Information System Proposal

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Information System Proposal Powered By Docstoc
					                Request For Proposal
                                for a
Behavioral Health Information System




                         July 27, 2001
                                                                                      Page
                                                                                     Number
Section I. Background Information
               The Santa Clara Valley Health & Hospital System (County)                   I-1
               The Mental Health / Alcohol and Drug Services                              I-2
               The Current Billing Information System                                     I-5
               Purpose of the Request for Proposal                                        I-6
               The Current Information Systems Environment                                I-8

Section II. Evaluation Criteria and Proposal Selection
               Criteria for Evaluation                                                    II-1
               Proposal Selection                                                         II-3
               Contract Issues and Negotiations                                           II-4
               Protest Procedures                                                         II-8

Section III. Submission Requirements
               Due Date, Return Addresses, Number of Copies                              III-1
               Key Event Dates                                                           III-2
               Questions Regarding the Submission                                        III-3

Section IV. Response Requirements
               Format For Response                                                        IV-1
               Cover Page and Board Letter of Authorization                               IV-2
               Executive Summary and Proposed System Overview                             IV-2
               Business Offering                                                          IV-2
                   Subsection One --General Description of the Vendor                     IV-2
                   Subsection Two -- Overview and Status of Proposed Application          IV-3
                   Subsection Three -- Hardware, Interfaces, and Operating Environment    IV-4
                   Subsection Four --Implementation Support Services                      IV-9
                   Subsection Five -- Ongoing Support Services                            IV-10
                   Subsection Six -- Client References                                    IV-12
                   Subsection Seven -- Cost Summaries                                     IV-13
               Support Documents and Miscellaneous Marketing Literature                   IV-16
Section V. Functional Requirements (provided and to be responded to electronically)


Section VI. Forms


Exhibit I – Current SCVHHS (County) Network Environment

Exhibit II – County Mental Health/Alcohol and Drug Operational Statistics

Exhibit III – County Mental Health/Alcohol & Drug Current Interface Summary

Exhibit IV – Indemnification and Insurance examples

Exhibit V – Local Preference Policy

Exhibit VI – County Contracting Principles

Attachment A1 – RFP Proposal Cover Page

Attachment A2 – RFP Checklist
    SECTION I
BACKGROUND INFORMATION
I.         Background

Santa Clara Valley Health & Hospital System (County)

The Santa Clara Valley Health and Hospital System (County) is comprised of:

          The Valley Medical Center (VMC)
          Public Health Department (PH)
          Alcohol and Drug Department (DADS)
          Mental Health (MH)
          Children's Shelter and Custody Health Service (CSCHS)
          Valley Health Plan (VHP)
          Community Outreach Programs

The following three County entities are pertinent to this Request for Proposal (RFP):

          Valley Medical Center (VMC) is an acute care public teaching hospital affiliated with
           Stanford University Medical School. VMC provides a full range of inpatient, emergency
           and outpatient services. Inpatient services include medical/surgical care and such special
           services as spinal and head injury acute rehabilitation, neonatal intensive care, high-risk
           maternity care, pediatrics intensive care, burn intensive care, and inpatient psychiatric
           services.

           SCVMC Statistics (for FY 1999-2000)
              Inpatient Days                  97,356
              Psychiatric Inpatient Days       1,701
              Emergency Visits                60,814
              Clinic Visits                  472,386

          Alcohol and Drug Department Services (DADS) is responsible for the development,
           implementation, coordination and evaluation of a continuum of alcohol and drug
           programs. With 77 locations across the County, these programs include preventive
           services, criminal justice services, treatment and recovery, family services and women‟s
           treatment services.

          Mental Health provides a broad range of mental health services through over 100
           County and contract operated program located throughout the County. Over 19,000
           children, adults, and older adults receive specialty mental health services, which range
           from early intervention, crisis intervention, outpatient, day treatment, crisis and
           transitional residential, 24-hour acute hospital, and long-term state hospital care.


Santa Clara Valley Health & Hospital System
Request for Proposal
July 27, 2001
b4d50d5f-8a2c-4b97-84db-aa9b370e63e7.doc           I-1
I.         Background

The Mental Health / Alcohol and Drug Services

Mental Health Department

The Mental Health Department of the Santa Clara Valley Health & Hospital System provides
services for County residents experiencing mental illness and/or serious emotional disturbance
through an array of County-operated and contracted programs. Together, these programs
(ranging from case management to long term hospital care) create Systems of Care for clients of
all ages. Services are provided in several languages by staff skilled at using the individual‟s
culture as a foundation for service delivery.

Systems of Care

The Mental Health Department is committed to providing a continuum of care for individuals
experiencing serious emotional disturbance and mental illness. These Systems of Care contain
specialized services developed for three age groups: 1) children, adolescents, and their families;
2) adults; and 3) older adults.

Family & Children’s Services

The Family and Children's System of Care offers a continuum of services to families and
children experiencing mental illness. Services include outpatient care, with specialized programs
for youth incarcerated within Juvenile Hall and the Ranches, and programs specific to the unique
needs of children and adolescents placed in the County Children‟s Shelter. In addition to clinic
and school-based treatment, the Department offers services for children and adolescents who
meet Special education eligibility criteria and are entitled for services under Special Education
AB 3632 legislation (Chapter 26.5 of the Government Code).

Outpatient services are provided by a network of County and contract agencies located
throughout the County. The Mental Health Clinic at Juvenile Hall provides crisis evaluation,
medication and brief treatment to incarcerated youth and youth placed in the Ranch programs on
a 24-hour/day basis. Specialized Services to Juvenile Probation Youth in outpatient programs
serve the needs of mentally ill juvenile offenders with serious emotional disturbances via
intensive case management and clinical outpatient services. The Children’s Shelter program
provides mental health crisis, medication, and brief treatment services to children and youth in
temporary custody. School-based services consist of intensive outpatient services located on
school sites, providing over 1300 hours per week of direct service time. Wraparound Services
are provided for youth at risk of or returning from out-of-home placement in mental health
institutions, allowing them to remain in their natural home or foster home with services
“wrapped” around the child and family. School Day Treatment Programs located in both public
and non-public school settings are open to special education students in need of mental health
treatment. Residential Day Treatment Services (RCL-14) are provided to seriously emotionally
disturbed youth placed in group homes. Inpatient services are provided through contracts with

Santa Clara Valley Health & Hospital System
Request for Proposal
July 27, 2001
b4d50d5f-8a2c-4b97-84db-aa9b370e63e7.doc        I-2
I.         Background

private hospitals in the bay area region. A new Community Treatment Facility (CTF) provides
contained residential treatment for severely disturbed youth.

Adult and Older Adult Services

 The Adult and Older Adult System of Care offers outpatient Service Teams, with special teams
for mentally ill young adults, homeless individuals, and special ethnic populations. The
residential continuum of care includes crisis residential services, supported board and care,
Institutes of Mental Disease (IMD) and state hospitalization services for those requiring long
term psychiatric care in a locked facility. Inpatient services are provided through Acute
Psychiatric Services of Valley Medical Center.

Clients identified as seriously mentally ill (SMI) are geographically assigned to Service Teams
that serve as the single point of responsibility for these clients. Service Teams provide outpatient
mental health services such as crisis intervention; individual, group, and family therapy;
assessments, evaluations, medication support services, rehabilitation; and case management and
money management services. A Young Adult Transition Team has been developed to aid SMI
young adults between the age of 18 and 24 with the stresses of coping with the responsibilities of
life in an adult world. Vocational Services are provided to the mentally ill to rehabilitate them to
learn job skills necessary to obtain gainful employment. Day Treatment Services are designed
to maintain the individual in a community setting and to serve clients at risk of psychiatric
hospitalization. Supported Housing programs provide long-term transitional affordable housing
options to SMI individuals and the Shelter Plus and Homeless Shelter programs serve to provide
shelter housing and link individuals with service providers to obtain permanent housing, and to
aid mentally ill homeless persons to transition off the streets and into assisted housing. Adult
Jail Services provides outpatient and inpatient mental health services to both men and women at
the Main Jail and at the Elmwood facility. The Custody Intensive Alternatives Program (IAP)
diverts non-violent mentally ill adults away from jail custody.

Emergency Psychiatric Services offers emergency psychiatric evaluation and short-term (up to
23-hour) crisis stabilization services to individuals experiencing acute psychiatric episodes who
are gravely disabled or pose a threat to themselves or to others. Acute Psychiatric services are
available at Barbara Aarons Pavilion for those requiring hospitalization beyond the 23-hour
stabilization period. Both of these programs are provided through Valley Medical Center. Crisis
residential and Transitional residential services provide rehabilitation services in non-
institutional settings to individuals at risk of hospitalization. Institutions for Mental Disease
(IMDs) programs provide locked skilled nursing care for clients requiring a longer-term program
to regain stability. All clients in IMDs are placed under conservatorship, and their progress is
followed by Service Teams. State Hospital placement is reserved for individuals displaying
such severe symptoms of mental illness that they are unmanageable in locked IMDs.
Neurobehavioral programs serve those who are disabled due to a brain injury, particularly those
whose needs cannot be managed effectively in a conventional skilled nursing facility.


Santa Clara Valley Health & Hospital System
Request for Proposal
July 27, 2001
b4d50d5f-8a2c-4b97-84db-aa9b370e63e7.doc        I-3
I.         Background

Crisis, Outreach, Referral, & Education Services (C.O.R.E.) The CORE Division serves as the
entry point for the mental health system. It also manages the entry to the Department of Drug &
Alcohol Services. In addition, the CORE division is responsible for mobile crisis, telephone
crisis support, and emergency response to disasters and critical incidents in the community.

The Mental Health Call Center and Authorization Unit provides phone response in three
languages (English, Spanish, Vietnamese) 24 hours per day, and receives roughly 10,000 calls
per year from members of the community, referring providers, health plans, and County
agencies. The Call Center provides mental health information and community service referrals,
screens for financial eligibility of Medi-Cal recipients, verifies client services information,
determines urgency of mental health need and provides linkage to appropriate mental health
services. Suicide & Crisis Services operates a 24-hour telephone crisis line and suicide
prevention service, staffed with almost 100 highly trained volunteers, and is privately funded
through a generous grant from the Morrison Trust. The Mobile Mental Health Team is a
collaborative effort between San Jose Police Department and the Mental Health Department
designed to provide crisis intervention response to police requests in targeted areas within San
Jose, in order to provide linkage to services for clients at high risk of incarceration due to mental
illness. Gateway is the point of entry into the Department of Alcohol and Drug‟s system of care,
and provides telephone screening and service authorization, as well as information and referral
services.

