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					State of Washington Dept. of Social and Health Services

MMIS Re-Procurement Request for Proposal

1. Overview and Background
1.1 Scope of Request for Proposals (RFP)

This Request for Proposals (RFP) is issued by the State of Washington Department of Social and Health Services (DSHS). DSHS invites proposals from qualified Bidders for Design, Development and Implementation (DDI) and maintenance of a modern Medicaid Management Information System (MMIS). The overall services and components to be acquired through this RFP encompass the following: 1. Modern MMIS, including client, provider, reference, prior authorization, claims processing, managed care, Coordination of Benefits (COB)/Third Party Liability (TPL), financial and drug rebate components. 2. Fully functional Pharmacy Point of Sale (POS) component. 3. Separate data warehouse, including Decision Support System (DSS), Executive Information System (EIS), Management and Administrative Reporting (MAR) and Surveillance and Utilization Review (SUR) functionality 1. 4. State-of-the-art Contact/Call Management System. 5. Electronic swipe card functionality supporting client eligibility. 6. Integrated Voice Response (IVR) component. 7. Imaging and document management services. 8. DDI, project management and staffing services, including provider and staff training, cultural and business process change management, risk mitigation, certification support and system documentation. 9. Ongoing system maintenance, data center operations and Facilities Management (FM) services. The contract term is for five (5) years with three (3) one (1) year renewal options, where the first two (2) years are for the DDI effort. On-going maintenance services will begin at the completion of DDI after the successful Vendor meets the State’s system acceptance criteria. To reduce costs and risks, Bidders are asked to propose the transfer of the baseline MMIS system from another state and to modify the transferred system to meet DSHS requirements identified in this RFP. The transfer system is defined as the six (6) MMIS subcomponents as defined by Part 11 of the State Medicaid Manual (i.e., Recipient, Provider, Claims Processing, Reference File, Surveillance and Utilization Review (SUR), Management and Administrative Reporting (MAR) subsystems). The Bidder should propose a transfer system that from its point of view provides the best overall fit for meeting the needs and requirements of DSHS. Bidders are also encouraged to partner or form alliances with other firms to offer “best of breed” features and functionality in the various ancillary components outside the core MMIS (e.g., IVR, swipe card technology, imaging, etc.).

1

A Fraud Abuse and Detection System (FADS) is to be procured separately.

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1.2 Vision, Goals and Objectives
DSHS’s overall vision, goals, and objectives of the MMIS Re-Procurement Project are identified below.

1.2.1 Vision Statement
DSHS desires a modern MMIS that is a flexible, modularly designed system and one that is user-friendly, easy to maintain, and easy to enhance.

1.2.2 Goals
The modern MMIS should respond to State budget constraints, provide the State Legislature with accurate and timely health care and expenditures information, and comply with Federal mandates which must be achieved. Improving DSHS’s ability to accomplish these objectives is in the best interest of the State. To that end, the following MMIS Re-Procurement goals have been established: 1. Implement a state-of-the-art modular MMIS that is consistent with the business requirements of DSHS and provides the flexibility to make timely changes to the system. 2. Improve the Department’s ability to keep up with and take advantage of modern relational database, imaging, document management and communications technology. 3. Perform initial and on-going training DSHS staff to work effectively within the modern MMIS environment consistent with scope decisions made by the Executive Steering Committee. 4. Maintain Health Insurance Portability and Accountability Act (HIPAA) compliance, support the storage and use of all HIPAA Electronic Data Interchange (EDI) transaction data elements and code sets, and maintain Privacy, Security, and National Provider Identifier (NPI) regulations under HIPAA. 5. Keep current with technology innovations. 6. Effectively manage Medicaid and similar non-Medicaid business policies, processes, practices and functions within the modern MMIS environment. 7. Bring about change incrementally through a phased implementation plan to leverage the MMIS and address both short- and long-term goals through 2008.

1.2.3 Objectives
The high-level objectives of the Re-Procurement project are to manage the procurement and implementation of a modern MMIS that meets the business needs of DSHS. The following objectives have been established; the success of each is measured by the identified performance measure:

Objective
Define the system scope of MMIS functionality that supports the strategic vision of Department Executives. Identify and document DSHS business

Performance Measure
Approval by Executive Steering Committee of recommended MMIS Scope. Validation of MMIS System

Complete



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Objective
needs and requirements for an MMIS within the agreed-upon system scope. Identify and analyze MMIS alternatives for addressing DSHS business needs and requirements. Select the “Best” alternative for meeting those business needs and requirements. Obtain necessary approvals and funding to complete DDI of the MMIS based on DSHS business requirements. Manage stakeholder expectations within and external to DSHS.

Performance Measure
Requirements by the DSHS CrossAdministration Team. Approval of Requirements Analysis Report and Investment Plan by Executive Steering Committee and Information Services Board (ISB).

Complete

2



Approval of Advance Planning Document – Implementation (APD-I) by CMS and of supplemental budget request by State Legislature. Stakeholders are supportive of the project and exhibit a clear understanding of the scope of the new system. Multiple Bidders respond with proposals that meet the requirements, allowing selection of the best Bidder. Business processes and users are trained and prepared to use the new system, such that core business functions continue uninterrupted. Implementation occurs on time and within budget.



On-going

Select a Bidder to complete DDI of the MMIS in a fair and competitive process. Ensure DSHS business processes and users are ready for the MMIS.

Manage DDI of the MMIS on schedule and within budget.

1.3

Need to Re-Procure Current MMIS

Several factors contribute to DSHS’s need to replace the current MMIS. Primarily, the current system does not address the State’s business needs. Additional drivers of the MMIS Re-Procurement Project include technical limitations of the current system, recommendations by the Joint Legislative Audit and Review Committee (JLARC) as well as CMS policy on re-procurement.

1.3.1 Business Needs
The Washington MMIS, as it was initially implemented, supported the business needs of the Medicaid program – a fee-for-service based business model. Over the ensuing years, the business needs of the program have evolved to meet new legislative mandates – from managed care to State Children’s Health Insurance Program (SCHIP) to Health Insurance Portability and Accountability Act (HIPAA). The current MMIS has failed to keep pace with these evolving business needs. A requirements definition process conducted by DSHS over a six-month period from October 2003 to March 2004
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Initial validation complete – requirements validation with successful Vendor to be completed during Design Stage.

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revealed numerous gaps between the current MMIS legacy system and current business needs and best practices. This requirements analysis 3 indicates DSHS needs a modern MMIS to improve the effectiveness of operating and managing Washington State’s Medicaid program. In short, the modern MMIS should address the most pressing needs of Washington’s Medicaid program, including: 1. Consolidate Medicaid and selected non-Medicaid payment information across the Department. The MMIS should allow for consolidation of all Medicaid payment information (medical and non-medical) across the Department. Currently, Medicaid payments are made by two (2) separate systems. This decentralization of data makes it difficult to effectively manage the Medicaid program through comprehensive views of historical data for the entire Medicaid program and its individual clients. For example, labor-intensive workarounds have been developed to support the recently enacted Medicaid Integrated Program. 2. Make maintenance and modifications easier. The MMIS should allow the Department to more easily maintain and modify the MMIS without always requiring the intervention of application programmers when the system’s data or behavior must be changed to address new business needs. This will allow DSHS to more easily add and modify programs due to legislative mandates and management decisions. 3. Improve customer service and support. The MMIS should improve customer service and self-service for clients and providers. For example, an MMIS that integrates multiple sub-systems (e.g., claims, third-party recoveries, provider enrollment, call center management, and client contact components) will provide improved customer service and support when clients and providers contact DSHS. On-line enrollment and inquiries also will provide convenience and customer service to providers and clients while supporting Washington’s continued goal to digitize government. 4. Provide flexible and responsive reporting. Flexible and responsive reporting is needed in the MMIS for users, administrators, policy makers, and federal oversight representatives, who require information in a timely manner to support data driven decision making and to better serve the Department’s constituents – providers, clients, other state government agencies, the State legislature, the Governor’s office, and CMS.
5. Standardize Encounter Data. The MMIS should support receipt of managed

care encounter data in standardized formats, providing more data integrity for analysis, reporting and to support rate setting activities. 6. Implement improved interfaces and interoperability. The MMIS should improve sharing of information within DSHS and between DSHS and other state agencies. For example, an improved interface between the MMIS and the Automated Client Eligibility System (ACES) is needed to improve the accuracy and timeliness of MMIS eligibility data. Opportunities exist outside the Department as well, such as an improved interface between the MMIS and the Agency Financial Reporting System (AFRS) to improve availability of financial

3

For detailed requirements analysis information, refer to the “Requirements Analysis Report” and “MMIS Needs and Issues Report” on the Procurement Library website (see instructions in Section 6.2.4).

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data, and between the MMIS and the Department of Health to verify provider credentialing/licensure before payment is rendered. 7. Support common provider and client identifiers. The MMIS design needs to support a common provider and client database to promote the sharing of information across DSHS and between agencies and other states. Common provider/client identifiers bring visibility to total service delivery, reduce duplicate coverage and enhance overall program management. 8. Automate manual processes and workarounds. Labor-intensive interventions, such as but not limited to claims adjudication, coordination of benefits, third-party recoveries, and provider enrollment need further automation. At a minimum, The MMIS should increase the number of automated audits and edits, rather than requiring workers to intervene and manually process claims. Automation of manual payment processes (A-19s) also will enhance payment integrity and visibility. The new MMIS will bring a number of improvements to the State’s Medicaid operation. The MMIS will integrate a single unique identifier for each client and for each provider to improve processing efficiency and management reporting. More automated functions for updating reference data will better support claims adjudication and third party recoveries. The use of a modern relational database and table driven edits will reduce the time required to respond to Change Service Requests (CSR’s) resulting from policy and program changes. Today, due to the technical limitations of the current MMIS, many needed changes have been managed through the use of manual work-around procedures or development of data, ancillary systems and reports that must be maintained separately from the MMIS. Improved efficiency through the integration of these separate solutions into the MMIS must be achieved through this new system.

1.3.2 Current Technical Limitations
The current MMIS was implemented in Washington in 1982, using 1970s technology from a previous installation in another state. When installed, the MMIS met the basic needs of the State at the time, including a classic fee-for-service medical service delivery model. However, in the last 20+ years, delivery of health care services has become much more sophisticated, requiring numerous system modifications over the years. Through this evolution, the MMIS has been modified over and over to adapt to each policy, program or service initiative. To date, approximately three million lines of COBOL code comprise the MMIS, using a non-relational VSAM database. There are multiple, non-integrated components that have been added over time to respond to new or different needs (e.g., managed care, medical claims, pharmacy claims, prior authorization, customer support, etc.). The current system supports Medicaid managed care and a multitude of waivers and special programs. Added independently over the years, none of these components interface with each other very well. The result is an MMIS that uses hard coded values embedded in millions of lines of code within 1500 individual programs. Implementing and managing policy changes and federal mandates such as HIPAA has been difficult because of current MMIS limitations. Over 20 small databases and separate reporting systems have been developed to work around the limitations of the current MMIS.

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The current MMIS served the Washington Medicaid program well while fee for service payment was its primary focus. In 2004, it is clear that the Governor’s Office, Legislators, and State and federal policy makers expect the MMIS to do much more than just pay bills. A modern MMIS with modular and flexible payment, reporting, and decision support system functions is desired. Like many states, Washington is faced with rapidly escalating program costs for many Medicaid services. This escalation is partially a reflection of a national crisis in rising health care costs. It is also a result of DSHS’s inability to implement significant new cost containment and quality assurance measures due to structural constraints and technical limitations within its current MMIS. Although the current MMIS has been modified over the years to respond to changing policies, programs and delivery models, it has reached a point where too many technical limitations prevent it from being responsive enough to Washington’s business needs.

1.3.3 Joint Legislative Audit and Review Committee (JLARC)
In a recent draft Washington Medicaid Study4, the Joint Legislative Audit and Review Committee (JLARC) reported the need to improve the MMIS and to improve the use of Medicaid data to coordinate services, forecast Medicaid caseloads, and support Medicaid policy decisions at the administrative and legislative levels.

1.3.4 Centers for Medicare & Medicaid Services (CMS) Policy
Federal regulations require that MMIS contracts be competitively bid periodically. DSHS competitively re-procured the current MMIS in 1989, just once since implementation in 1982. In September 2003, the MMIS Re-Procurement Project received Information Services Board (ISB) approval to extend the current MMIS vendor maintenance contract until 12/2007, giving DSHS the time needed to address re-procurement. Since then, the project sought approval from CMS for the same contract period through 12/2007. However, CMS approved extension of the contract through 12/2006 only. Therefore, DSHS is obligated to replace the MMIS no later than 12/2006, allowing just 24 months for DDI, rather than the 36 month DDI schedule requested by DSHS and deemed necessary to weather contingencies.

1.4

Operations and Maintenance Model

The current MMIS is largely run in-house. State staff manages key processes while Affiliated Computer Services (ACS), the current MMIS vendor, operates the MMIS from its own data center and provides ongoing maintenance and modification to the MMIS. Teams of state staff perform the bulk of operational services including the following: 1. Provider enrollment and relations. 2. Client services and relations. 3. Call center staffing and management. 4. Prior authorization. 5. Claims administration and processing.

4

See http://jlarc.leg.wa.gov/Reports/Medicaid_FinalReport.pdf for link to the JLARC report.

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State of Washington Dept. of Social and Health Services 6. Pharmacy services. 7. Imaging and document automation services. 8. Reference file updates. 9. Coordination of Benefits/Third Party Liability. 10. Financial operations. 11. Financial recovery.

MMIS Re-Procurement Request for Proposal

When the modern MMIS is in place, DSHS will continue with this Facilities Management (FM) operations and maintenance model, where state staff perform the majority of operations as identified above, and the successful Vendor provides system maintenance and operations support. The recently enacted Personnel System Reform Act establishes a process, beginning July 1, 2005, to allow competitive contracting to procure services previously provided by State staff. Current state law prohibits DSHS from competitive procurement of operations services.

1.5

Current MMIS Overview

The current MMIS environment includes several components as follows: 1. MMIS: Following installation in 1982, the MMIS was certified by CMS in 1983. With a certified MMIS, DSHS was able to secure on-going Federal Financial Participation (FFP) at the maximum 75% of operations costs and 50% of claims payments. 2. Pharmacy Point of Sale (POS): DSHS also operates a separate Pharmacy Point of Sale (POS) system that receives and adjudicates National Council for Prescription Drug Programs (NCPDP) 5.1 formatted claims. The POS feeds pharmacy claim results to the MMIS, which processes provider payment. Like the MMIS, the POS vendor is ACS. 3. Data Warehouse: In 2001, DSHS procured the development and operation of the Health Watch Technologies (HWT) Decision Support System (HWT-DSS). This modern system was developed by outside contractors and has significantly improved DSHS’s ability to detect Medicaid fraud and abuse, making Washington State a national model for using sophisticated technology to combat fraud, waste and abuse. The HWT-DSS is also used to help DSHS make policy and operations decisions based on up to date transaction and payment activity. The current MMIS feeds data via tape to the HWT-DSS on a monthly basis, with implementation of weekly feeds in the near future. Currently, DSS and Fraud and Abuse Detection System (FADS) functions are separate from the MMIS. DSHS wishes to consolidate DSS, EIS, MARS and SURS functions in the future MMIS. However, specialized FADS functionality will be procured under a separate contract. 4. HIPAA remediation: The current HIPAA solution includes a web front-end and a middleware/translator component for transforming incoming HIPAA compliant transactions into a proprietary format for processing by the MMIS. The middleware/translator also serves to build outgoing HIPAA compliant transactions from out-bound proprietary transactions.

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1.5.1 Multiple Payment Systems and Processes
Besides the current MMIS, DSHS relies on several other systems to handle Medicaid payments, including the Social Services Payment System (SSPS) and manual A-19 payments processed by the Office of Financial Management (OFM) Agency Financial Reporting System (AFRS). These systems also process claims for similar non-Medicaid payments, funded either by state-only or other federal funds. The DSHS Office of the Secretary, Chief Administrative Officer for Management Services (see Section 1.6.7 below), operates SSPS. The current SSPS processes claims for some Medicaid programs such as Developmental Disabilities Division (DDD) Skilled Nursing, Private Duty Nursing, and Medicaid Personal Care, as well as similar non-Medicaid programs such as Chore Services, Behavior Rehabilitation Services and various waiver programs. For reporting purposes the various manual and automated payments are combined through the use of a stand-alone database. Manual calculations and cross checks are performed to ensure the accuracy of the payment categories and totals. These payments are tracked and combined with the payments made through the MMIS to facilitate federally required reporting of Medicaid expenditures and utilization. Automating these processes and integrating a select set of these functions into the modern MMIS must increase accuracy and reduce the amount of time needed to administer manual payments. The current HWT-DSS database contains both current MMIS and SSPS data; however, since the client and provider IDs are not standardized between the two (2) systems, it is nearly impossible to obtain a consolidated, comprehensive view of Medicaid expenditures. By consolidating all Medicaid and similar non-Medicaid payments onto the future MMIS, DSHS anticipates a significant benefit in administration and management of the overall Medicaid program.

1.5.2 Social Service vs. Medical Services Delivery Model
Historically, provider payments within DSHS have been divided according to the service delivery model. MMIS follows a medical services delivery model where a client’s eligibility is based on program policy and parameters. That is, all clients whose economic and/or medical need characteristics qualify them for certain categories of eligibility qualify for the same set of services and units, unless a provider requests or receives prior authorization to render additional services. SSPS payments, on the other hand, adhere to a social services delivery model where a client’s eligibility is based on a social worker or case worker performing an assessment of a client’s needs. The plan of care is then specific to an individual client based on a set of services and units prescribed or authorized by the case worker for that specific client. Because of these different delivery models, Medicaid payments within DSHS have been historically segregated with transactions processed by two (2) different systems. Currently, MMIS and SSPS data must be extracted and matched external to each system, making overall Medicaid program analysis and post payment reviews very difficult. One of the primary goals of the MMIS Re-Procurement is to consolidate all Medicaid payments onto one payment system, giving managers and policy makers a comprehensive view of the DSHS Medicaid program as a whole, as well as fully integrated data on clients and providers.

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In addition to addressing portions of the Medicaid program, SSPS also handles nonMedicaid payments (i.e., programs that use state only funding or other sources of federal funding). Many of these programs are similar to their Medicaid counterpart in terms of services, providers, processing logic, and other parameters. The only major difference is the funding source. To the degree that these non-Medicaid payments are similar to Medicaid payments and do not require additional system customization, a secondary goal of the MMIS Re-Procurement Project is to leverage the investment in the new MMIS to handle these payments as well. Therefore, this RFP reflects the requirements and system functions needed to support all Medicaid payments and other similar nonMedicaid payments5 today and into the future. As shown below in Section 1.6, Multiple DSHS Stakeholders, many of the Medicaid and similar non-Medicaid programs currently supported by the SSPS and other systems or manual processes are candidates for integration into the modern MMIS.

