TARRANT COUNTY PURCHASING DEPARTMENT

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JACK BEACHAM, C.P.M., A.P.P. PURCHASING AGENT TARRANT COUNTY PURCHASING DEPARTMENT JUNE 11, 2015 ROB COX, C.P.M., A.P.P. ASSISTANT PURCHASING AGENT RFP FOR CLOUD-BASED ELECTRONIC HEALTH RECORDS SYSTEM 1. On Page 9 of RFP 2015-144, it is mentioned that Clear Health is a Meaningful Use certified EMR with core components. Could you clarify if the new system has a mandatory requirement of the same certification? If "yes" to my question 'a' then is the certification is mandatory as part of evaluation or could be certified after the Vendor is chosen? System should already be MU certified and should maintain MU certification. 2. Based on the location of implementation, do you have any preference for a location of cloud platform to be located for the application to be hosted? Continental United States only. 3. Is there any conference call bridge number for person who would like to attend this pre-proposal conference remotely? 4. Will Tarrant County post the sign-in sheet? No, but the names of companies and Tarrant County departments will be posted. 5. Tarrant County has system you are using now. Do you want to get off that system or just put it in a cloud? RFP is for a cloud-based Electronic Health Record System. TARRANT COUNTY ADMINISTRATION BUILDING, SUITE 303 100 E. WEATHERFORD, FORT WORTH TEXAS 76196 817-884-1414, 817-884-2629 (FAX)

6. Does the exiting provider (ClearHealth) offer a cloud-based solution? 7. Is Tarrant County open to a customized COTS solution or do you want an off-the-shelf system with pre-built modules? Refer to the specifications in the RFP. 8. Is a solution built on the salesforce.com platform viable to Tarrant County? Tarrant County will evaluate any solution to the standard of the specification of the RFP. 9. Can Tarrant County extend the deadline for the proposal due date? See Addendum 1. 10. Will Tarrant County be able to use the system if all modules are not certified as Meaningful Use? 11. Will Tarrant County be able to use the system if all modules do not have an ICD-10 Implementation Plan? 12. Is Tarrant County having issues or are there limitations with Clear Health? RFP is for Cloud-based EHR which is not our current installation. PAGE 2 OF Q&R

13. Will this solution replace Clear House or fill in gaps? RFP is for Cloud-based EHR which is not our current installation. 14. What is the decision making/award timeline? It is not known at this time. 15. Page 9-SOW-Ait is stated that you have 350 health professionals; and further on you state you have 3-5 Medical Providers; 30+RN/LVNs, 115 Admins, etc. Can you provide a number of clinical providers who deliver patient care and will be using the system? Current utilization is four (4) full time Medical Providers (two (2) MDs, two (2) Nurse Practitioners), Two (2) part time Medical Provider (MD) and thirty (30) + RNs and LVNs. 16. How many clinical providers will work more than 2 days per week? Four (4). 17. How many clinical providers will work less than or equal to 2 days per week? Two (2). 18. With 6 public health centers and 20 WIC clinics...how many facilities are involved in this procurement? How many providers per facility in regards to question 16 and question 17? Main campus houses majority of providers, one (1) remote clinic facility has provider scheduled periodically. 19. On page 24, after the warning sign, there is a section for "Company is." Is this part of the previous proposal signature page? Or is this expected to be a separate page or section? It is a continuation of the Proposal Signature page. PAGE 3 OF Q&R

20. Page 10 Overview, B7-extensive reporting capabilities. Can you please elaborate on any special reporting requirements? Not at this time. Report requirements change and can be very detailed. 21. Attachment B-Question 1.s. Must have a mobile platform capability. Can you please explain further your requirements for "mobile" technology? Currently tablets, ideally should have a Windows, ios and Android compatibility. 22. Attachment B-1.r. Record correction, redaction and locking...when you talk about redaction-do you require a way to black out a word/sentence/paragraph? Strike through and black out options are needed. 23. Do you want a single database linking all facilities: 24. Will you require interfaces to specific medical devices? If so, which ones? Interface with Swiss Ray X-ray machine is desired. 25. Are you interested in Population Health? 26. Please explain your requirements for Billing. Is billing strictly for out-patient? Billing is currently restricted to out-patient clinical services. It will focus on but not be limited to the following insurance carriers: Traditional Medicaid, Medicare, BCBSTX, various Medicaid MCOs, private and commercial group insurance plans. PAGE 4 OF Q&R