The Crisis Management Program component of the CORE Division provides critical incident
debriefings and coordinates the Mental Health response to disasters and emergencies in the
community, as well as providing training, consultation, and support to the Department‟s Refugee
Mental Health Program.

The CORE Division also supervises the team of mental health staff who provide services to the
Drug Treatment and Dual Diagnosis Treatment Court. The Division provides mental health
services to CalWORKS participants and represents the Department in the CalWORKS Health
Alliance, a collaboration of health, substance abuse, social services and mental health providers
that service CalWORKS families.


Alcohol and Drug Department Services (DADS)

The Santa Clara Valley Health and Hospital System Department of Alcohol and Drug Services
offers substance abuse prevention and treatment services to County residents. In fiscal year
1999-2000, substance abuse treatment for adults, children, adolescents, families and special
populations such as HIV-positive persons, and individuals with both mental health and substance
abuse problems, was provided for nearly 9,000 adult and youth clients through a network of
service providers.



Santa Clara Valley Health & Hospital System
Request for Proposal
July 27, 2001
b4d50d5f-8a2c-4b97-84db-aa9b370e63e7.doc         I-4
I.         Background

The Adult System of Care (ASC) is by far the largest component of DADS treatment services,
with children and adolescent services comprising a proportionately smaller part of system.
Typically, adult clients enter the ASC through Gateway, which serves as the principal entry point
into the County's substance abuse treatment network. Gateway conducts preliminary screening
and places clients into appropriate treatment modalities matched to the level of care they require.
DADS also offers behavioral health services to County employees including substance abuse
counseling through the Employee Assistance Program.

Treatment modalities include detoxification services, narcotics replacement (formerly known as
Methadone services), outpatient, and perinatal and residential services. Pregnant women and
recent mothers who require substance abuse treatment are referred to the perinatal program,
which offers intensive outpatient treatment for women. The ASC contracts with different
facilities in the County for the provision of services. Payment for services is based on client‟s
ability to pay, and a number of providers accept Medi-Cal clients. DADS also offers support
services for recovering substance abuse clients to facilitate their reintegration
into the family, the workplace and the community. Ancillary services include testing and
counseling for HIV-positive substance abuse clients, parenting skills classes, family counseling,
crisis counseling, transitional housing and job skills training for its recovering clients. As many
clients also suffer from mental illness, DADS expanded its dual diagnosis capability by adding
psychiatric services and case managers.

The Children, Adolescent and Families (CAF) division currently offers school-based care for
children and adolescents. CAF provides assessment, intervention and treatment services at
participating schools, Children‟s Shelter and Juvenile Hall. Adolescents referred for drug or
alcohol counseling or brief treatment by self, family, school, mental health services, social
services, police or probation have access to treatment through community-based organizations,
licensed practitioners and contracted private agencies in North and South County.

Together, the Mental Health Department and the Department of Alcohol & Drug Services
(DADS) recognize the need for increasingly integrated collaborative, culturally competent dual
diagnosis services. The two Departments have begun partnering to provide integrated
collaborative services in the following programs: CalWORKs Community Health Alliance, Drug
Treatment Court, integrated service team pilots via the Dual Diagnosis Collaborative, the
Intensive Alternatives Program, and the Catalyst Committee. It is recognized that these are
promising programs with planned growth and enhancement expected as positive outcomes are
achieved.



The Current Mental Health /Alcohol and Drug Services Clinical and Billing
Information System



Santa Clara Valley Health & Hospital System
Request for Proposal
July 27, 2001
b4d50d5f-8a2c-4b97-84db-aa9b370e63e7.doc        I-5
I.         Background

The Mental Health/Alcohol and Drug Services Department‟s current service and billing system,
INSYST, does not adequately support the business and clinical needs that have become more
sophisticated in recent years. Current needs that can not be met include the following:

           Inability to adequately coordinate patient care between different providers.
           Inability to offer Electronic Client Records (electronic charting).
           Inability to comply with new HIPAA (Health Insurance Portability and Accountability
            Act) EDI, Security, and individual Privacy provisions.
           Inability to utilize one system for both Managed Care and Short-Doyle clients.
           Inability to capture medication data, preventing the program from medication
            monitoring on a real-time basis.
           Inability to easily complete financial reporting and analysis of actual cost of service
            delivery, Incurred But Not Reported (IBNR) calculations, payments received, and other
            accounting requirements.
           Inability to interface with other County systems.

The Systems Office has growing concerns that the older VAX/Rdb technology used in the
INSYST system is weakening and quickly becoming obsolete. Technical obsolescence is
causing many problems including the following:

           Unacceptable downtime.
           Difficulty accessing data for analytical reports.
           Scarcity of adequate technical support with VAX/Rdb expertise.
           General system integrity and user confidence degradation.



Purpose of the Request for Proposal (RFP)

For the noted reasons, an INSYST system review with movement to newer technology was noted
in the recent SCVHHS (County) IT Strategic Plan document prepared by an outside healthcare
consulting firm. The Board of Supervisors of Santa Clara County requested that proposals for a
replacement behavioral health information system to evaluate the current vendor marketplace for
the best possible technical and business solution.

The goal of this project is to find and implement a superior service and billing system for the
Mental Health/Alcohol and Drug Departments. County is interested in improving the services
provided to its clients with the application of state of the art information technology to support its

Santa Clara Valley Health & Hospital System
Request for Proposal
July 27, 2001
b4d50d5f-8a2c-4b97-84db-aa9b370e63e7.doc            I-6
I.         Background

clinical, financial, and operational strategies. Specific areas that County desires to improve
include the following:

           A system based on open technology standards that will allow integration and visibility
            of client data across processes and systems of care.
           Integration and visibility of client data is tightly controlled by security mechanisms and
            services to conform with client confidentiality requirements and County policy.
           A stable and easy to support computing platform solution.
           An Electronic Client Record (ECR) to enable a „capture once-share often‟ model of
            client clinical, demographic, and financial information across processes, providers, and
            treatment modalities.
           Real-time medication management to reduce adverse drug events, and to increase client
            compliance.
           Support of HIPAA mandated EDI, data security, and individual privacy provisions.
           The ability to capture numerous cost and payment rates.
           The ability to report 'Incurred But Not Reported' calculations, actual payments received
            as compared to expected payments, and other financial accounting and revenue
            enhancement capabilities.

A steering committee has been formed to provide leadership, guidance, and definition of
business requirements for the replacement of the current INSYST system. The steering
committee is comprised of broad representation from the Mental Health/Alcohol and Drug
Services including clinical, finance, operations, and information technology expertise.

The Health Care Consulting Group of Kurt Salmon Associates (KSA) has been engaged to assist
and support County in this effort to select and plan for the implementation of a replacement
behavioral health information system. This Request for Proposal is the first deliverable of the
steering committee and encapsulates the requirements that County desires in a replacement
service and billing information system for the Departments of Mental Health/Alcohol and Drug
Services.

Specifically, the following are the applications County is seeking for current acquisition:

    PATIENT/CLIENT MANAGEMENT
      Preadmission
      Registration
      Admission, Discharge, Transfer, Medical Records Index
      Enterprise Master Patient Index
      Census reporting
Santa Clara Valley Health & Hospital System
Request for Proposal
July 27, 2001
b4d50d5f-8a2c-4b97-84db-aa9b370e63e7.doc            I-7
I.         Background

      Medical Records
      Online Client Eligibility

    PATIENT ACCOUNTING
      Grants Management
      Financial Analysis / Entitlement / Patient Financial Information
      Patient Accounting
      Payer Contract Management
      Cost Accounting

    MANAGED CARE OPERATIONS
      Member Enrollment / Eligibility
      Authorizations / Referral Tracking
      Provider Contract Management and Negotiation Support
      Provider Relations
      Access Management: Call Logs / Client Contacts

    CLINICAL OPERATIONS
      Electronic Medical Record
      Behavioral Health Assessment / Outcome Measurement
      Behavioral Health Treatment Plans and Notes
      Order Entry Management
      Clinical Decision Support
      Resource Scheduling
      Quality Assurance and Follow up
      EPrescriptions
      Clinician Access View
      Incident Reporting
      Clinical Pathways and Guidelines

    GENERAL SYSTEM FUNCTIONS
      Multientity
      Security mechanisms and services
      Interface Engine
      Screen builder
      User Report Generator
      Intranet / Extranet user access

County currently uses the Diamond system for Managed Care Operations. County is very
interested in a single vendor and information technology solution for the above functionality.
The ideal product or products will provide the functionality implied by the application/module

Santa Clara Valley Health & Hospital System
Request for Proposal
July 27, 2001
b4d50d5f-8a2c-4b97-84db-aa9b370e63e7.doc       I-8
I.         Background

name in a fully integrated suite or set of products across the two client-care delivery systems.
These products must support the direct interaction of clinician users and provide the ability to
enhance the clinical care process regardless of the point of care within County. Although a
single Vendor approach for core clinical and financial application is highly desired, County will
utilize multiple products and/or Vendors if, and only if, it is determined that a single approach
cannot meet its needs.


The Current Information Systems Environment

To better assist you in providing a proposal for a replacement service and billing information
system, a detailed description of the current information system and technology environment is
provided.

Network

SCVHHS (County) has evolved its single centralized computer network into a standardized,
open architecture, enterprise system operating under multiple platforms with Windows NT as the
primary platform. Multiple platforms include Novell, UNIX & VMS. The standardization
initiative has interconnected several dissimilar and standalone network systems which now
operate on the enterprise network. The Windows NT platform consists of PDC, redundant
BDCs, DHCP, DNS, WINS & RAS servers.

IP address assignment is handled through redundant DHCP (Dynamic Host Control Protocol)
servers, operating on Microsoft Windows NT servers which also support Dynamic Name
Services (DNS), roving user profiles, and central administration, distribution, and enforcement of
desktop configuration. Exhibit I – SCVHHS Network Environment depicts the current network
environment.



