HARRIS COUNTY

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HARRIS COUNTY
JOB NO. 02/0031
REQUEST FOR PROPOSAL Date Due: February 19, 2002
Cover Sheet DUE NO LATER THAN 1:00 P.M.

Proposals received later than the date
and time above will not be considered.

PROPOSAL FOR: HIPAA COMPLIANCE ASSESSMENT AND BUSINESS PROCESS
REENGINEERING EVALUATION FOR HARRIS COUNTY
HOSPITAL DISTRICT

OFFERORS NOTE!!
Carefully read all instructions, requirements and Please return proposal in the envelope provided or in a
specifications. Fill out all forms properly and comparable size envelope. Be sure that return envelope
completely. Submit your proposal with all appropriate shows the Job Number, Description and is marked
supplements and/or samples. "SEALED PROPOSAL."

RETURN PROPOSAL TO:
HARRIS COUNTY PURCHASING AGENT
1001 PRESTON AVENUE, SUITE 670
HOUSTON, TEXAS 77002

For additional information, contact Laurie Wainwright at 713-755-6597.

You must sign below in INK; failure to sign WILL disqualify the offer. All prices must be typewritten or
written in ink.
Total Amount of Proposal $____________________________

Company Name: ________________________________________________________________

Company Address: ________________________________________________________________

City, State, Zip Code: ________________________________________________________________

Taxpayer Identification Number (T.I.N.): _________________________________________________

Telephone No. __________________FAX No. _____________________e-mail__________________

Print Name: ________________________________________________________________________

Signature: __________________________________________________________________________
[Your signature attests to your offer to provide the goods and/or services in this proposal according to the published
provisions of this Job. When an award letter is issued, it becomes a part of this contract. Contract is not valid until
Purchase Order is issued.]

Revised 01/00

Page 1 of 21
TABLE OF CONTENTS

Items checked below represent components which comprise this bid/proposal package. If the item IS NOT checked, it is NOT
APPLICABLE to this bid/proposal. Offerors are asked to review the package to be sure that all applicable parts are included. If
any portion of the package is missing, notify the Purchasing Department immediately.

It is the Offeror's responsibility to be thoroughly familiar with all Requirements and Specifications. Be sure you understand the
following before you return your bid packet.

__X__ 1. Cover Sheet
Your company name, address, the total amount of the bid/proposal, and your signature (IN INK) should appear
on this page.

__X__ 2. Table of Contents
This page is the Table of Contents.

__X__ 3. General Requirements
You should be familiar with all of the General Requirements.

__X__ 4. Special Requirements/Instructions
This section provides information you must know in order to make an offer properly.

__X__ 5. Specifications
This section contains the detailed description of the product/service sought by the County.

__X__ 6. Pricing/Delivery Information
This form is used to solicit exact pricing of goods/services and delivery costs.

__X__ 7. Attachments

__X__ a. Residence Certification
Be sure to complete this form and return with packet.

_____ b. Bid Guaranty & Performance Bond Information & Requirements
This form applies only to certain bids/proposals. Please read carefully and fill out
completely.

_____ c. Bid Check Return Authorization Form
This form applies only to certain forms. Please read carefully and fill out completely.

_____ d. Vehicle Delivery Instructions
Included only when purchasing vehicles.

__X__ e. Minimum Insurance Requirements
Included when applicable (does not supersede "Hold Harmless" section of General
Requirements).

_____ f. Workers' Compensation Insurance Coverage Rule 110.110
This requirement is applicable for a building or construction contract.

_____ g. Financial Statement
When this information is required, you must use this form.

__X__ h. Reference Sheet

_____ i. Other
From time to time other attachments may be included.
Revised 09/00

Page 2 of 21
GENERAL REQUIREMENTS
FOR PROPOSALS

READ THIS ENTIRE DOCUMENT CAREFULLY. FOLLOW ALL INSTRUCTIONS. YOU ARE RESPONSIBLE
FOR FULFILLING ALL REQUIREMENTS AND SPECIFICATIONS. BE SURE YOU UNDERSTAND THEM.

General Requirements apply to all advertised requests for proposals; however, these may be superseded, whole or in part, by the
SPECIAL REQUIREMENTS/INSTRUCTIONS OTHER DATA CONTAINED HEREIN. Review the Table of Contents. Be
sure your proposal package is complete.

GOVERNING LAW
This request for proposals is governed by the competitive bidding requirements of the County Purchasing Act, Texas Local
Government Code, §262.021 et seq., as amended. Offerors shall comply with all applicable federal, state and local laws and
regulations. Offeror is further advised that these requirements shall be fully governed by the laws of the State of Texas and that
Harris County may request and rely on advice, decisions and opinions of the Attorney General of Texas and the County Attorney
concerning any portion of these requirements.

PROPOSAL COMPLETION
Fill out and return to Purchasing, ONE (1) complete proposal form, using the envelope provided. An authorized company
representative should sign the Cover Sheet. Completion of these forms is intended to verify that the offeror has submitted the
proposal, is familiar with its contents and has submitted the material in accordance with all requirements.

