Modern Electronic Health Records (EHR) for MDH Healthcare Facilities)

STATE OF MARYLAND MARYLAND DEPARTMENT OF HEALTH (MDH) REQUEST FOR PROPOSALS (RFP) MODERN ELECTRONIC HEALTH RECORDS (EHR) FOR MDH HEALTHCARE FACILITIES MDH/OPASS 21-18251 ISSUE DATE: FEBRUARY 27, 2020 NOTICE TO OFFERORS NOTICE A Prospective Offeror that has received this document from a source other than eMarylandMarketplace (eMMA) https://procurement.maryland.gov should register on eMMA. See Section 4.2. MINORITY BUSINESS ENTERPRISES ARE ENCOURAGED TO RESPOND TO THIS SOLICITATION. Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page ii of 117 VENDOR FEEDBACK FORM To help us improve the quality of State solicitations, and to make our procurement process more responsive and business friendly, please provide comments and suggestions regarding this solicitation. Please return your comments with your response. If you have chosen not

to respond to this solicitation, please email or fax this completed form to the attention of the Procurement Officer (see Key Information Summary Sheet below for contact information). Title: Modern EHR for MDH Healthcare Facilities Solicitation No: MDH/ OPASS-21-18251 1. If you have chosen not to respond to this solicitation, please indicate the reason(s) below:  Other commitments preclude our participation at this time  The subject of the solicitation is not something we ordinarily provide  We are inexperienced in the work/commodities required  Specifications are unclear, too restrictive, etc. (Explain in REMARKS section)  The scope of work is beyond our present capacity  Doing business with the State is simply too complicated. (Explain in REMARKS section)  We cannot be competitive. (Explain in REMARKS section)  Time allotted for completion of the Proposal is insufficient  Start-up time is insufficient  Bonding/Insurance requirements are restrictive (Explain in REMARKS section)  Proposal requirements (other than specifications) are unreasonable or too risky (Explain in REMARKS section)  MBE or VSBE requirements (Explain in REMARKS section)  Prior State of Maryland contract experience was unprofitable or otherwise unsatisfactory. (Explain in REMARKS section)  Payment schedule too slow  Other: __________________________________________________________________ 2. If you have submitted a response to this solicitation, but wish to offer suggestions or express concerns, please use the REMARKS section below. (Attach additional pages as needed.) REMARKS: ____________________________________________________________________________________ ____________________________________________________________________________________ Vendor Name: ________________________________ Date: _______________________ Contact Person: _________________________________ Phone (____) _____ - _________________ Address: ______________________________________________________________________ E-mail Address: ________________________________________________________________ Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page iii of 117 STATE OF MARYLAND MARYLAND DEPARTMENT OF HEALTH (MDH) KEY INFORMATION SUMMARY SHEET Request for Proposals IT - Modern EHR for MDH Healthcare Facilities Solicitation Number: MDH/ OPASS-21-18251 RFP Issue Date: February 27, 2020 RFP Issuing Office: Maryland Department of Health (MDH or the Department) Procurement Officer: Dana Dembrow Office of Procurement and Support Services 201 W. Preston Street, Room 416 Baltimore, MD 21201 e-mail: Office Phone: mdh.solicitationquestions@maryland.gov 410-767-0974 Contract Officer e-mail: Office Phone: Queen Davis Office of Procurement and Support Services 201 W. Preston Street, Room 416 Baltimore, MD 20201 mdh.solicitationquestions@maryland.gov 410-767-5335 Contract Monitor Todd A. Heckman, Program Manager Electronic Health Records Maryland Department of Health todd.heckman@maryland.gov Proposals are to be sent to: Queen Davis Office of Procurement and Support Services Queen.davis@maryland.gov Pre-Proposal Conference: Wednesday, March 18, 2020 at 2:00 PM Local Time 201 W. Preston Street, Conference Room L3, Baltimore, MD 21201 Opportunity to hear objectives and procedures for the RFP; also, to pose questions and make suggestions for the RFP responses and process. See Attachment A for directions and instructions. Remote participation will be enabled via phone conferencing. Questions Due Date and Time Tuesday, March 31, 2020 4:00 PM Local Time mdh.solicitationquestions@maryland.gov Proposal Due (Closing) Date and Time: Friday, April 24, 2020 at 2:00 PM Local Time Offerors are reminded that a completed Feedback Form is requested if a no-bid decision is made (see page iii). Date, time, and location may change at discretion of Procurement Officer MBE Subcontracting Goal: 0% mailto:mdh.solicitationquestions@maryland.gov mailto:mdh.solicitationquestions@maryland.gov mailto:Queen.davis@maryland.gov mailto:mdh.solicitationquestions@maryland.gov Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page iv of 117 VSBE Subcontracting Goal: 0% Contract Type: Firm Fixed Price with T&M Work Orders Contract Duration: 5-year base with 2, one-year option periods Primary Place of Performance: 201 W. Preston Street Baltimore MD 21201 SBR Designation: No Federal Funding: No Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page v of 117 TABLE OF CONTENTS – RFP 1 Minimum Qualifications ...................................................................................................................... 1 2 Contractor Requirements: Scope of Work ........................................................................................ 2 2.1 Summary Statement ..................................................................................................................... 2 2.2 Background and Purpose ............................................................................................................. 2 2.3 Contractor Responsibilities and Tasks ...................................................................................... 12 2.4 Responsibilities and Tasks......................................................................................................... 12 2.5 Functional/ Business Requirements ........................................................................................... 13 2.6 Training ..................................................................................................................................... 13 2.7 Required Project Policies, Guidelines and Methodologies ........................................................ 13 2.8 Deliverables ............................................................................................................................... 15 2.9 Service Level Agreement (SLA) ............................................................................................... 21 3 Contractor Requirements: General .................................................................................................. 22 3.1 Contract Initiation Requirements ............................................................................................... 22 3.2 End of Contract Transition ........................................................................................................ 22 3.3 Invoicing .................................................................................................................................... 23 3.4 Liquidated Damages .................................................................................................................. 25 3.5 Disaster Recovery and Data ...................................................................................................... 25 3.6 Insurance Requirements ............................................................................................................ 26 3.7 Security Requirements ............................................................................................................... 28 3.8 Problem Escalation Procedure ................................................................................................... 34 3.9 SOC 2 Type 2 Audit Report ...................................................................................................... 35 3.10 Experience and Personnel .......................................................................................................... 36 3.11 Substitution of Personnel ........................................................................................................... 38 3.12 Minority Business Enterprise (MBE) Reports ........................................................................... 40 3.13 Veteran Small Business Enterprise (VSBE) Reports ................................................................ 40 3.14 Work Orders .............................................................................................................................. 40 3.15 Additional Clauses ..................................................................................................................... 41 4 Procurement Instructions .................................................................................................................. 42 4.1 Pre-Proposal Conference ........................................................................................................... 42 4.2 eMaryland Marketplace Advantage (eMMA) ........................................................................... 42 4.3 Questions ................................................................................................................................... 42 4.4 Procurement Method ................................................................................................................. 43 Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page vi of 117 4.5 Proposal Due (Closing) Date and Time ..................................................................................... 43 4.6 Multiple or Alternate Proposals ................................................................................................. 43 4.7 Economy of Preparation ............................................................................................................ 43 4.8 Public Information Act Notice .................................................................................................. 43 4.9 Award Basis ............................................................................................................................... 44 4.10 Oral Presentation/Product Demonstrations ............................................................................... 44 4.11 Duration of Proposal .................................................................................................................. 44 4.12 Revisions to the RFP ................................................................................................................. 44 4.13 Cancellations ............................................................................................................................. 44 4.14 Incurred Expenses ..................................................................................................................... 45 4.15 Protest/Disputes ......................................................................................................................... 45 4.16 Offeror Responsibilities ............................................................................................................. 