27. Do you have a go-live date that you are looking to meet? 28. Do you have an IT staff? 29. Do you have any specific training requirements For users, none beyond normal system training. Possibly extended training for the administrator. 30. Can we include attachments to accompany this RFP that describe in more detail the processes and services offered? Tarrant County expects a thorough RFP response that addresses the topics of the Statement of Work and Attachments. 31. What is the total number of unique persons at TCPH that will appear as the rendering provider on electronic claims (i.e. loop 2310B)? Six (6) Providers. 32. Is TCPH able to provide a list of the provider NPI, organizational NPI, taxaonomy code and contracted payer identification number for each unique person counted in question 31? Yes, the NPI, TPI and taxonomy information will be provided to the winning bidder. 33. What is the vendor, system and version for the TCPH LIMS system? Unknown at this time. PAGE 5 OF Q&R

34. What is the approximate timeframe for implementation of the TCPH LIMS Unknown at this time 35. Can the item Technical 7D (Enable electronic date interchange (EDI)) be elaborated upon further? Electronic billing capability. 36. What are the anticipated use cases for connection with the Sandlot HIE? Unknown at this time. 37. Can the word "compatible" be explained in more detail regarding item 2f: Must be compatible with national claims processing Clearing houses such as: Navicure, Availity, Apex EDI, Emdeon, Claim MD, Zirmed, and Claimremedi. Ability to utilize any national clearing house for all electronic claim processing. 38. Attachment B: 'Must interface with Tarrant County Public Health Laboratory Information System (TCPHLIMS), Quest, LabCorp, ARUP and other external laboratory systems. Must interface with internal (Swiss Ray) and external Radiological systems integrating X-rays and mammograms into patient record.' Do they wish to electronically send orders and receive results or just receive results? We wish to electronically send orders and receive results if possible. 39. When they say they must interface with NTSP and State HIE's-do they wish to export CCDs or do they wish to both import and export CCDs from the HIEs? Also do they expect to receive more than CCDs? Example: lab or rad results of the CCD or hospital documentation (documents) outside of the CCD? The exact description of information exchange with HIE s is unknown at this time. PAGE 6 OF Q&R

40. Please provide a breakdown of the 350 users in terms of how many of those users in terms of functional role within the organization. Please note which of these users will provide services which will be billed for and billed under their own license. Current active users are one hundred forty (140). There are four (4) full time Medical Providers (two (2) MDs, two (2) Nurse Practitioners), two (2) part time Medical Provider (MD s). The remaining are RNs, LVNs and administrative staff 41. Will Tarrant County make specifications documents available to the successful vendor for each interface requested in the RFP? 42. There is a line for the Vendor name on the cover page of the RFP. Are we required to fill this in and submit the cover page? 43. Is fax the only way we can communicate with the County for this RFP? Please see RFP. 44. Should we provide a Certificate of Insurance with our RFP response? Respondents should provide evidence of insurability and ability to meet the insurance requirements. All insurance requirements would be required to be met prior to start of service. 45. Are we required to submit a signed copy of the County Business Associate Agreement (Attachment D)? No, not with the RFP response. It would be required of the awarded vendor. PAGE 7 OF Q&R

46. Regarding the Required Forms section, since our company does not qualify as a DBA or HUB business, those particular forms/certificates would not be applicable to us. Would that be correct, and if not, what should we submit for those items? If you do not qualify as a DBA or HUB, please mark N/A on the form and return with your response. 47. Can you please confirm the number of users currently utilizing the system? One hundred forty (140). 48. With regard to the RFP question about Qualifications, you ask us to include resumes, licenses and certification of management and staff that will operate/manager the services provided to the County". Can you specify which Netsmart employees you are specifically referring to i.e., Support, Implementation, Executive Management? Those members of the vendor s staff who will be directly managing, implementing or supporting this RFP 49. Would the County consider an extension of the proposal due date? See Addendum 1. 50. Can you tell us if the Proposal Signature Form consists of two pages, 23 and 24? If not, what is the form on page 24? Yes, page 24 is the continuation of the Proposal Signature Form on page 23. 51. Is the page with the question on page 14, Section VII.D considered a separate form, and if so should it be submitted as such? Or would you prefer our answer to be placed elsewhere in the proposal response? This page should be submitted as a form. PAGE 8 OF Q&R

52. Please elaborate on Page 11.IV.G and H. PCI/DSS is an actionable framework for developing a robust payment card data security process -- including prevention, detection and appropriate reaction to security incidents. SOC1 and SOC2 Compliance includes but is not limited to the provisioning of internal control reports on the services provided by a service organization to assess and address the risks associated with an outsourced services. 53. Please describe the conversion of data or access of data that will be required from the old to the new system? We do not want to lose accumulated data, particularly on clients with continuing care. How that can be accomplished is open to discussion and proposal. 54. Please clarify when the certificate of insurance is due: with the proposal, before award, or prior to start of work? See response to question 44. PAGE 9 OF Q&R