Data Communications


The communications infrastructure has also evolved from a flat Ethernet WAN to a switched
Ethernet and ATM topology. The router and switch group is CISCO standardized and its main
core is composed of fiber-linked CISCO 5000 series. Its current electronic capacity bandwidth is
estimated to be 6 GB per second. The SCVHHS backbone infrastructure is fiber optic-based
(collapsed backbone) with Category 5 twisted pair standard to the desktop. The bandwidth
supply to the desktops is 10/100 MB per second to each segment. Three firewalls connect the
enterprise network to Santa Clara County, State of California, and Siemens. The network
supports fiber links to 20 campus buildings and communications links to 81 remote sites via T-1,
Digital and Analog circuits. It provides access to 45 different systems. The network also supports
Ethernet-based automated monitoring and diagnostic systems.
Santa Clara Valley Health & Hospital System
Request for Proposal
July 27, 2001
b4d50d5f-8a2c-4b97-84db-aa9b370e63e7.doc       I-9
I.         Background


The infrastructure direction is to move to a fully switched edge device environment supporting
VLANs. Connectivity between switched edged devices and the core matrix is generally 1000
Mbps duplex links with a design goal of no more than 48 edge devices per 1000 Mbps link.
Further enhancing the throughput of the network will be the movement toward VLAN-based
broadcast domains restricted to no more than 15 switches supporting a maximum of 229 devices,
thereby enabling the use of eight-bit networks.
Part of the planning for the future is to move to a pure IP-based (Internet Protocol) network using
EIGRP (a proprietary Cisco) for routing. To the extent that Novell fileservers remain in use
across the health system, IPX routed via RIP/EIGRP will be utilized. The other protocols
currently in use (DEC-LAT, DECNET, and PCSI/AFCP) will be retired and the excessively
bridged networks currently in existence will be gradually eliminated. The ability to retire these
protocols and eliminate the excess bridging is dependent upon the replacement of many of the
existing information systems with systems to be acquired from Siemens and thus will entail work
over several years.

Dual/Redundant T1s typically support remote Clinics. Networks at clinics vary but can house
older "Shared 10" equipment. T1 usage is monitored and additional T1s are added as needed.
Some "priority queuing" is also used to manage telecommunications circuit bandwidth.
The County charter has strict regulations on dial-in and WAN connections from non-County
Networks. Special precautions would need to be taken for connectivity to any vendor networks,
including the implementation of County approved firewall and access control systems to isolate
and protect the SCVHHS and County networks.
A potential separation might include the following (a specific solution would need to be
reviewed and approved as required by County regulations):

          Dual PIX firewalls between the Siemens and SCVHHS Networks
          Dual PIX firewalls between the SCVHHS and County Networks (Replacing current
           router based ACLS)
          CITRIX Array for full function Dial-in
          SKEY and CRYPTOCARD for central dial-in authentication
          SecureID for standalone dial-in.
          Outgoing modem, fax and ISDN functions to be 100% server/router based pools. NAT
           (Network Address Translation) will be used in some applications as security and also
           resource pools.

The purpose of the County strategy of using a centralized, enterprise network system is to reduce
cost, eliminate redundancy, increase productivity, provide cost-effective access to information,

Santa Clara Valley Health & Hospital System
Request for Proposal
July 27, 2001
b4d50d5f-8a2c-4b97-84db-aa9b370e63e7.doc            I-10
I.         Background

make communication across a distributed healthcare enterprise more accessible, and improve
fault-tolerant methods to store, share, and access information.
Table 1 depicts the current and planned information technology and technical environment
standards supported by the Mental Health/Alcohol and Drug Services. It would be expected that
any potential BHIS technology be able to effectively operate in the current technical
environment as well as be scalable to incorporate emerging technology standards of the Health &
Hospital System, the County and the industry.

          TECHNICAL ENVIRONMENT                                CURRENT                FUTURE
               COMPONENT                                      STANDARD               STANDARD
 Backbone Network Topology                                Ethernet 10/100        Ethernet 10/100
 Horizontal Network Topology                              Ethernet 10            Ethernet 10
 Network Operating System                                 Netware 5.0            Netware
 Network Communication Protocols                          TCP/IP, DEC LAT,       TCP/IP, DEC LAT,
                                                          DEC NET                DEC NET
 Data Base Management System Standard                     Oracle                 Oracle
 Server Operating System                                  Windows NT             Windows NT
 Client Operating System                                  Windows NT             Windows 2000
 Desktop Productivity Suite                               Office 97              Office 2000
 E-mail Exchange                                          MS Outlook Exchange MS Outlook Exchange
 Web Browser                                              MS Internet Explorer   MS Internet Explorer
Table 1 - Technical Environment Standards


Table 2 summarizes key aspects of the operational application portfolio that will need to be
integrated with or replace by the new BHIS.

                                              HARDWARE/         DBMS
 APPLICATION                    VENDOR                                               USAGE
                                                 OS            FORMAT
 INSYST (aka                 Echo             DEC VAX         Oracle Rdb    Mental Health client
 OSCAR)                      Management       6630 Open                     demographics, episode and
                                              VMS 7.1                       service tracking, billing,
                                                                            A/R, contract provider
                                                                            claims, and Federal/State
                                                                            reporting



Santa Clara Valley Health & Hospital System
Request for Proposal
July 27, 2001
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I.         Background

                                              HARDWARE/          DBMS
 APPLICATION                    VENDOR                                                 USAGE
                                                 OS             FORMAT
 Diamond 725                 Siemens/SMS      DEC Alpha        BASIS Intl.   Mental health managed care
                                              4100 Unix 4.0    BBx /         billing, authorization,
                                              G                ISAM          provider credentialing,
                                                                             client contact log, and state
                                                                             reporting
 HDX                         Siemens/SMS      RCO Malvern                    Health Data Exchange
                                              PA                             provides real-time access to
                                                                             patients' MediCal
                                                                             beneficiary eligibility
                                                                             information, as well as
                                                                             Medicare and DIAMOND
                                                                             (managed care).
 RX/3000                     Pharmacy         HP/3000                        Public health and outpatient
                             Computer                                        pharmacies. Process
                             System, Inc.                                    prescriptions, patient
                                                                             records, cost/pricing, check
                                                                             drug interactions, bill
                                                                             transactions and
                                                                             management reporting.
 Invision                    Siemens/SMS                                     New – acute care hospital
                                                                             information system,
                                                                             radiology, imaging,
                                                                             interface engine, patient
                                                                             accounting, contract
                                                                             management, and master
                                                                             patient index.
                                                                             Implementation in progress
 General                     Brass/Stars                                     County financial and
 Accounting                                                                  general accounting system
 General                     Lawson                                          SCVHHS (County) general
 Accounting                                                                  ledger functionality
 M4 Methadone                Mallinckrodt / Dell Optiplex      MS Access     Track dispensing and
 Management                  Creative                                        utilization of methadone to
 System v3.25                Socio-Medics                                    clients




Santa Clara Valley Health & Hospital System
Request for Proposal
July 27, 2001
b4d50d5f-8a2c-4b97-84db-aa9b370e63e7.doc                I-12
I.         Background

                                              HARDWARE/          DBMS
 APPLICATION                    VENDOR                                                USAGE
                                                 OS             FORMAT
 Solution Plus               Health           HP Netserver     Progress     Mental Health prescription
                             Business         E-800 Pentium    8.3A         tracking, inventory control,
                             Systems          III HP-UX                     client drug profile,
                                                                            physician prescribing
                                                                            profile, drug interaction
                                                                            reporting, unit dose, third
                                                                            party billing and accounts
                                                                            receivable.
 Appointment                 Internally                        MS Access    Scheduling and tracking of
 Processing                  Developed                                      client appointments
 Computrust                                                                 Client Trust Fund
                                                                            Accounting
 Elite 6.0                   Teleform         IBM, MS          Multiple     Forms collection and
                                              Windows NT       MS Access    scanning for patient
                                                               data bases   instruments
 CarePartner 2.0             PhyCom           Windows NT       MS Access    DADS gateway client
                             Corporation                                    contact tracking system.
                                                                            Automated support for
                                                                            clinical protocols, clinical
                                                                            notes and decision criteria,
                                                                            questionnaires, outcomes
                                                                            tracking and reports
                                                                            generation.
 Cost Reports                N/A              Intel, Windows   Multiple     Contract provider
                                              95               MS Excel     monitoring performed on a
                                                               Worksheets   quarterly basis
 Mental Health               N/A              Intel, Windows   MS Access    Mental health provider
 Human                                        NT                            credentialing
 Resource
 System
 MEDS                        State of                                       California MediCAL
                             California                                     eligibility inquiry and
                                                                            response.
 CROSS                       University of    Intel, DOS       FoxPro       ACHENBACK Scoring
                             Vermont
Table 2 - Operational Application Portfolio




Santa Clara Valley Health & Hospital System
Request for Proposal
July 27, 2001
b4d50d5f-8a2c-4b97-84db-aa9b370e63e7.doc               I-13
I.         Background

Desktop Computer Platform Standard

SCVHHS (County) has standardized its computer platform. This standardization includes as a
minimum: personal computer (PC) hardware, desktop operating system, office application suite,
terminal emulation, and email. The main computer platform is reviewed annually and at times
revised during the course of the year contingent upon technology changes. Deviation from the
standard is considered on a case-by-case basis. The minimum standard for a desktop computer
platform is as follows:

(a)        PC Hardware:
           (1) Minimum:
                  CPU:             500 MHz
                  RAM:             128 MB
                  HDD:             12 GB
                  Monitor:         17‟ SVGA
           (2) Special (as of December 2000)
                  CPU:             700 MHz
                  RAM:             128 MB
                  HDD:             12 GB
                  Monitor:         17‟ SVGA
                  Speakers and Microphones (on some systems)

(b)        Desktop Operating System: Windows NT Workstation 4.0
(c)        Office Suite: Microsoft Office 97
(d)        Browser: Internet Explorer 5.5
(d)        Terminal Emulator:              Rumba
(e)        Email: Outlook/Microsoft Exchange




Santa Clara Valley Health & Hospital System
Request for Proposal
July 27, 2001
b4d50d5f-8a2c-4b97-84db-aa9b370e63e7.doc           I-14
  SECTION II
EVALUATION CRITERIA
       AND
PROPOSAL SELECTION
Criteria for Evaluation and Proposal Selection

County has identified a number of minimum requirements that will be used to evaluate important
elements of every proposal. Proposals from vendors should demonstrate a wide range of
software functionality in their applications. While a high level of functionality is a necessary
component of the proposal, the selected vendor must also represent an acceptable business,
financial, and technical risk and be able to demonstrate a track record of successful
implementations in similar public settings.

       Table 3 details the minimum requirements County will consider essential for any
proposal to be considered further. The satisfaction of these minimal requirements must be
documented in a cover letter (Attachment A-1) accompanying the proposal.