45 4.17 Acceptance of Terms and Conditions ........................................................................................ 45 4.18 Proposal Affidavit ..................................................................................................................... 46 4.19 Contract Affidavit ...................................................................................................................... 46 4.20 Compliance with Laws/Arrearages ........................................................................................... 46 4.21 Verification of Registration and Tax Payment .......................................................................... 46 4.22 False Statements ........................................................................................................................ 46 4.23 Payments by Electronic Funds Transfer .................................................................................... 47 4.24 Prompt Payment Policy ............................................................................................................. 47 4.25 Electronic Procurements Authorized ......................................................................................... 47 4.26 MBE Participation Goal ............................................................................................................ 48 4.27 VSBE Goal ................................................................................................................................ 48 4.28 Living Wage Requirements ....................................................................................................... 48 4.29 Federal Funding Acknowledgement .......................................................................................... 50 4.30 Conflict of Interest Affidavit and Disclosure ............................................................................ 50 4.31 Non-Disclosure Agreement ....................................................................................................... 50 4.32 HIPAA - Business Associate Agreement .................................................................................. 50 4.33 Nonvisual Access ...................................................................................................................... 51 4.34 Mercury and Products That Contain Mercury ........................................................................... 51 4.35 Location of the Performance of Services Disclosure ................................................................ 51 4.36 Department of Human Services (DHS) Hiring Agreement ....................................................... 51 4.37 Small Business Reserve (SBR) Procurement ............................................................................ 51 4.38 Maryland Healthy Working Families Act Requirements .......................................................... 51 Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page vii of 117 5 Proposal Format ................................................................................................................................. 53 5.1 Two Part Submission ................................................................................................................. 53 5.2 Proposal Delivery and Packaging .............................................................................................. 53 5.3 Volume I - Technical Proposal .................................................................................................. 54 5.4 Volume II – Financial Proposal ................................................................................................. 62 6 Evaluation and Selection Process ...................................................................................................... 63 6.1 Evaluation Committee ............................................................................................................... 63 6.2 Technical Proposal Evaluation Criteria ..................................................................................... 63 6.3 Financial Proposal Evaluation Criteria ...................................................................................... 63 6.4 Reciprocal Preference ................................................................................................................ 63 6.5 Selection Procedures.................................................................................................................. 64 6.6 Award Determination ................................................................................................................ 64 6.7 Documents Required upon Notice of Recommendation for Contract Award ........................... 65 7 RFP ATTACHMENTS AND APPENDICES .................................................................................. 66 Attachment A. Pre-Proposal Conference Response Form ................................................................ 69 Attachment B. Financial Proposal Instructions & Form .................................................................. 71 Attachment C. Proposal Affidavit ....................................................................................................... 74 Attachment D. Minority Business Enterprise (MBE) Forms ........................................................... 75 Attachment E. Veteran-Owned Small Business Enterprise (VSBE) Forms ................................... 76 Attachment F. Maryland Living Wage Affidavit of Agreement for Service Contracts ................ 77 Attachment G. Federal Funds Attachments ....................................................................................... 79 Attachment H. Conflict of Interest Affidavit and Disclosure ........................................................... 80 Attachment I. Non-Disclosure Agreement (Contractor) ................................................................. 81 Attachment J. HIPAA Business Associate Agreement ..................................................................... 82 Attachment K. Mercury Affidavit ....................................................................................................... 83 Attachment L. Location of the Performance of Services Disclosure ............................................... 84 Attachment M. Contract ....................................................................................................................... 85 Attachment N. Contract Affidavit .................................................................................................... 100 Attachment O. DHS Hiring Agreement ............................................................................................ 101 Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page viii of 117 Appendix 1. – Abbreviations and Definitions ....................................................................................... 102 Appendix 2. – Offeror Information Sheet ............................................................................................. 106 Appendix 3. – Non-Disclosure Agreement (Offeror) ........................................................................... 107 Appendix 4. – Electronic Health Records SaaS – Functional Requirements .................................... 108 Appendix 5. - Labor Categories ............................................................................................................ 109 Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page 1 of 117 1 Minimum Qualifications There are no minimum qualifications for this RFP. Refer to RFP Section 3.10.1 ‘Offeror Experience’ and RFP Section 3.10.2‘Offeror Preferred Experience’ and for experience and qualifications necessary to be considered reasonably susceptible for award. THE REMAINDER OF THIS PAGE IS INTENTIONALLY LEFT BLANK. Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page 2 of 117 2 Contractor Requirements: Scope of Work 2.1 Summary Statement 2.1.1 The Maryland Department of Health (MDH) is issuing this Request for Proposals (RFP) to procure a multi-tenant, subscription-based SaaS solution for electronic health records (EHR) and revenue-cycle management for twelve (12) healthcare facilities operated by MDH. This system is referred to as the new or modern EHR system for MDH. 2.1.2 The new EHR system will replace the legacy healthcare management information system (HMIS) used for census and billing, as well as a legacy pharmacy system and other clinical systems. The new EHR system will support the admission/discharge/transfer (ADT), billing, collections, pharmacy, laboratory, order entry, clinical documentation, behavioral health, and long-term care (LTC) functions of the facilities. The new EHR system shall be a cloud based hosted solution running in its own instance in a single data base. 2.1.3 An Offeror, either directly or through its subcontractor(s), must be able to provide all goods and services and meet all the requirements requested in this solicitation. The successful Offeror (the Contractor) shall remain responsible for Contract performance regardless of subcontractor participation in the work. 2.1.4 The State does not wish to procure a software application still under development. The SaaS solution shall have been fully operational within the last three years, and must have been in full and complete successful production for at least one (1) year in a behavioral healthcare provider organization with no less than 2,500 employees. 2.2 Background and Purpose 2.2.1 The Department and Health Care Facilities Maryland’s healthcare delivery system consists of public and private hospitals, nursing homes, outpatient clinics, home healthcare services, hospices, providers, and health educators, among others. As a public health department, the goal is to improve the health status of every Maryland resident and to promote access to quality healthcare. MDH is responsible to assist in this mission by regulating healthcare providers, facilities, and organizations, and manage direct services to patients, where appropriate. MDH has four major administrations or divisions: Behavioral Health Administration (BHA), Developmental Disabilities Administration (DDA), Public Health Services Administration (PHS), and Healthcare Financing Administration (HCF or Medicaid or MA). The last writes regulations and provides funding that govern and sustain the MDH facilities, but it does not directly operate any MDH facilities. In addition, the Department has 20 boards that license and regulate healthcare professionals; and various commissions that issue grants and research and make recommendations on issues that affect Maryland’s healthcare delivery system. MDH depends on a staff of more than 6,500 and a budget of more than $14 billion to provide health-related services to Maryland communities. The Behavioral Health Administration (BHA) promotes recovery, resiliency, health, and wellness for individuals who have emotional, substance use, addictive and/or psychiatric disorders. Most admissions (98%) involve patients involved in the criminal justice system (sometimes referred to as forensic patients). Among the BHA functions are: A. The Clinical Services Division, which ensures that an effective comprehensive system of behavioral health services and supports are available and accessible to emerging adults and adults throughout the lifespan in response to the needs of individuals with mental health conditions, substance-related disorders, and the co-occurring of the conditions and disorders. The Division evaluates the network Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page 3 of 117 of services that the BHA funds and has the responsibility for Statewide planning, development, administration and monitoring the comprehensive system of behavior health services of the BHA. The mission of the Division is implemented through the offices of Adult and Specialized Behavioral Health Services, and Quality Assurance; and the State Opioid Treatment Authority. B. The Children’s Services Division is charged with developing a system of care for young people and their families ranging from early childhood all the way through to the time when young people reach the age of majority and legally become adults. The system of care is designed to meet the needs of individuals within this age range who have mental health conditions, substance-related disorders, and those who have both. C. The Office of Judicial Services (OJS) oversees services provided for individuals with mental disorders and developmental/intellectual disabilities who are court-involved. OJS includes four divisions: 1. Adult Pretrial Services - responsible for coordinating mental-competency evaluations ordered by the adult criminal courts of Maryland. 