DOH13-052 ADAP Program Management Software Application -Questions and Answers-

Question #1: We are a little unsure of the exact structure of the Reply Format. Can you please confirm that the Reply should contain the following?:

One original version of the Title Page that has been completed and signed

One original version of Attachment B signed and dated

A sealed packet containing one original and seven paper copies and one electronic version (PDF copy on CD) of the Technical Reply that addresses the Goals, Services and Tasks as outlined in Section 3.0 of the ITN

A sealed packet containing one original copy of the Cost Reply (Attachment A) completed and signed

A sealed packet containing one paper and one electronic version (PDF copy on CD) of a redacted copy of the entire Reply (Title Page, Attachment B, Technical Reply and Cost Reply) if Vendor wishes to submit one

Answer #1:

One original version of the Title Page that has been completed and signed

One original version of Attachment B signed and dated

A sealed packet containing one original and seven paper copies and one electronic version (PDF copy on CD) of the Technical Reply that addresses the Goals, Services and Tasks as outlined in Section 3.0 of the ITN

A sealed packet containing one original copy of the Cost Reply (Attachment A) completed and signed

Question #2: Is more than one copy of the Title Page and/or Attachment B required? Answer #2: yes Question #3: Are the Title Page and Attachment B to be included in the Technical Reply sealed packet or submitted separately? Answer #3: separately Question #4: Are Attachments C, D and E not required to be returned as part of the Reply? Answer #4: yes

Question #5: Page 14, second paragraph of Section 5.6 references Vendor Diversity Expenditure

Report as Attachment B and states that Vendors do not have to return Attachment B with their

Reply. Is this a typo and should it be referenced as Attachment C in all places in this section?

Answer #5: yes

Question #6: Page 20, Attachment A, Cost Reply. What is the preferred structural formatting? Should the detailed narrative of Estimated Costs and Line Item Budget for the project be typed into Attachment A

and precede the vendor information/signature section? Or should the vendor information/execution section precede the narrative of Estimated Costs and Line Item Budget? Answer #6: The latter would be preferred. Question #7: Will all payments made to the Vendor under this contract be subject to the 1% transaction fee documented in PUR1000 point 14? Answer #7: yes Question #8: Will vendor be required to submit Invoices electronically through the Ariba Supplier Network for this contract as outlined in PUR1000 point 15? Answer #8: yes Question #9: Does the department have existing data that will need to be imported into the application? If so, is it digital or paper format? Answer #9: yes; both Question #10: Will this application integrate with CAREWare or replace it? Answer #10: The goal is to interface with CAREWare. Question #11: Will ADAP require a HIPAA compliant hosting solution for the finished application? Answer #11: yes Question #12: Will the system process the entered enrollment data and determine eligibility in an automated fashion? Answer #12: yes Question #13: Just to be clear, the solution should include web-based forms to allow applicants to complete the application process on-line, as well as the ability to upload completed qualification documentation? Answer #13: yes Question #14: Does the current system have a stakeholder notification component? Answer #14: yes

Question #15: Does the current system generate reports? If so, what types of reports? Answer #15: See Section 3.3(F); Reporting requirements include but they are not limited to HRSA’s requirements on client-level data, the National Monitoring Standards, demographics, prescription dispensing information. https://careacttarget.org/category/topics/adap-data-report-adr Question #16: Does the State have specific reporting requirements? If so, what are they? Answer #16: See Section 3.3(F); Reporting requirements include but they are not limited to HRSA’s requirements on client-level data, the National Monitoring Standards, demographics, prescription dispensing information. https://careacttarget.org/category/topics/adap-data-report-adr Question #17: Can the State provide information about the PBM system, e.g., underlying technology? Answer #17: The current PBM system is maintained by CVS Question #18: Is there an estimate of the total number of users and the high water mark of concurrent users? Answer #18: There are currently 240 users, approximately 25,000 eligible clients and an unknown number of new applicants. Question #19: Please describe the Technical Architecture for the TPL and PBM systems, including database and front end; Answer #19: This information is not available through this office. Question #20: Will the state provide production and test servers at their datacenter? Answer #20: yes Question #21: Is the state looking for a hosted solution? Answer #21: This has not been determined at this time. The vendor should propose a solution with and without this feature. Question #22: Are there existing logical data models for the legacy system and process models for the interactions of the proposed system with the TPL and PBM systems? Answer #22: No; However the proposed solution must be able to interface with third party providers Question #23: How many database tables are included in the legacy system? Answer #23: Approximately 100

Question #24: Please confirm that services to be provided under this contract are only related to the Florida ADAP and that no services are required to support other programs like the Premium Plus Insurance Program, Ryan White Part B Consortia or the State Housing Opportunities Program for Persons with AIDS. If not, please specify the programs to be supported and the functions required for each. Answer #24: Florida ADAP provides services to uninsured and the insured in the Premium Plus Insurance Program.

