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									                      IT Professional Technical Services
                               Master Contract

                               Statement of Work (SOW)
                               For Technology Services
                                      Issued By
                   Minnesota Department of Human Services

      Project Title: Communication and Accountability for Primary
                         Care System (CAPS)

         Service Categories: Web Design & Development –
    HTML/XML/DHTML CSS Javascript Websphere RAD Version 6,
         Web Applications Specialist – Java/JSP/Servlets

Business Need
    The Minnesota Department of Human Services (DHS) is one of the largest payers of
    health care in Minnesota. DHS provides health care services to more than 600,000
    Minnesotans through a combination of federal and state health care programs, including
    Minesota’s Medicaid program, Medical Assistance (MA), General Assistance Medical Care
    (GAMC), and MinnesotaCare (a subsidized health care program for people who live in
    Minnesota and do not have access to health insurance). These combined health care
    programs are jointly referred to as Minnesota Health Care Programs (MHCP). The
    Department’s Medicaid Management Information System (MMIS) pays MHCP
    expenditures in excess of $5 billion annually.

    MHCP administration is a joint state-county-tribal effort, with county and tribal human
    services agency staff performing the intake, eligibility determination and case
    management for the majority of MHCP clients. Program eligibility is determined by
    approximately 2500 workers at the State level, at the 87 counties and at the tribal level. At
    the current time, health care eligibility is determined using two DHS legacy systems for MA
    and GAMC, and a combination of manual processes and a legacy system for the
    MinnesotaCare program.

    The primary goal of CAPS is to facilitate the provision of quality physician-directed primary
    care coordination. The successfully developed product will provide the state with the
    capacity to offer Minnesota Medicaid enrollees the opportunity to return to a true “medical
    home,” which will coordinate care for a Medicaid client with complex health care needs.
    Satisfactory physician performance (as reported via this tool) would trigger a monthly care
    coordination payment to the physician. This user-friendly, real time direct electronic
    communication link between the physician and the state will provide DHS with valuable

    information not easily obtained via past methods such as third party disease management
    vendors, claims history, medical chart reviews, or reports from third parties such as health
    plans or research entities.

    While this statement of work is strictly focused on product development for primary care
    physician application, responses to this statement of work should detail how the proposed
    system would be scalable and adaptable for eventual use with all provider types, and
    could serve as an all-purpose health care coordination tool. For example, how a
    pharmacist providing Medication Therapy Management or a Home Care Agency providing
    community based care would find this tool helpful. Other important new capacities could
    include “smart” prior authorization, pay for performance programs based on real time
    reported clinical outcomes, enhanced medication therapy management, enhanced
    enrollee accountability for self care, and ability to host an online clinical care plan.
    Because of the central role that physicians play in the health care delivery system, as well
    as the nation-wide need for better coordination of care between the many new sites and
    layers of the health system, this proposal can model transformational change within both
    the Medicaid system and the commercial health care market.

    Proposals should identify how this solution is designed to address the current
    fragmentation of health care delivery, which causes costly, duplicative, and ineffective

    Proposals should document and identify implementation strategies of the proposed
    solution between the state, the primary care provider, the enrollee, and other providers

    involved in the enrollee’s care. Examples of the real-time capacities required of proposed
    solutions include:

           • physician reports outcome measures, which trigger monthly performance
           payments to physician.
           • state communicates an enrollee’s medical and drug utilization history to physician

           • health plan physician reports Encounter Data to state

           • provider communicates care goals and educational information to enrollee

           • physician requests prior authorization for services and reports key medical facts
           to state; state then communicates an immediate answer to the request for

           • state communicates required practice guidelines or outcome measures to

           • providers and team members communicate care plan and actions taken to one

Project Deliverables
    •   Project Plan

    •   Analysis and models
    •   Full documentation of requirements, analysis and design (business process, use case,
        information, technical UML models)
    •   Automated mailing to specific providers
    •   Authentication, authorization and access control to the CAPS application with the Oblix
        toolset and Sun LDAP, see use case P2
    •   Web based access within the MN-ITS portal, Java application see use case P2
    •   Defined information, detailed information gathering Java application, see use case P3
    •   Web based data collection Java application, see use case P4
    •   Implementation and integration of a smart prior authorization toolset, either custom
        built or off the shelf module with prior authorization treatment criteria imbedded
    •   Automated data upload from mainframe to distributed systems
    •   Required system changes the MN-ITS and MMIS applications to meet the pay for
        performance requirements, see use case P6
    •   Web based care coordination application Java application, see use case P7
    •   Performance reporting application including measures and web based reporting
    •   Test plans, test scenarios, test and quality assured applications
    •   Knowledge transfer of all business and technical aspects in that the State will take over
        and run the applications and support the business needs post-implementation
    •   Handoff back to State should include post-project review and lessons learned