2. Juvenile Pretrial Services - responsible for providing pre-adjudication evaluations for competency to proceed in Juvenile court. Unlike the adult criminal system, Juvenile Pretrial Services does not evaluate for criminal responsibility. Juvenile Pretrial Services oversees competency attainment services and the ongoing re-evaluations of juveniles who have been found incompetent to proceed but attainable. 3. Justice Services-Addictions - charged with monitoring and conducting court ordered evaluations and placing defendants into treatment under court orders. 4. Community Forensic Aftercare Program (CFAP) - responsible for monitoring individuals on signed orders of conditional release in both District and Circuit court in every county in the State of Maryland. D. The Developmental Disabilities Administration (DDA) provides a coordinated service delivery system to ensure appropriate services for individuals with developmental and intellectual disabilities. The DDA provides the following services: 1. Provides services for people with developmental disabilities. 2. Partners with individuals with developmental disabilities and their families to provide leadership and resources to enable these individuals in living fulfilling lives. 3. Is guided by the principle that individuals with developmental disabilities have the right to direct their lives and services. DDA oversees the operation of two State residential centers, the Holly Center in Salisbury and the Potomac Center in Hagerstown. Both State Residential Centers are responsible for the provision of needed services to people who have intellectual disabilities admitted to the facility while working to integrate these people into less restrictive settings in the community. The Secure Evaluation & Therapeutic Treatment (SETT) Program, located in Sykesville, provides evaluation and assessment services, as well as active treatment to people with intellectual disabilities and court involvement within a secure and safe environment. In addition, direct case consultation and assistance is provided to both criminal justice and human services staff regarding people with intellectual disabilities involved with the criminal justice system. The Public Health Services Administration (PHS) oversees nine major units (or bureaus) and 24 local health departments that provide surveillance, prevention, treatment, and regulatory oversight services to all Marylanders. PHS operates two Chronic Care Facilities (CCF), Deer’s Head Center Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page 4 of 117 and Western Maryland Center. These facilities provide comprehensive healthcare and rehabilitation services for the clinically complex patient and resident. The Western Maryland Center’s Specialty Hospital Medical Care Unit is a unique program that bridges the gap between hospital and home. Citizens of Maryland with multi-system and specialized healthcare needs are managed by a dedicated, interdisciplinary team of healthcare professionals that assist the patient in reaching their highest level of independence possible. Patients admitted to the hospital unit, who are ventilator dependent, require frequent intervention, rehabilitation, Peritoneal Dialysis, Total Parenteral Nutrition or special isolation. Any number of diagnosis and co-morbidities are accepted into the Specialty Hospital including but not limited to: Brain Injury Rancho I – II emerging and requiring ventilator management, Spinal Cord Injury, Multiple Trauma, Multiple systems failure, post Coronary Artery Bypass Graft or other open heart surgeries requiring extensive re-stabilization and rehabilitation, Stage III-IV wound management and wound vac, hyperalimentation, and infectious disease management and isolation including negative pressure isolation. MDH also operates five psychiatric hospitals, and two Regional Institute for Children and Adolescent (RICA) facilities. The total average daily census across all facilities is approximately 1,180. The smallest facility population is approximately 32 and the largest is approximately 377. 2.2.2 MDH Facilities A. Clifton T. Perkins Center - Jessup The Perkins Center is a maximum-security psychiatric hospital located in Jessup. Some patients stay for short periods, while others may stay for 20 years or more. Perkins has 298 beds. There are 58 clinical providers (doctors, nurse practitioners, licensed social workers, psychiatrists, etc.) at Perkins. With nurses, the total is 352. Perkins has its own pharmacy and will require access to a pharmacy module. Perkins uses an external laboratory, Quest, and will require an orders/results interface. B. Springfield Hospital Center - Sykesville Springfield Hospital has a campus setting with many buildings and is located in Sykesville. Springfield has 220 beds. There are 24 psychiatrists, 7 somatic physicians, 2 physician assistants, 23 psychologists, 25 social workers, 17 occupational therapists, 1 physical therapist, 163 registered nurses, 88 LPNs, 3 addiction specialists, 3 registered dietitians and 11 medical records staff that will use the new system. The State of Maryland has built a new data center on the grounds of the Springfield Hospital Center. MDH has placed an HMIS backup computer at the new data center. C. Sykesville SETT - Sykesville The Secure Evaluation & Therapeutic Treatment (SETT) Program provides evaluation and assessment services, as well as active treatment to people with intellectual disabilities and court involvement within a secure and safe environment. The Developmental Disabilities Administration (DDA) of MDH operates one SETT unit located on the grounds of Springfield Hospital Center. The SETT has 32 beds and 75 clinical providers. Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page 5 of 117 This unit does not have an in-house pharmacy, but they receive their medications from the Springfield Hospital Center’s pharmacy. D. Spring Grove Hospital Center - Catonsville Spring Grove has a campus setting with many buildings and is located in Catonsville. The facility has several different types of units with different dispensing requirements (unit dosing, 30 day, etc.). Spring Grove is the largest MDH facility, with 353 beds and 24 alternative living units (ALU) beds. There are 600 clinical providers including 450 nurses. Spring Grove has their own internal pharmacy. They use Quest as an external lab. They use TechCare for external radiology. E. Thomas B. Finan Center - Cumberland The Thomas B. Finan Center is located in Cumberland. Finan has 66 beds and 22 ALU beds. There are 130 clinical providers. Finan uses the Western Maryland Hospital Center as an external laboratory. The facility utilizes a system developed in-house (called DPOE, for Direct Physician Order Entry) to allow physicians to enter orders and staff to create/modify/print MARs and other medication forms. This system utilizes Access and is used as a front and back end to the existing pharmacy module used by the other pharmacies. The AIMS pharmacy module is used for dispensing medications. F. Eastern Shore Hospital Center - Cambridge The Eastern Shore Hospital is located in Cambridge and has 64 beds and 16 ALU beds. The facility uses the E-Chart system for patient census data and pharmacy management system. It does not use the AIMS pharmacy module. There are 6 psychiatrists, 1.5 somatic physicians, 1 forensic psychiatrist, 4 psychologists, 6 social works, 83.35 nursing FTEs, 11 rehabilitation staff and 6 medical records staff, who will all access the system. G. Deer’s Head Hospital Center - Salisbury The Deer’s Head Hospital Center is a chronic care facility located in Salisbury and has 80 licensed beds in the chronic care unit, 66 licensed long-term care beds, and services 60 dialysis and 16 PT/OT outpatients each day. There are 38 clinical providers, 150 clinical and direct care staff. Deer’s Head is using the OptimusEHR system from vendor Yardi. Deer’s Head uses an internal laboratory system (SchuyLab) and two external labs: the State of Maryland and Peninsula Regional Medical Center (Epic). They are running the DIAPro dialysis system from Gaia Software, use an external pharmacy (Allied), an external imaging service (Mobilez at Peninsula Regional Medical Center) and the OnDemand dietary system. They also use CMS for reporting SNF, LTCH and quality measures. H. Western Maryland Hospital Center - Hagerstown The Western Maryland Hospital Center is a chronic care facility located in Hagerstown and has 55-60 beds in use but is licensed for 123 beds. The facility provides three types of Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page 6 of 117 services: chronic care, traumatic brain injury and long-term care (for ventilator dependent patients). They are also using the Yardi OptimusEHR system. There are 151 clinical employees that would access the new system. They are using an external pharmacy (Allied) and are running Orchard Software for their internal laboratory. I. Holly Center - Salisbury The Holly Center is a developmental disability center located in Salisbury. Holly has 153 licensed beds but only 53 are occupied. There are 148 staff positions (including 92 direct care assistants, 24 RNs, seven LPNs, five PT/OT/ST, two social workers, one RD, one psychiatrist, one podiatrist, and one psychologist, seven contract professionals, and a nurse agency contract), who will all access the system. There is no existing EHR system, although they are using an Access database for census, in addition to HMIS. They use an external pharmacy (Allied) and an external lab at Peninsula Regional Medical Center, which runs Epic. J. Potomac Center - Salisbury The Potomac Center is a developmental disability center located in Salisbury. Potomac has 63 licensed beds and 95 clinical providers, all those who hold a license: doctor, RN, LPN, CNA, LCSW, Psychiatrist, Psychologist. They have no EHR in use at this time. They are using an external pharmacy (Pharmacare), external laboratories (LabCorp and a local hospital using Meditech Lab). K. RICA - Baltimore The Regional Institute for Children and Adolescents - Baltimore is a mental health residential treatment facility located in the city of Baltimore. The facility has 45 licensed beds but is operating with 34 beds. There are 28 clinical providers, excluding nurses. There are 22 licensed nurses/state employees, 17 unlicensed nursing staff/state employees, and 31 unlicensed nursing staff/contractual employees. They have no EHR in use at this time. They are using an external pharmacy (Allied), and two external laboratories Friends & LabCorp). L. JLG RICA – Rockville The John L. Gildner Regional Institute for Children and Adolescents is a residential, clinical, and educational facility serving children and adolescents with severe emotional disabilities, located in Rockville. The facility is operated in conjunction with the Montgomery County Public School district to provide an academic, behavioral, day and residential treatment program in a highly structured, therapeutically integrated milieu. The facility has 32 beds for residents and there are 75-day treatment children for which there are medical records. There are 41 clinical providers (five of whom are receiving their license & will require co- signature). In addition, there are 30 CAMHAs who access the medical record. They have no EHR in use at this time. They are using an external pharmacy (Allied), and an external laboratory (Quest). Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page 7 of 117 2.2.3 Current Systems: Overview The existing hospital management information system (HMIS) was purchased and implemented in 1987. HMIS originally included only census and billing functions. All MDH facilities use HMIS for census functions, as well as entering diagnoses and patient incidents (e.g., restraints, seclusion). In 1999 a pharmacy module was added. An admit-discharge-transfer (ADT) interface passes patient information from the census module to the pharmacy module. The current system is an electronic health record system used at the two chronic care facilities (Deer’s Head and Western Maryland), in addition to HMIS. It supports census, charting, pharmacy and Minimum Data Set (MDS) collection and submission for long term care. The system allows clinicians to chart by selecting icons from touch screens. The system also supports an electronic Medication Administration Record (eMAR) function. The e-Chart and e-Staff systems are used at the Eastern Shore Hospital Center for census (in addition to HMIS), medication ordering, clinical documentation, patient incident reporting, employee profiles, credentialing and infection control. DIAPro is used at Deer’s Head for clinical documentation for dialysis patients. SchuyLab is a laboratory system used at Deer’s Head for accessioning and processing specimens and reporting results via instrument interfaces. At all facilities except those noted above (Western Maryland, Deer’s Head and Eastern Shore), patient medical records and clinical documentation are not in electronic format and are primarily on paper. 2.2.4 Current Systems: Challenges A. Application Gaps 1. Nearly all functionality required for Promoting Interoperability (Meaningful Use) attestation is unavailable to MDH facilities with paper patient records. 2. None of the electronic health record systems in use are certified for Promoting Interoperability Promoting Interoperability (Meaningful Use). 3. Failure to attest to Promoting Interoperability (Meaningful Use) has resulted in reduced reimbursement from CMS. 4. Facilities using the current EHR and E-Chart/E-Staff systems are the only facilities that have made progress toward the HIMSS electronic health record model. 5. Heavy reliance on paper and manual processes in workflows create an environment with many opportunities for delay and error. B. Access to Information A. Paper records cannot be accessed remotely. On-call physicians must travel to the facility when called. B. Medical record audits must be performed manually with paper records. C. Quality reporting must be performing by manually pulling records and counting. D. There are a limited number of workstations available to physicians, nurses and other clinicians, and MDH will need to assess the expansion of the local network to accommodate additional workstations, as well as the type of workstation (desktop, laptop, tablet). C. Integration Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page 8 of 117 1. The industry standard is “enter once, use many”. 2. Patient information collected at facilities with paper records is re-written on multiple forms. 3. Facilities with Access database applications also require the re-entry of patient information due to a lack of integration among the applications. 4. HMIS is partitioned by facility, so patient information cannot be transferred to another facility when the patient is transferred, requiring large-volume fax transmissions and re- entry of data into HMIS. 5. Some facilities have no fully electronic order entry/results cycle with external pharmacies and labs, requiring: physicians hand write orders, nurses transcribe orders onto forms which are then faxed, followed by phone calls from the pharmacies/labs with questions, and then handwritten medication administration records are used – all disconnected processes that requires staff to monitor attentively. 6. There is no integration with the Maryland health information exchange, CRISP, so patient history, medication, allergies, problems cannot be obtained electronically. 7. There is no integration with county health department systems. 8. There is no integration with the Department of Public Safety and Correctional Services (DPSCD) nor with other county jail systems. 2.2.5 Current Systems: Key Functionality The existing systems, where deployed, support the following high-level processes and reporting: A. Census, including admissions/discharges/transfers (ADT) B. Order entry (and computerized physician order entry at some facilities) C. Pharmacy D. Clinician Documentation (including physicians, nurses, therapists, psychologists and other professionals) E. Laboratory F. Dialysis G. Long Term Care (LTC) H. Billing I. Credentialing J. Infection Control 2.2.6 Current Systems: Census / Billing / Revenue Cycle MDH seeks to increase the scope and quality of the reports and analytics that it generates from the new EHR system. MDH does not, however, currently expect to expand the areas or domains of key functionality for the new EHR system (at least not under the Phase 1 implementation period that is described herein). The following sections summarize the key functionality provided in the areas or domains listed above. Census data are collected and used by the Division of Reimbursements (DOR), program administrations, and hospital administrators. This information is used to invoice third party and private pay payers for services provided in the facilities and for a variety of administrative and management activities ranging from daily patient accounting to Joint Commission (JC) accreditation. The Division’s Financial Agent Offices (located at each State facility) forward billing information on a form (BIF – Billing Information Form) to DOR’s Central Office for processing. The Central Office staff sets up the appropriate billing in the Client Billing Profile and also uses this information to add any retroactive charges or adjustments that need to be made to the automated accounts receivable. Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page 9 of 117 DOR prepares billings for Medicare Part A, Medicare Part B (Ancillary & Physician), Medicaid, Insurance Companies, Sponsors, Hospital Bank and Social Security MDH Payee. Medicare Part A includes billings for Long Term Care Hospital Prospective Payment System (LTCH PPS) for the Chronic Facilities, Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) for the Mental Health Facilities and Skilled Nursing Facility Prospective Payment System (SNF PPS) for the Nursing Homes. These billings are prepared using manual hard copy data received from the State facilities. The claims are sent to Highmark Medicare Services for processing. The charges are entered manually into the Accounts Receivable (A/R) as are all payments received. Medicare Part B includes billings for Ancillary and Physician services. The Ancillary services billing is prepared using lab slips and logs sent from the facilities. This data is keyed into a menu option in the current system and it is processed during the monthly ancillary billing. The National Standard Format file created in this process is then processed through an 837 Translator developed in-house. The 837 file is then sent to Highmark Medicare Services for payment. The payments are entered manually into the A/R. The Physician services billing is prepared using Physician service logs sent from the facilities. This data is keyed into a menu option in the current system and it is processed during the monthly physician billing. The National Standard Format file created in this process is then processed through an 837 Translator program written in-house. The 837 file is then sent to Trailblazers (Blue Cross Blue Shield of South Carolina) for payment. An 835-remittance file is received from Novitas and the payments are electronically applied to the A/R. Medicaid includes billings for the Chronic, Behavioral Health, Developmental Disabilities and Nursing Homes. These billings are prepared using data from the Client Billing Profile and the Patient Moves data. The Chronic and Mental Health are billed using a per diem rate, and the Nursing Homes are billed based on Revenue Codes and Patient Moves. The National Standard Format files created by the system are then processed through the 837 Translator program. The 837 file is sent to Maryland Medicaid for processing. 835 remittance files received from Maryland Medicaid are then applied electronically to the A/R. Only Nursing Homes are billed based on Revenue Codes. Insurance claims are prepared on UB-04’s generated manually and by the system during the monthly billing process. The data used to prepare the bill is generated from the system’s Client Billing Profile and Census data. The UB-04’s are submitted to insurance companies for payment. The payments received are applied manually to the A/R. Sponsor Bills are created from data in the Client Billing Profile and the Census Module. The bills are generated by the system during the monthly billing process, printed on data mailers, separated manually and then mailed. The payments received are then entered manually into the A/R. Hospital Bank Billing is done based on data compiled on the Hospital Bank Rep printout. The data represents information contained in the Client Billing Profile and Patient Moves. The printout is sent to each facility’s Business Office for payment. The payments are entered manually into the A/R. Social Security and Maryland Department of Health (MDH) Payee Billing is generated based on data from the Client Billing Profile and patient moves. The charges are based on rates established by the Financial Agents in the State facilities. The payments consist of the Social Security check for the MDH Payee patients. The Social Security checks are direct deposit and the check files are sent to us by Banking Services in Annapolis for processing. The Social Security Unit then uses a system- generated Patient Allowance report to give each patient receiving a check a patient allowance. A transmittal is sent to MDH General Accounting for allocation of funds to the facilities. Supplemental Security Income (SSI) is not processed through HMIS. Retroactive Billings are prepared using Sponsor / Resource system billing options and also the Client Billing Profile. Retroactive billing is very common in the State Hospital billing environment. Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page 10 of 117 Financial investigations can take up to six months to complete and the patients stay for extended periods in the facilities thus causing accounts to be adjusted for retroactive periods. The Accounts Receivable (A/R) consists of invoiced entries and their associated company/plans. The entries are produced by monthly and on demand billings, charge entries, payment/adjustment entries, retroactive billing entries and re-bill entries. 2.2.7 Current Systems: Pharmacy The BHA operates five state psychiatric facilities with in-house pharmacies located throughout the State of Maryland. The new system will replace the legacy pharmacy management system used in these facilities. The new system will support all the functions of the in-house pharmacies. The SETT receives medications from one of the State psychiatric facility pharmacies, rather than a commercial pharmacy. The new EHR will track these transactions. 2.2.8 MDH also operates six other inpatient facilities that use the HMIS ADT module for patient census information but purchase their medications from outside pharmacies. They are not using the existing pharmacy management system and will not receive medications dispensed by the new EHR solution. 2.2.9 Application Coverage Fi = Finan; SG = Spring Grove; ES = Eastern Shore; Sp = Springfield; Pe + Perkins; RICA B = RICA Baltimore 2.2.10 Current Systems: ORYX Reporting The current HMIS system is fully compliant with all Joint Commission Performance Management (ORYX) reporting requirements coordinated through the National Research Institute’s (NRI) Behavioral Healthcare Performance Management System. These reporting requirements include, but Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page 11 of 117 are not limited to, patient episodes for all admissions and discharges and patient events such as injuries, patient seclusions and restraints, medication errors, patient leaves such as absent-without- leave (AWOL) or home visits and readmissions within 30 days of discharge. Additionally, the current system transmits electronic files on monthly patient episode and event data for each facility to NRI for editing purposes. All identified errors are returned to the facility for correction and retransmission to NRI. All monthly files must pass all fatal errors, as defined by NRI, before the next month is sent to NRI for editing purposes. The ORYX reporting requirements change on at least an annual basis and MDH’s Department of Information Technology makes changes to the HMIS source code to accommodate these changes. 2.2.11 Current Systems: User Groups The current system is used at each MDH facility by staff from admissions, medical records, physicians, nurses, therapists, consulting physicians, pharmacists and pharmacy technicians, lab technicians, administrators, social workers, utilization review, performance improvement, infection control, and others. Information is currently collected and used by DOR for billing, as well as NRI for ORYX reporting. The Maryland State Police (MSP) also queries a database extracted from HMIS (and augmented with data from all other State hospitals) to determine if a gun purchaser has been a psychiatric patient 2.2.12 State Roles In addition to the Procurement Officer and Contract Monitor, MDH has the following implementation personnel and will establish the following governance bodies: A. MDH Facilities Director. This role is the empowered leader, manager, and coordinator for all the MDH hospitals and healthcare facilities. This person will be final arbiter on decisions as to MDH facility requirements (functionality, workflow, reports, etc.) and EHR system configuration; and will be responsible for planning and executing Organizational Change Management (OCM). B. MDH EHR Delivery Manager. This role is the Program / Project Manager for MDH. The MDH EHR Delivery Manager shall be paired and partnered with the Contractor’s Program / Project Manager. This person will be responsible for the classic tasks of adhering to schedule, controlling scope, sticking to budget, fulfilling the Contract, addressing risks, and escalating issues, . C. MDH EHR Senior Business Analyst. This role is responsible for working with senior MDH leadership, the facilities, MDH OIT, and the Contractor’s team to understand, prioritize, and manage requirements; to design and decide the EHR workflow, configuration, and reports; to contribute to the planning and execution of OCM, including system training and support. D. MDH EHR Configuration and Integration Analyst(s): This role is responsible for administering, configuring (including reports), and maintaining the new EHR system. The role will work closely with the Contractor’s implementation team Contractor’s technical support. E. MDH OIT Director of Infrastructure. This role, which will be on part-time dedication to the EHR implementation, is responsible for understanding, planning, and fulfilling the requirements for hosting, operating, and securing the new EHR system. F. MDH OIT HMIS Team. The team will be dedicated to supporting the EHR implementation from both functional and technical perspectives, including collaboration with the Contractor in activities required for data cleansing and conversion; for hospital-by-hospital rollouts. G. Facility Leadership and Staff: MDH will obtain participation and provide access to leadership and staff within facilities as reasonably requested by Contractor. Requests from the Contractor shall be submitted to the MDH EHR Delivery Manager for decision. Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page 12 of 117 H. Program Management Office (PMO). MDH will establish a PMO to be led by the MDH EHR Delivery Manager in collaboration with the Contractor’s Program / Project Manager. I. Change Control Board (CCB): MDH will establish a CCM within the PMO in order to manage EHR scope consistent with the EHR Contract. The CCB will include representatives from the Contractor. The CCB will escalate decisions that it cannot resolve itself to the HER Executive Steering Committee and the Office of the Attorney General (OAG), as appropriate. J. Facilities Advisory Board (FAB): MDH will establish a FAB within the PMO to facilitate activity, communications, organizational change, and issue resolution with leadership of the facilities. The FAB will include the CEOS and COOs of the facilities along with others as deemed appropriate. K. EHR Executive Steering Committee (ESC or Steering Committee). MDH will establish a Steering Committee for executive sponsorship, including empowerment of the delivery team, mitigation of risks, and resolution of issues, including issues relating to the provisions and enforcement of the Contract. L. The current system is used at each MDH facility by staff from admissions, medical records, physicians, nurses, therapists, consulting physicians, pharmacists and pharmacy technicians, lab technicians, administrators, social workers, utilization review, performance improvement, infection control, and others. 2.3 Contractor Responsibilities and Tasks System implementation will span approximately two years, starting in 2020 and concluding by the end of 2022. Implementation will encompass activities such as deciding how to automate and standardize workflow; configuring the new EHR system; cleaning and converting data; engaging and training the end-user community; deploying to facilities in a multi-stage rollout; and launching the steady-state support services. MDH envisions deployment or rollout on a facility-by-facility, rather than an application-by- application or module-by-module basis. The approach might entail fully implementing three to four facilities for each of the deployments or “go-lives.” To minimize time-to-value and also to manage risk, facilities that have no EHR in place today will presumably be scheduled for deployment before those that are currently running other systems.. Existing patient data will need to be cleaned and converted. This process will need to identify and combine duplicate patient records across multiple facilities. The process will include creating digital images of records that are not in a structured digital format (e.g., paper records) and attaching them to the patient’s record. The Contractor shall also address the interface needs of each facility to internal and external laboratory systems, external pharmacy contractors, and the Gaia DIAPro dialysis system. These interfaces will need to be in place when the new system is implemented at each facility. 2.4 Responsibilities and Tasks 2.4.1 Contractor-Supplied Hardware, Software, and Materials A. SaaS applications shall be accessible from various client devices through a thin client interface such as a Web browser (e.g., Web-based email) or a program interface. B. The State shall be permitted limited user-specific application configuration settings. C. The Contractor is responsible for the acquisition and operation of all hardware, software and network support related to the services being provided, and shall keep all software current. Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page 13 of 117 D. All Upgrades and regulatory updates shall be provided at no additional cost. E. The Contractor shall prepare software releases and stage at the Department for validation in the system test environment. The Department will provide authorization to proceed. The Department will have the ability to manage the distribution of these releases to the appropriate sites. To support this requirement, the Contractor shall propose, provide and fully describe their solution for updating all sites with any new software releases. 2.5 Functional/ Business Requirements Functional/Business Requirements for the proposed EHR SaaS are listed in RFP Appendix 4 – MDH EHR RFP #21-18251 Appendix 4 – Functional and Business Requirements. 2.6 Training 2.6.1 Develop a training plan and approach, produce training courses and training materials, and conduct train-the-trainer, end-user, and technical training. Training materials shall reference appropriate system documentation and operating procedures. The Contractor shall coordinate with MDH’s Contract Monitor to arrange all training timelines. 2.6.2 Develop a comprehensive training plan and schedule that outlines the training approach for the technical staff training. The training plan shall consider and include the following minimum content: A. Overall training strategy and approach addressing end-user, technical, and periodic operational requirements. B. Information regarding training techniques to be used including lectures, videos, handouts, work samples, practice scenarios, reference sheets, student manuals. C. Classroom requirements, desktop and software requirements, system access requirements, required user-training security profiles, class locations, schedules and other logistics. 2.6.3 User Training A. Work with the State to assess end-user training needs. The Contractor shall conduct and train MDH staff in a train-the-trainer model. 