Question #25: To what extent is the ADAP Program Management Software Application expected to replace some or all of the CAREWare Application functions in place and used by the Department today? Answer #25: The ADAP application is a separate and distinct customized software system.

Question #26: Who will use the ADAP Program Management Software and for what purpose? Please specify the users types and the functions that they will be expected to be able to perform using the software. Answer #26: Users will be DOH employees, clients and providers Question #27: The ITN specifies that applicants will use the system to submit applications and

upload program qualification documentation. Are there additional functions expected to be

performed by applicants/clients when using the web portal?

Answer #27: To be determined during negotiations

Question #28: Is it the intent of the Department to streamline the eligibility processing function to

any extent? For example, will the vendor be responsible for performing the initial review of the

submitted application and program qualification documents for completeness before moving the application forward for an eligibility determination?

Answer #28: It is expected that an automated review process for the completeness of document submission will be included in the proposed solution.

Question #29: Please clarify the functions to be provided by the ADAP Program Management

Software Application and support services to be provided by the vendor. Examples of possible

functions and support services are provided below.

a. Mailroom functions for receipt of paper or FAX applications and program qualification

documentation and mailing of letters, notices, informational material

b. Handle undelivered mail or mail returned with a forwarding address based on state defined

procedures

c. Receive, image, and store paper applications and program qualification documentation and link

images to applicant/client record

d. Data enter application information received on paper or FAX

e. Enable upload and linking of documents to the applicant/client record by eligibility staff and

applicants via web-based application f. Generate missing information letters and track and manage missing information requests and

trigger events required to respond to the receipt of missing information and a lack of a timely

response

g. Generate decision notices

h. Maintain images of letters/notices sent to applicant/client and associate them to the applicant/client

record

i. Provide automated workflow required to manage the application and eligibility determination

process

j. Track status of client applications from start to completion

k. Limit ability to view and/or work application information by role of user and user relationship to

applicant/client

l. Provide ability to escalate tasks based on key dates or when specific conditions are met

m. Identify clients up for redetermination and initiate the redetermination process

n. Track application processing timeliness and escalate applications to a supervisor or other specialty

queue if timely processing is at risk

o. Limit viewing of applicant/client data by data type and user type and relationship of user to

applicant/client

p. Helpdesk services for applicants and other users of the system.

q. Appointment scheduling and schedule management by agency staff

r. Program reporting

Answer #29:

a. yes

b. yes

c. yes

d. yes

e. yes

f. yes

g. yes

h. yes

i. yes

j. yes

k. yes

l. yes

m. yes

n. yes

o. yes

p. yes

q. yes

r. yes Question #30: Please specify the type of data to be entered for each application? For example, is it

expected that all information from the ADAP application and the Eligibility Staff Assessment Worksheet will be entered?

Answer #30: It is expected that the proposed solution will include all currently used data from the ADAP application

Question #31: Is it expected that additional information will be entered as a result of the eligibility

determination process to enable automated support to track missing information, render a preliminary eligibility decision or to provide additional data required for program reporting?

Answer #31: yes

Question #32: Is it anticipated that the vendor's system will generate an eligibility decision based on

information entered and confirmed by eligibility staff or is the determination strictly made manually

by eligibility staff based on their review of the application data and the program qualification documentation?

Answer #32: The former is anticipated.

Question #33: Is the system required to track and manage events related to limited time eligibility

decisions? For example, is the system required to identify clients with limited time eligibility

decisions and generate tasks to be completed by eligibility staff and escalate tasks that are not

completed timely or place the client's eligibility at risk if not completed by a specific date? Is it a

system requirement to close eligibility at the end of the limited time eligibility period and generate

required notices? Answer #33: yes

Question #34: Please define the vendor's responsibility for initial and ongoing trainings of DOH and

other users of the system. Please indicate whether the vendor is responsible for training all users or

for training the trainers. In addition, please indicate the extent to which training will need to occur

outside of the Tallahassee area. Please estimate the number of users to be trained by the vendor

during system implementation and the number of users to be trained annually or when changes are

implemented that impacts the user experience.