Project Milestones and Schedule
    •   Projected Project Start Date

Project Environment (State Resources)
    The department proposes that the clinical policy development (outcome measures, for
    example) and the operational system (web-based tool) be built in-house, using a
    combination of current and temporary policy staff and systems architecture staff.

    The purpose of the following models is to provide a graphic demonstration of the various
    business processes that need to be part of this new system.

    The model on page four demonstrates the large picture or context. It identifies all of the
    use cases (P1 through P9) that are required of this new system.

    Each subsequent model explains one or two business processes, through a graphic
    depiction of the steps of a use case. For example, on page 4 P1 details the use case for
    the automated mailing business process.

                                                    Medicaid Transformation Grant
                                                          Context Level Framing Model
                              – This model represents a context level model of the business processes and the
                             information that flows through them. It is a framing model intended to clarify the work effort.

                                                                                                                   Information Deposit
                                                                                                                    Care Coordination
                                                                         Selected                                 & Information requests
                                                                         Providers                                                              Provider &
                                                                                                                       Coordinated             beneficiary
   Performance                                                                                                            Care
    Outcomes                                                                                                                                care coordination
                       Prior                                                                                           Provider to             information
                   Authorization                                                                                        Provider

                            Performance                                                                             Claims                                Permissions
                              Incentive                                                                           Submission                              for providers
                                based                              Service                    Letter to       Prior Authorization
                             information                                                                            Number                             Care Coordination
                                                                 Approval or                  enrolled
                                       Requested                 Disapproval                  providers
                                       Historical                                                            Payment for
                                         Data                           Credentialing information         Claims based on
                                                                          Capability & capacity           Prior authorization
                                               Request for                  Read request or                     number
                                              Fee for service                deposit data                  & performance
                                              Clinical history

                                                                                                                         P6 Trigger                   P7
               P4 Collect
                                                                                                                           Claims                  Coordinate
                                                                                                                          Payment                    Care

                                                                         P2 Select
                                      P3 Provide                         Providers
                                                                                          P1 Outreach
                                       To Select
                     PA #                                                                                                               Mgmnt
                 Authorization                                                                                                           Data
                    Detail                                Access to                                                             Processed
                                                            limited                                                               Claims
           Prior                                         information
                                   Clinical                                                                                                     Beneficiary provided
       Authorization                                                      Flag provider                           Submitted
                                   History                                                                                                       care coordination
        Approval                              Information                  acceptance                              Claims
                                                                                                Provider                                      Request for information
                                                                                                 Data                                            from providers
 P8 Report

                                                  Data Store

                     Data                                                                                                       MMIS Data Store
                                          Policy        Performance                   Information
                                       Performance       Measures
                                         Criteria                                                          Pay for performance
                                                                            Aggregated                         Information
          Business Need                                                    Medical History
                                                                                                                              Medical History
   Quality Information Exchange                                                                                               Diagnostics
        Policy & Measures                                                                                                     Hospital Stays
                                                 P9 Policy &
                   Adjusted Policy                 Analysis                                          P5 Gather &
                     & Measures                                                                      Upload Data
                   Based on results

   Department of                       Performance
  Human Services                        Measures

                                                             Medicaid Transformation Grant
                                                                 Use case for web access to information
                                                                 P3 Web based access to controlled information
      JAVA Web based application
          Via MN-ITS Portal

                                        & Authorization                                              Requested
    Oblix Web Authentication                                                                           Data
       User Management

                                               Information                                                                       Selected Providers
                                                 Request                            P3 Provide
                                                                                     To Select                 Request for
                                                                                     Providers                Fee for service
                                                                                                              Clinical history