2.6.4 Technical and Operations Training A. Provide a combination of hands-on and classroom training for technical and system operations staff. The Contractor shall ensure that sufficient training sessions are scheduled to train all staff identified in the use of the system in hosted environment. B. Technical transfer of knowledge: Include system support and operational aspects such as, configuration of tools used in the project, system table maintenance, security administration, interface operation for the extract files, and other system specific operations including the use of all system/data-related tools required to use the system. 2.7 Required Project Policies, Guidelines and Methodologies The Contractor shall be required to comply with all applicable laws, regulations, policies, standards and guidelines affecting Information Technology projects, which may be created or changed periodically. Offeror is required to review all applicable links provided below and state compliance in its response. Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page 14 of 117 It is the responsibility of the Contractor to ensure adherence and to remain abreast of new or revised laws, regulations, policies, standards and guidelines affecting project execution. These include, but are not limited to: A. The State of Maryland System Development Life Cycle (SDLC) methodology at: http://doit.maryland.gov/SDLC/Pages/agile-sdlc.aspx; B. The State of Maryland Information Technology Security Policy and Standards at: http://www.DoIT.maryland.gov- keyword: Security Policy; C. The State of Maryland Information Technology Non-Visual Standards at: http://doit.maryland.gov/policies/Pages/ContractPolicies.aspx; D. The State of Maryland Information Technology Project Oversight at: https://doit.maryland.gov/policies/Pages/default.aspx.aspx; E. The Contractor shall follow project management methodologies consistent with the most recent edition of the Project Management Institute’s Project Management Body of Knowledge Guide. 2.7.1 Product Requirements A. No international processing for State Data: As described in Section 3.7 Security Requirements, Offerors are advised that any processing or storage of data outside of the continental U.S. is prohibited. B. Any Contract award is contingent on the State’s agreement, during the Proposal evaluation process, to any applicable terms of use and any other agreement submitted with the Technical Proposal. Such agreed upon terms of use shall apply consistently across services ordered under the Contract. C. The Contractor shall not establish any auto-renewal of services beyond the period identified in Contract documents. D. In addition to any notices of renewal sent to the Department, Contractors shall email notices of renewal to the e-mail address designated by the Contract Monitor. 2.7.2 Technical Support A. “Technical Support” means Contractor-provided assistance for the services or Solution furnished under the Contract, after initial end-user support confirms a technical issue that requires additional troubleshooting capabilities; sometimes referenced as Tier II – IV support. B. The State shall be able to contact a Technical Support team member 24x7x365. C. Contractor Personnel providing technical support shall be familiar with the State’s account (i.e., calls shall not be sent to a general queue). D. Contractor shall return calls for service of emergency system issues within one (1) hour. E. Calls for non-emergency IT service requests will be returned within three (3) hours or immediately the following day if after Normal State Business Hours. F. The State shall be provided with information on software problems encountered at other locations, along with the solution to those problems, when relevant to State software. 2.7.3 Backup The Contractor shall: A. Perform backups for all application and configuration data that necessary to restore the application to full operability on suitable hardware. The backup shall consist of at least: i) Incremental daily backups, retained for one (1) month, http://www.doit.maryland.gov/ https://doit.maryland.gov/policies/Pages/default.aspx Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page 15 of 117 ii) Full weekly backups, retained for three (3) months, and iii) Last weekly backup for each month maintained for two (2) years; B. Maintain one annual backup C. Encrypt the backups using a shared key D. Perform a backup recovery at least semi-annually E. Provide on demand support for the State’s recovery of a backup set 2.8 Deliverables 2.8.1 Deliverable Submission A. For every deliverable, the Contractor shall request the Contract Monitor confirm receipt of that deliverable by sending an e-mail identifying the deliverable name and date of receipt. B. For every deliverable, the Contractor shall submit to the Contract Monitor, by e-mail, an Agency Deliverable Product Acceptance Form (DPAF), an example of which is provided on the DoIT web page here: https://doit.maryland.gov/contracts/Pages/writingITsolicitations.aspx. C. Unless specified otherwise, written deliverables shall be compatible with Microsoft Office, Microsoft Project or Microsoft Visio within two (2) versions of the current version. At the Contract Monitor’s discretion, the Contract Monitor may request one hard copy of a written deliverable. D. A standard deliverable review cycle will be elaborated and agreed-upon between the State and the Contractor. This review process is entered into when the Contractor completes a deliverable. E. For any written deliverable, the Contract Monitor may request a draft version of the deliverable, to comply with the minimum deliverable quality criteria listed in Section 2.8.4 Minimum Deliverable Quality. Drafts of each final deliverable, except status reports, are required at least two weeks in advance of when the final deliverables are due (with the exception of deliverables due at the beginning of the project where this lead time is not possible, or where draft delivery date is explicitly specified). Draft versions of a deliverable shall comply with the minimum deliverable quality criteria listed in Section 2.8.3 Minimum Deliverable Quality. 2.8.2 Deliverable Acceptance A. A final deliverable shall satisfy the scope and requirements of this RFP for that deliverable, including the quality and acceptance criteria for a final deliverable as defined in Section 2.8.4 Deliverable Descriptions/Acceptance Criteria. B. The Contract Monitor shall review a final deliverable to determine compliance with the acceptance criteria as defined for that deliverable. The Contract Monitor is responsible for coordinating comments and input from various team members and stakeholders. The Contract Monitor is responsible for providing clear guidance and direction to the Contractor in the event of divergent feedback from various team members. C. The Contract Monitor will issue to the Contractor a notice of acceptance or rejection of the deliverable in the DPAF (see online sample). Following the return of the DPAF indicating “Accepted” and signed by the Contract Monitor, the Contractor shall submit a proper invoice in accordance with the procedures in Section 3.3. The invoice must be accompanied by a copy of the executed DPAF or payment may be withheld. D. In the event of rejection, the Contract Monitor will formally communicate in writing any deliverable deficiencies or non-conformities to the Contractor, describing in those deficiencies what shall be corrected prior to acceptance of the deliverable in sufficient detail for the Contractor to address the https://doit.maryland.gov/contracts/Pages/writingITsolicitations.aspx Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page 16 of 117 deficiencies. The Contractor shall correct deficiencies and resubmit the corrected deliverable for acceptance within the agreed-upon time period for correction. 2.8.3 Minimum Deliverable Quality The Contractor shall subject each deliverable to its internal quality-control process prior to submitting the deliverable to the State. Each deliverable shall meet the following minimum acceptance criteria: A. Be presented in a format appropriate for the subject matter and depth of discussion. B. Be organized in a manner that presents a logical flow of the deliverable’s content. C. Represent factual information reasonably expected to have been known at the time of submittal. D. In each section of the deliverable, include only information relevant to that section of the deliverable. E. Contain content and presentation consistent with industry best practices in terms of deliverable completeness, clarity, and quality. F. Meets the acceptance criteria applicable to that deliverable, including any State policies, functional or non-functional requirements, or industry standards. G. Contains no structural errors such as poor grammar, misspellings or incorrect punctuation. H. Must contain the date, author, and page numbers. When applicable for a deliverable, a revision table must be included. I. A draft written deliverable may contain limited structural errors such as incorrect punctuation, and shall represent a significant level of completeness toward the associated final written deliverable. The draft written deliverable shall otherwise comply with minimum deliverable quality criteria above. 2.8.4 Deliverable Descriptions/Acceptance Criteria In addition to the items identified in the table below, the Contractor may suggest other subtasks, artifacts, or deliverables to improve the quality and success of the assigned tasks. Deliverables Summary Table* *The deliverables summary table may not list every contractually-required deliverable. Offerors and Contractors should read the RFP thoroughly for all Contract requirements and deliverables. THE REMAINDER OF THIS PAGE IS INTENTIONALLY LEFT BLANK. Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page 17 of 117 ID # Deliverable Description Acceptance Criteria Due Date / Frequency 2.8.4.1 2 . 8 . 4 . 1 Kick-off meeting No later than fifteen (15) Business Days after NTP 2.8.4.2 Project Management Plan (Release / Sprint plan) Project Management Plan (PMP) The project management plan shall include Integrated Project Schedule in MS Project format. The Integrated Project Schedule shall include the following: 1. Tasks, start and end dates; 2. Task duration; 3. Resource assignments; 4. Percentage complete per task; 5. Due dates for each project deliverable tasks defined no greater than 80 hours for a task; and 6. Expectations and tasking for State or other personnel. Project management services to manage the Contractor’s delivery approach and resources using industry standard and best-practice project management methods Final: No later than five (20) Business Days after the Kick- Off Meeting Integrated Project Schedule updates shall be included in Weekly Status Reports to the MDH Project Manager on a continuing basis, until work is completed to the satisfaction of the MDH Project Manager. 2.8.4.3 Requirements Traceability Matrix (RTM) Document that links requirements to their origins and traces them throughout the project life cycle. As outlined in the Contractor’s Project Management Plan, and updated as the initial RFP fixed scope of work progresses. 2.8.4.4 Problem Escalation Procedure The PEP must state how the Contractor will address problem situations as they occur during the performance of the Contract. As outlined in the Contractor’s Project Management Plan, and Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page 18 of 117 ID # Deliverable Description Acceptance Criteria Due Date / Frequency updated as the initial RFP fixed scope of work progresses. 