screening data, drug interactions




Configurable pharmacy alerts based on lab results - blood &urine tests, kidney function, pharmacogenomics




Real time update of pharmacy fills via Dr First, CPESN, or CCNC Pharmacy Home




Access to State Controlled Substance Database and Prescription Drug Monitoring Program




Access to National REMS databases Click here to enter text.


85. PharmacyManagement

Document encounters with the pharmacist?



86. Pharmacy Management

Track discussions regarding medication reconciliation with the patient, provider, and /or pharmacist?




Identification of pharmacies with the ability to dispense Clozapine through registration with the Clozapine Patient Registry database and on-going monitoring of labs for applicable patients




Identification of pharmacies able to fluently speak languages other than English or has a contracted service with a vendor who can translate between the pharmacist/pharmacy representative and the patient or patient representative




Identification of pharmacies with the ability and willingness to dispense naloxone and deliver proper counseling for its use in narcotic overdose situations




Identify pharmacies offering a Comprehensive Medication Review - A review of patient medications, including prescription, over-the-counter, herbal medications and dietary supplements to identify, resolve, and prevent medication-related problems, including adverse events




Identify pharmacies offering a Med Synchronization Program - Aligning all chronic medications for patients to be filled at the same time each month




Identify pharmacies offering Adherence Packaging - Unit dose packaging designed to assist patients with medication organization by incorporating date and time into the unit dose device; call pharmacy to determine whether or not fee applies



93. Client History History of patient medications, appointments and hospitalizations with associated costs



94. Client History Patient history of allergies, Immunizations, metabolic data, diagnoses, assessments, risk scores,



95. Client History Ability to pull information from specific fields within assessments, screenings and lab reports



96. Client History History of Labs, (dates/types/ results) does module highlighted abnormal lab results?



97. Client History Consent history available in client history Click here to enter text.


98. Client History Medicare claims reflected in Client History for dual eligibility



99. Client History Admission Screening available in client history



100. Client History Nursing Assessment available in client history



101. Assessments Ability to upload and attach an assessment form or text document to client history



102. Assessments Ability for user to configure multiple types of assessment questions, responses and scores



103. Assessments Ability to trend assessment scores over time and chart



104. Assessments Ability to configure patient or prescriber alerts based on assessment scores are



trends105. Assessments Ability to require providers add assessment

data and track completion Click here to enter text.


106. Client, Family &CaregiverInformation

Client, Family & Caregiver Information available in client history



107. Admit/Transfer/Discharge

Ability to receive Admit/Transfer/Discharge notifications in standard formats in real time




Ability to display Admit/Transfer/Discharge notifications on a case workers screen in real time




Ability to notify a Case Worker via email or text whenever an Admit/Transfer/Discharge notification is received in real time




Ability to receive Admit/Transfer/Discharge notifications



Tab 3 – WorkflowID Sub-category Evaluation Criteria Yes/No Vendor Comment

1. Workflow Integration

Ability to orchestrate workflow between Care Management and Claims Adjudication applications



2. Assignment & tracking

Ability to assign multiple patients to a single workflow at one time




Ability assign a care manager to a workflow or workflow task




Ability for a care manager to see new workflow tasks assigned to them




Ability to assign standard durations to a workflow or workflow task and have it automatically schedule




Ability for care manager to update a task and have the workflow automatically routed to the next care manager.




Ability to route workflow tasks to any Alliance organization or location.




Ability for a supervisor to retrieve the status of all workflow tasks assigned to a care manager.




Ability to attach documents to a specific workflow task or consumer




Ability to embed Relias courses in workflow Click here to enter text.



Ability to embed query or dashboard to workflow




Ability to generate email notifications from within the workflow. E-mails need to be saved within the system.



13. Care Pathways Pre-configured workflow available out of the box for each Care Pathway



14. User-created Workflows

Ability to create and modify custom workflows by users within the system (no vendor tasks required)



15. IM/Chat Provide a tool for real time communications among team members



16. Care Pathways Ability to have system prompts for “next steps/tasks” related to specific answers in screening or assessment tools CC may be completing



17. Care Pathways Workflow for Pharmacist Consults and Referrals



Tab 4 - Product HostingAlliance Behavioral Healthcare is looking for explicit detailed, technical responses to the following regarding SaaS solutions. Please provide your responses in the Comments section in the table below, using as much space as necessary to fully comment on a statement or answer a question.

ID # General Security Comments1. Alliance Behavioral Healthcare reserves the right to

periodically audit the infrastructure hosting the Alliance Behavioral Healthcare Management System application to ensure compliance with Alliance Behavioral Healthcare policies and standards. Non-intrusive network audits (basic port scans, etc.) may be randomly performed without prior notice. More intrusive network and physical audits may be conducted on site within 24 hour notice.