1.5.3 Manual Payment Processes (A-19s)
Manual payments (currently paid through an “A-19” form) are currently used in some situations that require payment to be made to a provider or client who is not enrolled as a Medicaid or Social Services provider or when other exceptional circumstances exist. Nearly every Administration within DSHS uses the A-19 process to record and track manual payments. Over the years the number of exceptional circumstances has grown. This growth is due to the functional limitations of the existing MMIS and SSPS systems. The A-19 transactions related to Medicaid and similar non-Medicaid programs are expected to be virtually eliminated with implementation of the modern MMIS as the modern MMIS must be flexible enough to handle exceptional circumstances.

1.5.4 Transaction Volumes
The Washington State Medicaid program pays nearly $4 billion a year in provider payments for health care services to needy Washingtonians. The new MMIS can be expected to pay approximately 135,000 providers and $332 million claims each month. Approximately 1 million clients will be supported by the new MMIS, of which half the client base (i.e., 500,000 clients) receives services via the Medicaid Managed Care program each month. Payments for the current MMIS system are processed weekly and payments to the current SSPS system are processed daily. Both systems use a warrant process that is managed by the Office of the State Treasurer. Consolidated monthly, weekly and daily claim volumes by dollar amount and number of transactions for MMIS and SSPS are represented below. Historically, claim volumes fluctuate from month to month, with an overall increase of approximately 20% per year. The figures represented below exclude child care payments from SSPS which are out of scope for the future MMIS.

5

This requirement assumes non-Medicaid services, providers and processing requirements are similar to their Medicaid counterparts.

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Current Dollar Volume (MMIS/SSPS)
$ 332 Million

$ 68 Million $ 13 Million

Monthly

Weekly

Daily

Current Transaction Volume (MMIS/SSPS)
2 Million

463,000 93,000

Monthly

Weekly

Daily

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Non-Claim Volumes
In addition to claim volumes identified above, estimated MMIS transaction volumes primarily for HIPAA-compliant transactions are as follows:

Transaction
Remittance Advice (835)

Volume per Month
78,000

Notes
Assumes 18,000 RAs per week – one (1) RA per active Medicaid provider * 52 weeks / 12 months = 78,000 per month. Each RA has an average of 25 claims, based on the monthly volume of claims. Assumes 550,000 from Medicaid Eligibility Verification system (MEVs), 50,000 Direct Data Entry and 2,500 phone inquiries. Assumes one (1) response for each inquiry. Average phone call inquiries (est. by Provider Relations). Assumes one (1) response for each inquiry. Assumes 15% of all claims are potentially pended and require additional information. Assumes one (1) response for each request for additional information Average phone call inquiries for Durable Medical Equipment (DME) / Prosthetics and Orthotic (P & O); excludes paper inquiries for dental, orthotic and DME/ P &O. Assumes an average of 2.5 responses for each request to obtain additional information. Assumes one (1) transaction per Managed Care enrollee per month, where an average of 500,000 Medicaid eligible clients are enrolled in Managed Care per month with monthly fluctuations of 10,000 to 30,000 per month. DSHS also intends to send transactions to 14 Regional Support Networks (RSNs) who will receive monthly premium payments. Acquisition RFP No. 0456-153

Eligibility Inquiry (270)

602,500

Eligibility Inquiry Response (271) Claim Status Inquiry (276) Claim Status Inquiry Response (277) Request for Additional Information (277) Request for Additional Information Response (275) Prior Authorization (278) Request

602,500 4,600 4,600 150,000

150,000 3,300

Prior Authorization (278) Response Premium Payment (820)

8,250

500,014

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Transaction
Enrollment (834)

Volume per Month
500,000

Notes
Assumes one (1) transaction per Managed Care enrollee per month (see above).

Total Est. Monthly Transactions (non-claim):

2,603,764

1.6

Multiple DSHS Stakeholders

The Department of Social and Health Services was established in 1970. The Department serves approximately 1.3 million people each year; about 1 out of every 4 residents state wide. DSHS is managed by the Office of the Secretary and six administrations, each with the authority to set Medicaid policy for their respective Medicaid and non-Medicaid health programs. The recent JLARC report identified a breakdown of Medicaid expenditures by Administration:

As stated above in Section 1.3.1, Business Needs, a primary goal of the MMIS ReProcurement Project is to consolidate all Medicaid and selected non-Medicaid payments into the modern MMIS. The Executive Steering Committee 6 expressed this goal for the project using the following criteria for including a payment within the scope of the MMIS are as follows: 1. Funding Source is Medicaid, regardless of service type (medical model or social services model). 2. Service type is medical, regardless of funding source. 3. Selected payments with similar processes. DSHS’s vision regarding the above criteria is to leverage the MMIS investment to address non-Medicaid payments to the extent that these payments are truly similar in
6

The Executive Steering Committee is comprised of the DSHS Secretary, Deputy Secretary, Assistant Secretaries, and Chief Officers.

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services, providers and processing logic as their Medicaid equivalent such that additional customization (e.g., design/development) is not required. For example, Medicaid Personal Care (MPC) and Chore services are nearly identical, except Chore clients are not Medicaid eligible. However, the services, providers and processing logic are the same. Further, implementation costs of the non-Medicaid programs will occur in the final implementation phase, allowing the State to isolate these costs and to apply a Medicaid cost allocation methodology agreed to by CMS. The following subsections reflect, by Administration, which programs are candidates for inclusion in the future MMIS based on the three (3) in-scope criteria above. The subsections also indicate the current payment system (MMIS, SSPS, A-19, or other).

1.6.1 Aging and Disability Services Administration (ADSA)
ADSA provides care to the frail elderly, adults with functional disabilities, and persons with developmental disabilities. Services are provided to those who require assistance to live independently in their own homes, or who receive care in an adult family home, boarding home or nursing home.

Criteria7

Programs

1. 2. 3. Title XIX Medical Similar Process

Adult Day Health IMR Services MMIS Medical/Dental Services Medical Transportation (Brokerage, Title XIX State Plan) Nursing Home Payments Current Payment System Nursing Home Audits/Settlements COPES Waiver SSPS PACE Managed Care Program DDD Skilled Nursing for those without Medicaid or private insurance Nurse Delegation

Y/N Y/N Y/N Y/N Y/N Y/N Y Y N Y/N

Y Y Y N Y N Y Y Y Y

N/A N/A N/A Y N/A Y N/A N/A N/A N/A

7

A “Y” in any column indicates payments will be handled by the modern MMIS. A “Y/N” indicates some, but not all, services meet the criteria in the column.

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Criteria7

Programs

1. 2. 3. Title XIX Medical Similar Process

Private Duty Nursing DDD Community Support Medicaid Personal Care (MPC) for Adults Family Support and Medicaid Personal Care (MPC) for Children Voluntary Placement Program (VPP) DDD Home & Community Based Services Waivers SSP (State Supplemental Payment) Nurse Aide Training DMIO (Dangerous Mentally Ill Offenders) Chore Services Discharge Resources, Home & Community Services Bed holds State Paid Adult Family Home Individual Provider Orientation State Paid Adult Residential Care (ARC) Adult Protective Services (APS) Medically Needy In-Home Waiver Medically Needy Residential Waiver Financial Related - Incapacity DDD Day Program Direct Payments DDD Supported Living DDD Group Homes June 2004 14 of 264

Y/N Y/N Y/N Y/N Y/N Y/N N Y N N N N N Y/N N N Y Y N Y/N Y/N Y/N

Y Y/N N Y/N Y/N Y/N N N Y/N N N N Y/N N N N Y Y Y N N N

N/A Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y N/A N/A N/A Y Y Y

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Criteria7

Programs

1. 2. 3. Title XIX Medical Similar Process

CHRIS – County Day Programs A-19 DDD Nursing Oversight Nursing Home Payments (non-Title XIX) Infant Toddler Early Intervention Program (ITEIP)

Y/N Y N N

Y/N Y Y Y

Y N/A N/A N/A

1.6.2 Children's Administration (CA)
CA protects children from abuse and neglect, provides family reconciliation services, arranges for foster home care and adoption services, and licenses child care providers.
Criteria8

Programs

1. 2. 3. Title XIX Medical Similar Process

MMIS

Adoption Medical Support Family Reconciliation Services

Y N N Y N N N Y/N N N N

Y Y/N N Y Y/N Y/N Y/N Y/N N N Y/N

N/A Y Y N/A Y Y Y Y Y Y Y

Current Payment System

Family Focused Services Medicaid Treatment Child Care (A-19) Crisis Residential Center SSPS Family Foster Care Sexually Aggressive Youth Behavior Rehabilitation Services (BRS) Hope Center Services Relative Support Services Adoption Support

8

A “Y” in any column indicates payments will be handled by the modern MMIS. A “Y/N” indicates some, but not all, services meet the criteria in the column.

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Criteria8

Programs

1. 2. 3. Title XIX Medical Similar Process

Independent Living Services Family Home Support Services Personal Care Services for Children

N N Y

N N Y

Y Y N/A

1.6.3 Economic Services Administration (ESA)
ESA helps individuals and families in need to achieve economic and social well-being by providing cash and food assistance, child support services, child care, and work-focused services designed to help people find and retain employment.
Criteria9

Programs

1. 2. 3. Title XIX Medical Similar Process

Current Payment System

Disability Medical Evaluation SSI Initial Evaluation SSPS SSI Records SSI Transportation Refugee and Immigration Assistance (A-19)

Y/N Y/N Y/N Y/N N

Y Y Y N Y

N/A N/A N/A Y N/A

1.6.4 Health and Rehabilitative Services Administration (HRSA)
HRSA provides resources to help clients with physical and mental disabilities, mental health problems, or chemical dependency, as defined by state and federal laws. HRSA is comprised of several divisions, three (3) of which plan to use the MMIS, including the Division of Alcohol and Substance Abuse (DASA), the Mental Health Division (MHD), and the Special Commitment Center (SCC).

9

A “Y” in any column indicates payments will be handled by the modern MMIS. A “Y/N” indicates some, but not all, services meet the criteria in the column.

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Criteria10

Programs (DASA)

1. 2. 3. Title XIX Medical Similar Process

Outpatient Chemical Dependency Treatment MMIS Residential Services (less than 17 beds) Support Services – Case Management, Urinalysis, Therapeutic Child Care Outpatient Chemical Dependency Treatment (County Contracts) Residential Services (more than 17 beds) Support Services – Housing Support and Interpreters Current Payment System

Y Y Y N N N

Y Y Y Y Y Y

N/A N/A N/A N/A N/A N/A

RSVP or A-19

Criteria10

Programs (MHD and SCC)

1. 2. 3. Title XIX Medical Similar Process

MMIS

Involuntary Mental Health Voluntary Mental Health CLIP Medical and Dental Visits CSTC Medical and Dental Visits SMHH Medical and Dental Visits

Y Y Y/N Y/N Y/N Y/N Y/N Y/N

Y Y Y Y Y Y Y Y

N/A N/A N/A N/A N/A N/A N/A N/A

Current Payment System

A-19

Court-Ordered Psychiatric Evaluations RSN Block Grant Payments (Premiums) SCC Medical and Dental Visits

10

A “Y” in any column indicates payments will be handled by the modern MMIS. A “Y/N” indicates some, but not all, services meet the criteria in the column.

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1.6.5 Juvenile Rehabilitation Administration (JRA)
JRA provides juvenile offenders with rehabilitation and offers programs to help them transition back to the community.
Criteria
11

Programs

1. 2. 3. Title XIX Medical Similar Process

MMIS

Current Payment System

Chemical Dependent Disposition Alternatives Assessment Residential Treatment & Care Programs

Y

Y

N/A

A-19

(* Title XIX eligibility pending) Contracted Community Facilities (BRS Services) Medical and Dental Visits

Y* Y N

Y/N Y/N Y

N/A N/A N/A

1.6.6 Medical Assistance Administration (MAA)
MAA provides health care coverage for low-income families, pregnant women, children, the elderly, and persons with disabilities. Coverage is provided through six programs, the largest of which is the Medicaid program. Nearly one million persons currently receive health care through these programs, including one-third of all children in the State. The administration’s budget represents 60 percent of the Department’s total spending.

Criteria11

Programs

1. 2. 3. Title XIX Medical Similar Process

Hospital Inpatient

Y Y Y Y Y Y

Y Y Y Y Y Y

N/A N/A N/A N/A N/A N/A

Current Payment System
11

Hospital Outpatient MMIS Managed Care Physician Pharmacy Dental

A “Y” in any column indicates payments will be handled by the modern MMIS. A “Y/N” indicates some, but not all, services meet the criteria in the column.

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Criteria11

Programs

1. 2. 3. Title XIX Medical Similar Process

Home Health Optical Durable Medical Equipment Transportation Family Planning SSPS First Steps Program Interpreter Services A-19 Transportation Services Refunds Out-of-State Providers/One Time Payments

Y Y Y Y Y Y/N Y Y Y Y

Y Y Y Y Y Y/N Y Y Y Y

N/A N/A N/A N/A N/A Y N/A N/A N/A N/A

1.6.7 Office of the Secretary
The Office of the Secretary is led by the DSHS Secretary and Deputy Secretary. Together with the Assistant Secretaries of the six DSHS Administrations, the Office of the Secretary is responsible for all health policy and resource management issues facing DSHS. The Office of the Secretary is involved with all aspects of DSHS with regard to budget development and monitoring, legislative relations, loss prevention and risk management, communications, personnel services reform, human resources, and information technology services. In addition to the Secretary, Deputy Secretary, and Assistant Secretaries, the Office of the Secretary includes the following key management positions:  The Chief Information Officer (CIO) who oversees the Information System Services Division (ISSD) including the offices of Communications, Customer Services, and Systems Operations. The Chief Financial Officer (CFO) who oversees the Financial Services Administration (FSA) including Accounting Services, Information Technology, Financial Recovery, Forecasting and Policy Analysis, and oversight of the Operating Budget. The Chief Administrative Officer (CAO) who oversees Management Services, Fraud Investigations, the Governor’s Juvenile Justice Advisory Committee, Lands and Buildings, and Research and Analysis services. 19 of 264 Acquisition RFP No. 0456-153

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

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The Director of Government and Community Affairs who oversees Constituent Services and Victim/Witness Notification services.

1.7

Business Process/Cultural Changes

Although the advanced capabilities of a modern MMIS represent significant benefits for DSHS, one of the biggest challenges of the Re-Procurement Project will be preparing users to be ready for this significant change in business processes. Because of the degree of change the MMIS procurement effort represents for DSHS organizationally, DSHS is very interested in working with the successful Vendor to effectively manage cultural and business process changes. These changes will result from DSHS replacing the MMIS that has been in place for over 20 years, as well as migrating all Medicaid and selected similar non-Medicaid payments from the current SSPS and manual processes to the modern MMIS. To mitigate the impact of this degree of change, DSHS plans to implement the modern MMIS in phases (see Section 1.8.3, Phased Implementation). Additionally, the MMIS Re-Procurement Project Office includes full-time, dedicated business analysts to investigate and document current business rules, policies and practices regarding program parameters, provider enrollment and certification, rate setting, client eligibility determination, prior authorization, claims processing and payment, and reporting, to name a few. Other critical business areas that can benefit from improved processes include, but are not limited to, more advanced surveillance and utilization management, improved management of front-end claims edits, fair hearings resolution, work flow management, prior authorization, provider enrollment and credentialing, and Third Party Liability (TPL) recoveries and cost avoidance. DSHS expects to learn much from the successful Vendor as the transfer system is introduced and business processes inherent to the transfer system are explained to key staff within Claims Processing, Pharmacy, Coordination of Benefits (Third Party Liability), Prior Authorization, Reference and DSS. Given the FM operations model, DSHS expects that the successful Vendor will train DSHS staff to assume responsibility for business operations. DSHS is interested not only in the system functionality of each Bidder, but also how Bidders can support DSHS in this important cultural transformation and training effort. Requirements around business process changes/training to which Bidders must respond are identified in Section 2, Management and Staffing Requirements. However, this need is raised here in Section 1 to underscore the importance DSHS places on bridging the gap between current and future MMIS operations.

1.8

Project Organization, Schedule and Implementation Phases

Additional background information that Bidders may find useful is provided below, including the State’s assigned staff, high-level project schedule and proposed implementation phases.

1.8.1 Project Organization
DSHS resources assigned to the MMIS Re-Procurement Project are as follows:

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Executive Steering Committee Project Sponsors DSHS Secretary & Deputy Secretary DSHS Assistant Secretaries Chief Officers

MMIS Re-Procurement Request for Proposal

Project Management Team Project Manager Deputy Project Manager Technical Manager

Oversight/Monitoring CMS ISB OFM Legislature ISSD/CIO QA

Cross-Administration Team DSHS Administration Representatives Project Office Secretary/Admin Communications Mgr. Infrastructure Architect Contracts/Legal Specialist. Budget/Fiscal Coord. Business Analysts (5) Business Teams Division/Section Representatives

1.8.2 Project Schedule
The following table and graphs show the proposed time line for the procurement tasks, as well as the Design, Development, and Implementation tasks for the modern MMIS. The time frames outlined here are estimates based on goals established by DSHS. As the procurement tasks progress, the begin dates for some of the tasks may change based on the amount of time required to secure review and approval of the plans by CMS and state oversight bodies.
MMIS Re-Procurement High Level Work Plan for Phases 1, 2 and 3 Planned End Date 7/15/2007

Task 1.