2.8.4.5 System Design Document Document that includes pertinent sections from the template available at: https://doit.maryland.gov/SDLC/Pages/templates- phases.aspx As outlined in the Contractor’s Project Management Plan, and updated as the initial RFP fixed scope of work progresses. 2.8.4.6 Implementation Plan Document that includes pertinent sections from the template available at: https://doit.maryland.gov/SDLC/Pages/templates- phases.aspx As outlined in the Contractor’s Project Management Plan, and updated as the initial RFP fixed scope of work progresses. 2.8.4.7 Data Migration Plan In MS Word format, the Data Migration Plan shall be delivered to the Contract Monitor and shall include methodology, scope, and approach for migrating data in support of the RFP initial scope of work As outlined in the Contractor’s Project Management Plan, and updated as the initial RFP fixed scope of work progresses. 2.8.4.8 Test Plan In MS Word format, the Test Plan shall be delivered to the Contract Monitor and shall include test cases and expected results for each EHR requirement for each of the following: • System Tests • Integration Tests • Security Tests • Performance Tests • User Acceptance Tests As outlined in the Contractor’s Project Management Plan, and updated as the initial RFP fixed scope of work progresses. https://doit.maryland.gov/SDLC/Pages/templates-phases.aspx https://doit.maryland.gov/SDLC/Pages/templates-phases.aspx https://doit.maryland.gov/SDLC/Pages/templates-phases.aspx https://doit.maryland.gov/SDLC/Pages/templates-phases.aspx Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page 19 of 117 ID # Deliverable Description Acceptance Criteria Due Date / Frequency 2.8.4.9 Test Results Report In MS Word format, the Test Results Report shall be delivered to the Contract Monitor and shall include the Contractor’s actual test results for each EHR requirement for each of the following: • System Tests • Integration Tests • Security Tests • Performance Tests • User Acceptance Tests As outlined in the Contractor’s Project Management Plan, and updated as the initial RFP fixed scope of work progresses. 2.8.4.10 Production- ready EHR System EHR System that meet all requirements stated herein and has been successfully installed and tested within each of the 12 facilities. As outlined in the Contractor’s Project Management Plan, and updated as the initial RFP fixed scope of work progresses. 2.8.4.11 System Administration Manual In MS Word format with system screen shots, the System Administration manual shall be delivered to the Contract Monitor and shall include instructions on how to conduct all system administration functions. As outlined in the Contractor’s Project Management Plan, and updated as the initial RFP fixed scope of work progresses. 2.8.4.12 Training Plan A. In MS Word format with system screenshots the detailed Training Plan shall be delivered to the Contract Monitor and shall include: 1. Training Schedule 2. Training Location(s) As outlined in the Contractor’s Project Management Plan, and updated as the RFP scope of work progresses. 2.8.4.13 Administrator Training Train Agency System Administrators that explain how the System has been configured and how best to manage it. As outlined in the Contractor’s Project Management Plan, and updated as the initial RFP scope of work progresses. Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page 20 of 117 ID # Deliverable Description Acceptance Criteria Due Date / Frequency 2.8.4.14 End User Training Train Agency trainers who will then be able to train other agency staff. As outlined in the Contractor’s Project Management Plan, and updated TORFP scope of work progresses. 2.8.4.15 User Support System documentation to include maintenance procedures, technical manuals, user manuals, data dictionary and other documents available as part of the proposed system. As outlined in the Contractor’s Project Management Plan, and updated as the RFP scope of work progresses. THE REMAINDER OF THIS PAGE IS INTENTIONALLY LEFT BLANK. Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page 21 of 117 2.9 Service Level Agreement (SLA) The State is sensitive to system performance, and its impact on user efficiency and perception. As a result, system performance measures shall be implemented as proposed and agreed to in the Contract and measured on a periodic basis as a means to maintaining a high level of system performance and user satisfaction. The Contractor is to implement measurements of their solution’s performance as proposed and explained in the Technical Proposal. The Contractor shall implement an SLA for system performance as proposed that is considered acceptable performance from an end-user’s point of view (e.g., response time of common transactions, system availability). The Contractor shall include both the measures and the frequency of measurement in its SLA prior to implementation. The new EHR shall be available to users at all times, with the exception of planned outages. THE REMAINDER OF THIS PAGE IS INTENTIONALLY LEFT BLANK. Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page 22 of 117 3 Contractor Requirements: General 3.1 Contract Initiation Requirements THIS SECTION IS INAPPLICABLE TO THIS RFP. 3.2 End of Contract Transition 3.2.1 The Contractor shall work toward a prompt and timely transition, proceeding in accordance with the directions of the Contract Monitor. The Contract Monitor may provide the Contractor with additional instructions to meet specific transition requirements prior to the end of the Contract. 3.2.2 The Contractor shall ensure that all necessary knowledge and materials for the tasks completed are transferred to the custody of State personnel or a third party, as directed by the Contract Monitor. 3.2.3 The Contractor shall support end-of-Contract transition efforts with technical and project support to include but not be limited to: A. The Contractor shall provide a draft Transition-Out Plan 120 Business Days in advance of Contract end date. B. The Transition-Out Plan shall address at a minimum the following areas: 1. Any staffing concerns/issues related to the closeout of the Contract; 2. Communications and reporting process between the Contractor, the Department and the Contract Monitor; 3. Any final training/orientation of Department staff; 4. Connectivity services provided, activities and approximate timelines required for Transition- Out; 5. Plans to complete tasks and any unfinished work items (including open change requests, and known bug/issues); and 6. Any risk factors with the timing and the Transition-Out schedule and transition process. The Contractor shall document any risk factors and suggested solutions. 3.2.4 Return and Maintenance of State Data A. Upon termination or the expiration of the Contract Term, the Contractor shall: (a) return to the State all State data in either the form it was provided to the Contractor or in a mutually agreed format along with the schema necessary to read such data; (b) preserve, maintain, and protect all State data until the earlier of a direction by the State to delete such data or the expiration of 90 days (“the retention period”) from the date of termination or expiration of the Contract term; (c) after the retention period, the Contractor shall securely dispose of and permanently delete all State data in all of its forms, such as disk, CD/DVD, backup tape and paper such that it is not recoverable, according to National Institute of Standards and Technology (NIST)-approved methods with certificates of destruction to be provided to the State; and (d) prepare an accurate accounting from which the State may reconcile all outstanding accounts. The final monthly invoice for the services provided hereunder shall include all charges for the 90-day data retention period. B. During any period of service suspension, the Contractor shall maintain all State data in its then existing form, unless otherwise directed in writing by the Contract Monitor. Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page 23 of 117 C. In addition to the foregoing, the State shall be entitled to any post-termination/expiration assistance generally made available by Contractor with respect to the services. 3.3 Invoicing 3.3.1 General A. The Contractor shall e-mail the original of each invoice and signed authorization to the Contract Monitor of each facility at e-mail address provided at the time of contract award. B. All invoices for services shall be verified by the Contractor as accurate at the time of submission. C. An invoice not satisfying the requirements of a Proper Invoice (as defined at COMAR 21.06.09.01 and .02) cannot be processed for payment. To be considered a Proper Invoice, invoices must include the following information, without error: 1. Contractor name and address; 2. Remittance address; 3. Federal taxpayer identification (FEIN) number, social security number, as appropriate; 4. Invoice period (i.e. time period during which services covered by invoice were performed); 5. Invoice date; 6. Invoice number; 7. State assigned Contract number; 8. State assigned (Blanket) Purchase Order number(s); 9. Goods or services provided; 10. Amount due; and 11. Any additional documentation required by regulation or the Contract. D. Invoices that contain both fixed price and time and material items shall clearly identify each item as either fixed price or time and material billing. E. The Department reserves the right to reduce or withhold Contract payment in the event the Contractor does not provide the Department with all required deliverables within the time frame specified in the Contract or otherwise breaches the terms and conditions of the Contract until such time as the Contractor brings itself into full compliance with the Contract. F. Any action on the part of the Department, or dispute of action by the Contractor, shall be in accordance with the provisions of Md. Code Ann., State Finance and Procurement Article §§ 15-215 through 15-223 and with COMAR 21.10.04. G. The State is generally exempt from federal excise taxes, Maryland sales and use taxes, District of Columbia sales taxes and transportation taxes. The Contractor; however, is not exempt from such sales and use taxes and may be liable for the same. H. Invoices for final payment shall be clearly marked as “FINAL” and submitted when all work requirements have been completed and no further charges are to be incurred under the Contract. In no event shall any invoice be submitted later than 60 calendar days from the Contract termination date. 3.3.2 Invoice Submission Schedule The Contractor shall submit invoices in accordance with the following schedule: A. For items of work for which there is one-time pricing (see Attachment B – Financial Proposal Form) those items shall be billed in the month following the acceptance of the work by the Department. Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page 24 of 117 B. For items of work for which there is annual pricing, see Attachment B– Financial Proposal Form, those items shall be billed in equal monthly installments for the applicable Contract year in the month following the performance of the services. 3.3.3 Deliverable Invoicing A. Deliverable invoices shall be accompanied by notice(s) of acceptance issued by the State for all invoices submitted for payment. Payment of invoices will be withheld if a signed DPAF is not submitted. B. Payment for deliverables will only be made upon completion and acceptance of the deliverables as defined in Section 2.4. 