      EVALUATION CRITERIA                             MINIMUM REQUIREMENT

Vendor Profile
A behavioral health/ Alcohol and Drug        Yes
specialty / human services vendor
Public/County operational Sites              5 or more fully implemented County clients
Software Function
Able to support HIPAA EDI compliance         Existence of a HIPAA program with a documented
                                             action plan
Strong support of clinical functionality     50% or greater current availability of required clinical
                                             functionality as detailed in Section VI Functional
                                             Requirements
Strong support of patient management and     75% or greater current availability of required patient
patient accounting functionality             management and patient accounting functionality as
                                             detailed in Section VI Functional Requirements
Vendor Support
Government Medicaid experience               Implementation experience with clients that have a
                                             significant Medicaid client base. Preferably in the
                                             California Medi-Cal environment. Client reference
                                             list with contact information must be provided.
Receptivity to user requirements             Existence of a formal user group. Preferably, a West
                                             Coast and/or California regional user group. Contact
                                             information for the user group chairperson must be
                                             provided.
       EVALUATION CRITERIA                                MINIMUM REQUIREMENT

Reputation for quality implementation support    Customer testimony attesting to the vendors ability to
                                                 implement the proposed system in similar large public
                                                 mental health/alcohol and drug provider
                                                 environments. Client reference list with contact
                                                 information must be provided
Reputation for responsive customer support       Pacific Coast Time customer support hours.
                                                 Preferably a West Coast located support center
System Technology
Able to support HIPAA Security Compliance        Existence of a HIPAA program with a documented action
                                                 plan
Availability to interfacing to desktop          Open integration capabilities with standard Windows
applications                                    based productivity applications including Word,
                                                Excel, and Access
Compatibility to existing and future County      Technology based on an open DBMS standard
Systems
Business Offering
Performance guarantees with penalties           The selected vendor will be expected to propose a
                                                hardware and software solution that enables guaranteed
                                                performance.
                                                The vendor is expected to back its performance
                                                warranties by providing, at no additional cost, all
                                                services and software necessary to achieve the
                                                warranted performance levels.
Acceptance criteria tied to a payment schedule Payment for software, hardware (if applicable), and
                                                services will be made according to milestones as
                                                indicated in Request for Proposal, pg. II-8. Ongoing
                                                software warranty and subsequent maintenance
                                                payment methods will not begin until the software
                                                has been accepted on a module-by-module basis.
Table 3 - Evaluation Criteria Minimum Requirements


A Steering Committee has been formed to provide guidance on the selection of a replacement
information technology solution. Each proposal will be scored on a 100-point scale. While all
aspects of the vendor response will be evaluated, the Steering Committee will evaluate all
proposals using the following criteria. Failure to comply with any part or procedure of the
Request for Proposal may be cause to eliminate a proposal from consideration.
Software Functionality (35 Points)
     Breadth and depth of software functionality for mental health and drug and alcohol
      requirements.
     Adherence to HIPAA EDI standards.
     Quality of software demonstrations.

System Technology (20 Points)
     Use of open and state of the industry system technology standards.
     Ability to support HIPAA Security services and mechanism guidelines.
     Reputation for software stability and reliability.

Vendor Support (18 Points)
     Completeness and proven track record of vendor support for both implementation and
      ongoing support.
     Experience with County and public organizations.

     Receptivity to software user requirements.

Vendor Profile (12 Points)
     The ability of the vendor to serve as a long-term business partner with County.
     Feedback from the vendor supplied client references.
     The RFP responses and adherence to the RFP submission requirements.

Business Offering (10 Points)
     The vendor‟s ability to define and supply the desired business relationship contractually.
     Performance guarantees with penalties.

Local Preference (5 Points)
     When two or more competing vendors are equally qualified, local firms shall be given
      preference (Please refer to Exhibit V).



Proposal Selection
All proposals receiving a total score of 70 points or more will be submitted to the Directors of
the Mental Health and Alcohol and Drug Services departments, and to the SCVHHS CIO for
final consideration. In making the final selection, the Directors and CIO will consider the
selection committee‟s scoring and feedback regarding all aspects of the proposal. False,
unresponsive, or misleading statements made in connection with any application may be
sufficient cause in and of itself to warrant rejection of a proposal. The panel‟s score is but one
consideration in determining whether or not a contract will be awarded to the provider. Contracts
are not automatically awarded to providers simply because they may have received the highest
scoring proposal.
The County reserves the right to repeal or cancel the RFP at any time, to reject any and all
applications, to not award contracts if proposals are inadequate or if contract negotiations are
unsatisfactory, and to waive any informality, technical defect or clerical error in any application,
as the interest of the County may require.

County will not be responsible under any circumstances for any costs incurred by respondents in
the generation and submission of proposals, site visits, presentations, documentation, or
marketing literature. All responses to this Request For Proposal and accompanying
documentation will become the property of County and will not be returned.


Contract Issues and Negotiations
After the County selects the successful vendor(s), the County will enter into contract negotiations
regarding the terms and conditions of the services to be rendered by said provider. Award of the
contract to successful vendor(s) will be conditional upon the negotiation of a contract in
substantial conformity to the County's current boilerplate with changes per negotiation or the
recommendation of the County Counsel's Office.
The resulting agreement(s) may contain various terms and conditions that include but are not
limited to the following.

       A. Satisfaction of evaluation criteria based on the vendor's proposal.
       The entire written proposal and all subsequent updates will be incorporated into the final
       agreement as Attachments. Acceptance of all hardware (when applicable) and software
       modules will be based upon representations made in the proposal.


       B. Liability limitations and insurance demonstrating the vendor's confidence that
           there is a low risk of failure of any part of the project.
       The successful vendor will be expected to meet the indemnification and insurance
       requirements to be determined by the monetary amount of the resulting agreement.
       Evidence that the required insurance has been obtained must be provided to the County
       by the vendor before work under the agreement begins.

       Samples of the various indemnification and insurance provisions that may be included in
       the agreement are set forth in Exhibit IV.
       C. Term of Agreement
   The Agreement will commence upon completion of necessary contract paperwork required
   by the County and continue through the term of the agreement, unless terminated earlier or
   otherwise amended by the County. The Agreement shall be for One (1) year terms, with
   Vendor providing County with new annual rates at least 120 days prior to the end of any
   annual term. Unless either party gives the other party written notice of its intent to terminate
   at the end of the then-current term, at least 90 prior to the end of any term, the Agreement
   shall automatically renew for successive one-year periods, up to three (3) additional years, on
   certain conditions that will be detailed in the contract. Any deficiency noted by the County
   must be addressed or resolved by the provider within thirty days of notification by the
   submission of a corrective action plan or resolution of the deficiency. This period (30 days)
   shall serve as the cure period for this agreement.

D. Termination
   County may terminate this Agreement at any time, either in whole or in part, by giving thirty
   days written notice specifying the effective date and scope of such termination. Vendor may
   terminate this Agreement at any time, either in whole or in part, by giving thirty days written
   notice specifying the effective date and scope of such termination. However, if Vendor
   elects to terminate this Agreement, the County's rights under any pending matter arising from
   Vendor's services hereunder will not be prejudiced due to such termination. Upon date of
   termination, all rights, powers, privileges and authority granted to Vendor under this
   Agreement will cease, and Vendor will have the duties provided below in Section 3b.

        Termination For Cause: County will have the right to terminate this Agreement
        after written notice to Vendor and after the expiration of any cure period
        provided for above in Section K-1, upon the occurrence of any of the following
        events of default:
        a. Failure of Vendor to perform any covenant of obligation set forth in the
           Agreement or any other agreement with the County;

        b. Any attempt by Vendor to assign, delegate or subcontract without County's
           consent as provided herein;

        c. Failure by Vendor to maintain insurance as required under this Agreement;

        d. Filing by or against Vendor of any petition for bankruptcy, any assignment by
           Vendor for the benefit of creditors, the levy of a writ of attachment or
           execution against Vendor's property of the appointment of a receiver for
           Vendor or Vendor‟s property; or, Unauthorized or excessive billing by
           Vendor.




E. Duties Upon Termination
   Upon termination of the Agreement, all finished or unfinished documents, data, assessments,
   reports, project plans and other materials (hereinafter collectively referred to as “materials”)
   prepared by Vendor under this Agreement will become the property of the County and will
           be delivered promptly to the County. Upon receipt of such materials, Vendor will be paid for
           services performed and reimbursable expenses incurred to the date of termination.

       F. Conflict of Interest
          Vendor promises, covenants, and warrants that the performance of its services and provision
          of its products and representation to County under this Agreement will not result in a conflict
          of interest. In the event of a conflict of interest or potential conflict, Vendor must disclose
          such conflict to the County and shall request the County's Board of Supervisors waive such
          conflict on a case-by-case basis.

       G. Nondiscrimination
          Vendor will comply with all applicable federal, state, and local laws and regulations
          including Santa Clara County's policies concerning nondiscrimination and equal opportunity
          in contracting. Such laws include, but are not limited to, the following: Title VII of the Civil
          Rights Act of l964 as amended; Americans with Disabilities Act of l990; The Rehabilitation
          Act of l973 (Sections 503 and 504); California Fair Employment and Housing Act
          (Government Code sections 12900 et seq.); California Labor Code sections 11-1,1102, and
          1102.1. Vendor will not discriminate against any subcontractor, employee or applicant for
          employment because of age, race, color, nation origin, ancestry, religion, sex/gender, sexual
          orientation, mental disability, physical disability, medical condition, political beliefs,
          organization affiliations, or marital status in the recruitment, selection for training, including
          apprenticeship, hiring, employment, utilization, promotion, layoff, rates of pay or other forms
          of compensation. Nor will Vendor discriminate in provision of services and products
          provided under this agreement because of age, race, color, national origin, ancestry, religion,
          sex/gender, sexual orientation, mental disability, physical disability, medical condition,
          political beliefs, organizational affiliations, or marital status.

       H. Governing Law: Venue
          This Agreement will be construed and enforced in accordance with the laws of the State of
          California. Proper venue for legal action regarding this Agreement will be the County of
          Santa Clara.

        I. Relationship of Parties: Independent Contractor
Vendor will perform all work and services described herein as an independent Contractor and not
as an officer, agent, servant or employee of the County. None of the provisions of the
Agreement is intended to create, nor shall be deemed or construed to be in a relationship of joint
venture, partnership or employer-employee. Neither party will have the authority to make any
statements, representation or commitments of any kind on behalf of the other party, or to use the
name of the other party in any publication or advertisements, except with written consent of the
other party or as explicitly provided herein. Vendor will be solely responsible for the acts and
omissions of its officers, agents, employees, contractors and subcontractors, if any. No person
performing the work or services described herein will be considered an officer, agent, servant or
employee of the County, nor will any person be entitled to any benefits available or granted to
employees of the County.

       J. Assignment: Subcontracting
   Vendor is prohibited from: (1) assigning or subcontracting this Agreement; or (2) delegating
   any duties or obligations hereunder in any manner whatsoever, either voluntarily or by
   operation of law, unless County first approves in writing such assignment, subcontract or
   delegation by written instrument executed and approved in the same manner as this
   Agreement. County may give or withhold such approval in its sole and absolute discretion.
   Any purported assignment or subcontract by Vendor in violation of these restrictions will
   confer no rights on any other party and will, at County's sole option, be void.