BigIP Load Balanced Web servers

                                Served applications

     Clustered Websphere             Front end
      JAVA Applications                                                                    This process is established to give select providers
                                   data stored                                             access to information gathered as a part of the
                                  Clinical History
                                                                                           standard claims and administrative processes as
                                                                                           well as information provided by other providers
                                                                                           using of the system. Examples of information
                                                                                           provided include but are not limited to:

                                                                                                  Primary Diagnosis
                                                                                                  Medication History
                           SAN                                                                    Hospital Admittance
                                                                                           To the extent standards exist, the information should
                                        If mainframe connectivity                          comply with standard information descriptions.
          Oracle 10G                    is required MQ Series or                           Standards organizations such as the following
    Real Application Clusters          CICS Transaction Gateway                            should be consulted:
                                      Claims & Administrative Data

        ZOS DB2 VSAM
         COBOL CICS

                                         Medicaid Transformation Grant
                                        Use case for upload to front end systems
                                           P5 MMIS data upload to front end system.

             This process is intended to describe the gathering of data form multiple data sources and uploading the
             information into a front end data storage area. The information will likely come from the MMIS mainframe
             system (SAM,DB2, ZOS) aggregated, formatted, and combined with information colleted on the front end
             system (Oracle 10G RAC Cluster). Likely information stored in this data structure would be:

                  Medication History
                  Primary Diagnosis
                  Hospital Stays

             Conceptual. Logical and physical data models should comply with HL7 naming conventions and
             standards to the extent possible.

                                  Clustered Websphere
                    Front end      JAVA Applications
                  data stored Intellegent PA Module
                 Clinical History                                           Reported
                                                                                                         P5 Gather &
                                                                                                         Upload Data
                                                                          Medical History


  If mainframe connectivity
                                      Oracle 10G
  is required MQ Series or
                                Real Application Clusters
 CICS Transaction Gateway
Claims & Administrative Data                                                   Claims
                                                                               Medical History
                                                                               Hospital Stays

                                                                                                 Pay for performance

                                       ZOS DB2 VSAM
                                        COBOL CICS

                                                          Medicaid Transformation Grant
                                                        Use case for claims submission web pages
                                                                P6 Trigger Claims Payment Process

      JAVA Web based application
          Via MN-ITS Portal

                                                                                          Prior Authorization
                                                          Authentication &                      Number
                                                                                                                                   Selected Providers
    Oblix Web Authentication
       User Management
                                             Claims                                                             Payment for
                                                                                                              Claims based on
                                                                        P6 Process                           Prior authorization
                                                                          Claims                                   number
                                                                                                               & performance

BigIP Load Balanced Web servers

                                         Served applications
                                            Batch mailbox
                                    MN-ITS Single claims submission

     Clustered Websphere
      JAVA Appllications
                                   Front end
                                  data stored
                                                 If mainframe connectivity
                                                 is required MQ Series or
                                                CICS Transaction Gateway


          Oracle 10G
    Real Application Clusters
                                                                             The existing infrastructure for claims processing would be
                                                                             leveraged for this process functionality. Modifications to the MN-
                                                                             ITS application and the MMIS mainframe application are within
                                                                             scope of this effort. The MN-ITS application is a JAVA Websphere
                                                                             base application connecting to the mainframe with MQ Series
                                                                             middleware. The on-line claims processing engine is a COBOL,
                                                                             CICS, DB2 ZOS mainframe system. The vendor will need to work
                                                                             very closely with state staff on these modifications.

        ZOS DB2 VSAM
         COBOL CICS

                                                          Medicaid Transformation Grant
                                                        Use case for coordination of care web pages
                                                        P7 Care Coordination web pages, controlled access by
                                                                     beneficiary and providers.