Description WA MMIS Re-Procurement

Planned Start Date 2/3/2003

Planning & Requirements Analysis 1.1. 1.1.1. 1.1.2. Planning/Requirements Definition Project Planning Requirements Analysis-Planning Acquisition 1.2. 1.2.1. Procurement Prepare Investment Plan 2/2/2004 2/2/2004 7/1/2004 2/29/2004 2/3/2003 2/3/2003 9/2/2003 2/27/2004 8/29/2003 2/27/2004

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Planned End Date 3/18/2004 5/1/2004 5/1/2004 5/1/2004 5/1/2004 6/30/2004 6/30/2004 7/1/2004 10/1/2004 9/1/2004 9/1/2004 10/1/2004 10/1/2004 1/18/2005 11/18/2004 1/18/2005 1/18/2005

Task 1.2.2. 1.2.3. 1.2.4. 1.2.5. 1.2.6. 1.2.7. 1.2.8. 1.2.9. 1.3. 1.3.1. 1.3.2. 1.3.3. 1.3.4. 1.4. 1.4.1. 1.4.2. 1.4.3. ISB review Prepare APD Prepare RFP

Description

Planned Start Date 3/18/2004 2/2/2004 2/2/2004 5/1/2004 5/1/2004 5/1/2004 5/1/2004 7/1/2004 7/1/2004 7/1/2004 9/1/2004 9/1/2004 10/1/2004 10/1/2004 10/1/2004 11/18/2004 1/18/2005

Deliver APD to CMS Deliver RFP to CMS CMS review and approval of APD CMS review and approval of RFP Release RFP Select DDI Contractor Bidders Prepare Responses DSHS Receives Responses DSHS Evaluates Responses DSHS Informs Apparent Successful Vendor Negotiate DDI Contract Conduct Negotiations CMS Review and Approval of the Contract Sign Contract

Business Process/Cultural Change 1.5 1.5.1 1.5.2 1.5.3 Business Process/Cultural Change Analysis of Current Business Processes Design Future Business Processes User Training/Orientation of Processes Design 1.6. 1.6.1. Design Complete Technical Design Development 1.7. 1.7.1. Development Complete Development Testing 1.8. 1.8.1. Testing UAT Test Implementation 1.9. Implementation 12/30/2006 12/30/2008 5/15/2006 5/15/2006 11/01/2006 11/01/2006 9/15/2005 9/15/2005 5/19/2006 5/19/2006 1/18/2005 1/18/2005 9/15/2005 9/15/2005 1/18/2005 1/18/2005 9/15/2005 5/15/2006 12/30/2006 9/15/2005 5/15/2006 12/30/2006

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Planned End Date 12/30/2006 12/30/2007 12/30/2008

Task 1.9.1. 1.9.2 1.9.3

Description Phase 1 DDI/Implementation Complete* Phase 2 DDI/Implementation Complete** Phase 3 DDI/Implementation Complete*** Certification

Planned Start Date 12/30/2006 12/30/2007 12/30/2008

2.0. 2.0.1. 2.0.2

WA MMIS Certification Prepare for Certification Conduct MMIS Certification Maintenance

12/30/2006 12/30/2006 6/30/2007

7/15/2007 6/30/2007 7/15/2007 12/30/201212

2.1

WA MMIS Maintenance

1/1/2007

* With completion of Phase 1, the CMS certifiable, core MMIS implementation will be complete. ** With completion of Phase 2, Medicaid programs from the current SSPS will be implemented on the modern MMIS. *** With completion of Phase 3, similar non-Medicaid programs from the current SSPS will be implemented on the modern MMIS.

1.8.3 Phased Implementation
To accomplish these goals, DSHS anticipates the modern MMIS implementation will be managed in three phases: 1. Phase 1: DSHS will implement the Medicaid transactions that are supported by the current MMIS. This first set of functionality supports the base requirements of the Washington Medicaid Program. The Phase 1 implementation is scheduled to be complete by 12/30/06 when the current MMIS contract expires. In addition to supporting current MMIS payments, DSHS expects that substantial improvements to the current operation will be realized. Once this milestone is reached and the system has been fully operational for six (6) months, DSHS will request formal CMS certification of the MMIS and secure the maximum federal matching funds for the operation of the MMIS. 2. Phase 2: DSHS will incrementally implement Medicaid programs that today are not supported by the current MMIS. Remaining Medicaid programs will be migrated to the modern MMIS from 12/30/06 to 12/30/07. These programs include for example, the COPES Nursing Services program, the Behavioral Rehabilitation Services program, and others. 3. Phase 3: Finally, non-Medicaid programs such as the Home Chore Services program and other programs will be implemented from 12/30/07 to 12/30/08. A listing of programs and the anticipated implementation phase are presented in Appendix AK – Implementation Phases by Administration and Program. DSHS anticipates that most of the design and development effort for the modern MMIS will occur during Phase 1. However, some DDI will occur in Phases 2 and 3, especially
12

Assumes the State exercises all three optional one-year extensions.

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around data conversion, testing, operational readiness and implementation tasks. DSHS also anticipates working with the successful Vendor to further define the contents of each phase based on the capabilities of the transfer system and the successful Vendor’s knowledge and expertise with similar implementations.

1.8.4 Operations and Maintenance
With start-up of live operations of current MMIS functionality to the new MMIS on 12/31/06, the former system will be taken out of service and operations and maintenance of the new system will begin. For the first two (2) years of operations and maintenance, programs from Phases 2 and 3 also will transfer claims processing from the current system(s) to the new MMIS. The overall contract term is for five (5) years with three (3) one-year options to renew (for a maximum of eight (8) years). The contract resulting from this RFP could extend through 2012 (if work begins 1/05 and all renewal options are exercised). Due to the phased implementation approach, operations and maintenance will occur in parallel with the implementation as follows:
Design/Development (DD) 2 Years Maintenance 6 Years

12/31/04
100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%

12/31/06

12/31/12

DD
Remaining Non-Medicaid 3.

RFP
Remaining Medicaid 2. Current MMIS 1.

Scope

Phase 1 Phase 2 Phase 3 Maintenance

2004-2006

12/2006

12/2007

12/2008

12/2008-12/2012

Phased Implementation

1.9

Selected Definitions

A full list of the acronyms and definitions used across DSHS is available on the Full Glossary on the Procurement Library website (see Section 6.2.4 for access instructions). Below is a partial set of definitions and acronyms designed to introduce Bidders to common terms used by the DSHS Administrations. Access to Baby and Child Dentistry (ABCD): A program that focuses on preventive and restorative dental care for Medicaid-eligible children from birth to age six, with parents encouraged to enroll children by age one.

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Adjudication: The processing of a transaction (claim) resulting in either a Pay, Deny, or Suspend status. Adult Family Home (AFH): A family home that contracts with DSHS to provide personal care and room and board for one to six adults unrelated to the person(s) providing the care. AFHs are licensed by ADSA. Agency: The Director, DSHS and/or the delegate authorized in writing to act on the Director’s behalf. Agency Financial Reporting System (AFRS): The state financial system of record that includes general ledger, accounting, accounts payable and payments. AFRS is maintained by the State of Washington’s Office of Financial Management. Aging & Disability Services Administration (ADSA): One of the six administrations of DSHS. ADSA brings together long-term care programs including home care, boarding home, and adult family home care, and nursing home services that are targeted to elderly people, as well as adults and children with disabilities. Agreement or Contract: A formal written document that defines what is expected of the Contractor/Vendor (Apparent Successful Vendor (ASV) until contract is signed) and DSHS. A proposed contract (agreement) is included with this document as Appendix AA – Sample Contract (Agreement). Alien Emergency Medical (AEM): A program that pays for emergency medical services to non-citizens. Ancillary Health Services: Health services ordered but not performed by a physician, including but not limited to, laboratory services, radiology services, and physical therapy. Applicant: An individual who has applied for assistance from DSHS but is not yet an eligible client. Application Process: The process by which a DSHS applicant becomes a client, including filing and completion of an application form, department review, and verification of required information. Some programs require applicant interviews. Application Software: Vendor or a third party's standard application software that is integrated into the MMIS. Enhancements to the Application Software provided by a Vendor or its suppliers will be considered as Application Software. Attorney General’s Office (AGO): Serves as legal counsel to more than 200 state agencies, boards and commissions, and colleges and universities, as well as to the Legislature and to the Governor. Advises and assists county prosecuting attorneys in the investigation, and if needed, the prosecution of crimes (including criminal prosecution of provider fraud). Issues legal opinions upon the request only of legislators, the heads of state agencies and county prosecuting attorneys. Authorization (medical services): For medical services administered by DSHS, the process by which a client or provider requests services that are not automatically included in the benefit plan. Authorization (social services): For social services administered by DSHS, the process by which a case manager or social worker approves services for a client. Automated Client Eligibility System (ACES): A data processing system designed to support client, financial, and management activities within DSHS. Through this system, staff members enter, update and inquire on data relating to assistance units, clients, June 2004 25 of 264 Acquisition RFP No. 0456-153

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other agencies, and providers. The ACES maintains eligibility information for most DSHS programs and interfaces with MMIS. Bidder: The firm or entity responding to this Request for Proposal (RFP). Centers for Medicare & Medicaid Services (CMS): A federal office under the Secretary of Health and Human Services, responsible for the review/approval of the MMIS Re-Procurement plans and for 90% Federal Funding Participation (FFP). Children’s Administration (CA): One of the six Administrations of DSHS. CA is committed to the safe and healthy growth and development of children in their homes, in out-of-home placements, and in day care. CA provides a comprehensive range of services to protect children from abuse and neglect, to support families, and to ensure quality care for children. Children’s Administration Management Information System (CAMIS): An in-house system that supports case management activities including eligibility determination and tracking of children’s placement, legal, medical, dental, and EPSDT information for the Children’s Administration. CAMIS also provides data feeds to SSPS through a nightly batch process for authorizing client services. Clean Claim: A claim that has no defect, impropriety (including a lack of any required substantiating documentation), or particular circumstance requiring special treatment that prevents timely payment. Client: An eligible person in a program administered by DSHS. Also known as a recipient in the Medicaid environment. Client Activity Tracking System (CATS): A system used by the Juvenile Rehabilitation Administration to track juvenile placement, locations, and sentencing. Client Authorization Services Input System (CASIS): Otherwise known as the SSPS front-end. CASIS is used by case workers for creating an SSPS authorization for client services with an automated electronic form. The application validates client data in the Developmental Disabilities Division (DDD) Common Client Data Base (CCDB), and validates provider and service code data in the SSPS before submitting the authorization to SSPS. Client Management Information System (CMIS): An in-house DSHS system that tracks client contact information, including caller information and reasons for contact. CMIS subsystems track enrollments, complaints, recoupments, exemptions, and disenrollments. CMIS makes use of data extracted from MMIS and IPND. Client Participation: The amount a client is responsible to pay each month toward the total cost of care they receive each month. It is the amount remaining after subtracting allowable deductions and allocations from available monthly income. (Some states refer to this as a Cost Share. ) Community Alternatives Program (CAP): A Medicaid waiver program that provides options in living arrangements to developmentally disabled clients in need of an Intermediate Care Facility - Mentally Retarded (IFC-MR) level of care. Community Options Program Entry System (COPES): A Medicaid waiver program that provides a client who has been assessed as in need of nursing facility care the option to remain at home or in an alternate living arrangement.

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Community Services Office (CSO): A local office of DSHS that provides cash, medical, and food benefits and services to eligible persons within a designated region. Comprehensive Assessment Reporting and Evaluation (CARE): An in-house system that determines client eligibility and service payment level for clients in ADSA home and community programs. Core MMIS: Defined as the 6 MMIS subcomponents as defined by Part 11 of the CMS State Medicaid Manual (i.e., recipient, provider, claims, reference file, Surveillance and Utilization (SUR), Management and Administrative Report (MAR) subsystems), as well as Managed Care functionality. Critical Access Hospital (CAH): A hospital designation/program that was created by the 1997 federal Balanced Budget Act as a safety net device, to ensure that Medicare beneficiaries have access to health care services in rural areas. It allows flexible staffing options relative to community needs, simplifies billing methods and creates incentives to develop local integrated health delivery systems, including acute, primary, emergency, and long-term care. Cross Administration Team (CAT): A workgroup made up of Administration officials from across DSHS. CAT members are responsible for the coordination of project status and communication of issues relative to system and business requirements for the modern MMIS. Day/Calendar Day: Monday through Sunday. Department of Health (DOH): A State of Washington department outside of DSHS that interfaces with DSHS Administrations in a variety of ways, including immunization registration, provider licensing, and vital statistics. Department of Information Services (DIS): The State department that oversees the procurement and implementation of information systems and infrastructure for all Washington State agencies. Department of Social and Health Services (DSHS): A State of Washington Department with six administrations that provide medical and social services to 1.3 million children and families each year. Diagnosis Related Group (DRG): A classification system which categorizes hospital patients into clinical coherent and homogenous groups to determine payment. Division of Child Support (DCS): A division within ESA that establishes paternity and collects child support for public assistance and non-assistance clients. DCS also determines if a client is not cooperating with support collection activities. Division of Developmental Disabilities (DDD): A division within ADSA that is responsible for services to developmentally disabled persons. Division of Employment and Assistance Programs (DEAP): An ESA Division that coordinates services and payments for health screenings for refugees and GA applicants. Division of Fraud Investigations (DFI): A division within the DSHS Management Services Administration responsible for detection and investigation of fraudulent activities by providers and clients. Division of Medical Management (DMM): An MAA division that performs medical review and quality assurance. June 2004 27 of 264 Acquisition RFP No. 0456-153

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DSHS Project Director: The person designated by DSHS to be responsible for financial and contractual matters regarding this RFP and resulting Agreement. DSHS Project Manager: The person designated by DSHS to be responsible for day-today management of DSHS resources for the project and monitoring the status of the Vendor’s performance under the resulting Agreement. Economic Services Administration (ESA): One of the six administrations of DSHS. ESA provides economic support, employment training, child support, medical services, and other services to help people in need achieve and maintain self-sufficiency. Employment Security Department (ESD): A State of Washington Department outside of DSHS that MAA uses to obtain information on provider employees. Enrollee: An individual eligible for medical benefits who participates in a particular program or health plan. Enrollment: (1) The act of a client’s becoming a member of a health plan, either by means of the client’s decision or by an automatic process. (2) The act of a medical or medically related provider applying for participation in the Medicaid Program on either a fee-for-service or capitated basis. Equipment: Equipment provided by the contractor and DSHS under the terms of the contract awarded as a result of this RFP. Exception Case Management (ECM): A unit within MAA that works with exceptional client situations such as health plan disenrollment requests and the Patients Requiring Regulation (PRR) program. Executive Steering Committee (ESC): The ESC is made up of DSHS executives who oversee the resource management, budget, and status of the MMIS Re-Procurement Project. Monthly ESC meetings are held to communicate the status of the project, deal with high-level issues, and mitigate risk. Health and Rehabilitation Services Administration (HRSA): The DSHS Administration that oversees alcohol and substance abuse services, Deaf and hard of hearing services, mental health services, the Special Commitment Center, and vocational rehabilitation services in the State of Washington. Health Care Authority (HCA): A State of Washington entity that provides health insurance coverage to state employees and sponsors a Basic Health Plan for private sector employees with low incomes. Health Care Provider: (HC Provider) Any person or organization that furnishes, bills, or is paid for medical or health services, or health care in the normal course of business. There are two major categories of providers who perform the following typical functions: 1. Fee for Service Provider: typically inquire about eligibility; inquire about benefits/specific benefits; contract with health plans; provide services; bill; and inquire about claim status. 2. Capitated Provider: typically inquire about eligibility; inquire about benefits/specific benefits; contract with health plans; provide services; report encounter records; receive capitation for managed care plan; send capitation; and receive encounter records.

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Health Insurance Portablility and Accountability ACT (HIPAA): Federal legislation aimed at administrative simplification for the health care industry, including rules on Transaction and Code Sets, privacy, security, NPI, etc. Health Watch Technologies – Decision Support System (HWT- DSS): A data warehouse and decision support system with historical data from MMIS claims and SSPS invoices. Identifiers: Unique identifier used in the administration of health care to signify a single health care provider, health plan, employer, and individual (consumer); intended to simplify administrative processes, such as referrals and billing, improve accuracy of data and reduce costs. Infant Toddler Early Intervention Program (ITEIP): An ADSA early intervention program that provides services to children that schools recognize as developmentally disabled. Information Services Board (ISB): A 15-member Board comprised of leadership from the Legislature, state agencies, higher education and the private sector. State law directs the ISB to: develop standards governing the acquisition and disposition of equipment, software and purchased services; approve Information Technology (IT) acquisitions or set rules that delegate acquisition authority; develop statewide or interagency technical policies; review and approve the statewide IT strategic plans; provide oversight on large projects; establish and monitor appeals processes. Information System Services Division (ISSD): The entity within the Office of the Secretary that develops and administers IT standards and policies applicable to DSHS, manages the e-center and IT Portfolio program. Information Services Division (ISD): The Division within MAA that provides information systems development services and oversight of operations for the MMIS and other information systems that support the Medical Assistance Administration. Inclusive Case Management System (ICMS): A system used by the Economic Services Administration (ESA) of DSHS to maintain General Assistance client information. Integrated Provider Network Database (IPND): A database that maintains information on providers in health plan networks including plans sponsored by MAA and HCA. It is the basis for managed care provider data available from the DSHS Web Site. Integrated Test Facility (ITF): A suite of modern software designed to establish an isolated environment for testing computer applications. Separate test regions for unit, system, and user acceptance test data as well as appropriate copies of the logic modules that make up the system are established. Version control procedures and update schedules are used to facilitate tests, track bugs and facilitate regression test analysis. Juvenile Rehabilitation Administration (JRA): One of the six Administrations of DSHS. JRA provides preventative, rehabilitative, residential, and transitional programs for juvenile offenders. Labor and Industries (L&I): The State of Washington Worker's Compensation Agency. It provides cash and medical benefits to eligible persons who are injured while working and interfaces with DSHS for provider employee information.

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Maintenance and Operations: Services provided by the Vendor post DDI, including but not limited to system enhancements and upgrades, data center operations and staffing, and Pharmacy Clinical Services (see RFP Sections 2.8 and 4.8.2). Mandatory Requirement (MR): The specifications within each section or subsection of this RFP which are marked (MR) in the title, including all referenced appendices and documentation, are Mandatory Requirements of this RFP, which will be scored as Pass/Fail. A Bidder’s proposed solution must meet all mandatory requirements. Failure, in the Transmittal Letter, to indicate Bidder’s agreement with all MR sections may result in disqualification of the Bidder’s proposal. Medicaid Eligibility Verification System (MEVS): An interactive electronic system that medical providers use to verify eligibility for Medicaid clients. Medicaid Management Information System (MMIS): The federally approved system used by the Washington Medicaid program to pay provider claims for goods and services authorized under the State Plan. The MMIS is certified by CMS and is the primary information system used by DSHS to pay for health care. Medicaid Managed Care (MCO): The Medicaid program that administers contracts with health plans to provide services to Medicaid eligible clients on a per-member permonth premium payment basis. Medical Assistance Administration (MAA): One of the six administrations of DSHS. MAA provides health care coverage to low-income families. Medical Eligibility Determination Services (MEDS): A statewide CSO that determines children's eligibility in an expedited manner for applicants applying for Medicaid. Medicaid Information Technology Architecture Initiative (MITA): A federal initiative to modernize the technology and architecture of Medicaid Management Information Systems (MMIS). Medical Personal Care (MPC): A Medicaid program that provides personal care and essential household tasks for clients living in their own home or in a community residential setting. Medically Necessary: A term for describing requested service which is reasonably calculated to prevent, diagnose, correct, cure alleviate or prevent worsening of conditions in the client that endanger life, or cause suffering or pain, or result in an illness or infirmity, or threaten to cause or aggravate a handicap, or cause physical deformity or malfunction, and there is no other equally effective, more conservative or substantially less costly course of treatment available or suitable for the client requesting the service. "Course of treatment" may include mere observation or, where appropriate, no treatment at all. Medicare Physician Fee Schedule Database (MPFSDB): A Medicare Data Base that is used by MAA as a basis for physician’s payments. Mental Health Division (MHD): A division within the DSHS Health & Rehabilitative Services Administration that is concerned with mental health services. National Provider Identifier (NPI): A HIPAA rule to provide a national standard health care provider identifier to aid in administrative simplification. NIST: National Institute of Standards and Technology. June 2004 30 of 264 Acquisition RFP No. 0456-153

State of Washington Dept. of Social and Health Services Modern MMIS: The future MMIS as opposed to the current MMIS.