2. Please provide documentation with the proposed architecture that includes a full network diagram of the potential Alliance Behavioral Healthcare Management System application environment, illustrating the relationship between the environment and any other relevant networks, with a full data flowchart that details where the potential Alliance Behavioral Healthcare Management System data would reside, the applications that manipulate it and the security thereof.


3. Please tell us about your organization’s ability to immediately disable all or part of the functionality of the application should a security issue be identified.


ID # Physical Security Comments4. Would the equipment hosting the application for Alliance

Behavioral Healthcare be located in a physically secure facility which requires, at a minimum, badge access?


5. Would the infrastructure (hosts, network equipment, etc.) hosting the Alliance Behavioral Healthcare Management System application be located in a locked cage-type environment?


6. Alliance Behavioral Healthcare must have the final approval of who is authorized to enter any locked physical environment, as well as access to the Alliance Behavioral Healthcare application infrastructure.


7. Please disclose, by name and title, who in your organization would have access to the environment hosting the application for Alliance Behavioral Healthcare.


8. Alliance Behavioral Healthcare requires that a SaaS disclose their SaaS background check procedures and results to grant approval for use of a SaaS.

Describe, in detail, your background check procedures.


ID # Network Security Comments9. Tell us if the network hosting the application is physically

isolated from any other network or customer.

If the network hosting the application is not physically isolated from any other network or customer, please describe the configuration settings confirming data and processing segregation.


10. Describe how Alliance Behavioral Healthcare users will connect to the solution.

If connection will be via a private circuit, such as frame relay, then that circuit must terminate on the Alliance Behavioral Healthcare extranet and the operation of that circuit will come under the procedures and policies that govern the Alliance Behavioral Healthcare Business Partners.

OR if connection will go over a public network such as the internet, appropriate firewalling technology must be deployed by the SaaS vendor, and the traffic between Alliance Behavioral Healthcare and the SaaS must be protected and authenticated by cryptographic technology.


ID # Host Security Comments11. Describe how and to what extent the host operating systems

(Unix, NT, etc.) comprising the Alliance Behavioral Healthcare Management System application infrastructure has been hardened against attack.


12. Provide a listing of current patches on hosts, including host OS patches, web servers, databases and any other material application.


13. Tell us how and when notification for security patches for the applications will be provided.


14. Describe, in detail, your processes for monitoring the integrity and availability of your hosts.


15. Describe, in detail, your password policy for the Alliance Behavioral Healthcare Management System infrastructure,


including minimum password length, password generation guidelines and how often the passwords are changed.

16. Does the solution generate all user accounts and provide a one-time password which must be changed at the first logon?


17. Does the solution provide information on the account generation, maintenance and termination process for both maintenance and user accounts?

Include information about how an account is created, how account information is transmitted to the user, and how accounts are terminated when no longer needed.


ID # Web Security Comments18. At Alliance Behavioral Healthcare’s discretion, the SaaS

provider may be required to disclose the specific configuration files for any web servers and associated support functions (such as search engines or databases).


19. Identify all of the SaaS application tools Click here to enter text.20. Provide documentation for Quality Assurance testing and web

code review for the Alliance Behavioral Healthcare Management System application will be using.


ID # Cryptography Comments21. Tell us if the Alliance Behavioral Healthcare Management

System application infrastructure will use any non-standard cryptography.


22. Do the algorithms used by the application have the strength to equate to 168-bit TripleDES?


23. Alliance Behavioral Healthcare requires that any connections to the solution utilizing the Internet must be protected using any of the following cryptographic technologies: IPSec, SSL, SSH/SCP or PGP.

Tell us the cryptographic technology that will be used in the Alliance Behavioral Healthcare Management System application.


24. Indicate if the Alliance Behavioral Healthcare Management System infrastructure application will require PKI.


SECTION 4 – IMPLEMENTATION In this section, vendor is requested to identify implementation and training resources, and illustrate a successful implementation methodology.

Tab 1 - Approach Please identify your implementation methodology and describe the nature of your implementation assistance with brief comments on the following topics:

Process review and redesign• Project Planning • Project Scheduling (include project timeline)• Personnel assignment by role

• Project planning & control / project management approach• Software customization• Orientation and training• System testing• User acceptance Implementation• On-going support – please provide available examples of on-going support

Tab 2 - Data Conversion Provide a detailed explanation of any tools you have available for conversion of data as well as a detailed explanation of your conversion methodology.

Provide examples of systems you have converted from in past engagements including amount of data converted, time to convert etc.

Are there any limitations on the conversion of data from existing systems into your system? If yes, please explain in detail what those limitations are.

What edit capabilities do you employ to prevent the conversion of bad data and what visibility into the data captured in those edits do you provide?