Answer #34: To be determined at negotiation

Question #35: Please provide more information regarding the need to track pharmaceutical

transactions with the PBM, TPL Administrator, and other entities? We envision that there will be a

need to obtain other insurance information that is resident in the PBM or with other TPL services

through the use of data matching and data sharing via file transfers or web services so that this

information can be used to collect other insurance information that may impact eligibility and ADAP

payments. If this is correct, what is the expected method and frequency for these data transfers? Is it

necessary for the system to track ADAP expenses or other data and to provide this data to the PBM?

If do, please describe the source of the ADAP expenses and/or other data to be shared with the PBM,

the purpose for providing the data to the PBM, and the general business rules to be applied to this

process. Please provide additional information regarding the need to "track pharmaceutical

transactions." Please provide the type of transactions to be tracked, the source of the transactions, the

purpose of tracking them, and the general business rules to be applied to this process. Is it also

expected that the ADAP Program Management software solution will provide any other data to the

PBM or other entities? If so, please specify the type of data to be provided and the entities expected

to receive the data as well as the frequency of data provision.

Answer #35: The proposed solution should include the ability to track pharmaceutical transactions for clients in an industry standard secure manner.

Question #36: Please provide the following:

a. Number of users

b. Location of users

c. Days and hours of system operation

d. Helpdesk hours of operation

e. Anticipated number of letters/documents to be generated and mailed by the vendor by type of

letter/document Answer #36:

a. more than 20,000 including clients

b. statewide

c. 24x7x365

d. 8am to 6pm EST e. To be determined

Question #37: Is the system required to route applications received via the web portal to specific agencies? If so, what are the criteria for routing applications?

Answer #37: no

Question #38: Is the vendor responsible for the cost of postage for letter/documents mailed to clients?

Will postage costs be a pass-through to the DOH? If not, how should the vendor address postage

costs in its response?

Answer #38: To be negotiated

Question #39: Please provide examples and documentation of existing reports that will need to be

provided by the ADAP Program Management software solution

Answer #39: See Section 3.3(F); Reporting requirements include but they are not limited to HRSA’s requirements on client-level data, the National Monitoring Standards, demographics, prescription dispensing information. https://careacttarget.org/category/topics/adap-data-report-adr

Question #40: Is the Department able to specify its implementation budget and annual operating

budget for the services required by the ITN?

Answer #40: No

Question #41: Does the Department have a specific date by which the system needs to be

operational?

Answer #41: It is anticipated that the proposed solution will be implemented statewide by Fall 2014

Question #42: Please provide a description of the Department's team that will work with the vendor

during system implementation.

Answer #42: The implementation team has not been determined at this time.

Question #43: Will stakeholders and or users external to the Department be represented on the

Department's implementation team or available for requirements definition?

Answer #43: The implementation team has not been determined at this time.

Question #44: Please indicate the maximum points possible for total Reply submission in Section

6.3, Evaluation Criteria, page 17.

Answer #44: See Section 6.3.1 on page 18

Question #45: Please provide the methodology to be used to score the compare the Cost Reply.

Answer #45: The methodology will include costs but does not make cost the determining factor in the selection

Question #46: Will highest technical reply be the only vendor subject to negotiations?

Answer #46: No

Question #47: How will significant variation in costs be addressed?

Answer #47: To be determined

Question #48: Please specify how the vendor is to present costs in the Cost Reply. For example, does

the Department require a cost for implementation separately from operations? Does the Department

require costs to be presented only for the one-year term of the contract or is it expected that the

vendor will provide costs for subsequent renewal years available in the contract? What is the role of

the 67 county health departments in providing program information, receiving and/or processing

applications, determining eligibility, handling inquiries, developing reports, etc.? Answer #48: See Attachment A – Cost Reply

Question #49: Page 1, Paragraph 1.1 Statement of Purpose

“Florida ADAP currently utilizes an internally developed application to access data maintained on a

Microsoft SQL Server 2005 Enterprise Edition server; this application is also accessed by the county

health departments through the Department’s secured internal network.”

1. Is it the intention of the Department to continue to use the Microsoft SQL Server 2005 Enterprise

Server for storage of data and generating database-based reporting and the Department’s existing

network for connectivity?