PROPOSAL RETURNS
Offerors must return all completed proposals to the office of the Harris County Purchasing Agent reception desk at 1001 Preston
Avenue, Suite 670, Houston, Texas before 1:00 P.M. on the date specified. Late proposals will not be accepted.

GOVERNING FORMS
In the event of any conflict between the terms and provisions of these requirements and the specifications, the specifications shall
govern. In the event of any conflict of interpretation of any part of this overall document, Harris County's interpretation shall
govern.

ADDENDA
When specifications are revised, the Harris County Purchasing Agent will issue an addendum addressing the nature of the change.
Offerors must sign it and include it in the returned proposal package.

HOLD HARMLESS AGREEMENT
Contractor, the successful offeror, shall indemnify and hold Harris County harmless from all claims for personal injury, death
and/or property damage resulting directly or indirectly from contractor's performance. Contractor shall procure and maintain,
with respect to the subject matter of this proposal, appropriate insurance coverage including, as a minimum, public liability and
property damage with adequate limits to cover contractor's liability as may arise directly or indirectly from work performed under
terms of this proposal. Certification of such coverage must be provided to the County upon request.

WAIVER OF SUBROGATION
Offeror and offeror's insurance carrier waive any and all rights whatsoever with regard to subrogation against Harris County as an
indirect party to any suit arising out of personal or property damages resulting from offeror's performance under this agreement.

SEVERABILITY
If any section, subsection, paragraph, sentence, clause, phrase or word of these requirements or the specifications shall be held
invalid, such holding shall not affect the remaining portions of these requirements and the specifications and it is hereby declared
that such remaining portions would have been included in these requirements and the specifications as though the invalid portion
had been omitted.

BONDS
If this proposal requires submission of proposal guarantee and performance bond, there will be a separate page explaining those
requirements. Offers submitted without the required proposal bond or Cashier's Check are not acceptable.

Page 3 of 21
TAXES
Harris County is exempt from all federal excise, state and local taxes unless otherwise stated in this document. Harris County
claims exemption from all sales and/or use taxes under Texas Tax Code §151.309, as amended. Texas Limited Sales Tax
Exemption Certificates will be furnished upon written request to the Harris County Purchasing Agent.

FISCAL FUNDING
A multi-year lease or lease/purchase arrangement (if requested by the specifications), or any contract continuing as a result of an
extension option, must include fiscal funding out. If, for any reason, funds are not appropriated to continue the lease or contract,
said lease or contract shall become null and void on the last day of the current appropriation of funds. After expiration of the
lease, leased equipment shall be removed by the contractor from the using department without penalty of any kind or form to
Harris County. All charges and physical activity related to delivery, installation, removal and redelivery shall be the
responsibility of the offeror.

PRICING
Prices for all goods and/or services shall be negotiated to a firm amount for the duration of this contract or as agreed to in terms of
time frame. All prices must be written in ink or typewritten. Where unit pricing and extended pricing differ, unit pricing
prevails.

SILENCE OF SPECIFICATIONS
The apparent silence of specifications as to any detail, or the apparent omission from it of a detailed description concerning any
point, shall be regarded as meaning that only the best commercial practice is to prevail and that only material and workmanship of
the finest quality are to be used. All interpretations of specifications shall be made on the basis of this statement. The items
furnished under this contract shall be new, unused of the latest product in production to commercial trade and shall be of the
highest quality as to materials used and workmanship. Manufacturer furnishing these items shall be experienced in design and
construction of such items and shall be an established supplier of the item proposed.

SUPPLEMENTAL MATERIALS
Offerors are responsible for including all pertinent product data in the returned proposal package. Literature, brochures, data
sheets, specification information, completed forms requested as part of the proposal package and any other facts which may affect
the evaluation and subsequent contract award should be included. Materials such as legal documents and contractual agreements,
which the offeror wishes to include as a condition of the proposal, must also be in the returned proposal package. Failure to
include all necessary and proper supplemental materials may be cause to reject the entire proposal.

MATERIAL SAFETY DATA SHEETS
Under the "Hazardous Communication Act", commonly known as the "Texas Right To Know Act", an offeror must provide to
the County with each delivery, material safety data sheets which are applicable to hazardous substances defined in the Act.
Failure of the offeror to furnish this documentation will be cause to reject any bid applying thereto.

EVALUATION
Evaluation shall be used as a determinant as to which proposed items or services are the most efficient and/or most economical
for the County. It shall be based on all factors which have a bearing on price and performance of the items in the user
environment. All proposals are subject to negotiations by the Purchasing Agent and other appropriate departments, with
recommendation to Commissioners Court. Compliance with all requirements, delivery and needs of the using department are
considerations in evaluating proposals. Pricing is NOT the only criteria for making a recommendation. A preliminary
evaluation by Harris County will be held and appropriate proposals will be subjected to the negotiating process. Upon
completion of the negotiations, Harris County will make an award. All proposals that have been submitted shall be available and
open for public inspection after the contract is awarded except for trade secrets or confidential information contained in the
proposals and identified as such.