K. Invoicing and Payment Schedules
   County will be obligated to compensate the Vendor pursuant to the terms and conditions of
   this Agreement only for the performance, to the reasonable satisfaction of the County, of
   those products and services that take place during the term of this Agreement. County will
   not be obligated to compensate Vendor for any work, services, or products performed by
   Vendor which do not arise directly from the performance of tasks and provision of products
   relating to the terms of the agreement.

       Payment for software, hardware (if applicable), and services will be made
       according to milestones as indicated below:

       1. Hardware (if applicable):

             Ten percent at contract signing.
             Ninety percent when the installed hardware passes the manufacturer's
              certification.
             If hardware is provided by the software vendor, County expects that the
              hardware can be returned to that vendor, with a full refund of all hardware
              payments to date, if software acceptance cannot be achieved.

       2. Out-of-pocket expenses as incurred, up to a project cap, which is to be
          negotiated.

       3. Software license and implementation support payments for each module:

             Twenty percent at contract signing.
             Twenty percent upon successful integrated acceptance testing.
             Twenty percent at live date, with live defined as the point at which the
              software is utilized as the primary tool for processing real data.
             The remaining 40 percent will be paid when the system passes final
              acceptance testing as measured against the vendor's response to the RFP
              requirements, system documentation, and custom programming
              specifications.

       Ongoing software warranty and subsequent maintenance payment periods will not
       begin until the software has been accepted on a module-by-module basis.
Protest Procedures
On January 31, 2002, the Department will send letters to applicants advising of the Department
Director‟s and CIO‟s decision. Applicants who have not received a letter by January 31, 2002
may call the Department at (408) 885-6490. Applicants whose proposals are not selected may
file a written appeal no later than February 28, 2002. The written appeal should clearly state the
regulatory, legal or review process violation that is grounds for the appeal or the Board
Principles that have been violated.

Protests must be in writing and should be addressed to:
    Santa Clara Valley Health & Hospital System
    Attention: CIO, Information Systems
    2325 Enborg Lane, Suite 240
    San Jose, CA 95128
After review of the appeal, the CIO will issue a written response. Applicants not satisfied with
the CIO's response may request that their appeal be forwarded to the County Board of
Supervisors.




                   SECTION III
     SUBMISSION REQUIREMENTS
Due Date, Return Addresses and Number of Copies

The vendor must send a letter of intent to bid at the address provided below to Ms. Cheri
Silveira-Moliere. The letter must be received by August 8, 2001. Revised date is
September 10, 2001. Indicate in the letter of intent the following:

      The system(s) that will be proposed.
      The primary contact person will be for all matters related to the proposal.
      A complete listing of all clients using the proposed products to facilitate preliminary
       reference checking logistics.




The vendor must send the Proposal at the address provided below to Ms. Cheri Silveira-Moliere.
To assure that all vendor proposals receive a fair and complete evaluation, County requires that
vendors answer all questions completely without any deviation from the instructions in this RFP.
Proposals that deviate from the required format and content without advance permission from
County will not be considered. The original response, with signatures of corporate officers
binding the firm and indicating concurrence with all aspects of the bid, and five (5) copies must
be received by September 04, 2001 Revised date is 9/24/01 at 12:00 p.m., Pacific Standard
Time.

All letters of intent and proposal packages will be time/date stamped by the County at the
time of receipt. This stamp will serve as the only acceptable evidence to establish whether a
receipt was timely.

Use of the U.S. Mail will be at the prospective provider‟s own risk. Late proposals will not be
considered unless it is determined by the County that the late receipt was due to mishandling by
the County after receipt at the above address. Proposals delivered after this date and time will
not be accepted. Postmarks will not be accepted in lieu of the actual receipt of the proposal
package. No extensions will be given beyond the response deadline.

The delivery point for the five (5) copies and the original will be:

               Ms. Cheri Silveira-Moliere
               Manager Systems Office
               Santa Clara Valley Health and Hospitals System (County)
               2325 Enborg Lane, Suite 240
               San Jose, CA 95128
Key Event Dates
       Request for Proposal Issued – July 27, 2001
       Letter of Intent Due – August 08, 2001 Revised date 9/10/01
       Final date for questions – August 17 , 2001
       Final date for Responses to RFP – September 04, 2001 Revised date 9/24/01
       RFP evaluation – September 04 through September 24, 2001 Revised date 9/25-
        10/19/01
       Reference checking – September/October 2001 Revised October/November 2001
       County onsite presentations and demonstrations – October 2001 Revised November
        2001
       Site visits to operational sites – October/November 2001 Revised
        November/December 2001
       Identification of finalist Vendors – October/November 2001 Revised
        November/December 2001
       Contract negotiation -- November /December 2001 Revised December
        2001/January 2002
       Contract award – January 2001 Revised February 2002

All dates are subject to change as County needs may require.


Adjustments to the proposal package will not be accepted after the proposal deadline,
unless the County determines additional information is needed from prospective contractors to
evaluate the proposals. Such information will be requested within 14 days following the
proposal deadline and must be received within three (3) working days following the date
requested.

Proposal Opening:

Cheri Silveira-Moliere or the Department‟s designee will open and record all proposals in
SCVHHS IS Department, located at 2325 Enborg Lane, Suite 240, San Jose, CA 95128 on
September 04, 2001 at 5:00 P.M Revised 9/24/01 5:00pm PST

Proposals become the property of the County and shall not be returned.

The California Public Records Act set forth in Government Code sections 6250 et seq. governs
access to public records. The act provides that access to information concerning the conduct of
the public‟s business is a fundamental and necessary right of a person in the state. Consequently,
all proposals, attachments, and other materials submitted in response to this RFP shall be
considered public information (except as provided herein) and the exclusive property of the
County. As such, proposals will not be returned to their respective applicants.

(a) In the event the County receives a request for inspection of any Proposals submitted pursuant
    to the RFP following the public release date, it is a responsibility of the organization that
    submitted the proposal to assert confidentiality rights, if any exist. The County is not
    responsible for and will not make objections to disclosure or assert privacy rights on behalf
    of the contractor. Proposal materials will be subject to public inspection absent a judicial
    determination that they are exempt from disclosure. Contractor‟s submission of proposal
    materials shall be deemed a complete waiver of any claims whatsoever against the County
    and its agents, officers and employees that the County has violated any right to privacy,
    disclosed confidential proprietary and or trade secret information or has caused any damage
    by allowing such inspection or disclosure.

(b) Notwithstanding the foregoing, no proposal materials shall be released to the public nor shall
    the public have access to such proposal materials during the RFP process until such time as
    the Board of Supervisors awards the contract. Thereafter, the public will have access to the
    proposal materials, as provided in this RFP.

(c) In the event that any contractor deems any portion of their proposal confidential or
    proprietary or otherwise contains business or trade secrets, then those specific sections must
    be plainly marked as “confidential,” “proprietary,” or “trade secrets.” The County shall
    notify Contractor is disclosure of these materials is sought. It shall be the Contractors
    obligation to seek a protective order. County shall not be liable or in any way responsible for
    the disclosure of any such information including, but not limited to, disclosures required or
    permitted under the California Public Records Act or otherwise by law.


Questions Regarding the Submission

The vendor is encouraged to seek further information and clarification by submitting questions to
Cheri Silveira-Moliere. All questions regarding this submission must be made in writing.
Electronic mail is the preferred medium.

All questions and the respective answers will be shared with competing vendors. The vendor
must pay careful attention to the requirement that it may only contact Cheri Silveira-Moliere at
County during the system selection process. Vendors that are currently doing business with the
institution must limit their contacts to those necessary to support existing operations. Although
the vendor may be referred to other personnel, any vendor that initially contacts other County
personnel in person, in writing, or by telephone, without previous notification and approval, may
be disqualified from consideration.

Questions must be received by August 17 and shall be sent to:

               Mrs. Cheri Silveira-Moliere
               Manager Systems Office
Santa Clara Valley Health and Hospitals System
2325 Enborg Lane
San Jose, CA 95128
Transmissions may be made via email to Cheri.Silveira@hhs.CO.Santa-
Clara.CA.US or FAX to (408) 885-2036
  SECTION IV
RESPONSE REQUIREMENTS
IV. Response Requirements

Format For Response


     The business and technical proposal will consist of three or four sections, assembled in a
     loose-leaf notebook to allow for easier distribution of material. Depending on the size of the
     submission, each section may occupy a separate notebook.

          Section One - Cover Page and Board Letter of Authorization
          Section Two - RFP Checklist
          Section Three – Executive Summary and Proposed System Overview
          Section Four – Business Offering
            Subsection One -- General Description of the Vendor
            Subsection Two -- Overview and Status of Proposed Applications
            Subsection Three-- Hardware, Interfaces, and Operating Environment
            Subsection Four -- Implementation Support Services
            Subsection Five -- Ongoing Support Services
            Subsection Six -- Client References
            Subsection Seven -- Cost Summaries


          Section Five – Functional Offering of Software Applications
          Section Six – Support Documents and Miscellaneous Marketing Literature

Guidelines for preparing each specific section are as follows:

          Each section must have its own table of contents indicating all subsections and page
           numbers.
          Each page must be uniquely numbered within each section at the same location on each
           page.
          Labeled tabs must separate subsections within each section.
          The date of the submission must be placed on each page in the same location, thus
           enabling County to differentiate among the original and updated versions the vendor may
           be asked to provide.
          Unbound sets of forms and functional specifications to be used in the vendor's response
           are enclosed with the RFP. Also forwarded via email to the vendor are electronic
           versions (Word 97 and Excel 97) of the said forms and functional specifications.



Santa Clara Valley Health & Hospital System
Request for Proposal
July 27, 2001
b4d50d5f-8a2c-4b97-84db-aa9b370e63e7.doc          IV-1
IV. Response Requirements
Cover Page and Board Letter of Authorization
     An authorized officer or employee of the organization submitting the proposal must sign all
     proposals. If an administering board or board of directors is required to authorize submission
     of the proposal, a minute order or memorandum shall be attached to the proposal on behalf of
     the organization; otherwise, all members of the governing board for the organization must
     sign the proposal. (Attachment A-1)

RFP Checklist

     A checklist has been included to ensure that all required documents and attachments are
     included. Incomplete proposals will not be reviewed. (Attachment A-2)


Executive Summary and Proposed System Overview

1. Provide a condensed version of the highlights and contents of the proposal. The purpose is to
   provide County with a broad understanding of the entire proposal.