2. How will a client access the secured network to submit applications and information?

3. Does the Department desire a secure web-based means for applicants to connect to that server, or

is it preferable for the new applicant to access, update and store data in that server without having

the applicant access the server directly?

Answer #49:

1. no; MS SQL 2008 is the preferred platform

2. via web

3. a secure web-based solution is expected.

Question #50: Page 7, Paragraph 3.1 Program Goals

The goal of this Invitation to Negotiate (ITN) is to acquire a web-based software system that will allow

Florida ADAP to centralize its program qualification documentation and achieve a paperless application

option.

1. How many users will need to access the system at the same time for completing applications or

for updating documentation?

2. Will applicants have access to personal computers, document scanners, tablet PCs, or smart

phones for scanning qualification documentation?

3. Are signed copies of applications or other documentation desired?

4. Has the Department defined a step-by-step workflow process for receiving, processing and

approving the applications?

5. Does the Department have a defined document archiving solution for storage of the finished

applications, or will the database in Paragraph 1.1 continue to be used?

This paperless option must comply with federal and state laws, regarding protection of private health

information in a way that is streamlined, cost-effective, and provides ease of access.

The successful respondent must demonstrate expertise, technical knowledge, and the ability to ensure this

new web-based software system allows ADAP to be the payer of last resort.

6. What criteria must be met to be the payer of last resort, and how can ADAP be allowed to be that

payer?

Answer #50:

1. See response to Question 18

2. Unknown

3. yes

4. the currently defined process is manual

5. yes – See DOHP 250.2

6. To be discussed at negotiations

Question #51: 3.2 Scope of Services

The web-based software system will allow Florida ADAP to centralize its program qualification

documentation and achieve a paperless application process. The system must have functionalities to track

pharmaceutical transactions with all PBM, TPL Administrator, and other entities working with the Florida

ADAP. The database or module must integrate linkage with TPL and PBM services and have the ability to

track client applications from start to completion. The system must have an encryption security

component to secure the web-based feature for gathering eligibility information.

3.3 Tasks

The successful respondent is solely responsible for the satisfactory performance of the tasks described in

this program. By execution of the resulting procurement, the successful respondent recognizes its singular

responsibility for the tasks, activities, and deliverables and warrants that it has fully informed itself of all

relevant factors affecting accomplishment of the tasks, activities, and deliverables and agrees to be fully

accountable for the performance thereof.

Replies shall demonstrate how the respondent will complete the following required tasks under Contract.

1. Is the Department interested in purchasing products and services under Florida State Term

Contracts (if available), or is this intended to only be

At the minimum, the established software system must have the capacity to:

A) Enable applicants to electronically submit all required ADAP qualification documentation and upload

attachments.

2. How will applicants get access to the network and to the necessary equipment to upload any

necessary attachments?

3. Are live signatures required for forms and attachments?

B) Notify ADAP clients of critical program information such as recertification, electronically or by mail

in a secure manner.

4. Will clients be a user of the system?

5. Are reports available from the current database to trigger the need for outbound documents?

C) Comply with all applicable provisions of the state and federal laws relating to the confidentiality of

client information.

6. We provide a secure database as a part of our solution, and can use MS SQL is preferred. What

is the Department’s preference?

D) Provide a multilingual web-based interface for clients at the appropriate literacy levels in English,

Spanish, and Haitian Creole as well as access for persons with disabilities.

7. What access is needed for persons with disabilities? Text-to-speech? Speech input? Braille

printouts?

E) Track pharmaceutical transactions in coordination with PBM and TPL services and other entities

working with the Florida ADAP to ensure it is always the payer of last resort.

8. How is the tracking of the pharmaceutical transactions being done now? Are drugs being

dispensed by the state pharmacy on Highway 20, and will those transactions require tracking?

F) Track and report client-level data and provide comprehensive reporting that enables Florida ADAP to

manage resources, monitor and evaluate the program, and meet State and Federal reporting requirements.

9. What are the reporting requirements at present? What components of reports are needed to

continue into the future system?

G) Encrypt and secure eligibility enrollment information gathered through a web-based component.

10. Does the Department require encryption and security that exceed HTTPS level of security? If

so, what levels of encryption are required?

Answer #51:

1. yes

2. via web

3. no

4. yes

5. yes

6. Respondent to propose

7. Respondent to propose

8. Through ADAP and Pharmacy software; yes

9. See Question 18

10. Respondent to propose