INSPECTIONS
Harris County reserves the right to inspect any item(s) or service location for compliance with specifications and requirements
and needs of the using department. If an offeror cannot furnish a sample of a proposed item, where applicable, for review, or fails
to satisfactorily show an ability to perform, the County can reject the offer as inadequate.

Page 4 of 21
TESTING
Harris County reserves the right to test equipment, supplies, material and goods proposed for quality, compliance with
specifications and ability to meet the needs of the user. Demonstration units must be available for review. Should the goods or
services fail to meet requirements and/or be unavailable for evaluation, the offer is subject to rejection.

DISQUALIFICATION OF OFFEROR
Upon signing this proposal document, an offeror offering to sell supplies, materials, services, or equipment to Harris County
certifies that the offeror has not violated the antitrust laws of this state codified in §15.01, et seq., Business & Commerce Code, or
the federal antitrust laws, and has not communicated directly or indirectly the offer made to any competitor or any other person
engaged in such line of business. Any or all proposals may be rejected if the County believes that collusion exists among the
offerors. Proposals in which the prices are obviously unbalanced may be rejected. If multiple proposals are submitted by an
offeror and after the proposals are opened, one of the proposals is withdrawn, the result will be that all of the proposals submitted
by that offeror will be withdrawn; however, nothing herein prohibits a vendor from submitting multiple offers for different
products or services.

AWARD
Harris County reserves the right to award this contract on the basis of LOWEST AND BEST OFFER in accordance with the laws
of the State of Texas, to waive any formality or irregularity, to make awards to more than one offeror, to reject any or all
proposals. In the event the lowest dollar offeror meeting specifications is not awarded a contract, the offeror may appear before
the Commissioners Court and present evidence concerning his responsibility after officially notifying the Office of the Purchasing
Agent of his intent to appear.

ASSIGNMENT
The successful offeror may not assign, sell or otherwise transfer this contract without written permission of Harris County
Commissioners Court.

TERM CONTRACTS
If the contract is intended to cover a specific time period, the term will be given in the specifications under SCOPE.

MAINTENANCE
Maintenance required for equipment proposed should be available in Harris County by a manufacturer-authorized maintenance
facility. Costs for this service shall be shown on the Pricing/Delivery Information. If Harris County opts to include maintenance,
it shall be so stated in the purchase order and said cost will be included. Service will commence only upon expiration of
applicable warranties and should be priced accordingly.

CONTRACT OBLIGATION
Harris County Commissioners Court must award the contract and the County Judge or other person authorized by the Harris
County Commissioners Court must sign the contract before it becomes binding on Harris County or the offeror. Department
heads are NOT authorized to sign agreements for Harris County. Binding agreements shall remain in effect until all products
and/or services covered by this purchase have been satisfactorily delivered and accepted.

TITLE TRANSFER
Title and Risk of Loss of goods shall not pass to Harris County until Harris County actually receives and takes possession of the
goods at the point or points of delivery. Receiving times may vary with the using department. Generally, deliveries may be made
between 8:30 a.m. and 4:00 p.m., Monday through Friday. Offerors are advised to consult the using department for instructions.
The place of delivery shall be shown under the "Special Requirements/Instructions" section of this proposal and/or on the
Purchase Order as a "Deliver To:" address.

WARRANTIES
Offerors shall furnish all data pertinent to warranties or guarantees which may apply to items in the proposal. Offerors may not
limit or exclude any implied warranties. Offeror warrants that product sold to the County shall conform to the standards
established by the U.S. Department of Labor under the Occupational Safety and Health Act of 1970. In the event product does
not conform to OSHA Standards, where applicable, Harris County may return the product for correction or replacement at the
offeror's expense. If offeror fails to make the appropriate correction within a reasonable time, Harris County may correct at the
offeror's expense.

Page 5 of 21
PURCHASE ORDER AND DELIVERY
The successful offeror shall not deliver products or provide services without a Harris County Purchase Order, signed by an
authorized agent of the Harris County Purchasing Agent. The fastest, most reasonable delivery time shall be indicated by the
offeror in the proper place on the proposal document. Any special information concerning delivery should also be included, on a
separate sheet, if necessary. All items shall be shipped F.O.B. INSIDE DELIVERY unless otherwise stated in the
specifications. This shall be understood to include bringing merchandise to the appropriate room or place designated by the using
department. Every tender or delivery of goods must fully comply with all provisions of these requirements and the specifications
including time, delivery and quality. Nonconformance shall constitute a breach which must be rectified prior to expiration of the
time for performance. Failure to rectify within the performance period will be considered cause to reject future deliveries and
cancellation of the contract by Harris County without prejudice to other remedies provided by law. Where delivery times are
critical, Harris County reserves the right to award accordingly.

CONTRACT RENEWALS
Renewals may be made ONLY by written agreement between Harris County and the offeror. Any price escalations are limited to
those stated by the offeror in the original proposal.