      JAVA Web based application
          Via MN-ITS Portal

                                                                                         Information Deposit
                                                             Authentication &             Care Coordination
                                                              Authorization             & Information requests

    Oblix Web Authentication
          Authentication                                                                                                   Selected Providers
       User Management
                                      Beneficiary provided                                        Care
                                       care coordination                                       Provider to
                                         Information &                                          Provider
                                     Request for information
                                        from providers                    P7
                                                                                                     for providers &
                                                                                                    Care Coordination
BigIP Load Balanced Web servers                                                                 Provider &
                                                JAVA                                        care coordination
                                         Served applications                                   information
                                            Batch mailbox
                                    MN-ITS Single claims submission

     Clustered Websphere
      JAVA Appllications
                                   Front end
                                  data stored
                                                 If mainframe connectivity
                                                 is required MQ Series or
                                                CICS Transaction Gateway

                           SAN                                                       This process intends to primarily make available information for
                           Data                                                      the purposes of coordination of care for the beneficiary. The
                                                                                     primary purpose would be sharing information from provider to
                                                                                     provider with beneficiary approval. Provider to beneficiary and
          Oracle 10G                                                                 beneficiary to provider is a secondary objective. This would be
    Real Application Clusters                                                        made available through the MN-ITS portal. Information would
                                                                                     be provided such as:

                                                                                          Primary Diagnosis
                                                                                          Medication History
                                                                                          Hospital Admittance
                                                                                          Treatment plan

        ZOS DB2 VSAM
         COBOL CICS

      JAVA Web based application
          Via MN-ITS Portal
                                                                                    Medicaid Transformation Grant
                                                                                       Use case for reporting performance

                                                                                                  P8 Report Performance

                                                        Authentication &
    Oblix Web Authentication                             Authorization
       User Management
              LDAP                                                                                 Performance
                                        Industry standard
                                          & DHS defined
                                       performance criteria

                                                                       P8 Report

                                                                                                                            Selected Providers
                                      Submittal Response

BigIP Load Balanced Web servers                                                                    Performance
                                                                                                   Data Results
                                           Served applications
                                             MN-ITS Portal

     Clustered Websphere
      JAVA Appllications
                                   Front end
                                  data stored
                                                 If mainframe connectivity
                                                 is required MQ Series or
                                                CICS Transaction Gateway


          Oracle 10G
    Real Application Clusters

                                                                             This function will facilitate the reporting of performance indicators to
                                                                             the Department of Human Services by selected providers enrolled in
                                                                             the program. The provider will contribute this information in very
                                                                             straight forward direct data entry windows as a the vehicle for
                                                                             collecting provider input. Direct data entry windows will be a
                                                                             component of the MN-ITS Provider portal.

        ZOS DB2 VSAM
         COBOL CICS

                                                        Medicaid Transformation Grant
                                                              Use case for the purposes of
                                                             policy and performance analysis
                                                              P9 Analysis of Policy and Performance
      JAVA Web based application
          Via MN-ITS Portal

                                                                                         Business Need
                                                                                Quality & Performance Measures
                                                                                         Policy & Criteria
                                                       Authentication &
                                                                                              Policy & Measures
    Oblix Web Authentication                                                                 based upon Results
          Authentication                                                                                                          MDHS Staff
       User Management
                                         Policy Reflected
                                     in Performance Measures

                                                                          P8 Policy &                       Coordinated
                                                                          Performance                          Care
                                                                            Analysis                        Provider to
                                    Measurable/Actionable                                                    Provider
                                    Performance Results

                                                                                                                           Standards for
BigIP Load Balanced Web servers
                                                                                                                           Clinical Care
                                                  JAVA                                                            Performance Standards & Criteria
                                           Served applications
                                              Batch mailbox
                                           Web service based
                                          Performance Algorithm

     Clustered Websphere
      JAVA Appllications                                                                 National Standards Organizations
                                   Front end
                                                                                           for clinical quality (i.e. ICSI)
                                  data stored
                                                 If mainframe connectivity
                                                 is required MQ Series or
                                                CICS Transaction Gateway


          Oracle 10G
    Real Application Clusters                                     The Department of Human Services will leverage performance measures
                                                                  and standards created by key players in this business area (i.e. ICSI). Within
                                                                  scope of the project is a software component that can reside on top of the
                                                                  data structure that will perform the reporting functions. The reporting
                                                                  functions will need to be flexible and interoperable (exposed as web service)
                                                                  with the MN-ITS portal. It must provide the function of reporting, business
                                                                  analects, and dimensional intelligence robust enough to meet the needs of
                                                                  the grant, and robust enough to be a leverage able asset that may be reused
                                                                  for other business reporting functions.