MMIS Re-Procurement Request for Proposal

Office of Accounting Services (OAS): An office within the DSHS Financial Services Administration (FSA) that is responsible for the agency’s cost allocation plan, chart of accounts, federal draws, cash receipting, payroll and CMS 64 preparation. This office also handles the distribution of the weekly warrants and remittance advices issued to the Medicaid Providers. Office of Financial Management (OFM): The state agency responsible for providing accounting policy and the maintenance of the Agency Financial Reporting System (AFRS). Office of Financial Recovery (OFR): An office within the DSHS Financial Services Administration (FSA) that is responsible for collection of debts owed from providers and clients to the Department, including financial, medical, and food stamp overpayments and Department liens. Office of the Attorney General (OAG): The state entity responsible for criminal prosecution, including prosecution of fraudulent providers and clients. Office of the State Treasurer: The state entity responsible for cash management activities related to processing of all Medicaid payment warrant files and EFT transactions to Medicaid providers. Payment Review Program (PRP): A State of Washington Program that performs postpayment review to identify claim errors that resulted in overpayments to providers and initiates recoveries. Prime Vendor/Contractor: The primary entity that accepts full responsibility for the entire Scope of Work requested in this RFP. Primary Care Case Management (PCCM): An arrangement by which a provider contracts with DSHS as a primary care case management (PCCM) provider to provide health care services to eligible MAA clients under MAA's Managed Care Program. Primary Care Options Program (PCOP): An MAA program that enables managed care clients to select primary care providers. Primary Care Provider (PCP): An individual physician, Advanced Registered Nurse Practitioner (ARNP), or Physician Assistant (PA) who provides and coordinates medical care services. Prior Authorization (PA): See Authorization (medical) and Authorization (social service). Program of All-Inclusive Care for the Elderly (PACE): A Medicaid program that provides a comprehensive set of Medicare/Medicaid acute and long term care services in a home and community based setting on a pre-paid capitated basis in designated areas of the State. Procedure, Diagnosis, Drug, and DRG (PDDD) File: A basic Reference File in the current Washington MMIS. Proposed Solution: The full functionality of the transfer system proposed by the Bidder in its response to this RFP. Providers: Any individual or entity furnishing Medicaid goods or services under an agreement with the Medicaid agency. June 2004 31 of 264 Acquisition RFP No. 0456-153

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Regional Support Network (RSN): An entity that covers a county or a group of counties that is certified by the Mental Health Division (MHD) of DSHS to administer community mental health programs at a local level. Each RSN contracts with facilities and outpatient providers and distributes block grant funds for authorized mental health services. Residential Care Services (RCS): A division of ADSA that sets rules for and inspects residential care facilities. Resource Based Relative Value Scale (RBRVS): A method of paying physicians for services that places a value on each procedure based on the duration, complexity, skill, and training required to perform the service. MAA multiplies RBRVS values by a statewide factor to determine physician payment rates. RFP Coordinator: The single point of contact for those Bidders who are interested in responding to this RFP. Scored Requirement (SR): The section or subsections of this RFP, which are marked (SR) in the title. These requirements will be scored in accordance with Section 7, Evaluation and Selection. Software: The object code version of computer programs and any related documentation that enables the operation of the MMIS, excluding maintenance diagnostics. Software must also mean the source code version, where provided by the contractor. Social Service Payment System (SSPS): An automated system used by DSHS to authorize and pay for social services. Social Service Provider: Any person or organization that furnishes, bills, or is paid for social services in the normal course of business. Specifications: All technical and functional requirements, legal and regulatory requirements, performance standards, and any other objective criteria that need to be met to confirm correct performance. State Medicaid Manual: Part 11 of the CMS manual governing Medicaid Management Information Systems, including MMIS approval procedures and system requirements. The CMS link to the State Medical Manual, Part 11 is: http://www.cms.hhs.gov/manuals/45_smm/sm_11_11_toc.asp State Plan: The comprehensive written commitment by a Medicaid agency, submitted under 1902(a) of the Social Security Act and approved by CMS, to administer or supervise administration of a Medicaid program in accordance with Federal and state requirements. Subcontractor: One not in the employment of the contractor, who is performing all or part of the services awarded by the contract resulting from this RFP, where said individual has a separate contract with the Contractor. The term "Subcontractor(s)" means Subcontractor(s) in any tier. System: The complete collection of the Software, Systems Software, processes, data and equipment as described in the successful Vendor’s proposal, integrated and functioning together, in accordance with the applicable requirements and specifications. System Software: Operating system software, software utilities, project software development tools, database management software, programming languages, and other June 2004 32 of 264 Acquisition RFP No. 0456-153

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third party software (except for the Application Software) that the successful Vendor will license to DSHS in machine readable format for use with the equipment and software. Enhancements to the Systems Software. Time: All references to time refer to the local time in Olympia, Washington. Transfer System: The MMIS that the Bidder proposed to transfer from another state to Washington. Transportation and Interpreter Services Section (TISS): An MAA Section that provides transportation and interpreter services to MAA clients. Transportation services are arranged through transportation brokers. Treatment and Assessment Report Generation Tool (TARGET): A system maintained by the DSHS Division of Alcohol and Substance Abuse (DASA) that maintains chemical dependency residential treatment data. Vendor: The firm or entity performing services under a contract awarded under this RFP, including all employees of the Vendor. Washington Medical Integration Project (WMIP): A DSHS program developed to examine the potential benefits of providing services in a more integrated fashion to aged and disabled clients who receive medical care, mental health treatment, and long-term care services. Working/Business Days: Monday through Friday, except for legal holidays observed by the State of Washington. Working Connections Child Care (WCCC): A DSHS program that helps families with children pay for child care to find jobs, keep their jobs, and get better jobs.

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2. Management and Staffing Requirements
The Bidder must respond to the requirements below in accordance with Section 6, Instructions to Bidders.

2.1

(MR/SR) Transmittal Letter

In lieu of responding to each of the requirements of Section 2.1 individually, the Bidder’s proposal must include a transmittal letter that meets the requirements below. The transmittal letter: 1. (MR) Must be written on the Bidder's official business letterhead stationery. 2. (MR) Must be signed and dated by an individual with full authority to legally bind the entity submitting the Proposal to this RFP. 3. (MR/SR) Must contain all of the following items in the following order: a. (MR) A statement that the proposed solution meets all the minimum qualifications and all the Mandatory Requirements (MR) set forth in the RFP and its amendments, if any. (MR) A statement that acknowledges and agrees to all of the rights of DSHS including the RFP rules and procedures and the terms and conditions of this RFP, including any amendments. (MR) A reference to all RFP amendments received by the Bidder (identified by amendment issue date) to represent that the Bidder is aware of all such amendments. If no RFP amendments have been received, the Bidder should so state. (MR) An itemization of all materials and enclosures being provided with the Bidder’s Proposal. (SR) Any other representations, promises and warranties as the Bidder deems appropriate and wishes to convey to DSHS.

b.

c.

d. e.

2.2

(SR) Executive Summary

The Bidder’s proposal must summarize the proposed project management approach and overall services, giving the evaluators a strong general overview of the Management, Technical, and Functional proposals of the Bidder. The Bidder’s proposal must: 1. State the Bidder’s ability and willingness to work cooperatively with DSHS and designees. 2. State that the Bidder agrees to comply with the procurement process described in the RFP. 3. State that the Bidder understands the scope and objectives of the project and agrees to meet the requirements specified in the RFP. 4. State that the Bidder will perform the services described in the RFP. 5. Identify and describe the transfer system the Bidder proposes as the basis of June 2004 34 of 264 Acquisition RFP No. 0456-153

State of Washington Dept. of Social and Health Services its MMIS solution.

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6. State that the Bidder’s proposed solution will meet all federal MMIS Certification requirements. 7. State that the Bidder’s proposed solution is fully HIPAA compliant. 8. Summarize the proposed goods and services. 9. Identify any operational issues. 10. Identify any unique or innovative features. 11. Provide an overview of the risks associated with this project, critical success factors, and actions DSHS should consider during the analysis and implementation stages. 12. Explain how the proposed solution represents to DSHS the best option for its MMIS, and why DSHS should select the proposed solution.

2.3
1. 2.

(SR) System Development Life Cycle (SDLC) Methodology
Identify and describe a proposed system development life cycle methodology for the project. Define the roles and responsibilities, including those of non-Bidder resources (e.g., state, providers), related to the recommended SDLC methodology and who will fill those roles and responsibilities. Explain the benefits of the recommended SDLC methodology for DSHS.

The Bidder’s proposal must:

3.

2.4

(SR) Project Management Approach

In addition to successful Vendor’s personnel and subcontractors, the project team consists of managers and staff from DSHS, oversight consultation from an independent private firm and from staff of the Department of Information Services (DIS) Information Services Board (ISB). The DSHS Project Sponsor has ultimate project responsibility for DSHS and is supported by an executive sponsor and an Executive Steering Committee. Refer to Section 1.8.1 for an overview of the project organization. The Bidder’s proposal must: 1. Based on knowledge of and experience with similar MMIS projects, describe the overall project management approach, including but not limited to planning, organizing, and managing the staff and activities throughout the life of the project, to ensure the smooth administration of the project. 2. Explain with specificity the Bidder’s approach to promoting teamwork, facilitating open and timely communication, and ways the Bidder’s staff will support a collaborative effort among the Bidder, any subcontractors, DSHS, and DSHS designees. 3. Agree the Bidder will either conduct internal quality assurance or will retain an independent firm to conduct quality assurance, and that the Bidder will provide to DSHS any quality assurance reports that are produced during the project. June 2004 35 of 264 Acquisition RFP No. 0456-153

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4. Describe how the Bidder will coordinate efforts with the DSHS Re-Procurement Project team to address multiple stakeholder needs. 5. Describe what sets the Bidder’s solution apart from the competition and what makes it the best approach for DSHS’s new MMIS. 6. State that the Bidder will provide overall management of the Bidder's proposed solution.

2.5

(SR) Project Management Processes

The Bidder must describe its project management process in specific detail sufficient to support each component identified in sections 2.5.1-2.5.5. See Section 2.10.2 for deliverables related to this section that will be required during the Planning and Start-up stage.

2.5.1 Risk Assessment and Mitigation Requirements
The Bidder’s proposal must: 1. 2. 3. Describe an overall approach to risk management and mitigation for the project. Describe the Bidder’s process for documenting and reporting risks and risk status to DSHS. Identify potential risks currently foreseeable to the Bidder for this engagement, rank in order of highest risk, and identify recommended steps to mitigate those risks. Assess any risk of failing to meet the implementation deadline imposed by CMS. Identify and describe the Bidder’s proposed tool(s) to track, manage, and report risks and to facilitate the Bidder’s Risk Management Plan. Agree that the Bidder’s proposed Risk Management tools will be accessible by Bidder staff, DSHS staff, and DSHS designees. Agree that the Bidder’s responsibilities include development and implementation of a Risk Management Plan that identifies and mitigates risks throughout the entire system development life cycle, including implementation. Agree that the Bidder’s proposed Risk Management process and tools are subject to DSHS approval. Explain the benefits of the recommended Risk Management and Mitigation process to DSHS.

4. 5. 6.

7. 8.

2.5.2 Issue Resolution Requirements
The Bidder’s proposal must: 1. Describe the Bidder’s approach and process for issue identification, communication, resolution, escalation, tracking, approval by DSHS, and reporting. Provide sample issue resolution forms and procedures the Bidder has used in other successful projects. 36 of 264 Acquisition RFP No. 0456-153

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Identify and describe the Bidder’s proposed tool to track, manage, and report on issues/action items and facilitate its issue resolution process that includes an automated tracking and management system. Agree that the tool will be accessible by Bidder staff, DSHS staff, and DSHS designees. Explain the benefits of the Bidder’s issue resolution approach. State that the Bidder’s proposed issue resolution process addresses the entire System Development Life Cycle. Agree that the Bidder’s proposed issue resolution process and tools are subject to DSHS approval.

4. 5. 6. 7.

2.5.3 Change Control Requirements
Controlling scope and providing for system changes caused by legislative mandates or other causes is extremely important to DSHS in maintaining project accountability. Change control is ongoing throughout the entire duration of the contract and is subject to the following limitations:
 

The successful Vendor shall perform system maintenance, as defined in RFP Section 2.8.2, Operations and Maintenance, at no additional cost to DSHS. The successful Vendor shall perform system enhancement tasks defined as follows: - Implementation of capabilities not included in the RFP. - Activities necessary to meet new or revised federal requirements. - Activities necessary to meet new or revised state requirements. - Changes to established reports, screen or tape formats.



During DDI, DSHS may exercise its option for change requests for system enhancements consistent with the change control process outlined below and not to exceed 10% of the proposed fixed price for DDI per RFP Section 5.1, Cost Proposal. During Operations and Maintenance, the state may exercise its options for change requests for system enhancements consistent with the change control process outlined below and not to exceed 10,000 hours per year at the agreed upon blended hourly rate per RFP Section 5.1, Cost Proposal. Describe both graphically (e.g., via a flowchart) and in text a recommended approach to change control, including steps, roles and responsibilities, and decision points. Describe the Bidder’s cost estimating steps and process for providing a written estimate to DSHS of the cost and duration for every change. Provide sample change control forms and procedures the Bidder has used in other successful projects. Agree that written approval by DSHS is mandatory for every change before the Bidder begins development of that change. Agree that written approval by DSHS is mandatory for every change before the 37 of 264 Acquisition RFP No. 0456-153



The Bidder’s proposal must: 1.

2. 3. 4. 5.

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State of Washington Dept. of Social and Health Services Bidder begins implementation of that change. 6. 7.

MMIS Re-Procurement Request for Proposal

Agree in the proposed change control process that the Bidder will provide DSHS with justification of every change suggested by the Bidder. Agree that any changes shall be provided at a reasonable price to be negotiated between the Bidder and DSHS, and that if the Bidder and DSHS cannot come to an agreement on price and schedule to implement such mandated changes, the Bidder agrees to perform the work at the price proposed by the State’s project manager and to pursue the dispute resolution process to resolve open issues. Identify and describe the Bidder’s proposed tool(s) to track, manage, and report on change control items and to facilitate the Bidder’s change control approach, including an automated tool that tracks history in a database. History must include the estimate and actual cost and duration for every change request as well as cumulative cost and schedule impacts for all changes for all periods DSHS specifies. Agree that the Bidder’s proposed change control tools will be accessible by the Bidder, DSHS, and DSHS’s designees.

8.

9.

10. Describe steps for updating the work plan for changes identified during DDI and approved by DSHS. 11. Explain the benefits of the recommended change control approach for DSHS. 12. Agree that the Bidder will meet all change control requirements throughout the term of the contract. 13. Agree that the Bidder’s proposed change control process and tracking tool are subject to DSHS approval.

2.5.4 Communication and Coordination Requirements
There is a large and diverse stakeholder group, both internal to DSHS and external to DSHS, in the MMIS Re-Procurement Project. To better understand the diverse stakeholders of the MMIS Re-Procurement Project, Bidders are encouraged to review the Stakeholder Management Plan found in the Procurement Library (See Section 6.2.4 for instructions to access the library). Within this context, the Bidder’s proposal must: 1. Describe the Bidder’s approach to communication and coordination, including stakeholder management, and the Bidder’s proposed tools to facilitate its approach, including a communication and correspondence tracking database kept by the Bidder to which DSHS and designees have access. Discuss how the Bidder has assisted other customers with stakeholder management, including an identification of the groups with whom the Bidder has worked and the resulting outcomes. Agree that the Bidder will actively participate with MMIS Re-Procurement staff to ensure effective communication and coordination within the project, including Bidder staff, subcontractor staff, DSHS, and other stakeholders within and external to the agency, including providers. Agree that the Bidder’s proposed Communication and Coordination process is subject to DSHS approval. 38 of 264 Acquisition RFP No. 0456-153

2.

3.

4.

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MMIS Re-Procurement Request for Proposal

2.5.5 Integration Management Requirements
The Bidder’s proposal must: 1. 2. Explain with specificity the Bidder’s recommended approach to integration management and fully identify system integration tools and techniques. Agree that the successful Vendor must provide and implement trouble-shooting tools that will diagnose incompatibility problems within hardware, software, and data communications network components of the project environment. Incompatibility problems include problems that occur among components on the same platform, as well as problems that occur among different platforms. Agree that Bidder is responsible for the integration of all components of Bidder’s proposed solution. Describe the metrics Bidder will use to measure the success of its integration efforts.

3. 4.

2.6

(MR/SR) Bidder Qualifications

2.6.1 (MR/SR) General Bidder Information Requirements
The Bidder’s proposal must: 1. (MR) Identify the name, address, principal place of business, and telephone number of the legal entity to be named as a party to the contract. 2. (MR) Identify Bidder’s Federal Employer Identification Number (FEIN) and Washington State Uniform Business Identifier (UBI) Number (if currently registered). 3. (MR) Commit Bidder to registering with the Washington State Department of Revenue, if Bidder is not already registered, within 30 days of being named the Apparently Successful Vendor (ASV) or before the resulting contract is signed, whichever occurs first. 4. (MR) Commit Bidder to collect, report, and pay all applicable State taxes if selected as the Apparently Successful Vendor. 5. (MR) Identify the name, address and the telephone number(s) of the Principal Officers or Owners of Bidder’s company/corporation. 6. (SR) Identify the legal status (e.g., registered corporation, partnership, etc.) of the Bidder and the year the entity was established. 7. (SR) Identify and describe any merger or acquisition in which the Bidder is involved or may become involved during the period of this contract. 8. (SR) Identify every contract or portion thereof to which the Bidder is/was a party or to which the Bidder is/was associated with a party as a subcontractor or partner that has been terminated in whole or in part in the last seven (7) years, and provide full details regarding such termination, including: a statement of the problem; a client contact name, address and telephone number; the Bidder’s position on the matter; and the ultimate disposition of the matter or, if the matter has not yet been resolved, a detailed description of the current status of the matter. Further, provide any notices Bidder has received of breach from any June 2004 39 of 264 Acquisition RFP No. 0456-153

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government agency, as well as any notice of termination on any project, even if the termination did not occur, such as due to curing the breach or another result. Further, agree that failure of the Bidder to fully disclose all information asked for in this requirement subjects the Bidder to immediate disqualification from the procurement process or, if such failure is discovered after contract formation, grants DSHS the right to rescind the contract at its sole discretion. 9. (SR) Identify all litigation in which the Bidder has been involved in the last seven (7) years regarding a project, and provide details regarding each litigation, including: jurisdiction of the litigation; a statement of the problem; a client contact name, address and telephone number; the Bidder’s position on the matter; the ultimate disposition of the matter or, if the matter has not yet been resolved, a detailed description of the current status of the matter; and the Case name and cause or docket number if a case was filed. Further, agree that failure of the Bidder to fully disclose all information asked for in this requirement subjects the Bidder to immediate disqualification from the procurement process or, if such failure is discovered after contract formation, grants DSHS the right to rescind the contract at its sole discretion.(SR) Identify all federal debarments that have been directed at the Bidder or any entity with which the Bidder is proposing a relationship. Further, agree that failure of the Bidder to fully disclose all information asked for in this requirement subjects the Bidder to immediate disqualification from the procurement process or, if such failure is discovered after contract formation, grants DSHS the right to rescind the contract at its sole discretion. 10. (SR) Provide similar and separate information for the Bidder and every proposed subcontractor in response to all Section 2.6.1 requirements.