INVOICES AND PAYMENTS
Offerors shall submit an original invoice on each purchase order or purchase release after each delivery, indicating the purchase order
number. Invoices must be itemized. Any invoice which cannot be verified by the contract price and/or is otherwise incorrect, will be
returned to the offeror for correction. Under term contracts, when multiple deliveries and/or services are required, the offeror may invoice
following each delivery and the County will pay on invoice. Contracts providing for a monthly charge will be billed and paid on a monthly
basis only. Prior to any and all payments made for good and/or services provided under this contract, the offeror should provide his
Taxpayer Identification Number or social security number as applicable. This information must be on file with the Harris County Auditor’s
office. Failure to provide this information may result in a delay in payment and/or back-up withholding as required by the Internal Revenue
Service.

TERMINATION
Harris County reserves the right to terminate the contract for default if Seller breaches any of the terms therein, including
warranties of offeror or if the offeror becomes insolvent or commits acts of bankruptcy. Such right of termination is in addition to
and not in lieu of any other remedies which Harris County may have in law or equity. Default may be construed as, but not
limited to, failure to deliver the proper goods and/or services within the proper amount of time, and/or to properly perform any
and all services required to Harris County's satisfaction and/or to meet all other obligations and requirements. Harris County may
terminate the contract without cause upon thirty (30) days written notice.

RECYCLED MATERIALS
Harris County encourages the use of products made of recycled materials and shall give preference in purchasing to products
made of recycled materials if the products meet applicable specifications as to quantity and quality. Harris County will be the
sole judge in determining product preference application.

SCANNED OR RE-TYPED RESPONSE
If in its response, offeror either electronically scans, re-types, or in some way reproduces the County's published proposal
package, then in the event of any conflict between the terms and provisions of the County's published proposal package, or any
portion thereof, and the terms and provisions of the response made by offeror, the County's proposal package as published shall
control. Furthermore, if an alteration of any kind to the County's published proposal package is only discovered after the contract
is executed and is or is not being performed, the contract is subject to immediate cancellation.

FLOPPY DISK
If offeror obtained the specifications on a floppy disk in order to prepare a response, the proposal must be submitted in hard
copy according to the instructions contained in this Request-for-Proposals package. If, in its response, offeror makes any changes
whatsoever to the County's published specifications, the County's specifications as published shall control. Furthermore, if an
alteration of any kind to the County's published specifications is only discovered after the contract is executed and is or is not
being performed, the contract is subject to immediate cancellation.

YEAR 2000 COMPLIANCE
All products and/or services furnished as part of this contract must be year 2000 compliant. This applies to all computers
including hardware and software as well as all other commodities with date sensitive embedded chips.

Revised 01/00

Page 6 of 21
SPECIAL REQUIREMENTS/INSTRUCTIONS

The following requirements and specifications supersede General Requirements where applicable. The
terms “Harris County” or “HCHD” are understood to include the Harris County Hospital District
(HCHD or District).

VENDOR INSTRUCTIONS
Responses to this Request for Proposals shall be formatted as follows:
All proposals must be typed on standard 8 ½ x 11 paper, indexed with a table of contents and placed in a
binder or folder. Proposals should be bound such that sections are easily detachable. Proposals should
be organized in the following order for consistency and easy screening:

Section I RFP Cover Page (completed); Residence Certificate (completed)
Section II Narrative of proposed program
Section III Pricing
Section IV Proposer’s information: resumes, education, experience, licenses, insurance
certificates, references
Section V Any standard agreement(s) or contract(s) associated with your response
Section VI Additional information as appropriate

Proposers should include ONE (1) “ORIGINAL” (CLEARLY MARKED “ORIGINAL”) and FIVE
(5) COPIES (CLEARLY MARKED “COPY”) of the response sealed in an envelope or package for
delivery to the Harris County Purchasing Agent per the instructions in the General Requirements (see
Proposal Completion and Proposal Returns). All documents included in the proposal and the outside of
the envelope or package must be marked with the vendor’s name and the job number that corresponds to
this RFP.

Evaluation will consider the most cost productive, efficient and effective plan. Emphasis will be placed
on capability to perform within the program as well as meeting the needs of the using department. While
Harris County appreciates a brief straightforward and concise reply, the vendor must fully understand
that the evaluation is based on the information provided. Accuracy and completeness are essential.
Omissions, ambiguous or equivocal statements may be construed against the vendor. The proposal
response may be incorporated into any contract which results from this RFP, and vendors are cautioned
not to make claims or statements which they are not prepared to commit to contractually. Failure of the
vendor to meet such claims will result in a requirement that the vendor provide the resources necessary
to meet submitted claims.

The vendor is expected to examine all documents, forms, specifications and all instructions. Failure to
do so will be at the vendor’s risk.

All documents will be held by the County and are NOT subject to public review until an award is made.
Under the Request For Proposal process, sealed offers will be received and opened in the Office of the
Purchasing Agent. At and after opening, proposals will NOT be part of the public record and subject to
disclosure, but will be kept confidential until time of award. When such award is completed, proposals
will be available for public inspection including those portions marked confidential and/or
proprietary.

Page 7 of 21
Harris County will not be liable for any costs incurred by any vendor in preparing a response to this RFP.
Vendors submit proposals at their own risk and expense. Harris County makes no guarantee that any
equipment or services will be purchased as a result of this Request for Proposals, and reserves the right
to reject any and all proposals. All proposals and their accompanying documentation will become the
property of the Harris County Hospital District.