2. Provide an overview of the features and capabilities of the proposed applications and the
   relationships among applications and among product lines.

3. Identify those overall and application-specific features and capabilities that differentiate the
   proposed product(s) from competing products.

4. Describe how you feel the proposed product offering will add value to County.


Business Offering

Please provide a narrative response to all questions, and where requested, complete the
appropriate Form as indicated. Forms are located in Section IV of this document and are also
provided electronically.


  (1)      Subsection One – General Description Of The Vendor

           This subsection describes the vendor's organization and operations, as well as provides a
           brief overview of the product(s) bid.

           A. General Description of the Vendor - Use Form 1. Provide the corporate profile data.


           B. Describe the Vendor's Mission

Santa Clara Valley Health & Hospital System
Request for Proposal
July 27, 2001
b4d50d5f-8a2c-4b97-84db-aa9b370e63e7.doc          IV-2
IV. Response Requirements
           C. Attach the vendor's most recent annual report including audited financial statements.

           D. Description of Subcontractor - Form 2. Complete form if subcontractors are used in
              the context of the proposed products.

           E. Provide an overview of the operating structure of the firm. Define the relationship
              between the parent company and subsidiaries, if applicable. Describe the history of
              recent acquisitions and mergers, if applicable.


(2)        Subsection Two – Overview and Status of Proposed Applications

           This subsection describes and reviews the status of the proposed product applications.
           Responses to detailed functional specifications will be solicited in the Functional
           Requirements section of this RFP. The vendor is required to:

           A. Provide an overview of the features and capabilities of each of the proposed
              applications as well as the relationship and level of integration among applications
              and among product lines.

           B. Product Information - Form 3. Use form to describe product history and system
              release information for each product. Be sure to complete a copy of this form for
              each product family. Include the year each application was generally available to the
              marketplace as well as the number of clients live with the application. (Note that a
              client may have several sites, but should be counted as one “client”.) Also, indicate
              the status of applications in the same product family that are not being bid.

           C. Applications Bid - Form 4. Use form to clarify the names of the vendor's applications
              and corresponding modules being bid, relative to the RFP designations for required
              functions.

           D. Applications Not Bid - Form 5. Use form to indicate the status of applications in the
              same product family that are not being proposed. Use the status designations defined
              below:
                           1. Fully Operational -- Has been in use on a non-test-site (non-pilot,
                              non-alpha, non-beta) basis by at least two clients for at least six months.
                           2. Not Fully Operational -- Currently is under field test or under preliminary
                              internal development.
           E. Describe how the system or each product, if different, stores the century, year, month
              and date.

           F. To allow County to assess the firm's development success, list initially planned and
              actual dates for major development projects for the current and two previous years.
Santa Clara Valley Health & Hospital System
Request for Proposal
July 27, 2001
b4d50d5f-8a2c-4b97-84db-aa9b370e63e7.doc               IV-3
IV. Response Requirements

           G. Identify those overall and application-specific features and capabilities that
              differentiate the proposed product(s) from competing products.

           H. System Architectural Design-Form 6. Use form to indicate the presence (yes) or
              absence (no) of the architectural tools and capabilities listed. Also, indicate whether
              or not each architectural tool is included in the bid. Use the "Notes" column to make
              any comments, notes, or exclusions.

           I. Provide an example of standard screen formats that are representative of the „look-
              and-feel‟ of the application(s). Are the users able to change or modify the screen
              formats? If so, how? What are the tools provided to customize screens?

           J. Identify current and future plans for utilization of each software product on an
              intranet and/or extranet. If applicable, state those applications or products,
              technology, and status (i.e., available, in development, future). Can the user utilize a
              Web Browser front-end to access the system?

           K. Describe additional service offerings that may be relevant or useful to County. For
              instance, does your company offer customer relationship management (CRM)
              solutions for operational client contact management?


  (3)      Subsection Three – Hardware, Interfaces, and Operating Environment
           Specifications

           This subsection reviews the hardware requirements and other technical aspects of the
           system being proposed. Exhibit II provides some key statistics provided by County to
           assist the Vendor in sizing its hardware offering properly. The vendor is required to
           conform to the following guidelines when sizing its proposed solution:

               The total number of recommended peripheral devices (e.g., workstations, net
                computers, hand held devices, printers, microcomputers, modems, and interface
                ports) must be adequate to support the applications proposed based on experience
                with similar clients.
               The recommended server(s) must be of sufficient capacity on delivery to
                accommodate a 25 percent growth in transaction volumes (see current statistics in
                Exhibit II), as well as a 25 percent growth in number of users.
               The disk storage capacity of the system must, upon delivery, be sufficient to
                accommodate 25 percent growth. The vendor should assume an unlimited data
                retention period when determining the amount of disk storage. The vendor should
                also assume three-years of historical client and financial data will need to be migrated
                to the new proposed system environment.
Santa Clara Valley Health & Hospital System
Request for Proposal
July 27, 2001
b4d50d5f-8a2c-4b97-84db-aa9b370e63e7.doc            IV-4
IV. Response Requirements
               Fault-tolerance and full redundancy is a County computing platform requirement.
               Recommended networking requirements to support the system configuration must be
                described. In particular, specify the types of network protocols, network topologies,
                and communication interfaces supported by the system. Please refer to Table 1 of
                Section 1. - Background for specifics of the current SCVHHS (County) network
                infrastructure.
           The vendor must be willing to provide guarantees that the proposed configuration will
           meet the criteria defined above upon delivery.

           A. Describe your system architecture in terms of e.g., client server (two-tier, three tier,
              N-tier). In general, would you describe your system to be decentralized or
              centralized, or a flexible hybrid?

           B. County requires the ability to communicate and share information between systems in
              an open and integrated environment. Describe the system's ability to extract data and
              share with report writing/other applications.

           C. Describe the computing platform architecture that you have proposed. For example,
              is it Massively Parallel Processing (MPP), Symmetrical Multi Processing (SMP), Non
              Uniform Memory Architecture (NUMA), etc.

           D. Attach a comprehensive and detailed parts breakdown (formal quote from the
              hardware manufacturer is preferred) which highlights each component of the
              configuration, unit cost, suggested quantity, total purchase price, unit maintenance
              cost, total maintenance cost, freight and shipping cost, and shipping insurance cost.
              Hardware costs can be summarized in Subsection 7 of Section III – Response
              Requirements. All recommended hardware required to operate the system(s) must be
              included in the configuration, including, but not limited to the following components:
              1. Server platform
              2. Disk Drives
              3. Tape Drives
              4. Jukeboxes
              5. CD-ROM systems
              6. Device Controllers
              7. Printers
              8. Workstations
              9. Bar code or hand held devices
              10. Multiplexors or other Remote Communication Devices
              11. Shipping and Insurance
              12. Freight and Delivery
              13. Hardware Installation
Santa Clara Valley Health & Hospital System
Request for Proposal
July 27, 2001
b4d50d5f-8a2c-4b97-84db-aa9b370e63e7.doc           IV-5
IV. Response Requirements
           E. A schematic that describes the interconnections among components.

           F. Describe your strategy for integrating the proposed computing infrastructure into the
              current County infrastructure.

           G. Based on the configuration and volumes proposed in Part A above, identify the
              guaranteed maximum response time, the measurement period, and the functions
              excluded. At a minimum, the hardware proposal should meet the following
              performance levels:

                1. Response time of two seconds or less for at least 95 percent of all activities during
                   any single hour of the day (excluding downtime).

                2. Response time of five seconds or less for the remaining five percent of all
                   activities.

           H. The system should be available 24 hours per day, seven days per week. Describe the
              reasons the proposed system would not be available to the users. Address the
              following issues related to scheduled downtime and partial system availability:

                1. Delineate which applications are not accessible to the users, and for how long,
                   during nightly and weekly downtime.

                2. Identify other types of processing that restrict or limit user access to the system.

                3. Describe the impact of periodic system updates/back-ups on the availability of the
                   system to the users.

                4. Describe the normal production turnover procedure for the proposed products. Is
                   the system operation interrupted to bring online screens or programs into
                   production? Is system operation interrupted to bring batch programs into
                   production? Is system operation interrupted to make changes in the
                   communications environment?

                5. Please explain the approach utilized to ensure the desired 24 X 7-system
                   availability. Describe any additional hardware and/or software costs required to
                   assure 24 X 7 availability.

           I. Hardware Upgrade Path - Form 7. Use form to describe the upgrade path for the
              hardware configuration included in your proposal. Note that the first column for
              Form 7 should be completed using the configuration proposed that will accommodate
              25 percent growth. The ability to expand the hardware configuration on a field-
              upgradeable basis is of primary concern to County.

Santa Clara Valley Health & Hospital System
Request for Proposal
July 27, 2001
b4d50d5f-8a2c-4b97-84db-aa9b370e63e7.doc            IV-6
IV. Response Requirements
           J. List all specific supported devices including, but not limited to, workstations, wireless
              devices, and network computers. Please provide the following information for each
              device supported.

                1. The recommended configuration including optimal RAM, hard disk space, CD-
                   Rom, etc. If different categories of end-user require a different device
                   configuration, please make that delineation.
                2. What operating systems are compatible to the proposed system?
                3. In proposing recommended devices, is any feature or functionality gained or lost
                   by utilizing one device over another? For example, a network PC over a desktop
                   workstation.
                4. Identify any environmental constraints or requirements of the proposed devices.
                5. What is the maximum number of devices that can be supported by the proposed
                   hardware configuration within the required response time?
              6. What are the system‟s capabilities for downloading and uploading data or reports
                  between PCs and the host computers? How are current clients doing this? Does
                  any third-party software facilitate this? Describe the system‟s ability to download
                  information into a database for comparison against other submitted data.
           K. State the specific reasons for recommending the proposed configuration and
              manufacturers over other available hardware options.

           L. Systems Software - Form 8. Use form to provide a listing of all systems software
              required to run the proposed application(s).

           M. Interface Experience - Form 9. Use form to provide a listing of the other financial
              and clinical systems to which the proposed system has previously been interfaced and
              that are applicable to this RFP. Be sure to include interface experience with the
              following applications (and state experience with the specified vendors, if any):

                1.    General Financials – PeopleSoft
                2.    Siemens Invision – Patient Management / Patient Accounting
                3.    Diamond – Managed Care
                4.    WebMD (previously MEDEAmerica Solution Plus) – Pharmacy
                5.    CompuTrust – Client Trust Fund Accounting
                6.    ePhysician – Prescriptions
                7.    CSM M4 - Methodone Management System
                8.    Echo Management Clinician Desktop - Patient Management / Patient Accounting

           N. Are interfaces custom developed or are they generated using an interface engine? Is
              the interface engine available to County to maintain the interface(s)?