2.6.2 (MR/SR) Financial Solvency Requirements
Bidders must demonstrate financial solvency. The Bidder’s proposal must: 1. (MR) Agree that DSHS may conduct an independent check on financial solvency through the DSHS Office of Financial Recovery (OFR). 2. (MR) Agree that if financial solvency is not demonstrated to DSHS’s satisfaction, DSHS may, at its sole discretion, disqualify Bidder’s organization from participation in this procurement. 3. (SR) Include a completed Appendix AB – Financial Information, Representations, and Disclosures form. 4. (SR) Provide similar and separate information for the Bidder and every proposed subcontractor in response to all Section 2.6.2 requirements.

2.6.3 (MR) Minimum Bidder Qualifications
DSHS will consider Bidders who meet the minimum qualifications identified below. Should DSHS determine, at its sole discretion, that a firm does not meet these minimum qualifications, DSHS will disqualify the firm from the evaluation and selection process. The Bidder’s proposal must: 1. Demonstrate Bidder’s experience in implementing large claims processing systems, and must identify and describe at least one (1) system that meets this requirement. June 2004 40 of 264 Acquisition RFP No. 0456-153

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2. Demonstrate that Bidder’s proposed key staff is experienced with implementing an MMIS. Identify the staff person(s), their role(s) in implementing an MMIS, and the state(s) where it was implemented. 3. Agree that Bidder will transfer an MMIS from another state and modify it to meet Washington specific requirements.

2.6.4 (SR) Relevant Prior Experience Requirements
The Bidder’s proposal must:

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1. Complete the following table for each MMIS the Bidder has implemented or is implementing in other states:
State Start/End Month/Year Certification Month/Year Hardware Platform Primary Language Database Annual Claim volume Annual Claim Dollars # of Users Contract Amount Client Contact (name/role/phone/email)

2. Complete the following table for other large non-MMIS claims management systems the Bidder has implemented or is implementing:
Jurisdiction/ Agency Start/End Month/Year Hardware Platform Primary Language Database Annual Claim volume Annual Claim Dollars # of Users Contract Amount Client Contact (name/role/phone/email)

3. Complete the following table for any other relevant, large-scale systems the Bidder has implemented or is implementing that are not identified above:
Client Start/End Month/Year Hardware Platform Primary Language Database Annual trans. volume Annual trans. Dollars # of Users Contract Amount Client Contact (name/role/phone/email)

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4. Identify the state(s) in which the Bidder’s proposed transfer system is currently implemented. 5. Explain why this is the system the Bidder is proposing and the degree of fit with Washington’s requirements, including the percentage of Washington’s requirements that the system meets without modification and the basis for that assessment. 6. Describe the Bidder's role in each engagement described above and state Bidder’s level of responsibility (For example, primary, subcontractor) for all phases of the project including requirements analysis, process design, construction, testing, and final implementation. Describe any pilot implementation phases. 7. Clearly describe the scope and scale of those projects, including the Bidder's performance in terms of schedule and budget. Explain positive and negative variances from the schedule and budget. 8. Agree that DSHS reserves the right to contact all above client contacts and any other contacts provided by current or former clients, and that this contact may be considered by DSHS in scoring the Bidder. 9. Describe the Bidder’s experience in developing and operating systems on the hardware and software platforms proposed for Washington. 10. Identify and describe any units in Bidder’s organization that have reached CMM Level 2 or higher certification, and describe those units’ involvement in this project. 11. Describe how Bidder will employ CMM processes and practices in this project. 12. State how many years experience Bidder has managing and staffing projects with complexity and scope comparable to that required by DSHS for the MMIS.

2.6.5 (SR) Bidder Customer References Requirements
Scores for this section will be based on Bidder references. DSHS reserves the right to conduct checks of Bidder references, by telephone or other means, and evaluate the Bidder based on these references. DSHS considers references to be extremely important. It is the Bidder's responsibility to ensure that every reference contact is available during the evaluation period. (See Section 6.3, Activities and Schedule, for the planned RFP evaluation period.) The Bidder’s proposal must: 1. Include a minimum of three (3) and a maximum of five (5) Bidder customer references. At least two (2) of these references must be from MMIS or comparable projects. For every reference, the Bidder’s proposal must provide the company name, contact name, contact job title, address, telephone number and email for that reference. Agree that references must be independent of the Bidder’s company/corporation (i.e., non-Bidder owned, in whole or in part, or managed, in whole or in part), and include a statement that each reference meets this requirement. Agree that DSHS reserves the right to contact all above customer references, and that this contact will be considered by DSHS in scoring the Bidder. Agree that DSHS reserves the right to contact any other entity or person it wants to contact with regard to the Bidder, including parties in addition to those recommended by the Bidder. Further, agree that this contact may be used by DSHS in scoring the Bidder.

2.

3. 4.

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State that the Bidder has notified each client reference that they may be contacted by DSHS and has assured that each reference will be available during the evaluation period. (See Section 6.3, Activities and Schedule, for the approximate RFP evaluation period.) Provide similar and separate information for the Bidder and every proposed subcontractor in response to all Section 2.6.5 requirements.

6.

2.6.6 Minority and Women’s Business Enterprise (MWBE) Information Requirements
The following voluntary numerical MWBE participation goal has been established for this project:  Minority Business Enterprises: (MBE’s) or Women’s Business Enterprises (WBE’s): 35%

These goals are voluntary, but achievement of the goals is encouraged. However, unless required by federal statutes, regulations, grants, or contract terms referenced in the contract documents, no preference will be included in the evaluation of bids/proposals. No minimum level of MWBE participation will be required as a condition for receiving an award or completion of the contract work. Proposals will not be rejected or considered non-responsive if they do not include MWBE participation. Bidders may contact the Washington State Office of Minority and Women’s Business Enterprises (OMWBE) at 360-753-9693 to obtain information on certified firms for potential subcontracting arrangements. The Bidder’s proposal must: 1. Indicate if the Bidder or any of its subcontractors is a certified minority-owned and/or women-owned business. Proof of certification must be attached to the Bidder's proposal. Indicate the level of MWBE participation, if applicable.

2.

2.7

(SR) Approach to Organization and Staffing

The organization of Bidder staff and the appropriate assignment of tasks are extremely important to DSHS to ensure the overall success of this project. DSHS expects that Bidders will propose their best-qualified staff for this project. Should proposed staff not be available when work begins, Bidder must provide evidence in the form of resumes and descriptions of relevant experience for any staff proposed as alternates to the proposed team members.

2.7.1 Overall Project Approach/Requirement
The Bidder’s proposal must: 1. 2. Include a description of the overall approach to project organization and staffing, including subcontractors, that addresses the entire scope of the project. Include a project organization chart identifying by name and position the Bidder’s key staff (i.e., down to at least the lead level), including subcontractors, responsible for carrying out the entire scope of the project. Identify by name and position in separate text or in the project organization chart the person(s) who will for each phase:

3.

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State of Washington Dept. of Social and Health Services a. Act as the project manager. b. Establish and manage the work plan. c. Be the lead analyst(s). d. Be the chief architect(s) responsible for overall design. e. Be in charge of application development. f. Be in charge of interface development. g. Be in charge of system testing and acceptance testing. h. Be in charge of cultural/business change management. i. j. l. Be in charge of training. Be in charge of the CMS certification process. Be in charge of data conversion.

MMIS Re-Procurement Request for Proposal

k. Be in charge of system implementation/deployment.

2.7.2 Project Management and Key Staff Qualifications Requirements
Scores for this section will be based on the proposed Project Manager and key staff qualifications, experience, and references. Experience and references from projects where the work performed was different than this project may not score as well as references where the work performed was similar to this project. At its discretion, DSHS will contact the project manager and key staff references. The Bidder’s proposal must: 1. Provide resumes (in lieu of responding to the requirements of Section 2.7.2 individually) that include the following information in the following order for each person identified in Section 2.7.1 above: a. b. c. d. e. f. g. h. Identify individual by name, title, roles and responsibilities on the team. Describe knowledge, skills, and abilities. Describe system development knowledge, skills, and abilities. Describe relevant hardware and software experience. Describe relevant education and training. Describe experience with roles similar to that proposed for this project. Provide number of years experience in the proposed role. Describe direct experience in similar projects with:      Project Planning. Project Management (for Project Manager Only). Business Area/Process Analysis. System Design/Redesign. System integration testing and support of user acceptance testing.

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Describe experience and position on other MMIS implementation projects. Describe with specificity any experience in implementing the proposed transfer system. Include three (3) references, including reference name, company name, job title, company address, telephone number and email address. References must be independent of the Bidder’s organization (i.e., non-Bidder owned or managed).

2. Agree that reference information is current and accurate. 3. Demonstrate that the proposed Project Manager has the appropriate and comprehensive experience to complete this MMIS implementation successfully. The Bidder's proposed Project Manager must have a minimum of ten (10) years experience in managing similar projects of comparable size and complexity; ten (10) years experience specific to MMIS project management experience is highly desirable. 4. Demonstrate that the proposed team has the appropriate and comprehensive experience to complete this MMIS implementation successfully.

2.7.3 Approach to Project Lines of Authority/Staff Communications Requirements
The Bidder proposal must include a discussion of the proposed lines of authority, coordination, and communication to include communication between the parties. The Bidder’s proposal must: 1. 2. 3. 4. 5. 6. 7. 8. Describe lines of authority/communications between DSHS and Bidder executives, directors, and officers. Describe lines of authority/communications between DSHS and Bidder project management. Describe lines of authority/communications between DSHS and Bidder key staff. Describe lines of authority/communications between DSHS and Bidder on-site project staff. Describe lines of authority/communications between Bidder project management and Bidder on-site staff. Describe lines of authority/communications between Bidder project management and Bidder off-site staff. Describe lines of authority/communications between Bidder and subcontractors. Describe lines of authority/communications between DSHS and subcontractors.

2.7.4 Project Staffing Requirements
For the purpose of this section, “Project Staff” includes Bidder personnel and all subcontractor staff. The Bidder’s proposal must: 1. State the minimum number of staff that will be assigned to this project throughout the life of the project. If this number will change throughout the life of the project, identify when those changes will take place and the minimum number of staff that will be

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State of Washington Dept. of Social and Health Services assigned to this project during those changes. 2.

MMIS Re-Procurement Request for Proposal

Identify where all staff assigned to this project, including developers, will be geographically located (city, state, country) throughout the lifecycle of the project and explain how and to what extent they will be accessible to the DSHS project team. Agree that the Project Manager will be in Olympia full-time throughout the project. For staff geographically located outside of Olympia, Washington, identify what Bidder staff will come on-site to work with stakeholders (e.g., for requirements validation, testing, and business process change) and describe in detail the tasks or phases for which they will come on-site, when, and for how long. Agree that the Bidder must provide all office space and equipment for its staff. Describe the process and timeline for bringing proposed staff onto the project.

3.

4. 5.

2.7.5 Continuity of Project Personnel Requirements
In order to ensure the success of this project, it is important that there is a continuity of Key Staff assigned to the project. The Bidder’s proposal must: 1. Describe policies, plans, and intentions with regard to maintaining continuity of personnel assignments throughout the performance of any agreement resulting from this RFP. Address whether availability of any of the proposed personnel could be impacted from existing or potential contracts to which such staff are assigned or proposed. State what priority DSHS would have in cases of conflict between existing or potential contracts. Discuss the Bidder's plans to avoid and minimize the impact of personnel changes. Identify planned backup personnel assignments. Agree that Bidder’s proposed project personnel may not be reassigned, replaced, or added during the project without the prior written consent of the DSHS Project Manager. Should a key staff position be vacated, Bidder must give DSHS resumes of, and an opportunity to interview and approve, potential replacements for that employee. Agree that the DSHS Project Manager reserves the right to require a change in successful Vendor's project personnel at the DSHS Project Manager’s sole discretion and that DSHS must be given an opportunity to interview and approve potential replacements for that employee. However, DSHS will not unreasonably exercise this option and will take reasonable steps to work with the successful Vendor toward a solution. Commit to using the personnel identified in the proposal and agree to DSHS's right to approve proposed personnel changes during the term of the contract. Agree that responses to Section 2.7.5 requirements apply to proposed Subcontractor key staff as well as Bidder’s proposed staff.

2. 3. 4. 5. 6.

7.

8. 9.

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2.8 (SR) Overall Approach to MMIS Operations and Maintenance
With cutover of live operations to the new MMIS on 12/31/06, the former system will be taken out of service and operations and maintenance of the new system will begin. For the first two (2) years of operations and maintenance, additional programs will be implemented on the new MMIS as described in the Implementation Phases in Section 1.8.3. The overall contract term is for five (5) years with three (3) one-year options to renew (for a maximum of eight (8) years). The contract resulting from this RFP could extend through 2012 (if work begins in 1/05 and all renewal options are exercised). When the modern MMIS is in place, DSHS will continue with this Facilities Management (FM) operations model, where state staff performs the majority of operations as identified in Section 1.4, Operations Model. The successful Vendor will provide system maintenance and operations as well as Pharmacy Clinical Services described in Section 4.8.2.

2.8.1 Organization and Staffing
The Bidder’s proposal must: 1. Provide a project organization chart identifying by position and roles/responsibilities only (i.e., not by name) the Bidder’s key staff (down to at least the lead level), including subcontractors, responsible for carrying out the operations and maintenance of the MMIS after implementation in accordance with the requirements of Section 4.26, Operations. Agree to DSHS's right to approve proposed personnel for operations and maintenance during the term of the contract. Describe the Bidder’s proposed data center environment. Bidder must include its proposed data center location (City, State) and how the Bidder proposes to connect to the State network (See Section 3.11, Network Connectivity).

2. 3.

2.8.2 Operations and Maintenance
The successful Vendor shall perform operations and maintenance throughout the life of the contract at no additional cost to DSHS to include the following:


Data center operations Updates, patches and repairs to components of the production, test and all other Washington accessible environments including but not limited to: hardware operating systems database systems application and other software utilities for systems, database, software, communications voice, video, data communications lines communications software drivers configurations





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deficiency or problem with the functionality developed or implemented specifically for Washington during DDI deficiency or problem with the functionality of subsequent system enhancements

The Bidders Proposal Must: 1. Describe the Bidder’s approach to systems operations and maintenance and agree that the tasks identified above will be included as part of the proposed fixed price for operations and maintenance as identified in Appendix AC, Cost Proposal Form. 2. Agree that the Bidder will maintain the Integrated Test Facility (ITF) established during DDI including all specified environments, promotion and version control procedures, and tools as described in Section 3.10, Test Environment and Integrated Test Facility. Include a description of regression test procedures. 3. Describe Bidder’s approach for promoting approved changes from integration testing environment to User Acceptance Testing and from User Acceptance Testing to production environment. 4. Describe Bidder’s process for dealing with emergency fixes. Include how Bidder’s fix will be tested and promoted through testing environments to production.

2.8.3 Contract Administration
The Bidder’s Proposal Must: 1. Describe the Bidder’s approach to providing ongoing training to DSHS staff and providers. This includes, but is not limited to, training of new staff and training on new system functionality. Include proposed frequency and types of training. Agree that the Bidder will continue to follow the Issue Resolution Process, as described in response to Section 2.5.2, Issue Resolution Requirements, throughout the operations phase or the Bidder must propose an alternative Issue Resolution Process. Agree that the Bidder will continue to follow the Change Management Process, as described in response to Section 2.5.3, Change Control Requirements, throughout the operations phase or the Bidder must propose an alternative Change Management Process. Agree that the Bidder will continue to follow the Stakeholder Communication and Coordination Plan as described in response to Section 2.5.4, Communication and Coordination Requirements, throughout the operations phase or the Bidder must propose an alternative Communication and Coordination Process. Agree that the Bidder will establish a problem resolution process including a help desk that satisfies requirements in Section 4.26.3, Problem Resolution. Agree that the Bidder will be responsible for maintaining MMIS User Manuals and MMIS Operating Procedures Manual as described in Section 2.10.5. Agree that the Bidder will develop an Annual Business Plan, semi-annual evaluation reports that assess the Bidder’s activities in support of the Annual business Plan and provide revisions, and monthly status reports stating progress in achieving goals established in the plan. Plan should include the following elements; an outline of major activities planned for the coming year, business improvement objectives and outcomes for the coming year, methodology for performing activities and meeting objectives,

2.

3.

4.

5. 6. 7.

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methods for measuring customer service performance, methods for identifying where customer services performance is inadequate, approach for developing and implementing corrective actions. 8. Describe the Bidder’s approach for monitoring and reporting performance of the system during operations. Include metrics that will be tracked, frequency of reporting and access methods to data. Agree that Bidder will walk-through performance reports at the request of DSHS.

9.

10. Describe the Bidder’s approach for transitioning to another entity at the end of the contract period. Further, agree that the Bidder will cooperate completely with DSHS and the subsequent entity including, but not limited to, data conversion, parallel testing, and system cutover.

2.9

(SR) Approach to Subcontractors

In order to achieve the best combination of experience and skill, Bidders may contract with other firms to provide improved solutions that are in the best interest of the State and the Bidder. In all instances of Bidder relationships with other parties, one Bidder must serve as the Prime Contractor and bear the responsibility for successful performance of this engagement. If any such relationships are proposed, the Bidder’s proposal must: 1. 2. 3. 4. Identify and describe any relationship with another party. Describe in detail Bidder’s management of subcontractor relationships to ensure high quality performance of all subcontractor functions. Agree that any and all such relationships, including "advisors", must be subcontractors to the Bidder and that the Bidder must be the Prime Contractor. Agree that, as the Prime Contractor, Bidder accepts full responsibility for successful performance of the entire Scope of Work requested in this RFP and will indemnify the State for the acts and omissions of its subcontractors. Agree that DSHS has the same rights to remove subcontractor or other party staff as it does Bidder staff.

5.

2.10 (SR) Design, Development and Implementation (DDI) Stage Requirements
The DDI tasks have been organized into the following major stages: 1. 2. 3. 4. 5. 6. 7. 8. Planning and Start-up. Requirements Verification. Detailed Design. Development/Unit Testing/Integration Testing. Interface Development/Testing. Data Conversion. User Acceptance Testing. Operational Readiness Testing.

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State of Washington Dept. of Social and Health Services 9. Implementation/Deployment.