EVALUATION PROCESS
All proposals will be examined by an evaluation committee.

Proposals that do not conform to the instructions given or which do not address all the services as
specified may be eliminated from consideration. Harris County, however, reserves the right to accept
such proposal if it is determined to be in the District’s best interest to do so.

Harris County may initiate discussions with vendors. Discussions may not be initiated by vendors. Harris
County expects to conduct discussions with vendor personnel authorized to contractually obligate the
vendor with an offer. Vendors shall not contact any Harris County Hospital District personnel during
the RFP process without the express permission from the Office of the Harris County Purchasing Agent.
Harris County Purchasing may disqualify any vendor who has made site visits, contacted HCHD
personnel or distributed any literature without authorization from this office.

All correspondence relating to this RFP, from advertisement to award, shall be sent to the Harris County
Purchasing Department. All presentations and/or meetings between the Harris County Hospital District
and the vendor relating to this RFP shall be coordinated by the Harris County Purchasing Department.

No award can be made until the Harris County Hospital District Board of Managers approves such
action.

Submission of a proposal implies the vendor’s acceptance of the evaluation criteria and vendor
recognition that subjective judgments must be made by the evaluating committee.

This Request for Proposal in no manner obligates the County and/or the District to eventual rental, lease,
purchase, etc. of any equipment or service described, implied or which may be proposed, until confirmed
by a written contract. Progress toward this end is solely at the discretion of Harris County and may be
terminated at any time prior to the signing of the contract.

Selected vendors may be expected to make a presentation to the evaluation committee. Vendor
presentations will develop into negotiating sessions with the successful vendor as selected by the evaluation
committee. If Harris County is unable to agree to contract terms, Harris County reserves the right to
terminate contract negotiations with that vendor and initiate negotiations with another vendor. Vendors
shall not contact any Harris County Hospital District personnel during the RFP process without the express
permission from the Office of the Harris County Purchasing Agent. Harris County Purchasing may
disqualify any vendor who has made site visits, contacted personnel or distributed any literature without
authorization from this office.

Page 8 of 21
SPECIAL REQUIREMENTS/INSTRUCTIONS-(Continued)

EVALUATION CRITERIA
The award of the contract shall be made to the responsible vendor whose proposal is determined to be
the best evaluated offer resulting from negotiations, taking into consideration compliance with
instructions, specifications and quality of the services proposed which best meet the needs of the using
department. Harris County may use references and site visit information to make judgments directly
affecting the award of this proposal.

MINIMUM CONTRACTOR QUALIFICATIONS
The District requires the following as minimally acceptable information from all vendors interested in
responding to this RFP:
 Current resume(s) for individuals(s) assigned to this project.
 Corporate/individual qualifications, including certifications.
Each individual team member must meet at least one of the following requirements, however, the team
as a whole shall meet all requirements. Representative(s) of the selected Contractor Corporation and
individual team members, particularly those submitted as the Project Director, may be interviewed
before final selection.

A. Project Management Qualifications
1. Demonstrated knowledge of HIPAA regulations.
2. Has provided HIPAA overview, project planning, general regulation and impact summaries
to large heath care organization(s).
3. Has developed a healthcare assessment and strategy analysis methodology,
management/assessment tool, or operational software used to evaluate HIPAA or similar
requirements that:
a. Facilitates standardization;
b. Analyzes requirements and policy compliance;
c. Includes structured cost-benefit model;
d. Supports EDI standard tables and reports;
e. Includes core assessment checklist and summaries;
f. Integrates with other collaborative methodology products;
g. Aids in rapid execution of required planning and operational document functions;
h. Involves development presentations to senior level executives and managers;
i. Has experience in managing integration, implementation, or development projects for
large healthcare organizations.

B. Assessment Qualifications
1. Demonstrated knowledge of HIPAA regulations.
2. Has used a management and assessment tool or operational software specifically related to
regulatory requirements, (e.g. HIPAA)
a. Has developed policy/procedure design and implementation, risk analysis, and/or
disaster recovery management programs.
b.Has implemented (or begun implementation of) HIPAA transaction sets, code sets and
identifiers.
c. Has knowledge and understanding of HCPCS, ICD, DRG, APC and other healthcare
regulations and standards (i.e. JCAHO).

Page 9 of 21
SPECIAL REQUIREMENTS/INSTRUCTIONS-(Continued)

d. Has experience in health insurance and/or financial systems.

C. Security Compliance
1. Has previously performed HIPAA security compliance surveys and developed
recommendations.
2. Has developed or will use a comprehensive security software management program or
assessment which specifically applies HIPAA requirements to:
a. IT security compliance
b. Assure privacy protection
c. Secure systems from intrusions
d. Secure database software
3. Has developed information security policies, audit procedures and reports, job level security
matrix, etc.
4. Has experience with information system security (network and telecommunications)
management in organizations similar to the District.

D. Transaction Sets & Processing
1. Has extensive EDI experience working with major healthcare systems.
2. Has knowledge of data interchange mapping, e.g. HL7
3. Has provided EDI readiness assessments for major healthcare provider or insurer.
4. Has EDI claims technical and business expertise.