        ZOS DB2 VSAM
         COBOL CICS

Agency Project Requirements
    Proposals must:
       1. Meet industry standards consistent with security and privacy requirements, best
          practice, and cost-effectiveness. The tool will meet the following standards:
             a. Must meet or exceed standards for HIPAA security and privacy.
             b. Industry standard transactions sets will be used where appropriate.
             c. The web application must be delivered via a web service intended to comply
                 with the MITA service oriented architecture standard in a J2EE distributed
             d. Leverage the existing MMIS infrastructure of operating and database
                 software, hardware, network components, legacy and data warehouse
                 interface capabilities.
             e. Employ industry best practices in methodologies and tool sets for project
                 management (MPI), business analysis (RUP), architecture (RSA),
                 construction (RAD), testing (RUT), and implementation (RCQ).
             f. Be compliant with federal grant regulations, as applicable, including the

                 i. Compliance with Executive Order 11246 of September 24, 1965, entitled
                      ‘‘Equal Employment Opportunity,’’ as amended by Executive Order
                      11375 of October 13, 1967, and as supplemented in Department of Labor
                      regulations (41 CFR chapter 60). (All construction contracts awarded in
                      excess of $10,000 by grantees and their contractors or sub-grantees)
                 ii. Compliance with the Copeland ‘‘Anti-Kickback’’ Act (18 U.S.C. 874) as
                       supplemented in Department of Labor regulations (29 CFR Part 3). (All
                       contracts and sub-grants for construction or repair)
                 iii. Compliance with the Davis-Bacon Act (40 U.S.C. 276a to 276a–7) as
                       supplemented by Department of Labor regulations (29 CFR Part 5).
                       (Construction contracts in excess of $2000 awarded by grantees and
                       subgrantees when required by Federal grant program legislation)
                 iv.Compliance with Sections 103 and 107 of the Contract Work Hours and
                       Safety Standards Act (40 U.S.C. 327–330) as supplemented by
                       Department of Labor regulations (29 CFR Part 5). (Construction
                       contracts awarded by grantees and subgrantees in excess of $2000,
                       and in excess of $2500 for other contracts which involve the employment
                       of mechanics or laborers)

                 v. Compliance with all applicable standards, orders, or requirements issued
                     under section 306 of the Clean Air Act (42 U.S.C. 1857(h)), section 508
                     of the Clean Water Act (33 U.S.C. 1368), Executive Order 11738, and
                     Environmental Protection Agency regulations (40 CFR part 15).
                     (Contracts, subcontracts, and subgrants of amounts in excess of
                 vi. Mandatory standards and policies relating to energy efficiency which are
                     contained in the state energy conservation plan issued in compliance
                     with the Energy Policy and Conservation Act (Pub. L. 94–163, 89 Stat.

      Additional Agency Requirements
      •   The product will be implemented on the Health Care Operations DC1 hardware
          infrastructure. The implementation must follow the development, testing, quality
          assurance and production implementation disciplines. The product will have a CICS
          Transaction Gateway or MQ Series interface with the mainframe system located at the
          States Department of Administration building. There are redundant fiber connections to
          that facility. The application must also comply with the HCO standards for n-tier JAVA
          development. The application must function within the rules established by the Chief
          Information Security Officer. Zones of control architecture which includes firewalls,
          system hardening compliance, and application security and logging will require strict
      •   The vendor will be required to provide detailed architecture, software architecture,
          detailed design documentation, release notes and training documentation as HCO will
          assume operations, enhancements and ongoing support services for the application.
      •   The vendor must provide an estimate of the hardware requirements of the application
          such as CPU, memory and data storage. The application will be deployed on Sun
          Micorosystems Hardware currently running Solaris 10. Application servers are also
          Sun Microsystems servers running Solaris 10 and Websphere in a clustered mode.
          The Oracle 10G database is running a real application cluster in three nodes.
      •   Compliance with the Healthcare Operations MITA architecture will be required. The
          MITA Technical Architecture Committee will provide guidance to the vendor as it
          pertains to detailed technical standards.
      •   Compliance with Statewide Project Management Methodology is required. Project
          management institute plans processes are to be strictly adhered to.