MMIS Re-Procurement Request for Proposal

10. CMS Federal Certification. 11. Project Deliverables. Within this section, Section 2.10, Bidders are asked to respond to the requirements of each major stage, including State responsibility, successful Vendor responsibility, proposed deliverables and milestones. Within Section 2.10, if the Bidder has a different deliverable methodology that meets or exceeds the objectives of the deliverables specified in this RFP, the Bidder must identify and describe its suggested deliverables and explain how they meet or exceed the objectives of the deliverables specified in this RFP. Bidders should be aware that DSHS anticipates implementing the MMIS Re-Procurement Project generally in three (3) phases as described in Section 1.8.3, Phased Implementation. DSHS expects to work with the successful Vendor to further define the programs to be implemented in each phase, based on the capabilities of the transfer system and the successful Vendor’s knowledge and expertise with similar implementations. Given this approach, some deliverables identified within this section may be produced for each implementation phase, especially deliverables related to Data Conversion, User Acceptance testing (UAT), Operational Readiness Testing and Implementation/Deployment activities. Bidders should frame their response to Section 2.10 based on this phased implementation approach.

2.10.1

General Design, Development and Implementation (DDI) Requirements

The Bidder chosen as the successful Vendor is responsible for carrying out the tasks, producing the deliverables, and meeting the milestones of each DDI stage identified below. In addition to the identified requirements, the successful Vendor is responsible for meeting the requirements of deliverable development, review and acceptance, including walk-throughs per Section 2.10.12, Approach to Project Deliverables. Successful Vendor and State responsibilities include, but are not limited to, the following: State Responsibilities  Review and acceptance of the proposed format and content of all task deliverables prior to development.  Review successful Vendor deliverables, determine whether the deliverable complies with applicable specifications, and provide written comments to the successful Vendor within a mutually agreed upon number of business days after receipt.  Conduct weekly status meetings with the successful Vendor to review progress against the work plan.  Conduct bi-weekly Change Management and Work Plan review meetings with the successful Vendor.  Review bi-weekly written status reports and bi-weekly work plan/task schedule updates.

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State of Washington Dept. of Social and Health Services    Monitor successful Vendor progress to task milestones. Work with the successful Vendor to resolve issues.

MMIS Re-Procurement Request for Proposal

Analyze, authorize, and add to the contract, any changes to Work as described in this RFP.

Successful Vendor Responsibilities    Prepare an outline and obtain acceptance from DSHS for the contents and format for each deliverable before beginning work on the deliverable. Obtain written acceptance from DSHS on the final deliverables for each task. Revise deliverables, if required, using DSHS review findings to meet content and format requirements and comply with applicable specifications.    Report progress and status through bi-weekly status reports. Conduct bi-weekly work plan reviews. Attend weekly status meetings with the DSHS Project Manager and project team members.  Attend bi-weekly change control meetings and work plan review meetings with the DSHS Project Manager and project team members.  Provide a meeting record to include new/updated action items from all status, change control, work plan review and other regularly scheduled meetings within three (3) business days of the meeting.  Deliver written status reports and updated work plans/schedules one (1) business day, at least twenty-four (24) hours, before the status meeting.  Identify scope of work issues and seek DSHS acceptance before commencing changes to work described in the RFP. The Bidder’s proposal must: 1. Provide a high level schedule and overall approach to DDI (in addition to the detailed work plan identified in Section 2.11, Project Work Plan). 2. Address the following constraints in a high-level schedule in Bidder’s work plan and approach to the DDI stages: a) The successful Vendor must allow a minimum of twelve (12) weeks for User Acceptance Testing followed by four (4) weeks for Operational Readiness Testing. b) The start of Operations and Maintenance must be on or before January 1, 2007.

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3. Describe the Bidder’s approach to coordinating the responsibilities of the State with those of the successful Vendor to ensure overall project success.

2.10.2

Approach to Planning and Start-up

The deliverables produced during the Planning and Start-up stage will include but not be limited to:      Revised Work Plan. Risk Management Plan. Issue Resolution Process. Change Management Process. Stakeholder Communication and Coordination Plan. Revised Work Plan

2.10.2.1

A project work plan as described in Section 2.11, Project Work Plan is required as part of the Bidder’s proposal. The work plan will be finalized and accepted as part of the Planning and Start-up stage. Bidder proposals must: 1. Describe their approach to revising the work plan. Include State and successful Vendor responsibilities during this stage. 2. Agree that the revised work plan will be a deliverable accepted by DSHS and delivered within 45 days of contract signing. 2.10.2.2 Risk Management Plan

The Bidder’s proposal must: 1. Describe Bidder’s approach to developing a Risk Management Plan as described in Section 2.5.1, Risk Assessment and Mitigation Requirements. Include an outline of the plan, and describe DSHS and successful Vendor responsibilities during plan development. 2. Describe Bidder’s approach to training DSHS staff regarding the Risk Assessment and Mitigation Process. 2.10.2.3 Issue Resolution Process

The Bidder’s proposal must: 1. Describe Bidder’s approach to developing an Issues Resolution Process as described in Section 2.5.2, Issue Resolution Requirements. Include State and successful Vendor responsibilities during process development. 2. Describe how the Issue Resolution Process will be documented. 3. Describe Bidder’s approach to training DSHS staff regarding the Issue Resolution Process.

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State of Washington Dept. of Social and Health Services 2.10.2.4 Change Control Process

MMIS Re-Procurement Request for Proposal

The Bidder’s proposal must: 1. Describe Bidder’s approach to developing a Change Control Process as described in Section 2.5.3, Change Control Requirements. Include State and successful Vendor responsibilities during process development. 2. Describe how the Change Control Process will be documented. 3. Describe Bidder’s approach to training DSHS staff regarding the Change Control Process. 2.10.2.5 Stakeholder Communication and Coordination Plan

The Bidder’s proposal must: 1. Describe Bidder’s approach to developing a Stakeholder Communication and Coordination Plan as described in Section 2.5.4, Communication and Coordination Requirements. Include an outline of the plan and describe DSHS and successful Vendor responsibilities during plan development. 2. Describe Bidder’s approach to training DSHS staff regarding the Stakeholder Communication and Coordination Plan.

2.10.3

Approach to Requirements Verification

The State anticipates that the proposed transfer MMIS will support the majority of the requirements stated in this RFP. However, it is understood that the transfer system will require modification to meet all DSHS needs. The deliverable produced during the Requirements Verification stage is the Requirements Specification Document (RSD). The purpose of the RSD is to identify proposal requirements, validate requirements with stakeholders, identify how and where the requirements are met in the MMIS design and to define system acceptance criteria. The Bidder’s proposal must: 1. Describe Bidder’s overall approach to the Requirements Verification stage. 2. Describe Bidder’s approach to gaining a detailed understanding of the Washington State Medicaid Program. 3. Describe Bidder’s approach to verify and refine the system requirements specified in this RFP through Joint Application Design (JAD) sessions and/or interviews. 4. Describe Bidder’s approach to demonstrating the transfer MMIS in JAD sessions and identifying how the transfer system will meet the RFP requirements. 5. Describe Bidder’s approach to demonstrating the transfer MMIS in JAD sessions and identifying system functions that were not identified as requirements in the RFP but are part of the transfer system. Describe how these functions will be explained and how they will be integrated into the RSD. Agree that these functions, which are already part of the transfer MMIS, are to be delivered at no extra cost to DSHS. 6. Describe how Bidder will reach an agreed upon system design with DSHS that will address all requirements in the RFP and integrate the results of the JAD sessions. 7. Describe how Bidder will reach agreed upon system acceptance criteria with DSHS.

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8. Describe how Bidder will train project and State staff to the proposed transfer system. 9. Describe Bidder’s approach to addressing new requirements identified between the release of the RSD and the Phase 1 implementation date. 10. Describe successful Vendor responsibilities during the Requirements Verification stage. 11. Describe State responsibilities during the Requirements Verification stage. 12. Describe deliverables from the Requirements Verification stage. 13. Identify major milestones achieved through the Requirements Verification stage.

2.10.4

Approach to Detailed Design

This stage involves the development of the designs for the Washington State MMIS. Deliverables produced during this stage include but are not limited to:   General Systems Design (GSD). Detailed Systems Design (DSD).

The DSHS MMIS Re-Procurement Project Team has established a working relationship the DSHS Enterprise Architecture Program (EAP). The successful Vendor will also be expected to establish a working relationship with EAP. The purpose of the EAP is to create and use an enterprise architecture as a framework for decision making for business, technology and information systems for DSHS. The framework is primarily made up of policies, principles, models and standards. The Enterprise Architecture framework will be utilized to make all enterprise IT decisions and all enterprise business decisions that have a significant impact on IT. Additionally, the framework may be used for enterprise decisions that don't have a significant impact on IT because it provides a common language for enterprise issue discussion and resolution. The successful Vendor will work with EAP to ensure design principles are followed. Specific areas of interest include the design and use of components supporting the use of common provider and client IDs and the design and development of common eligibility and authorization interface components. The Bidder’s proposal must: 1. Agree that Bidder will work with EAP to ensure General Systems Design and Detailed Systems Design deliverables follow the Enterprise Architecture framework. (See related requirements in Sections 3.9 and 3.12). 2.10.4.1 General System Design

The Bidder’s proposal must: 1. Describe Bidder’s approach for developing the General System Design deliverable. 2. Describe specific contents of the General Systems Design deliverable. 3. Describe the roles of DSHS and successful Vendor staff in the development of the General System Design deliverable. 4. Describe how the general design will be documented and made available to DSHS staff. 5. Describe the Bidder’s process for obtaining DSHS acceptance of the General System June 2004 55 of 264 RFP No. 0456-153

State of Washington Dept. of Social and Health Services Design. 2.10.4.2 Detailed System Design

MMIS Re-Procurement Request for Proposal

The Bidder’s proposal must: 1. Describe Bidder’s approach for developing the Detailed System Design deliverable. 2. Describe specific contents of the Detailed System Design deliverable. 3. Describe the roles of DSHS and successful Vendor staff in the development of the Detailed System Design deliverable. 4. Describe how the Detailed System Design will be documented and made available to DSHS staff. 5. Describe the Bidder’s process for obtaining DSHS acceptance of the Detailed System Design.

2.10.5

Approach to Development, Unit Testing, and System Integration Testing

The objectives of the Development/Testing Stage are to install, modify, and develop a federally certifiable MMIS on the successful Vendor's hardware and to perform unit, system/sub-system, integration, and parallel testing to ensure all MMIS requirements are satisfied. In order to do this, the successful Vendor must establish its hardware, software and network environment including connection to the State network. This stage will also include the design and implementation of an Integrated Test Facility (ITF). This test facility will contain the User Acceptance Test, Impact Analysis and Training environments as well as specific testing requirements included in but not limited to Section 3.10, Test Environments and Integrated Test Facility (ITF). Deliverables produced from this stage include:            System Test Plans. System Test Results. System Integration Test Plans. System Integration Test Results. MMIS User Manuals. MMIS Operating Procedures. Integrated Test Facility configuration and set-up. Generation of test data sets. Regression test guidelines. Integrated Test Facility Procedures. Revised Detailed System Design.

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State of Washington Dept. of Social and Health Services The Bidder’s proposal must:

MMIS Re-Procurement Request for Proposal

1. Describe Bidder’s overall approach to development and testing. Bidder must include quality assurance processes and requirements traceability. 2. Agree that the Bidder will adopt, implement and document rigorous and professionally sound unit, system, integration and regression test procedures. 2.10.5.1 System and Integration Testing

The Bidder’s proposal must: 1. Describe Bidder’s approach for developing Test Plans (System and Integration) including development of test cases and test data. 2. Describe Bidder’s proposed tool and procedures for tracking, managing, and reporting system bugs discovered during testing. 3. Describe the process that will be used to correct problems in the system. 4. Describe Bidder’s approach for updating documentation based on test results. 5. Describe Bidder’s procedures for notifying DSHS of failures to meet requirements and other problems discovered in testing, testing progress, and adherence to the test schedule, and so forth. 6. Describe Bidder’s approach to correcting problems discovered during testing. 7. Describe Bidder’s approach for re-testing failed test cases after system modification. Include a description of regression test procedures. 8. Describe Bidder’s process for parallel system testing showing that the same test cases processed by the existing MMIS and the newly developed MMIS have the same results, including an explanation for any discrepancies in the results. 9. Describe Bidder’s approach for providing a summary of the status of testing, including frequency of reporting, numbers of problems identified by type of problem and numbers of problems corrected. 10. Describe specific deliverables from System and Integration Testing. 11. Describe how the deliverables will be documented and made available to DSHS staff. 12. Agree that the successful Vendor must provide test plans, test cases and test results from system and integration testing to DSHS for acceptance prior to beginning User Acceptance Testing. 13. Describe Bidder’s approach for obtaining DSHS acceptance of system and integration test results. See Section 3.10 for specific testing requirements. 2.10.5.2 MMIS User Manuals

As part of the Detailed Design stage, the successful Vendor must develop draft versions of the MMIS User Manual and MMIS Operating Procedures documentation. These documents will be refined during subsequent activities but must be finalized for use during User Acceptance Testing. See Section 4.20 for specific System/User Documentation requirements.

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MMIS Re-Procurement Request for Proposal

1. Describe Bidder’s approach to development of the MMIS User Manual. 2. Describe contents of the MMIS User Manual and proposed organization. 3. Describe how DSHS staff will be involved in the development of the MMIS User Manuals including acceptance. 4. Describe procedures for maintaining the MMIS User Manuals throughout the Operations stage including DSHS acceptance of updates. 5. Agree that the MMIS User Manuals will be accessible on-line and that up to three (3) paper copies may be produced upon request at no additional cost to DSHS. 6. Describe Bidder’s approach for training DSHS staff using the MMIS User Manual as a basis. 2.10.5.3 MMIS Operating Procedures

The MMIS Operating Procedures Manual defines the relationships and responsibilities of the successful Vendor and DSHS personnel for MMIS operations. The operating procedures must include production control procedures, scheduled batch processes, on request batch processes, file updates, mass adjustment runs, receipt and response to all EDI transactions, paper claims and attachment imaging and tracking, claims resolution procedures, all provider, client and user support procedures needed to manage the daily operations of the MMIS, and similar activities. The Bidder’s proposal must: 1. Describe Bidder’s approach to development of the MMIS Operating Procedures Manual. 2. Describe contents of the MMIS Operating Procedures Manual. 3. Describe how DSHS staff will be involved in the development of the MMIS Operating Procedures including acceptance. 4. Describe procedures for maintaining the MMIS Operating Procedures Manual throughout the Operations stage including distribution of procedure updates. 5. Agree that the MMIS Operating Procedures Manual will be accessible on-line and that paper copies may be produced upon request. 6. Describe Bidder’s approach for training DSHS staff to the MMIS Operating Procedures. 2.10.5.4 Integrated Test Facility (ITF)

The ITF environments and the procedures for managing the ITF are established in the Development/Testing stage. The ITF environments will contain a complete, functioning copy of the most recent accepted version of the MMIS software throughout the life of the contract. ITF will reside in a separate system region dedicated specifically to Washington (a logical partition may be utilized). See Section 3.10, Test Environments and Integrated Test Facility. The Bidder’s proposal must: 1. 2. Describe Bidder’s proposed ITF including all testing and training environments. Describe Bidder’s overall approach for establishing the ITF and ITF procedures.

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State of Washington Dept. of Social and Health Services 3. 4. 5. 6. 7. 8. 9. 2.10.5.5

MMIS Re-Procurement Request for Proposal

Describe processes for migrating the then-most recently accepted MMIS software to the ITF environments. Describe specific procedures for backing up, restoring, and refreshing all permanent data stores in the Integrated Test Facility environments. Describe processes for applying emergency fixes to the ITF environments Describe the steps necessary for authorized staff to utilize the ITF. Include access procedures. Describe the migration process and the steps needed to move or copy software from integration test libraries to the ITF environments. Describe the migration process and the steps needed to move or copy software from the ITF to production. Describe the role of the State and successful Vendor staff in developing the ITF Procedures including acceptance process. Revised Detailed System Design (DSD)

The successful Vendor must revise the DSD to reflect changes identified during the testing process. The successful Vendor must provide updated pages to the State for review and acceptance. The Bidder’s proposal must: 1. Describe Bidder’s approach for updating the DSD including obtaining State acceptance of amendments. 2. Agree that a change log will be generated and draft DSD updates will be presented to DSHS prior to updates being formally published. 3. Describe the roles of State and successful Vendor staff in updating the DSD.

2.10.6

Approach to Interface Development and Testing

The Interface Development and Testing stage will consist of the planning, development, and testing of all incoming and outgoing interfaces with the MMIS. This stage will include design of an interface architecture that will simplify the interface development and maintenance process using middleware or similar technologies. This stage will also include the development of interface software, establishment of interface procedures and testing of interfaces software and procedures. The Interface Development stage will demonstrate, through comprehensive testing, that all required data inputs and outputs are functioning as designed and all interface requirements are satisfied. The deliverables for the Interface Development and Testing stage include:  Interface Architecture including the technologies and methods employed for developing interfaces.    Detailed Requirements for each Interface. Operational Procedures for each interface including interface method (e.g. FTP, Web Services Request, etc.), frequency, timing, etc. Interface Test Plans and Results.

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MMIS Re-Procurement Request for Proposal

The Interface Development stage must address development of all interfaces and satisfy all requirements identified in Section 3.12, Interface. The Bidder’s proposal must: 1. Describe Bidder’s approach to developing an interface architecture including proposed tools (e.g. middleware) and methods. 2. Describe Bidder’s approach to defining detailed requirements for each interface and obtaining DSHS acceptance of requirements. 3. Describe how DSHS staff will participate in the interface requirements definition. 4. Describe Bidder’s approach to the development of interface operational procedures. 5. Describe Bidder’s approach for developing interface test plans including development of test cases and test data. 6. Describe procedures for tracking and correcting deficiencies discovered during testing. 7. Describe procedures for notifying DSHS of: problems discovered in testing; testing progress and adherence to the test schedule. 8. Describe how test results will be provided to DSHS for review and acceptance. 9. Describe Bidder’s approach to reporting progress and problems with interface testing. 10. Describe how the successful Vendor will obtain DSHS acceptance for completed interfaces. 11. Describe the role of State and the successful Vendor staff during interface development and testing.

2.10.7

Approach to Data Conversion

The Data Conversion stage will consist of the planning, development, testing, and coordination of all data and file conversions required to support the operation of the new MMIS. The data conversion requirements shall include changes to current provider types, categories of service, diagnosis codes, procedure codes, and all relevant subsystem reference files. The Data Conversion stage will also include development of conversion software and/or manual procedures, testing of conversion programs and procedures, and preliminary conversion of all files. The Data Conversion stage will demonstrate, through comprehensive testing of conversion processes, that all data required to support MMIS processing will be available and accurate. The Data Conversion stage will be performed concurrently with the Development/Testing stage. The deliverables for the Data Conversion stage include:     Conversion Plan. Conversion Requirements. Conversion Test Plans and Results. Preliminary Converted Files.