REFERENCES
References shall include company name, contact person, telephone number, and an overview of
consulting services provided by the individual or firm. The District may contact these references and
inquire of the Contractor’s and/or proposed team member’s work performed, as well as to verify
experience cited in meeting the above requirements.

INVOICES
Contractor shall submit an invoice upon completion of each deliverable. The HIPAA Project Manager
will consider Deliverables complete only upon written acceptance. Each invoice shall include at a
minimum, detail of objectives(s) and deliverable(s) completed with reference to the price for each.

Page 10 of 21
SPECIFICATIONS

HIPAA COMPLIANCE ASSESSMENT AND BUSINESS PROCESS REENGINEERING
EVALUATION FOR HARRIS COUNTY HOSPITAL DISTRICT

SCOPE
Harris County Hospital District invites qualified vendors to submit proposals for consulting services to
evaluate and assess mandated regulatory compliance with the Health Public Law 104-191,
Administration Simplification Compliance Act, Public Law 107-105, 45 CFR Parts 160 and 164, as
amended, and the Texas Health and Safety Code Chapter 181, (Texas Medical Records Privacy Act) as
amended, hereinafter referred to as (“HIPAA”). For additional information, contact Laurie Wainwright
in the Office of the Harris County Purchasing Agent at (713) 755-6597 (E-mail:
loretta_wainwright@co.harris.tx.us).

I. HARRIS COUNTY HOSPITAL DISTRICT

The Harris County Hospital District (“HCHD” or “the District) is the nation’s fourth largest public
metropolitan health system and a world leader in trauma care. The Hospital District was established as
a result of a referendum in 1965 and became operative in January 1966. The governing body, the Board
of Managers, is composed of nine members appointed by Harris County’s Commissioners Court. The
District consists of three (3) hospitals, Ben Taub General Hospital, Lyndon B. Johnson General Hospital,
and Quentin Mease Community Hospital, along with various Community Health Clinics through Harris
County, a Dental Center, and a clinic dedicated to the care of AIDS patients. In addition, the District
owns a Medicaid HMO corporation that currently contracts for approximately 13,000 covered lives.

District Licensed Beds
Ben Taub 507
LBJ 201
Quentin Mease 49
Bassinets 149

District Admissions
Ben Taub 23,657
LBJ 14,577
Quentin Mease 609

Emergency Visits
Ben Taub 98,650
LBJ 78,567

Clinic Visits
Ben Taub 144,465
LBJ 86,607
Neighborhood 448,404
School Based 29,157
Thomas Street (HIV) 15,986
Homeless 117,585

Page 11 of 21
SPECIFICATIONS-(Continued)

The District is currently in the process of implementing new Information Systems. As these Systems are
implemented, current business processes will be evaluated and reengineered to better utilize the
capabilities of the System and become HIPAA compliant. The Systems currently being implemented
are:
Per-Se – This system will provide patient management and billing & collections functionality.
In addition, it will provide electronic claims/remittance processing functionality. The anticipated go-live
date is September 2002.

Epic – This system will provide the enterprise clinical solution. It will include an Enterprise
Master Person Index, Ambulatory Practice Management, and Enterprise Clinical Systems to include
clinical workstations, order management and results and clinical and administrative decision support.
This project is currently sequenced through 2004.

McKesson is the system for billing, collections, etc, currently in place in the District and will be
overlapping during the above installations.

II. PROJECT OBJECTIVES

The selected vendor (Contractor) will perform a modified assessment of the District’s current
environment and provide recommendations to include project control documents suitable for use in the
HIPAA remediation activities necessary for achieving compliance within the mandated time frames.
Vendor should be familiar with Texas HIPAA Law and, where more stringent, use the Texas Law. The
goal is to have a cost-effective strategy, detailed work plans and budget figures needed to meet the four
major categories of HIPAA. The District wishes to use standardization of processes wherever possible.
For this reason, one hospital, two health centers and the Medicaid HMO will be evaluated. Where issues
are discovered, a standardized approach will be implemented across the District wherever such remedies
are attainable. The four major categories are:
 EDI transaction standards and code sets
 Unique identifiers for individuals, employers, health plans, and providers
 Security, confidentiality, and electronic signatures
 Privacy for individually identifiable health information

Completion of the scope of work will be evidenced by completion of the deliverables listed below.

1. Assessment Project Plan

The Contractor shall deliver a HIPAA Assessment Project Plan. The objective of the plan is to
provide a clear roadmap of tasks, resources, timing, communications, risks and strategy
necessary to assess the District’s readiness to comply with each of the four major categories of
HIPAA. There should be a separate and clear plan for each major category. Each Plan should
clearly identify tasks requiring District personnel participation and/or District’s sole
responsibility. Each Project Plan must define:

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SPECIFICATIONS-(Continued)

a. Roles for the Contractor Project Director, Contractor Staff, District HIPAA Manager,
and District Staff, and specific project teams as defined in the Project Plan;
b. All resources required to complete the engagement, noting particularly key functional
roles of District personnel that must be involved, e.g. Health Information
Management;
c. Time commitments required of all parties;
d. General schedule (GANTT chart) of activities;
e. Methods for problem escalation and resolution for both the Contractor and District.
f. Listing and resumes of Contractor personnel including quantity, skill types and
deployment schedule to complete the project.
g. A communication plan to support the assessment effort, containing, why, what, how,
when and to whom information is to be communicated. Both internal and external
stakeholders are to be included in the communication plan; and
h. An approach and a plan for transferring knowledge gleaned from the assessment to
District staff and other relevant parties, including any change management methods of
proven success.