Tab 3 - Project PlanSubmit a sample project plan that identifies your methodology in implementing our solution. The plan should identify the scope and level of effort (in hours or days) required of vendor personnel, CLIENT project team, and end users. Preferably, a summary in MS Project.

Tab 4 - Education and TrainingDescribe your approach to user training. This should include approach (train the trainer, classroom, etc.), location of any classes, and training materials used.

If formal education facilities and/or programs are offered, the recommended courses and corresponding costs should be specified. In addition, the vendor is requested to submit education catalogs, if available, indicating syllabus, course dates, location, and tuition costs.

Tab 5 - StaffingOutline the staffing considerations involved with implementing your solution. List the specific roles and the number of full and part-time equivalents you would expect to fill those roles under normal circumstances. Please include all relevant resources (staff, administration, support, Information Service, etc.), the number of years that they have been with the company, the number of years that they have been implementing this particular software and the number of years that they have been working in a healthcare environment.

SECTION 5 – MAINTENANCE AND SUPPORTIn this section vendor is requested to describe its ongoing support of the installation and system users.

Tab 1 - Software Support Describe your maintenance/support policy in terms of key features. Describe alternative support packages, if any. Address maintenance/support functions in the context of the following topics and any others that may be pertinent.

• Trouble line for problem call-in• Initial installation and configuration• Remote dial-in diagnostics• On-site, local support• Software release/fix down loading process• Response time guarantees• User groups and newsletters• Controlled change request process• Use of Internet for problem reporting and management

Indicate whether application software updates are distributed on a scheduled basis. Please also indicate the method of communication.

Tab 2 - Warranty PeriodDescribe provisions of the software warranty, including the term of such provisions and when the warranty period begins, with respect to modular software, by module.

SECTION 6 - THE COST PROPOSALThe Vendor must include and complete all tabs of the Cost Proposal in a clear and accurate manner. It is the responsibility of the Vendor to clearly identify all costs associated with any item or series of items in this RFP. Costs that are not clearly identified will be borne by the Vendor. Prices quoted must be held firm for minimum of ninety (90) days.

Tab 1 - Pricing StrategyIndicate the basis of your software pricing strategy (i.e., based on number of staff, number of performance management modules, etc.). If software is assembled from multiple vendor sources, this should be identified. If there is an additional cost for non-production system (such as a test system), please identify that as well.

Tab 2 - Software MaintenanceIdentify annual cost and the basis on which adjustments are made to ongoing software maintenance charges as well as any expected increases projected for the next five years.Tab 3 - Implementation Support Implementation and support fees are to be identified. Address the flat fee or hourly cost of the following and provide an estimated total cost to Alliance based on experience with other like implementations:

One time feesOne time/Initial implementation fees: Click here to enter text.

One time feesTraining fees: Click here to enter text.Consulting fees: Click here to enter text.

Initial year costs (include all fees for license, use, access, etc.)For x providers: Click here to enter text.For each additional provider: Click here to enter text.

Provide the pricing algorithm used to calculate this cost.


Ongoing annual costs (include all fees for maintenance & operations (M&O), support, software, hardware, use, access, etc.)

For x providers: Click here to enter text.

For each additional provider: Click here to enter text.

Provide the pricing algorithm used to calculate this cost. Also, provide your policy regarding price increases.


Five (5) year cost of ownershipIndicate the estimated TCO ("total cost of ownership") for the product over a 5 year period.


Additional Costs (if any)Training Costs Click here to enter text.

Project Management Click here to enter text.

Process re-design Software modifications (custom programming)


On-going support Provide examples of potential support issues


Travel, per diem and any other expenses associated with the delivery and implementation of the proposed items must be included in the Vendor’s costs.


SECTION 7 - EVALUATION AND AWARD CRITERIATab 1 – Evaluation ProcessBids will be examined promptly after opening and award will be made at the earliest possible date. Bids may be withdrawn by written notice.

Tab 2 – Evaluation CriteriaAlliance will evaluate proposals based on the following:

Evaluation CriteriaDepth of FeaturesWorkflow

Provider PortalMember PortalBehavioral Care PathwaysMigration of Claims HistoryHEDIS ReportingRisk

DifferentiationCost

Tab 3 - Award of ContractAlliance reserves the right to award to a single Responder deemed to be fully qualified and best suited among those submitting proposals on the basis of the evaluation factors included in the Request for Proposals. Price shall be considered, but shall not be the sole determining factor. Once the proposals are ranked and the most qualified firm(s) are determined, Alliance may conduct further negotiations, and/or request presentations from firm(s) to further assist in the clarification of information and selection process.

Attachment A

Attachment B

Attachment C

Attachment D

€¦ · web viewalliance behavioral healthcare is seeking a care management system comprising of...

Documents