The Data Conversion stage must address conversion of all data necessary to meet all functional specifications and requirements in this RFP including the Health Watch Technologies (HWT)DSS. See Section 1.5, Current Environment, for a description of HWT-DSS. Bidders should propose a Data Conversion approach that satisfies the requirements yet is cost effective. June 2004 60 of 264 RFP No. 0456-153

State of Washington Dept. of Social and Health Services The Bidder’s proposal must: 1.

MMIS Re-Procurement Request for Proposal

Agree that Bidder will convert all data stored in current MMIS files to the new MMIS database as part of Implementation Phase 1. Three years of claim history is stored in current MMIS files. Agree that Bidder will convert data stored in SSPS files to the new MMIS to support programs being converting Implementation Phases 2 and 3. Up to one year of history is stored in SSPS files. Agree that Bidder will convert data from current sources including the current MMIS (three years of history), Extended Database extract files (back to 1991), HWT-DSS (back to 1997), and Eligibility by Month files (back to 1991) to the new Data Warehouse. Describe Bidder’s approach to developing a data conversion plan as a deliverable and obtaining DSHS acceptance for the plan. Describe Bidder’s approach to defining detailed conversion requirements, including identifying data sources for all sub-systems and obtaining DSHS acceptance of requirements. Describe how DSHS staff will participate in the conversion requirements definition. Describe Bidder’s approach to the development of conversion procedures including software development. Describe Bidder’s approach for developing conversion test plans including development of test scenarios and test data. Describe procedures and timelines for tracking and correcting deficiencies discovered during testing.

2.

3.

4. 5.

6. 7. 8. 9.

10. Describe procedures for notifying DSHS of problems discovered in testing, testing progress and adherence to the test schedule. 11. Describe how test results will be provided to DSHS for review and acceptance. 12. Describe Bidder’s approach to reporting progress and problems with data conversion. 13. Describe how successful conversion results will be reported to DSHS, including before and after versions of each file conversion, and DSHS acceptance process for conversion. Describe how unsuccessful conversion will be documented. 14. Describe Bidder’s approach in assisting State staff in identifying data that must be cleaned up. 15. Describe the roles of State and successful Vendor staff during data conversion.

2.10.8

Approach to User Acceptance Testing

The User Acceptance Testing (UAT) stage is designed to demonstrate that the MMIS, as installed by the successful Vendor, meets DSHS specifications, performs all processes correctly, and passes acceptance criteria identified during requirements verification. Bidders must allow a minimum of twelve (12) weeks for User Acceptance Testing. UAT will follow completion of unit, system and integration testing and certification by the successful Vendor that all system components meet entrance criteria for UAT.

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MMIS Re-Procurement Request for Proposal

UAT is designed to ensure that all MMIS functions are tested by users including but not limited to, proper functioning of edits, audits, and business rules, the accuracy of claim records payment and file maintenance, and the format and content of all system outputs, including outputs from reporting functions from the Data Warehouse. UAT also offers the opportunity to test User Manuals, forms, procedures and business processes. All MMIS subsystems and modules will be tested. UAT will be conducted in a controlled and stable environment as identified in the Integrated Test Facility requirements. These tests may utilize all of, or select parts of, the preliminary converted files. Deliverables from the UAT stage include but are not limited to:     User Acceptance Test Plan. User Acceptance Test Cases. User Acceptance Test Results Document. An MMIS that passes all Acceptance criteria.

DSHS will be responsible for developing the User Acceptance Test Plan and User Acceptance Test Cases. DSHS will also identify the schedule for user acceptance test cycles and delivery of output. The successful Vendor will be responsible for the maintenance and operation of the UAT environment, ensuring that a current, thoroughly tested UAT environment is available at all times, preparing acceptance test data, and developing the User Acceptance Test Results Document. The state will identify the schedule for user acceptance test cycles and delivery of output. Bidder proposals must: 1. 2. Agree that Bidder will fully and promptly cooperate with DSHS in the UAT process. Agree that Bidder will be solely responsible for making changes; providing refinements and/or upgrades; providing software, hardware, programming, and professional and/or technical services as may be necessary to correct any deficiencies, problems, failures, incompatibilities, and/or errors identified during UAT. Agree that Bidder will provide a separate User Acceptance Testing environment for the entire UAT period as well as the operations period of the contract. Describe Bidder’s approach to supporting UAT. Include availability of UAT environment, preparation of test data, response to discrepancies and resolution of problems. Agree that Bidder will make available all User Acceptance Test documentation including files and reports necessary to validate test results. These test results will be made available to DSHS no later than one (1) working day following execution of test cases. Agree that Bidder will provide regular reports during UAT to include problems identified, description of problem, type of problem, corrective steps taken, resolution of problem, etc. At the end of UAT, Bidder will provide an Acceptance Test Results document that will include the information above as well as problems outstanding at end of UAT period, impact of outstanding problem on operations, and cumulative impact of problems. Describe Bidder’s approach for obtaining DSHS acceptance of Acceptance Test

3. 4.

5.

6.

7.

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State of Washington Dept. of Social and Health Services Results Document. 8. 9.

MMIS Re-Procurement Request for Proposal

Describe the support that will be provided to DSHS for creation of test cases that cover all system functions, processes and interfaces. Describe the Bidder’s approach for supporting DSHS staff in the analysis of test results.

10. Describe the process and timelines for correcting discrepancies and ensuring corrected code is thoroughly tested and migrated to the UAT environment for retesting. 11. Agree that the Bidder will perform regression testing during UAT. Further, agree that the Bidder will coordinate with DSHS on timing of regression tests.

2.10.9
2.10.9.1

Approach to Operational Readiness
Operational Readiness Testing

The successful Vendor will be required to demonstrate readiness to perform all successful Vendor MMIS functions and contractual requirements. Bidders must allow a minimum of four (4) weeks for Operational Readiness Testing which will follow User Acceptance Testing. The Operational Readiness Testing is designed to ensure that the successful Vendor is ready to process all inputs, price claim records correctly, meet all reporting requirements, utilize a properly functioning data communications network, and have a demonstrated back- up capacity. Operational Readiness Testing will include a volume test of several days of production capacity claim records volumes to demonstrate that the MMIS and the successful Vendor's staff are prepared for full production. Operational Readiness Testing will also ensure that all business areas are ready for production. This includes testing of new processes and procedures in concert with the new system. Operational Readiness Testing may include a pilot test of actual claims processing in a full operational environment from claim submission through the check request process. An additional component of the Operational Readiness Testing is the demonstration and verification of physical data center security, data security, and fire/disaster prevention and recovery procedures. The disaster recovery processing portion of the Operational Readiness Testing will be limited to a recovery during a daily and a weekly process cycle. The length of the test will be the amount of time that is necessary to recover from the disaster and provide proof that the recovery has been successfully completed. Deliverables from Operational Readiness Testing will include but are not limited to:      Updated MMIS User Manuals. Operational Readiness Checklists for each Business Area. Cutover Schedule. Operational Readiness Report. An MMIS that passes all Operational Readiness requirements.

Bidder proposals must:

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MMIS Re-Procurement Request for Proposal

1. Describe Bidder’s approach to updating the MMIS User Manual and obtaining DSHS acceptance of amendments. 2. Describe Bidder’s approach to testing the business continuity and data backup procedures. 3. Describe Bidder’s approach to volume testing to include several days of production capacity claim records to demonstrate that the MMIS and the successful Vendor's staff are prepared for full production. 4. Describe Bidder’s approach to collecting and preparing production data including all HIPAA EDI transactions in preparation for the pilot test. 5. Describe Bidder’s approach to verifying the output of the pilot test. 6. Describe Bidder’s approach to producing Operational Readiness Checklists for each business area including roles of State and successful Vendor staff in the checklist development. Describe proposed content of checklists. 7. Describe Bidder’s approach to developing a Cutover Schedule to include specific activities that will be cutover, when cutover will occur and activity dependencies. 8. Describe Bidder’s approach to certifying, through Operational Readiness Testing, that the MMIS, its subsystems, functions, processes, operational procedures, staffing, telecommunications, and all other associated support is in place and ready for Operation. Describe documentation of certification results (Operational Readiness Report). 9. Describe Bidder’s approach for obtaining acceptance of the Operational Readiness Report. 10. Describe roles of the State and successful Vendor staff during Operational Readiness Testing. 2.10.9.2 Provider Readiness Plan

The Provider Readiness plan identifies all the activities required to ensure providers are ready and able to use the new MMIS when implemented. Development of this plan will begin during design and be refined during subsequent activities. The plan will be executed during each implementation phase for the providers impacted during that phase. Provider Readiness will include: Provider Enrollment: Ensure that all providers are enrolled and issued new provider IDs from the new MMIS. This includes cross-referencing to other provider ID’s and recording provider group affiliations, clearing house relationships, power of attorney statements, and other provider details. Provider Transaction Certification: Ensure all providers submitting electronic transactions have thoroughly tested those transactions prior to submitting in production and are compliant with HIPAA implementation guides, State companion guides and State billing instructions. Provider Training: Ensure providers are trained in the use of the Internet and IVR functions required for claim submission, status inquiries, eligibility inquiries, prior authorization submittal, social service claim verification, and any other proposed MMIS provider functions. The Provider Training will include instruction in proper online provider enrollment steps, manual billing procedures, and understanding of RAs.

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MMIS Re-Procurement Request for Proposal

Refer to Section 3.13. for additional requirements regarding provider readiness. Bidder proposals must: 1. Agree that Bidder will work with DSHS staff to ensure all providers are enrolled in the new MMIS. 2. Describe the Bidder’s approach to transitioning existing providers to the new system including outreach and awareness, data collection of provider group relationships, submission methods, assignment of provider IDs, cross referencing of group IDs, cross referencing multiple IDs and completion of the enrollment process, transaction testing and cutover to the new system. 3. Agree that Bidder will provide all provider training plans, training materials, training facilities and schedule training as appropriate prior to each MMIS implementation phase. Bidder will also be required to provide periodic training throughout the Operations stage for new providers. DSHS will provide policy specialists who will assist Bidder staff in developing and delivering the training. 4. Describe Bidder’s approach to training providers in MMIS functions and must include Bidder’s approach to planning, and scheduling training for all types of providers in different geographic regions across the State.

2.10.10 Approach to Implementation/Deployment
2.10.10.1 Phase 1 Requirements DSHS plans to have three distinct implementation phases. Phase 1 will implement the Medicaid transactions that are supported by the current MMIS. This first set of functionality supports the base requirements of the Washington Medicaid Program. Phase 1 implementation is scheduled to be complete by 12/30/06 when the current MMIS contract expires. In addition to supporting current MMIS payments, DSHS expects that substantial improvements to the current operation will be realized. During Phase 1, the successful Vendor shall perform final data conversion (see Section 2.10.7) and implement all functionality required to support processing of Medicaid payments paid by the current MMIS. The successful Vendor will also implement all Data Warehouse functionality during Phase 1. Date of receipt shall determine whether the current MMIS and incumbent vendor or the new MMIS and the successful Vendor will be responsible for processing claim records. The incumbent vendor will be responsible for all claim records processed through the last payment cycle in December 2006. The successful Vendor will be responsible for all claim records not adjudicated by that date. Successful Vendor must ensure and warrant that the installation of the successful Vendor supplied system, including converted data, will be accomplished without interruption to current MMIS processing. Bidder proposals must: 1. Describe Bidder’s approach for ensuring no interruption to current MMIS processing will occur during Implementation Phase 1. 2. Describe how the successful Vendor will coordinate/cooperate with the incumbent MMIS vendor and DSHS during Implementation Phase 1.

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State of Washington Dept. of Social and Health Services 2.10.10.2 Phase 2 Requirements

MMIS Re-Procurement Request for Proposal

Phase 2 will incrementally implement Medicaid programs that today are not supported by the current MMIS. Remaining Medicaid programs will be migrated to the modern MMIS from 12/31/06 to 12/31/07. These programs include for example, the COPES Nursing Services program, the Behavioral Rehabilitation Services program currently processed in SSPS. During Implementation Phase 2, the successful Vendor shall implement all functionality required to support processing of all remaining Medicaid payments not paid by the current MMIS (including manual A-19 payments). This will include data conversion from SSPS. For payments currently processed in SSPS, date of receipt shall determine whether the SSPS or the new MMIS will be responsible for processing claim records. The SSPS will be responsible for all claim records processed up to the Phase 2 implementation date. Bidder proposals must: 1. Describe Bidder’s approach for ensuring no interruption to new MMIS processing during Implementation Phase 2. 2. Describe how the successful Vendor will coordinate/cooperate with SSPS during Implementation Phase 2. 2.10.10.3 Phase 3 Requirements

Phase 3 will incrementally implement non-Medicaid programs such as the Home Chore Services and others which can be supported by the implemented system (no additional system modifications required). These programs will be implemented from 12/31/07 to 12/31/08. This phase will include data conversion of non-Medicaid program data currently stored in SSPS. For payments currently processed in SSPS, date of receipt shall determine whether the SSPS or the new MMIS will be responsible for processing claim records. The SSPS will be responsible for all claim records processed up to the Phase 3 implementation date. Bidder proposals must: 1. Describe Bidder’s approach for ensuring no interruption to new MMIS processing during Implementation Phase 3. 2. Describe how the successful Vendor will coordinate/cooperate with SSPS during Implementation Phase 3. DSHS anticipates that design and development of the modern MMIS occurs primarily during Phase 1, while Phase 2 and 3 efforts primarily focus on data conversion and implementation of programs outside of the current MMIS. The following deliverables will be finalized and executed during each implementation phase:      MMIS Implementation Plan. MMIS Systems Documentation. Business Process/Cultural Change Plan. State Training Plan. Final Converted Data in accordance with specifications.

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State of Washington Dept. of Social and Health Services  “Back-Out” Contingency Plan.

MMIS Re-Procurement Request for Proposal

DSHS anticipates that Requirements Verification, Design, Development, and Unit, System and Integration Testing will primarily occur in Phase 1. All three phases will include Interface Development and Testing, Data Conversion, User Acceptance Testing, Operational Readiness Testing, Provider Readiness activities and Implementation/Deployment activities and deliverables as specified below. 2.10.10.4 Implementation Plan An Implementation Plan will be created for each major implementation phase (Phases 1, 2 and 3). Development of an Implementation Plan generally will begin during design and be refined during development. The tasks in the Implementation Plan will be performed during the Implementation/Deployment stage. The Implementation Plan identifies all the activities which must be accomplished for a successful implementation. At a minimum, for each phase, the plan should include:  Recommended approach for completing incremental implementation by program (Phase 2 only).   Plans and schedules for designing, ordering, and distributing all required MMIS forms. Identification of cutover procedures and dates for submittal of claim records, both manual and electronic.  Document resolution of inventory issues (for example, suspense, claim records on hand, provider enrollments).    Methodology for handling adjustments to incumbent-processed claim records. Procedures and dates for provider enrollment and/or recertification. Process to accommodate provider updates, recipient data changes, reference changes, and prior authorizations, after final conversion but before implementation. Bidder proposals must: 1. Describe Bidder’s approach to development of the electronic Implementation Plan for each implementation phase. Include when the plan will be developed and how it will be modified during subsequent activities. 2. Describe Bidder’s approach for managing performance of Implementation Plan tasks. 3. Describe contents of the Implementation Plan to include the items above and other items the Bidder feels are necessary. 4. Describe the role of the Bidder and DSHS in the implementation planning. 5. Describe the role of the Bidder and DSHS in supporting implementation tasks. 6. Describe the process for obtaining DSHS acceptance of the Implementation Plan for each implementation phase. 7. Describe Bidder’s process for training DSHS staff regarding the Implementation Plan.

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State of Washington Dept. of Social and Health Services 2.10.10.5 MMIS Systems Documentation

MMIS Re-Procurement Request for Proposal

The successful Vendor is responsible for providing to DSHS complete, accurate, and timely documentation of the MMIS. The MMIS Systems Documentation must be provided prior to final State acceptance of the entire MMIS. Following Implementation Phase 1, and again, following Implementation Phases 2 and 3, the successful Vendor must prepare updates to the MMIS Systems Documentation to incorporate all changes, corrections, or enhanc ements to the MMIS. Updates to the MMIS Systems Documentation must be delivered to the State prior to state acceptance of the change, unless otherwise agreed to by the State. For more detailed specifications see Section 4.20 System/User Documentation. Bidder proposals must: 1. Describe Bidder’s approach to development of the MMIS Systems Documentation. 2. Describe the contents of the MMIS Systems Documentation. 3. Include examples of descriptions and function and feature narratives. 4. Include example Subsystem flowcharts, identifying each program, input, output, and file. 5. Include examples of Input, Output and File definitions. 6. Include examples of program documentation to include, program narratives, and the relationships between the programs and modules. 7. Include an example list of input and output files and reports. 8. Examples of File layouts. 9. Examples of File names and conventions. 10. Example Program source listings. 11. Example physical file definitions including intermediate and work files. 12. Example record layouts, with reference to file names and data element names. 13. An example data element dictionary. 14. Description of component to component integration/system inter-operability. 15. Operations run documentation with schedules and dependencies. 16. Describe Bidder’s approach for obtaining acceptance of the MMIS Systems Documentation. 17. Describe procedures for maintaining the MMIS Systems Documentation throughout the Operations stage including distribution of amendments. 18. Agree that the MMIS Systems Documentation will be accessible online and that up to three (3) paper copies may be printed upon request at no additional cost to DSHS. 19. Bidder’s approach to providing training to DSHS technical staff on the new system. 2.10.10.6 Business Process/Cultural Change Management Plan Because of the degree of change the MMIS procurement effort represents for DSHS organizationally, DSHS is very interested in working with the successful Vendor to effectively define and implement cultural and business process changes. Not only will DSHS be replacing the MMIS that has been in place for over 20 years, the agency will migrate all Medicaid payments from the current SSPS as well as selected similar non-Medicaid payments to the June 2004 68 of 264 RFP No. 0456-153

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MMIS Re-Procurement Request for Proposal

modern MMIS. The MMIS Re-Procurement project presents an opportunity to not only replace the MMIS, but also a chance to reinvent many business processes within the agency. It is expected that business process changes will occur in virtually every process supported by the new MMIS. Bidder proposals must: 1. Describe Bidder’s approach to developing Business Process/Cultural Change deliverables. At a minimum, Bidder’s response should include the items below for each business process impacted by the new system including, but not limited to, provider enrollment, prior authorizations, TPL/COB, and Claims Processing. However, Bidder may include additional/alternative tasks supported by their methodology. a. Evaluate current business process documentation developed by DSHS. b. Produce, with assistance from DSHS staff, future business models including process descriptions, workflows, staff utilization and skill requirements. c. Perform gap analysis between current and future business models. d. Identify deficiencies in new MMIS and define required modifications. e. Produce, with assistance from DSHS staff, migration plans to implement future business models. f. Provide training to DSHS staff on future processes including the use of the new MMIS in performing/supporting future processes. Describe Bidder’s approach for managing performance of Business Process/Cultural Change tasks and deliverables. Describe Bidder’s experience with similar Business Process/Cultural Change management for other states or clients. Describe the role of the successful Vendor and DSHS in the Business Process/Cultural Change management process. Describe the process for obtaining DSHS acceptance of the Business Process/Cultural Change tasks and deliverables. 2.10.10.7 State Staff Training Plan The State Staff Training Plan identifies all the activities leading up to, and including the training of State staff, at all levels, in the proper use of the MMIS. This includes State staff performing functions identified in Section 1.4, Operations Model as well as staff working within Community Service Offices and from other administrations that will be new users of the modern MMIS. Training will occur prior to each implementation phase. DSHS expects the successful Vendor to train state staff as if they are an extension of the successful Vendor’s personnel in a Fiscal Agent (FA) state. Specific areas where training must be addressed include but are not limited to:        COB/TPL. Claims Processing including Social Services claim processing and billing. Pharmacy. Prior Authorization. Drug Rebate. Accounts Receivable. Imaging/Document Management.