Santa Clara Valley Health & Hospital System
Request for Proposal
July 27, 2001
b4d50d5f-8a2c-4b97-84db-aa9b370e63e7.doc           IV-7
IV. Response Requirements
           O. HIPAA mandates the use of standard transaction sets for a number of healthcare
              electronic data interchanges. Please provide detail information on how the proposed
              system will generate and/or receive the following ANSI ASC X12 4010 transaction
              standards:
              1. Eligibility inquiry/response (270 / 271)
                2. Health Claim Status inquiry / response (276 / 277)
                3. Health care services review - referral certification and authorization (278)
                4. Benefit Enrollment and Maintenance - enrollment/disenrollment in a health plan
                   (834)
                5. Health Claims/COB/Encounters (837)
                6. Claims payment and remittance advice (835)

           P. HIPAA provisions for data confidentiality, integrity, and availability are of critical
              concern to County. Describe the features offered by the proposed system that support
              the following security features:

                1. Controls that restrict access to resources and allow access only to privileged
                   entities using one or more of the following: context based, user based, role based,
                   terminal location, time of day, and emergency access.
                2. Audit control mechanisms to record and examine system access activity.
                3. Entity authentication mechanisms to corroborate that an entity provided access to
                   resources is who it says it claims to be. Possible authentication mechanisms
                   could include but are not limited to the following: biometrics, password,
                   telephone callback, and token system.
                4. Automatic signoff
                5. Data encryption
                6. Digital signature

           Q. Describe your recommended file backup procedures, including time requirements and
              archiving capabilities. Also, describe preventative maintenance for application
              software, systems software, and hardware.

           R. Does the system have the ability to have different business rule preferences per
              practice/location? Please describe how the proposed product could handle multiple
              practices, and the ability to maintain separate, but integrated, databases if requested.

           S. Performance guarantees – System performance is considered to be a critical technical
              issue for a successful implementation of these applications. It is required that the
              selected software and hardware solution perform according to its required
Santa Clara Valley Health & Hospital System
Request for Proposal
July 27, 2001
b4d50d5f-8a2c-4b97-84db-aa9b370e63e7.doc            IV-8
IV. Response Requirements
                specifications. The selected vendor will be expected to propose a hardware and
                software solution that enables guaranteed performance.

                The vendor is expected to back its performance warranties by providing, at no
                additional cost, all services and software necessary to achieve the warranted
                performance levels.


  (4)      Subsection Four – Implementation Support Services

  This subsection details how the vendor plans to assist County to implement the proposed
  application(s). The vendor should include a realistic workplan that minimizes risks and takes
  into account the needs of County.

  All required implementation support and training must be clearly described and associated
  costs included in Subsection Seven. Identify any optional implementation services that are
  available.

           A. Implementation Support Proposed - Form 10. Use form to describe the vendor's
              implementation support proposed.

           B. Provide an overview of the implementation schedule, indicating when each
              application function will become available. Justify the sequencing decision and
              describe other feasible alternatives and the pros and cons of each.

           C. Show a task level implementation plan and indicate for each task:

                1.     Output or result
                2.     Estimated elapsed timeframe
                3.     Estimated County person-hours required by title/role
                4.     Estimated Vendor person-hours required by title
                5.     Interdependencies

           D. Recommended County Staffing Requirements - Form 11. Use form to indicate the
              recommended staff requirements necessary to install and operate the product(s).
              Differentiate between Systems Office and departmental staffing needs.

           E. Implementation Support Description - Form 12. Use form to summarize the
              allocation of vendor-provided support proposed for project management, training, and
              implementation support, by application.

           F. Describe the proposed approach to provide tailoring and design assistance for the
              applications. Such support would include screen design, report design, profile and
              table building, historical data migration, and other options available to County.
Santa Clara Valley Health & Hospital System
Request for Proposal
July 27, 2001
b4d50d5f-8a2c-4b97-84db-aa9b370e63e7.doc             IV-9
IV. Response Requirements

           G. Describe the Vendor‟s role in interface development. In particular, address the
              responsibilities and resources required from County in interface analysis,
              specifications, and testing.

           H. Does your methodology include process improvement? If so, describe the process.
              What is the Vendor‟s responsibility versus County responsibility? Provide examples
              of Vendor‟s role in previous sites where process improvement was performed as part
              of the implementation.

           I. Describe the availability of hardware-related implementation support. Include the
              following services:

                1. Workstation placement and environmental assessment.
                2. Computer room environmental assessment with recommendations for space,
                   power, cooling, and all other necessary environmental considerations.
                3. Installation of hardware in the computer room.
                4. Hardware testing.
                5. Loading and testing of operating system and utilities.

           J. Describe post implementation follow-up activities that will be provided by the
              vendor. Specifically address the following tasks:

                1. Post live system debugging to bring application function into full conformance
                   with documentation, proposal, and modification specifications.
                2. Six-month and 12-month post live operational (non-technical) audits to review
                   County utilization of the software and to provide recommendations for optimizing
                   benefits.

           K. Describe the training materials and user technical documentation and updates
              provided by the vendor.

           L. Describe support provided for system conversion. Identify files commonly converted
              by clients and provide estimated cost of conversion in Subsection Seven.


  (5)      Subsection Five – Ongoing Support Services

  This Subsection details the level of ongoing support provided by the Vendor after
  implementation.

           A. Ongoing Support Description - Form 13. Use form to describe the ongoing system
              support and customer support options offered by the Vendor. The forms provide for
Santa Clara Valley Health & Hospital System
Request for Proposal
July 27, 2001
b4d50d5f-8a2c-4b97-84db-aa9b370e63e7.doc         IV-10
IV. Response Requirements
                descriptions of two distinct levels of support. Form 13 is for Basic support and Form
                13(2) is for a Premium level of support. If more than two support levels are offered,
                add additional copies of the form as needed. Note the level of service at the top of the
                page and respond to the questions accordingly.

           B. Clearly state any other features that distinguish the levels of ongoing support offered
              other than the issues covered on Form 13.

           C. Describe the types of services for each level of support that are covered on a 24-hour
              basis, such as:

                1. User hotline or problem line.

                2. Remote problem diagnostic services.

                3. Software and any Vendor-supplied hardware.

                4. Hardware maintenance services for any Vendor-supplied hardware.

                5. Hardware and software maintenance expected from third parties.

           D. Describe the Vendor's response time to requests for assistance. Indicate the time
              period in which a knowledgeable person will respond to the request for assistance and
              the timeframe in which work will begin to correct the identified system problem.
              Delineate timeframes for different categories of problems (e.g., critical, major, and
              minor) and describe each category. Describe the problem tracking system and
              methodology used.

           E. Describe the Vendor's policies regarding escalation of unresolved support issues to a
              higher level:

           1. What are the Vendor-established criteria for escalation?

           2. What are the timing criteria to escalate?


           3. To what party does this issue escalate?

           4. If satisfaction is still not received, what are the subsequent procedures?

           F. Describe your policies regarding response to changes in federal, California, Santa
              Clara County, JCAHO, HIPAA, and third-party payor regulatory requirements or
              changes in standard industry practices.


Santa Clara Valley Health & Hospital System
Request for Proposal
July 27, 2001
b4d50d5f-8a2c-4b97-84db-aa9b370e63e7.doc           IV-11
IV. Response Requirements
           G. If your software conforms to all California State regulations, provide the names of
              ALL California sites where this is being provided, and state exactly to which “State
              regulations” the software conforms.

     H. Software Change Policy - Form 14. Use form to address issues such as training
        requirements and estimated cost. Using the Vendor's own terminology, identify and
        define each category of enhancement that a client will encounter. For example,
        "Version" (or "Release", "Upgrade", etc.) is defined as a significant rewrite of the
        software. It may require conversion to a new hardware platform or database management
        system and typically includes significant new function”. "Enhancement" is defined as ...
        "Fix " is defined as..., etc.

           I. Does the Vendor provide ongoing modification assistance, and if so, which of the
              following components are included and at what cost?

           1. Specification writing
           2. Coding
           3. Installation and testing

           J. Does the Vendor have active national and regional user groups? If so, describe the
              functions of the user groups and the frequency of their meetings. What kind of
              ongoing educational services are provided? How are these educational services
              accessible (e.g. the web, self-study courses, etc.)?


     (6) Subsection Six – Client References

     This subsection identifies an appropriate subset of the Vendor's client base, which County
     can contact to discuss the product, support, and performance.

           A. Provide a list of all clients utilizing the proposed products.

           B. Provide a list of clients who have deinstalled the proposed products in the last 18
              months.

           C. Client Base Overview - Form 15. Use form to summarize the extent of client
              experience with the system(s) proposed. Of interest is the number of implementation
              sites, number of live operational sites, number of de-installed sites, and the number of
              sites in California.

           D. Client References - Form 16. Use form to list at least ten current clients that are
              utilizing the proposed software and that meet at least one of the criteria listed below.
              Include at least one reference for each criterion.


Santa Clara Valley Health & Hospital System
Request for Proposal
July 27, 2001
b4d50d5f-8a2c-4b97-84db-aa9b370e63e7.doc           IV-12
IV. Response Requirements
           1. Public mental health service providers, preferably operating in the state of California

           2. Public alcohol and drug service providers, preferably operating in the state of
              California

           3. Multientity organizations, with five or more owned and/or contracted provider
              locations.

           E.     Interface History - Form 16(2). Use form to describe interface experience of the
                  client reference sites.


     (7) Subsection Seven – Cost Summaries

     This subsection asks the Vendor is asked to provide a complete description of all one-time
     and ongoing costs associated with the proposal. The cost proposal should be submitted on
     Forms 17 through 23. Costs must be described at the level of detail specified in the forms.
     Please include all costs that will be required to make the proposed application fully
     operational.

           A. Recommended Hardware Costs - Form 17. Use form to specify all hardware costs.
              Costs must be included for each item shown on the schematic developed for your
              response to Subsection Three -- Hardware, Interfaces, and Operating Environment. A
              detailed price quotation from the hardware manufacturer can be substituted for
              Form 17. However, every item must be clearly labeled with its corresponding part
              number, suggested quantity, unit cost, total purchase price, unit annual maintenance,
              and total annual maintenance. For purposes of calculating annual maintenance costs,
              assume that 24-hour, seven-day onsite service is required. If the Vendor or hardware
              manufacturer offers extended maintenance (e.g., a lump sum up-front payment for
              multiple years of hardware support), include this cost as an option.