For each entry in the completed assessment, Contractor shall describe how the data/process is
impacted by HIPAA compliance requirements, specifically including:
 Description of/reference to specific rules that create an impact: and
 Assessment of whether the Texas privacy law or the Health Insurance Portability
and Accountability Act should be more stringently applied; and
 Assessment of legal liabilities and/or potential monetary sanctions imposed for
failure to comply with the associated rules.

The assessment process and final document should also include results of reviewing the
following, and all other areas the Contractor deems appropriate:

a. Business operations and processes where patient data is created, modified, reviewed,
transferred, or exchanged;
b. Existing patient information flow documentation, whether automated or manual;
c. Sources/repositories of patient information, whether automated (e.g. databases, disk,
diskette, or tape files) or manual (e.g. hard copy films, clinician notes, lab
orders/results, appointment data, documents with patient signature, or other
documents normally found in a patient record);
d. Manual forms and electronic transaction formats, identifiers, data element values and
code sets related to patient data, associated source(s) and destination(s);
e. HCPCS codes, types and uses;
f. Policies and procedures related to processing patient information, addressing both
automated and manual methods;
g. Policies and procedures related to security, confidentiality, and privacy of patient
data, addressing both automated and manual data;
h. Business partner relationships, associated memorandums of understanding, contracts,
and agreements, where transfer of patient data may occur;

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SPECIFICATIONS-(Continued)

i. Subcontracted or partner providers, benefit managers, clearinghouses; delegated
medical management, contracted medical record review, transcription services,
contracted benefit managers, third-party administrators, primary and secondary
payers, etc.;
j. Information technology, systems, one-way interfaces, automated data exchange, and
e-commerce applications that use, create or modify patient data;
k. Automated security features and mechanisms (e.g. network and systems architectures,
firewalls, DMZ’s, user authentication, public key and certificate features, electronic
signature implementation, back-up storage and retrieval processes);
l. Network transmission data defining current traffic related to patient identifiable
information in any format including file transfers, batch processes, online real-time
transactions, emails and attachments, web uploads/downloads, and web site inquiries.
m. Automated and manual data recovery processes and storage locations and any other
areas that are affected by HIPAA, whether stated or not in this document.
n. Sources and repositories of provider information including provider number, whether
automated (e.g. databases, disk, diskette, tape files) or manual documents, forms and
reports containing provider information. Physical access to all facilities as it affects
the previously mentioned;
o. Current portfolio of in-process IT projects and business initiatives that affect handling
of either patient or provider information; and
p. Website security and the exchange of patient information between provider and payer.

2. HIPAA Compliance Definition and Checklist

The Contractor shall deliver a definition of “HIPAA Compliant” for each of the finalized rules
and an accompanying checklist or other suitable tracking tool to the District. This tool shall
clearly identify automated systems, policies and business processes which satisfy or do not
satisfy the definition of HIPAA Compliance. Upon receiving approval from the District, the
tracking tools will be used by the Contractor to identify compliant and non-compliant automated
system components, policies or business process components. These components will be
identified by District program or service. The Contractor will update the tracking tool no less
frequently than weekly. Updates will be delivered to the District on a weekly basis unless
otherwise agreed upon.

3. Business Gap Analysis

The Contractor shall perform the assessment as described in the approved Assessment Project
Plan (as approved by the District) and deliver a Business Gap Analysis. This document shall
identify each District business process or data source that is non-compliant with HIPAA
regulations. Additionally, the Contractor shall indicate areas that may currently be compliant,
but not so with future rule versions (e.g. ICD-9 is compliant, but ICD-10 required by 2003).

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SPECIFICATIONS-(Continued)

The GAP Analysis should clearly define risks involved in the District remaining non-compliant
in financial terms, and identifying specific financial opportunities in achieving compliance. All
issues to be addressed should be prioritized in accordance with scheduled compliance time
frames vs. work effort required, costs and benefits where applicable.

The Contractor shall include the District in alternative analysis discussions that support the gap
analysis. The Contractor will ensure that the District receives the maximum benefit of the
Contractor’s analysis and consideration of options. The District also wishes to ensure that the
‘To Be’ assessment is aligned with the strategic plans and goals for the District and its Board of
Managers.