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State of Washington Dept. of Social and Health Services     

MMIS Re-Procurement Request for Proposal

MMIS Services (Reference Table, Business Rule maintenance, etc.). Data Warehouse (casual, analytical, and super users). Call Center. Interactive Voice Response (IVR). Managed Care. 1. Agree that successful Vendor will provide all staff training plans, training materials, training facilities and schedule training at an appropriate time prior to the completion of each implementation phase. The successful Vendor will also be required to provide periodic training throughout the Operations and Maintenance stage for new staff or staff who change positions. 2. Describe Bidder’s approach to training state staff to fully understand all MMIS processes, including Bidder’s approach to planning, and scheduling personnel for training.

Bidder proposals must:

2.10.10.8 Final Conversion Section 2.10.7, identifies the necessary tasks to ensure all conversion processes were created and adequately tested. For each implementation phase, this process will perform the final data conversion of all files necessary for MMIS functions to operate correctly. This task also includes conversion of historical data to the Data Warehouse. Bidder proposals must: 1. Describe Bidder’s approach to working with DSHS to obtain all necessary source fil es from DSHS and the incumbent vendor required for final conversion. Include all claimrelated receipts and pended claim records on hand from the current MMIS. Describe how outstanding transactions will be processed through the modern MMIS. 2. Describe Bidder’s approach to storing archive files transferred from the current MMIS. 3. Describe Bidder’s approach to monitoring conversion progress and reporting. 4. Describe how successful conversion results will be reported to DSHS including before and after versions of each file conversion. 5. Describe Bidder’s process for reporting problems and assessing impact on the remaining conversion schedule. 6. Describe Bidder’s final conversion verification process to include: a. File balancing to DSHS and incumbent's control totals. b. Validating content of all reference files. c. Correcting any problems identified during final file conversion . 7. Describe Bidder’s approach for making converted files available for review online, where appropriate. 8. Describe Bidder’s approach for obtaining DSHS acceptance of final conversion. 2.10.10.9 Business Report and Data Verification

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MMIS Re-Procurement Request for Proposal

Once final data conversion is complete, a final verification step is required to ensure all required reports produce expected results from the new MMIS. This includes all reports (MARS/SURS) required for CMS Certification. Reports will be executed from the new MMIS and compared to reports produced from the old MMIS for the same reporting period. 1. Agree that Bidder will perform the reports verification. 2. Describe the Bidder’s approach to reports verification. 3. Describe documentation to be produced describing process and successful completion of reports verification. 4. Describe Bidder’s approach for obtaining DSHS acceptance of report verification results. 2.10.10.10 Back-Out Contingency Plan A Back-out Contingency Plan is developed to identify the steps necessary to return the system to its status prior to the Implementation Phase beginning. For Implementation Phase 1, this involves the continued use of the current legacy MMIS, for subsequent implementation phases, it involves returning the new MMIS to its “state” prior to beginning the specific Implementation Phase. Bidder proposals must: 1. Describe the Bidder’s approach to developing Back-out Contingency plans for each implementation Phase. 2. Describe proposed contents of the Back-out Contingency Plan. 3. Describe the role of the successful Vendor and DSHS in back-out contingency planning. 4. Describe the process for obtaining DSHS acceptance of the Back-out Contingency Plan. 5. Describe Bidder’s process for training DSHS staff regarding the Back-out Contingency Plan. 2.10.10.11 Final Acceptance and Cutover The final step in each of the three implementation phases is to officially accept and cutover to the new system functionality. This will include notification to providers of the date from which all claim and other transaction records are to be submitted to the new system, provide new billing procedures to the providers and officially accept and cutover to the new system functionality. 1. Describe Bidder’s approach and content of notification to providers of the new MMIS functionality, new billing procedures, and the date from which all transaction records are to be submitted to the successful Vendor. 2. Agree that any communication with providers must be accepted by DSHS prior to its release to providers. 3. Describe Bidder’s approach to final acceptance of the MMIS Implementation.

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2.10.11 Approach to Certification
MMIS certification is scheduled to begin six (6) months after the completion of Design, Development and Implementation Phase 1. DSHS will direct the MMIS certification process and act as the contact with CMS during the certification process. DSHS will prepare the MMIS certification letters to CMS and accept Vendor-produced MMIS certification documentation. The successful Vendor will support the certification process by:  Producing the letter of submission, reports and data necessary as outlined in the State Medicaid Manual, Part 11, Chapter 2, Section 11241 and Chapter 3, Sections 11300 through 11375. Preparing required documentation, reports, and crosswalks. Providing personnel to brief appropriate State staff on certification procedures, system operations, and other information necessary for State staff to make appropriate presentations at the time of CMS certification. Provide MMIS expertise to answer questions or provide insight during the certification process.

 



The MMIS that is provided by the successful Vendor must meet all federal standards and possess all functional capabilities required by CMS for certification, as described in Part 11 of the Medicaid Manual and in 42 CFR 433, Subpart C. Bidder proposals must: 1. State whether the Bidder’s proposed transfer system is currently CMS certified. Explain all conditions, if any, CMS imposed on the certification of the proposed transfer system. If the proposed transfer system is developed/imp+lemented and is in the certification process, specify the status of this process and the expected date of certification. 2. Agree that it is the Bidder’s responsibility to design, develop and Implement a fully certified MMIS to Washington. Affirmatively and explicitly state Bidder’s commitment to deliver an MMIS including all sub-systems and components that will meet or exceed all CMS MMIS certification requirements. Further, demonstrate the Bidder’s understanding of the certification requirements and the process for obtaining CMS certification by describing, in detail, the steps Bidder will take to achieve certification, including how the successful Vendor will support DSHS in the CMS certification process. 3. Include a proposed timeline for preparation of certification materials and presentation of the materials to the DSHS Project Manager. 4. Describe Bidder’s experience with MMIS Certification with other states, including experience of key personnel. 5. Describe the successful Vendor roles and responsibilities during this stage. 6. Describe State roles and responsibilities during this stage. 7. Describe deliverables from this stage. 8. Describe the milestones to be achieved through this stage.

2.10.12 Approach to Project Deliverables
The Bidder must identify its approach to developing and submitting the project deliverables identified in this RFP. The approach to project deliverables must identify the proposed steps in

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the deliverable development process, from development of outlines, templates, and acceptance criteria through review, finalization and acceptance. Additionally, Bidders must clearly identify successful Vendor and state responsibilities during the project deliverable process. Bidders are encouraged to deliver partial drafts (e.g., section by section) especially when deliverables are lengthy to manage mutual expectations and to ensure the satisfactory completion of deliverables. Bidders also must consider the impact on reviewers when multiple deliverables are under review simultaneously by the same stakeholder group, and adjust review and correction periods accordingly. Bidder proposals must: 1. 2. 3. Describe the Bidder’s general approach to deliverables development, acceptance criteria, draft submission, revisions, and final acceptance. Commit to submitting for State approval acceptance criteria before work begins on the deliverable. Agree that deliverables must comply with all applicable specifications as developed during Requirements Verification (see Section 2.10.3) and Detailed Design (see Section 2.10.4). Include a full list of all deliverable titles and expected delivery dates. Commit to producing deliverable outlines or templates for DSHS acceptance before work begins on the deliverable. Commit to submitting draft deliverables to the DSHS Project Manager with adequate agreed upon review periods before distribution to a wider stakeholder audience. Agree that all deliverables (draft and final) will be presented in electronic format with a cover letter specifying that the successful Vendor’s project manager and quality assurance team have fully reviewed the deliverable and that it is ready for DSHS review because it meets all the deliverable requirements. Agree that upon DSHS request, the successful Vendor will prepare up to three (3) paper copies of any deliverable. Commit to storage of all deliverables in a common electronic repository that contains an index and location of all current and historical deliverable documents, and to provide on-line access to the repository for both the successful Vendor and DSHS staff at any time.

4. 5. 6. 7.

8. 9.

10. Agree that the successful Vendor will incorporate comments and distribute revised draft deliverables to identified DSHS stakeholders for review and comment. 11. Agree that the successful Vendor will include a change log specifying the section, page number and brief description of any changes with the submission of a revised deliverable. 12. Agree that upon DSHS request, the successful Vendor will conduct formal walkthroughs of draft deliverables with identified DSHS stakeholders. 13. Agree that the successful Vendor will ensure adequate review periods commensurate with the length, content and complexity of any deliverable. 14. Commit to storing all written DSHS acceptance letters in electronic format in the common deliverable repository, and that the repository will be accessible to DSHS and successful Vendor staff at all times.

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15. Clearly identify successful Vendor and state responsibilities in the deliverable review process. 16. Describe the Bidder’s approach to version control and tracking of deliverables, including use of automated tools. 17. Incorporate the tasks and milestones related to each deliverable in the Work Plan required in Section 2.11, Project Work Plan, including state and successful Vendor tasks.

2.11 (SR) Project Work Plan
Keeping a structured work plan that facilitates tracking of the stages, activities, tasks, and implementation phases required to deliver the modern MMIS is critical to the success of the MMIS implementation. The ability to identify, discuss and report on the critical path of the project is required. DSHS expects the Bidder to track all tasks assigned to Bidder staff, and any subcontractors. The Bidder’s proposal must summarize the need for and timeline when DSHS and other stakeholder resources will be needed to complete DSHS discussion, deliverable review, and other tasks. DSHS intends to develop and maintain an “Official” project work plan identifying state tasks and appropriate Bidder tasks, milestones and deliverables identified in the Bidder’s detailed work plan. The Bidder tasks will be selected as “anchor” points against which Bidder progress will be monitored. The successful Vendor will be expected to report progress against the official work plan. The Bidder’s proposal must: 1. 2. Include a preliminary proposed project work plan in electronic form using Microsoft Project 2000 or later. Provide an overall schedule to support the stages identified in this RFP. Include the activities listed in Section 2.10, as well as tasks, milestones, deliverables, task dependencies and resources for delivering the proposed solution. Show sufficient sub-task levels so that no lowest-level task requires longer than 2 weeks to complete. Identify activity start and completion dates and the planned dates for initial submission, initial review, return to Bidder for revision/correction, revision/correction, walkthroughs, second level review, revision/correction, and DSHS acceptance of each deliverable. Identify all proposed resources by ID number and title/position. Include a separate listing of resource ID numbers with corresponding names of Bidder’s staff. Show tasks requiring DSHS resources, summarize the proposed use of DSHS resources, and state any assumptions regarding anticipated involvement of these resources. Further, agree that the Bidder retains final responsibility for the quality of the deliverables. Show task and individual time assignments and schedules in a Gantt type chart. Provide a critical path diagram showing all significant tasks/activities and interdependencies. Commit Bidder to finalize the Work Plan, developed jointly with and accepted by DSHS 74 of 264 RFP No. 0456-153

3. 4.

5. 6.

7. 8. 9.

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10. Agree that the finalized Work Plan becomes part of the Bidder’s response and that it will be incorporated in the contract by reference upon its acceptance by DSHS. 11. Describe how the initial schedule will be created including specific estimating guidelines for project planning. 12. Describe an approach to providing bi-weekly updates to the “Official” project work plan as described in Section 2.12.4. 13. Agree that revisions to the official work plan do not relieve the successful Vendor of its responsibility or liability for having failed to meet milestones under a prior work plan, unless authorized representatives of the State affirmatively agree in writing to waive such liability. 14. Agree that the successful Vendor must meet with DSHS every two weeks to walkthrough proposed updates to the official work plan maintained by the state and to obtain DSHS’ consent to the updates. 15. State that the Bidder understands that the state will maintain the official work plan used to report project progress and status. 16. Agree that the Bidder will maintain their detailed work plan(s) and publish those work plan(s) and updates to a common drive to which the Bidder, DSHS, and DSHS designees have access. 17. Describe what project management tools, if any, will be used by the Bidder to maintain their detailed work plans.

2.12 (MR) Project Status Meetings and Status Reporting
The successful Vendor must participate in regularly scheduled meetings and produce the specified documentation outlined below.

2.12.1
1. 2.

Approach to Weekly Status Meetings
Agree that there will be scheduled status meetings every week with the successful Vendor and the DSHS Project Manager and other members of the project team. Agree that these meetings will follow a standard pre-set agenda jointly prepared by the successful Vendor Project Manager and DSHS Project Manager, but will also allow successful Vendor and DSHS to discuss other issues that may concern either party. Acknowledge the Bidder's understanding of required status meetings and reports. Commit the Bidder’s Project Manager to attend the weekly status meetings, with the understanding that DSHS may agree to the Project Manager's attendance via telephone conference to the extent that it will not jeopardize project progress. Agree that upon DSHS request, any member of the Bidder’s project team may be asked to attend or be dismissed from attending the weekly status meeting. Commit to producing written meeting records, in a format agreed to with the DSHS Project Manager, within three (3) days of the meeting.

The Bidder’s proposal must:

3. 4.

5. 6.

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Commit to storing all meeting records and relative cover letters in electronic format within the common deliverables repository, to include an index of meeting records, and that the repository will be accessible by both Bidder and DSHS staff at any time.

2.12.2
1. 2.

Approach to Bi-Weekly Status Reports
Agree that every other week, at least 24 hours prior to the status meeting, the successful Vendor must provide brief written status reports prior to these meetings. Agree that the status reports will describe: (1) the previous two weeks’ activities, including problems encountered and their disposition, results of tests, what was accomplished as expected and on time, what was not accomplished as expected and on time, recommendations on meeting missed deadlines; (2) plans for the coming two weeks; (3) tasks behind schedule, i.e., tasks at risk of not being completed by their deadline, and what successful Vendor is doing to mitigate the risks; and (4) any action items or problems that have arisen that need to be addressed immediately. Agree that successful Vendor will report every two weeks metrics regarding major remaining tasks and outstanding action items for all deliverables defined in Section 2.10 and incorporated into the official work plan. Include status report examples from past projects of Bidder and a recommended sample report format. Agree that the format and level of detail for the status reports shall be subject to DSHS acceptance. Agree that DSHS reserves the right to formally state disagreements with status report and may, at the discretion of DSHS, require revised status reports. State that, upon request by DSHS, the Bidder will provide additional summary graphs, reports, presentations of information, or information in a different format to DSHS or designee.

The Bidder’s proposal must:

3.

4. 5. 6. 7.

2.12.3

Approach to Bi-weekly Change Control Status Meetings

The purpose of this meeting is to review all change requests, to approve and prioritize requests and to review status of all active change requests. Bidder Proposals must: 1. Agree that there will be scheduled change control meetings every two weeks with the successful Vendor and the DSHS Project Manager and other members of the project team. Agree that these meetings will follow a standard pre-set agenda jointly prepared by the successful Vendor’s project manager and DSHS’ project manager, but will also allow the successful Vendor and DSHS to discuss other issues that may concern either party. Agree the Bidder's understanding of required change control meetings and reports. Commit the Bidder’s Project Manager to attend the bi-weekly change control status meetings, with the understanding that DSHS may agree to the Project Manager's attendance via telephone conference to the extent that it will not jeopardize project

2.

3. 4.

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Agree that upon DSHS request, any member of the Bidder’s project team may be asked to attend or be dismissed from attending the bi-weekly change control status meeting. Commit to producing written meeting records, in a format agreed to with the DSHS Project Manager, within three (3) days of the meeting. Commit to updating the change control tracking tool to reflect the decisions made in the Change Control Status meeting. Commit to storing all meeting records and relative cover letters in electronic format within the common deliverables repository, to include an index of meeting records, and that the repository will be accessible by both Bidder and DSHS staff at any time.

6. 7. 8.

2.12.4

Approach to Bi-weekly Work Plan Review Meeting

The purpose of this meeting is to review the official work plan, identify potential schedule issues and agree upon any changes to the work plan. Bidder Proposals must: 1. Agree that there will be scheduled Work Plan review meetings every two weeks with the successful Vendor and the DSHS Project Manager and other members of the project team. Agree that these meetings will follow a standard pre-set agenda jointly prepared by the successful Vendor’s project manager and DSHS’ project manager, but will also allow the successful Vendor and DSHS to discuss other issues that may concern either party. Acknowledge the Bidder's understanding of required work plan review meetings and the need for formal review and reporting of official work plan changes. Commit the Bidder’s Project Manager to attend the bi-weekly work plan review meetings, with the understanding that DSHS may agree to the Project Manager's attendance via telephone conference to the extent that it will not jeopardize project progress. Agree that upon DSHS request, any member of the Bidder’s project team may be asked to attend or be dismissed from attending the bi-weekly work plan review meeting. Commit to producing written meeting records, in a format agreed to with the DSHS Project Manager, within three (3) days of the meeting. Agree that the vendor will come to this meeting with updates to the official work plan maintained by state staff. Commit to storing all meeting records and relative cover letters in electronic format within the common deliverables repository, to include an index of meeting records, and that the repository will be accessible by both Bidder and DSHS staff at any time.

2.

3. 4.

5.

6. 7. 8.

2.12.5

(MR) Oversight/Stakeholder Reporting Requirements

There is internal and external oversight for this project. For example, independent non-DSHS Quality Assurance (QA) monitoring will be conducted throughout the term of the project. The QA

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consulting firm will serve as an independent, objective consultant for the project. The QA contractor will consult with the DSHS Project Manager in managing project risks and expectations and will assist in the evaluation of deliverables. CMS requires that a periodic Detailed Implementation Schedule report be submitted. The successful Vendor will be required to generate status reporting materials that may be easily used to assist the MMIS ReProcurement Project manager in generating Oversight/Stakeholder Reports. For an overview of the stakeholders to this project, see the Stakeholder Management Plan in the Procurement Library, described below in Section 6.2.4. The successful Vendor may be required to generate status materials and attend additional meetings with oversight/stakeholders upon the request of the DSHS Project Manager. The Bidder’s proposal must: 1. 2. Agree that the successful Vendor will cooperate with internal and external oversight to this project whenever necessary in the State’s opinion. Commit Bidder to attend additional, albeit infrequent, Oversight/Stakeholder management meetings at DSHS’ request.

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