                All recommended hardware required to operate the system(s) as identified in the
                Vendor's schematic must be included in the pricing proposal, including but not
                limited, to the following:

                1.    CPU
                2.    Disk Drives
                3.    Tape Drives
                4.    Jukeboxes
                5.    CD-ROM systems
                6.    Device Controllers
                7.    Printers
                8.    Workstations
                9.    Bar code or hand held devices
Santa Clara Valley Health & Hospital System
Request for Proposal
July 27, 2001
b4d50d5f-8a2c-4b97-84db-aa9b370e63e7.doc              IV-13
IV. Response Requirements
                10. Cabling
                11. Emulation or Network Cards
                12. Multiplexors or other Remote Communication Devices
                13. Shipping and Insurance
                14. Freight and Delivery
                15. Hardware Installation

                Please note: In the case of desktop devices (e.g. workstations, local printers), the
                Vendors should include a recommendation of total devices required and a per unit
                cost. However, the bid should not include the total cost of purchasing all
                recommended devices.

           B. Provide a description of the hardware warranty included with the initial purchase
              price. Specifically address the following questions in your response:

                1. When does the warranty begin?
                2. What is the duration of the warranty?
                3. Which components of the configuration are covered by this warranty?
                4. Does the warranty cover onsite service or is County required to drop off parts for
                   service?
                5. For which parts are drop-off service required?
                6. What is the guaranteed turnaround time for repairs for both onsite service and
                   drop-off service?

           C. Application Software Costs - Form 18. Use form to describe all costs associated with
              the proposed application software. Pricing should be provided on a
              module-by-module basis. Columns are provided on this form to describe one-time,
              annual, implementation and training costs, which also must be listed by module. In
              addition, license, implementation, and ongoing fees for all custom software must be
              included on this form. Fixed fee proposals that cap implementation fees are required.
              Describe in detail all charges that are included and excluded from the fixed price
              umbrella. During the drafting of the contract, the selected Vendor will be required to
              warrant that all costs are included as described in the proposal.

           D. If the fixed price is tied to assumptions about size or volumes, then these assumptions
              must be stated. Specify price increases or discounts that will occur if County falls
              above or below these assumptions.

           E. If the Vendor offers extended maintenance (e.g., a lump sum up-front payment for
              multiple years of support), include this cost as an option.




Santa Clara Valley Health & Hospital System
Request for Proposal
July 27, 2001
b4d50d5f-8a2c-4b97-84db-aa9b370e63e7.doc           IV-14
IV. Response Requirements
           F. Other Software Costs - Form 19. Use form to identify one-time license fees and
              annual maintenance fees for all pre-requisite system software, including operating
              systems, database management system, utilities, form builders, etc.

           G. Interface Costs - Form 20. Use form to specify costs for providing interfaces to
              external or other foreign systems. You should describe the Direction (one-way or
              two-way), Mode (online or batch) and Type (HL-7, X12, or custom) as well as the
              one-time and annual costs associated with each interface, separately priced. A column
              is provided to describe any additional implementation costs associated with the
              interface. It is expected that the functional interface specifications will be jointly
              developed with the vendor and priced on a fixed or not-to-exceed basis prior to
              contract signing. Refer to Exhibit III-Current Interface Summary for current
              inbound/outbound interfaces that will need to be created.

           H. Conversion Costs - Form 21. Use form to describe data conversion costs. County
              assumes Vendors are responsible for conversion of data from County current file
              format into proposed system format for any conversions proposed. If cost estimates
              are made on any other assumptions please provide detailed information such as:

                1.     What files will be converted from the existing BHIS (i.e., Echo
                       INSYST/OSCAR)?
                2.     What files will be converted from the existing managed care operations
                       information system (i.e., DIAMOND)?
                3.     What are the conversion assumptions?
                4.     Specify Vendor's format for the conversion file

I.           I. Additional Costs - Form 22. Use form to itemize any costs that cannot be placed in
             any of the categories above.

J. Cost Notes and Assumptions - Form 23. Use form to describe any assumptions,
limitations, or clarifications required to understand the proposal.

           K. Workplan including major milestones and identification of the responsible parties.

                It is expected that the proposal will include a list of important implementation
                milestones. Additionally, it is expected that the selected vendor will provide a
                detailed implementation workplan for all phases of the project. This workplan will be
                incorporated in the agreement. Information to be included in the workplan consists of
                the following:

                      1. Detailed activities.

                      2. Responsible parties (both vendor and County).
Santa Clara Valley Health & Hospital System
Request for Proposal
July 27, 2001
b4d50d5f-8a2c-4b97-84db-aa9b370e63e7.doc            IV-15
IV. Response Requirements

                      3. Person-hours required for responsible parties to accomplish each detailed
                         task.

                      4. Elapsed times (i.e., start and completion dates).

           L. Cost Summary - Form 24. Use form to summarize any and all specified costs.
               4.


Support Documents And Miscellaneous Marketing Literature

Include a second section that contains sample standard reports, marketing literature, and other
back-up documentation or optional submissions.




Santa Clara Valley Health & Hospital System
Request for Proposal
July 27, 2001
b4d50d5f-8a2c-4b97-84db-aa9b370e63e7.doc             IV-16
                               SECTION V
      FUNCTIONAL REQUIREMENTS




Santa Clara Valley Health & Hospital System
Request for Proposal
July 27, 2001
b4d50d5f-8a2c-4b97-84db-aa9b370e63e7.doc      IV-17
V. Functional Requirements
The functional specifications included in this Section provide detailed information system
requirements for the application(s) to be acquired. Each requirement has been given a unique
mnemonic and number that will be used for reference purposes. In order to complete this
section, the vendor must respond to each requirement according to the directions below.

In the „Source‟ worksheet, please enter the Vendor‟s name, and each of the application names
and tools/utilities that are being bid and are needed to satisfy each requirement. These are
labeled "A," "B," "C," "D," and "E." For the purpose of clarity, County expects that an
application is a set of features and functions which can be brought live without IS/user/vendor
programming or intervention, only with master file and parameter/profile building. If screen
building, report writing, inquiry writing, or data manipulation coding is to be done by
IS/user/vendor, then a vendor or third-party tool/utility is being utilized.

To complete each functional specification response on Functional Requirements - Form A the
vendor must indicate "STATUS," "SOURCE," and "COMMENTS" as shown below. Each
comment should be succinct and discretely numbered.

                                   STATUS                                 COMMENTS REQUIRED
 NOW                   Available and fully operational in the         Any exclusions.
                       field on a nontest site basis. No user
                       tools/utilities are required to achieve this
                       feature other than the use of the
                       application(s) indicated in the "Source"
                       response.
 SOON                  Available and under field test at a client     Any exclusions. One-time or
                       site. No user tools/utilities are required     ongoing costs incremental to those
                       to achieve this feature other than the use     bid for "A" through "E." Availability
                       of the application(s) in the "Source"          date for code load. Current status.
                       response.




Santa Clara Valley Health & Hospital System
Request for Proposal
July 27, 2001
b4d50d5f-8a2c-4b97-84db-aa9b370e63e7.doc
V. Functional Requirements

                                   STATUS                                 COMMENTS REQUIRED
    FUTURE             This feature or function is not currently      Any exclusions. One-time or
                       available, nor is it in field-testing.         ongoing costs incremental to those
                       However, if client licenses the                bid for "A" through "E." Availability
                       application(s) listed in the "Sources"         date for code load. Current status.
                       response and/or the user tools/utilities
                       specified in the "Source" response, then
                       client will receive it with a future release
                       of the system.
    USER               This feature or function is not standard       Any exclusions. One-time or
    MODIFIES           to the system; however, it is available if     ongoing costs incremental to those
                       the client licenses the application(s)         bid for "A" through "E." Estimated
                       listed in the "Source" response or the         number of hours it would take the
                       user tool/utility specified in the "Source"    vendor to complete, at a fee, if client
                       response is deployed by the client.            were to request this work be done by
                                                                      the vendor.
    CUSTOM             This feature or function is not standard       Any exclusions. One-time or
                       to the system; however, if the client          ongoing costs incremental to those
                       licenses the application(s) listed in the      bid for "A" through "E." Description
                       "Source" response, then the vendor will        of how the work would be done
                       provide the modification. Alternatively,       (tool/utility or source code change).
                       the vendor will make a source code             Availability date for code load.
                       change to provide the function.
    WON'T              This feature or function is not available,     None.
    PROVIDE            in testing, or planned for future
                       development.

The following specifies all functional requirement categories included in Section VI. Each
functional requirement is assigned a mnemonic for future ease of reference.

    PATIENT/CLIENT MANAGEMENT
      Intake / Preadmission / Preregistration (PRE)
      Registration (REG)
      Admission, Discharge, Transfer, Medical Records Index (ADT)
      Enterprise Master Patient Index (MPI)
      Census Report (CEN)
      Medical Records (MED)
      Online Client Eligibility (OCE)




Santa Clara Valley Health & Hospital System
Request for Proposal
July 27, 2001
b4d50d5f-8a2c-4b97-84db-aa9b370e63e7.doc
V. Functional Requirements
    PATIENT ACCOUNTING
      Grants Management (GRM)
      Financial Analysis / Entitlement / PFI (PFI)
      Patient Accounting: Billing / Claims / Remittance processing / A/R (PAM)
      Payer Contract Management and Negotiation Support (PCM)
      Cost Accounting (CAM)

    MANAGED CARE OPERATIONS
      Member Enrollment / Eligibility (MEE)
      Authorizations / Referral Tracking (ART)
      Claims Processing/Adjudication (CPA)
      Provide Contract Management and Negotiation Support (CMN)
      Provider Relations (PRM)
      Access Management: Call Logs / Client Contacts (ACM)

    CLINICAL OPERATIONS
      Electronic Medical Record (EMR)
      Behavioral Health Assessment and Outcomes Measurement (BHA)
      Behavioral Health Treatment Plans and Notes (BHT)
      Order Entry (OEM)
      Clinical Decision Support (CDS)
      Resource Scheduling (RES)
      Quality Assurance and Followup (QAF)
      Clinician Access View (CAV)
      Incident Reporting (INC)
      Clinical Pathways and Guidelines (CLP)
      Eprescriptions (ERX)

    GENERAL SYSTEM FUNCTIONS
      Multientity (MEN)
      Security mechanisms and services (SEC)
      Interface Engine (IEN)
      Screen builder (SCR)
      User Report Generator (URG)
      Intranet / Extranet user access (WEB)




Santa Clara Valley Health & Hospital System
Request for Proposal
July 27, 2001
b4d50d5f-8a2c-4b97-84db-aa9b370e63e7.doc
SECTION VI
   FORMS

				
DOCUMENT INFO
Description: Information System Proposal document sample