The gap analysis shall include but not be limited to the following:

a. Current business ‘As Is’ Assessment. The objective of this task is to document the
current business processes and policies so that their current degree of compliance can
be assessed.
b. The Contractor shall deliver a business ‘To Be’ HIPAA analysis. The objective of
this task is to document what needs to be done to bring each of the processes and
policies from the ‘As Is’ analysis with HIPAA compliance issues into compliance.
c. The Contractor shall provide analysis and information of both a positive and negative
nature, e.g. analysis and information that shows there is a HIPAA compliance issue or
information that demonstrates that HIPAA compliance issues do not exist.
d. Every ‘As Is’ analysis showing HIPAA compliance issues shall have a corresponding
‘To Be’ analysis. The ‘To Be’ analysis shall describe HIPAA readiness; the
Contractor shall involve the District in alternatives identification and analysis for how
readiness is to be achieved.

The Contractor shall deliver best practices and best practice diagrams for the District’s business
processes, policies, procedures and automated systems impacted by HIPAA. The objective of
this task is to implement best practices where possible to address HIPAA requirements. Each
recommendation should include estimates of required resources (based on best available
information), advantages and disadvantages, as well as risks associated with each option. The
best practice diagrams will provide a high picture of impacts/alternatives to the District for
purposes of remediation.

a. The best practices and best practice diagrams shall be created with assistance from
District staff and other parties deemed appropriate by the District, through meeting
facilitated by the Contractor.
b. The best practice diagrams will be considered for use in reengineering business
practices.

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SPECIFICATIONS-(Continued)

4. Remediation Project Control Documents

a. A plan for the Design, Development and Implementation of the strategy as developed
from the Gap Analysis. The objective of this task is to provide a roadmap to remediation
for HIPAA compliance and prepare the District for subsequent design, development and
implementation projects necessary to achieve HIPAA compliance. The plan shall
include, but not be limited to:
i. Detailed steps needed for implementing each strategy;
ii. An estimate of District resources, number, skill types need for Design,
Development and Implementation stage; and
iii. Necessary deliverables by type, number and a timeline for delivery.

5. A Plan for Implementation of Recommendations

This plan should include a minimum and maximum of assistance from the Contractor to
implement recommendations that would facilitate compliance with the four major
categories of HIPAA. There should be a separate estimate of minimum and maximum
range of assistance for each category. This plan should be based on prior knowledge of
previous clients’ results, showing greatest risks and challenges. Each plan should
estimate resources of both the District and Contractor to include a best guess estimate of
time and fees.

6. A Plan for Education and Training of the District’s management and staff who will be
involved with the HIPAA implementation processes.

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PRICING/DELIVERY INFORMATION

PRICING
Provide pricing for your services in Section III of your response. Pricing for each segment of your work
should be itemized and detailed.

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RESIDENCE CERTIFICATION

Pursuant to Texas Government Code §2252.001 et seq., as amended, Harris County requests Residence
Certification. §2252.001 et seq. of the Government Code provides some restrictions on the awarding of
governmental contracts; pertinent provisions of §2252.001 are stated below:

(3) "Nonresident bidder" refers to a person who is not a resident.

(4) "Resident bidder" refers to a person whose principal place of business is in this state, including a
contractor whose ultimate parent company or majority owner has its principal place of business in
this state.

 I certify that ______________________________________ is a Resident Bidder of Texas as defined in
[Company Name]
Government Code §2252.001.

 I certify that ______________________________________ is a Nonresident Bidder as defined in
[Company Name]
Government Code §2252.001 and our principal place of business is ______________________________.
[City and State]

Revised 7/97

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Attachment e

Minimum Insurance Requirements

• The contractor shall, at all times during the term of this contract, maintain insurance coverage with
not less than the type and requirements shown below. Such insurance is to be provided at the sole
cost of the contractor. These requirements do not establish limits of the contractor's liability.

• All policies of insurance shall waive all rights of subrogation against the County, its officers,
employees and agents.

• Upon request, certified copies of original insurance policies shall be furnished to Harris County.

• The County reserves the right to require additional insurance should it be deemed necessary.

A. Workers' Compensation (with Waiver of subrogation to Harris County) Employer's Liability,
including all states, U.S. Longshoremen, Harbor Workers and other endorsements, if applicable to
the Project.

Statutory, and Bodily Injury by Accident: $100,000 each employee. Bodily Injury by Disease:
$500,000 policy limit $100,000 each employee.

B. Commercial General Liability Occurrence Form including, but not limited to, Premises and
Operations, Products Liability Broad Form Property Damage, Contractual Liability, Personal and
Advertising Injury Liability and where the exposure exists, coverage for watercraft, blasting
collapse, and explosions, blowout, cratering and underground damage.

$300,000 each occurrence Limit Bodily Injury and Property Damage Combined $300,000 Products-
Completed Operations Aggregate Limit $500,000 Per Job Aggregate $300,000 Personal and
Advertising Injury Limit. Harris County shall be named as "additional insured" on commercial
general liability policy.

C. Automobile Liability Coverage:

$300,000 Combined Liability Limits. Bodily Injury and Property Damage Combined. Harris
County shall be named as "additional insured" on automobile policy.

Revised 12/00

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Attachment h
REFERENCES

Reference #1

Organization Name:_______________________________________________________________
Contact Name/Telephone No.: ______________________________________________________
Address:________________________________________________________________________
_______________________________________________________________________________
Consulting services provided:_______________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________

Reference #2

Reference #3

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REFERENCES

Reference #4

Reference #5

Reference #6

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