Responsibilities Expected of the Selected Vendor

      •   Proposals must include a proposed change management process subject to
          negotiation at the time of award.
      •   Proposals must include a vendor staffing plan
      •   Project Documentation
      •   Proposals must describe project management roles and responsibilities of contract and
          state staff.
      •   Proposals must identify processes proposed for training/ knowledge transfer to state
      •   Proposals must describe proposed testing and acceptance criteria
      •   Proposals must include a detailed project plan
      •   The vendor will facilitate, document and formally present user requirements,
          conceptual design, detailed design and work with state database administrators to
          develop the logical data model. Design documentation will be delivered in UML
          standard format.
      •   Development, unit test, system test and quality assurance of the application is required
          by the vendor. The state has the final say in the acceptance of the application.
      •   The vendor will provide release notes for each build release of the application in the
          states format.
      •   Knowledge transfer to state application developers is required.
      •   Knowledge transfer to state operations staff is required.

      •   The state owns all application code developed by the vendor in this effort. No
          proprietary solutions are up for discussion.
      •   User training documentation and a train the trainer model is another component of the
          project. The vendor must provide the training materials and train a set of trainers at the
          state for application use.

Process Schedule
     • Deadline for Questions                            August 10, 2007 4:30 pm CDT
     • Posted Response to Questions                      August 22, 2007, 4:30 pm CDT
     • Proposals due                                     September 4, 2007, 2:30 pm CDT
     • Anticipated proposal evaluation begins            September 4, 2007
     • Anticipated proposal evaluation & decision        September 21, 2007

      Required Skills
      • The required skills are a pass/fail evaluation. Only those responses that pass the
        required skills will be scored on the remaining factors
      • Five years Project Management PMIBOK methodology and state project management
        methodology, templates, and disciplines are required. This a very high profile project
        that must bee accomplished in a very short window of time on a very constrained
        budget. The project manager will be required to develop the plan quickly, execute the
        plan carefully meeting quality standards, time constraints and budget constraints. The
        project manager must be able to work in a high pressure environment and deliver the
        desired results.
      • Analysis (UML) three years experience in methodologies & tool sets in the following:
                   Business process modeling
                   Use case Modeling
                   State transition Modeling
                   Data Modeling
                   Group facilitation & requirements gathering
                   Five years experience is desired on major systems implementations.
      • Five years experience using the standards in which Health Care Operations built
        their existing architecture: Websphere RAD Version 6.0 JAVA Software
        Development with Oracle 10G RAC (IFS) Database.MQ Series as transport
        middleware from JAVA application to mainframe Medicaid Management Information
        System- COBOL, DB2.
      • A senior level programmer with three years experience in integrating using web
        services in a services-oriented architecture. This would include experience in
        integrating custom built applications and off the shelf applications COTS.

      Desire Skills
        o All skills listed above are required.

      Any questions regarding this Statement of Work should be submitted via e-mail by August
      10, 2007, 2:30 pm CDT to:
            Tom Trant
            Minnesota Department of Human Services
            Health Care Operations Division

Questions and answers will be posted on the Office of EnterpriseTechnology website by August
22, 2007, 4:30 p m CDT (

SOW Evaluation Process
    The required skills are a pass/fail evaluation. Only those responses that pass the required
    skills will be scored on the remaining factors:

       •   Company (5%)
       •   Experience (20%)
       •   Three References (10%)
       •   Desired skills (10%)
       •   Work Plan (25%)
       •   Cost (30%)

    **Note: For procurements exceeding $477,000, member countries of the World
    Trade Organization’s Government Procurement Agreement must be treated on the
    same basis as U.S. companies under the terms of the treaty. A reference sheet
    including a list of current members is available at:

Response Requirements
    Proposals must include the following:

    • Company overview
        a) Company history, growth
        b) Current financial data if publicly available
    • Project Overview
    • Information sufficient to demonstrate you meet the required skills.
    • Detailed response to “Business/Project Requirements”
        a) Description of the vendor’s understanding of the need and explanation of their
           proposed solution.
        b) Explain in detail how the proposed project will meet the State’s requirements.
        c) Proposal should include description of the projects proposed software/hardware
    • Proposals must detail the vendor’s “Project Approach”
        a) Proposals must describe how the vendor will approach their participation in the
           project. This includes:
           1) Organization and staffing (including staff qualifications, resumes, etc.)
           2) Work-plan with life-cycle cost breakdown here
           3) Contract/change management procedures
           4) Project management (e.g. quality management, risk assessment/management,
           5) Documentation of progress such as status reports
    • Detailed response to staff augmentation
        1) Resume
        2) Cost
    • References: Provide three clients using the solution
    • Additional Documents that must be submitted:
        a) Affirmative Action Certificate of Compliance

        b) Affidavit of non-collusion

        c) Location of Service Disclosure
        d) Certification Regarding Lobbying

Proposal Submission Instructions
    •   Response Information:
        a) Responses must be mailed or delivered to Tom Trant
        b) Minnesota Department of Human Services
            Health Care Operations Division
            444 Layfayette Road North
            Saint Paul, Minnesota 55101
        c) Attention: Medicaid Transformation Grant Selection Committee
    • Submissions may be delivered by US mail, FedX , other carrier, courier or in person.
    • Submissions should include one (1) original and five (5) hard copies.
    • Key dates:
        a) Response due date; September 4, 2007, 2:30 pm, CDT
    Vendors may not contract anyone other than Tom Trant regarding any part of this

General Requirements

    Proposal Contents
       By submission of a proposal, Responder warrants that the information provided is true,
       correct and reliable for purposes of evaluation for potential award of a this work order.
       The submission of inaccurate or misleading information may be grounds for
       disqualification from the award as well as subject the responder to suspension or
       debarment proceedings as well as other remedies available by law.

    Disposition of Responses
       All materials submitted in response to this SOW will become property of the State and
       will become public record in accordance with Minnesota Statutes, section 13.591, after
       the evaluation process is completed. Pursuant to the statute, completion of the
       evaluation process occurs when the government entity has completed negotiating the
       contract with the selected vendor. If the Responder submits information in response to
       this SOW that it believes to be trade secret materials, as defined by the Minnesota
       Government Data Practices Act, Minn. Stat. § 13.37, the Responder must: clearly mark
       all trade secret materials in its response at the time the response is submitted,
       include a statement with its response justifying the trade secret designation for each
       item, and
       defend any action seeking release of the materials it believes to be trade secret, and
       indemnify and hold harmless the State, its agents and employees, from any judgments
       or damages awarded against the State in favor of the party requesting the materials,
       and any and all costs connected with that defense. This indemnification survives the
       State’s award of a contract. In submitting a response to this RFP, the Responder

    agrees that this indemnification survives as long as the trade secret materials are in
    possession of the State.

The State will not consider the prices submitted by the Responder to be proprietary or trade secret materials.

Conflicts of Interest
  Responder must provide a list of all entities with which it has relationships that create,
  or appear to create, a conflict of interest with the work that is contemplated in this
  request for proposals. The list should indicate the name of the entity, the relationship,
  and a discussion of the conflict.

    The responder warrants that, to the best of its knowledge and belief, and except as
    otherwise disclosed, there are no relevant facts or circumstances which could give rise
    to organizational conflicts of interest. An organizational conflict of interest exists when,
    because of existing or planned activities or because of relationships with other
    persons, a vendor is unable or potentially unable to render impartial assistance or
    advice to the State, or the vendor’s objectivity in performing the contract work is or
    might be otherwise impaired, or the vendor has an unfair competitive advantage. The
    responder agrees that, if after award, an organizational conflict of interest is
    discovered, an immediate and full disclosure in writing must be made to the Assistant
    Director of the Department of Administration’s Materials Management Division (“MMD”)
    which must include a description of the action which the contractor has taken or
    proposes to take to avoid or mitigate such conflicts. If an organization conflict of
    interest is determined to exist, the State may, at its discretion, cancel the contract. In
    the event the responder was aware of an organizational conflict of interest prior to the
    award of the contract and did not disclose the conflict to MMD, the State may terminate
    the contract for default. The provisions of this clause must be included in all
    subcontracts for work to be performed similar to the service provided by the prime
    contractor, and the terms “contract,” “contractor,” and “contracting officer” modified
    appropriately to preserve the State’s rights.

    Foreign Outsourcing of Work Prohibited
All services under this contract shall be performed within the borders of the United States.
All storage and processing of information shall be performed within the borders of the
United States. This provision also applies to work performed by subcontractors at all tiers.

Statement of Work does not obligate the state to award a work order or complete the
assignment, and the state reserves the right to cancel the solicitation if it is considered to
be in its best interest. The Agency reserves the right to reject any and all proposals.

Indemnification and Hold Harmless
     The Contractor must indemnify, save, and hold the State, its agents, and
     employees harmless from any claims or causes of action, including attorney’s fees
     incurred by the State, arising from the performance of this contract by the
     Contractor or the Contractor's agents or employees. This clause will not be
     construed to bar any legal remedies the Contractor may have for the State's failure
     to fulfill its obligations under this contract.

                                  STATE OF MINNESOTA
                     IT Professional Services Master Contract Work Order
       This work order is between the State of Minnesota, acting through its _____ ("State") and _____
       ("Contractor"). This work order is issued under the authority of Master Contract T-Number 502TS,
       CFMS Number _________, and is subject to all provisions of the master contract which is
       incorporated by reference.
          NECESSARY.] the State is empowered to engage such assistance as deemed necessary.
       2. The State is in need of [ADD BRIEF NARRATIVE OF THE PURPOSE OF THE
       3. The Contractor represents that it is duly qualified and agrees to perform all services described in
          this work order to the satisfaction of the State.
                                                            Work Order
       1   Term of Work Order
           1.1 Effective date:__________, or the date the State obtains all required signatures under Minn. Stat. § 16C.05,
                  subd. 2, whichever is later.
           [The Contractor must not begin work under this work order until it is fully executed and the Contractor has been
           notified by the State’s Authorized Representative to begin the work.]
           1.2     Expiration date: _____, or until all obligations have been satisfactorily fulfilled, whichever occurs first.

2      Contractor’s Duties
                 The Contractor, who is not a state employee, will: ______[Thorough Description of Tasks/Duties]

       3   Consideration and Payment
           3.1 Consideration. The State will pay for all services performed by the Contractor under this work order as
                A. Compensation. The Contractor will be paid as follows:
                     [For projects, list out each deliverable and amount to be paid for each deliverable. Only if a specific
                     deliverable cannot be defined, insert an hourly rate.]
                B. Travel Expenses. Reimbursement for travel and subsistence expenses actually and necessarily incurred
                     by the Contractor as a result of this work order will not exceed $_____.
                C. Total Obligation. The total obligation of the State for all compensation and reimbursements to the
                     Contractor under this work order will not exceed $_____.
           3.2 Invoices. The State will promptly pay the Contractor after the Contractor presents an itemized invoice for
                the services actually performed and the State's Authorized Representative accepts the invoiced services.
                Invoices must be submitted timely and according to the following

       4   Liability
               Indemnification and Hold Harmless
               The Contractor must indemnify, save, and hold the State, its agents, and
               employees harmless from any claims or causes of action, including attorney’s fees incurred by the State,
               arising from the performance of this contract by the Contractor or the Contractor's agents or employees. This
               clause will not be construed to bar any legal remedies the Contractor may have for the State's failure to fulfill
               its obligations under this contract.

       5   Foreign Outsourcing
           Contractor agrees that the disclosures and certifications made in its Location of Service Disclosure and
           Certification Form submitted with its proposal are true, accurate and incorporated into this work order contract by

6   Authorized Representatives
    The State's Authorized Representative is ___________. The State's Authorized Representative

    will certify acceptance on each invoice submitted for payment.

    The Contractor's Authorized Representative is ______________. If the Contractor’s
    Authorized Representative changes at any time during this work order, the Authorized
    Representative must immediately notify the State.

Individual certifies that funds have been encumbered as
required by Minn. Stat. 16A.15 and 16C.05.

By: ______________________________________________ ______________________________________________ By:
                                                                        (with delegated authority)
Date: _____________________________________________                    Title:______________________________________

CFMS Contract No. _________________________________                    Date:______________________________________

    The Contract or certifies the appropriate person(s)
    Have executed the contract on behalf of the Contractor as
    required by applicable articles or bylaws

By: ______________________________________________

Title: _____________________________________________



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