3.3.4 Time and Materials Invoicing A. All time and material invoices shall be accompanied by a signed timesheet as described below and notice(s) of acceptance issued by the State: DPAF for each time period. Include for each person covered by the invoice the following, individually listed per person: name, hours worked, hourly labor rate, invoice amount and a copy of each person’s timesheet for the period signed by the Contract Monitor. B. Time Sheet Reporting Within three (3) Business Days after the 15th and last day of the month, the Contractor shall submit a semi-monthly timesheet for the preceding half month providing data for all resources provided under the Contract. At a minimum, each semi-monthly timesheet shall show: 1. Title: “Time Sheet for >”; 2. Issuing company name, address, and telephone number; 3. For each employee /resource: a) Employee / resource name, and b) For each Period ending date, e.g., “Period Ending: mm/dd/yyyy” (Periods run 1st through 15th, and 16th through last day of the month.): i) Tasks completed that week and the associated deliverable names and ID#s; ii) Number of hours worked each day; iii) Total number of hours worked that Period; iv) Period variance above or below 40 hours; v) Annual number of hours planned under the Task Order; vi) Annual number of hours worked to date; and vii) Balance of hours remaining; 4. Annual variance to date (Sum of periodic variances); and 5. Signature and date lines for the Contract Monitor. C. Time sheets shall be submitted to the Contract Monitor prior to invoicing. The Contract Monitor shall sign the timesheet to indicate authorization to invoice. 3.3.5 For the purposes of the Contract an amount will not be deemed due and payable if: A. The amount invoiced is inconsistent with the Contract; Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page 25 of 117 B. The proper invoice has not been received by the party or office specified in the Contract; C. The invoice or performance is in dispute or the Contractor has failed to otherwise comply with the provisions of the Contract; D. The item or services have not been accepted; E. The quantity of items delivered is less than the quantity ordered; F. The items or services do not meet the quality requirements of the Contract; G. If the Contract provides for progress payments, the proper invoice for the progress payment has not been submitted pursuant to the schedule; H. If the Contract provides for withholding a retainage and the invoice is for the retainage, all stipulated conditions for release of the retainage have not been met; or I. The Contractor has not submitted satisfactory documentation or other evidence reasonably required by the Procurement Officer or by the Contract concerning performance under the Contract and compliance with its provisions. 3.3.6 Travel Reimbursement Travel will not be reimbursed under this RFP. 3.4 Liquidated Damages 3.4.1 MBE Liquidated Damages THIS SECTION IS INAPPLICABLE TO THIS RFP. 3.4.2 Liquidated Damages other than MBE THIS SECTION IS INAPPLICABLE TO THIS RFP. 3.5 Disaster Recovery and Data The following requirements apply to the Contract: 3.5.1 Redundancy, Data Backup and Disaster Recovery A. Unless specified otherwise in the RFP, Contractor shall maintain or cause to be maintained disaster avoidance procedures designed to safeguard State data and other confidential information, Contractor’s processing capability and the availability of hosted services, in each case throughout the Contract term. Any force majeure provisions of the Contract do not limit the Contractor’s obligations under this provision. B. The Contractor shall have robust contingency and disaster recovery (DR) plans in place to ensure that the services provided under the Contract will be maintained in the event of disruption to the Contractor/subcontractor’s operations (including, but not limited to, disruption to information technology systems), however caused. 1. The Contractor shall furnish a DR site. 2. The DR site shall be at least 100 miles from the primary operations site, and have the capacity to take over complete production volume in case the primary site becomes unresponsive. C. The contingency and DR plans must be designed to ensure that services under the Contract are restored after a disruption within twenty-four (24) hours from notification and a recovery point objective of one (1) hour or less prior to the outage in order to avoid unacceptable consequences due to the unavailability of services. Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page 26 of 117 D. The Contractor shall test the contingency/DR plans at least twice annually to identify any changes that need to be made to the plan(s) to ensure a minimum interruption of service. Coordination shall be made with the State to ensure limited system downtime when testing is conducted. At least one (1) annual test shall include backup media restoration and failover/fallback operations at the DR location. The Contractor shall send the Contract Monitor a notice of completion following completion of DR testing. E. Such contingency and DR plans shall be available for the > to inspect and practically test at any reasonable time, and subject to regular updating, revising, and testing throughout the term of the Contract. 3.5.2 Data Export/Import A. The Contractor shall, at no additional cost or charge to the State, in an industry standard/non- proprietary format: 1. perform a full or partial import/export of State data within 24 hours of a request; or 2. provide to the State the ability to import/export data at will and provide the State with any access and instructions which are needed for the State to import or export data. B. Any import or export shall be in a secure format per the Security Requirements. 3.5.3 Data Ownership and Access A. Data, databases and derived data products created, collected, manipulated, or directly purchased as part of a RFP are the property of the State. The purchasing State agency is considered the custodian of the data and shall determine the use, access, distribution and other conditions based on appropriate State statutes and regulations. B. Public jurisdiction user accounts and public jurisdiction data shall not be accessed, except (1) in the course of data center operations, (2) in response to service or technical issues, (3) as required by the express terms of the Contract, including as necessary to perform the services hereunder or (4) at the State’s written request. C. The Contractor shall limit access to and possession of State data to only Contractor Personnel whose responsibilities reasonably require such access or possession and shall train such Contractor Personnel on the confidentiality obligations set forth herein. D. At no time shall any data or processes – that either belong to or are intended for the use of the State or its officers, agents or employees – be copied, disclosed or retained by the Contractor or any party related to the Contractor for subsequent use in any transaction that does not include the State. E. The Contractor shall not use any information collected in connection with the services furnished under the Contract for any purpose other than fulfilling such services. 3.5.4 Provisions in Sections 3.5.1 – 3.5.3 shall survive expiration or termination of the Contract. Additionally, the Contractor shall flow down the provisions of Sections 3.5.1-3.5.3 (or the substance thereof) in all subcontracts. 3.6 Insurance Requirements The Contractor shall maintain, at a minimum, the insurance coverages outlined below, or any minimum requirements established by law if higher, for the duration of the Contract, including option periods, if exercised: 3.6.1 The following type(s) of insurance and minimum amount(s) of coverage are required: Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page 27 of 117 A. Commercial General Liability - of $1,000,000 combined single limit per occurrence for bodily injury, property damage, and personal and advertising injury and $3,000,000 annual aggregate. The minimum limits required herein may be satisfied through any combination of primary and umbrella/excess liability policies. B. Errors and Omissions/Professional Liability - $1,000,000 per combined single limit per claim and $3,000,000 annual aggregate. C. Crime Insurance/Employee Theft Insurance - to cover employee theft with a minimum single loss limit of $1,000,000 per loss, and a minimum single loss retention not to exceed $10,000. The State of Maryland and the Department should be added as a “loss payee.” D. Cyber Security / Data Breach Insurance Throughout the Term and for three (3) years thereafter, cyber risk/ data breach insurance (either separately or as part of a broad Professional Liability or Errors and Omissions Insurance) with limits of at least US $5 (five) million per claim. Any "insured vs. insured" exclusions will be modified accordingly to allow the State additional insured status without prejudicing the State’s rights under the policy (ies). Coverage shall be sufficiently broad to respond to the Contractor's duties and obligations under the Contract and shall include, but not be limited to, claims involving privacy violations, information theft, damage to or destruction of electronic information, the release of Sensitive Data, and alteration of electronic information, extortion, and network security. The policy shall provide coverage for, not by way of limitation, breach response costs as well as regulatory fines and penalties as well as credit monitoring expenses with limits sufficient to respond to these obligations. E. Worker’s Compensation - The Contractor shall maintain such insurance as necessary or as required under Workers’ Compensation Acts, the Longshore and Harbor Workers’ Compensation Act, and the Federal Employers’ Liability Act, to not be less than. one million dollars ($1,000,000) per occurrence (unless a state’s law requires a greater amount of coverage). Coverage must be valid in all states where work is performed. F. Automobile or Commercial Truck Insurance - The Contractor shall maintain Automobile or Commercial Truck Insurance (including owned, leased, hired, and non-owned vehicles) as appropriate with Liability, Collision, and PIP limits no less than those required by the State where the vehicle(s) is registered, but in no case less than those required by the State of Maryland. 3.6.2 The State shall be listed as an additional insured on the faces of the certificates associated with the coverages listed above, including umbrella policies, excluding Workers’ Compensation Insurance and professional liability. 3.6.3 All insurance policies shall be endorsed to include a clause requiring the insurance carrier provide the Procurement Officer, by certified mail, not less than 30 days’ advance notice of any non- renewal, cancellation, or expiration. The Contractor shall notify the Procurement Officer in writing, if policies are cancelled or not renewed within five (5) days of learning of such cancellation or nonrenewal. The Contractor shall provide evidence of replacement insurance coverage to the Procurement Officer at least 15 days prior to the expiration of the insurance policy then in effect. 3.6.4 Any insurance furnished as a condition of the Contract shall be issued by a company authorized to do business in the State. 3.6.5 The recommended awardee must provide current certificate(s) of insurance with the prescribed coverages, limits and requirements set forth in this section within five (5) Business Days from notice of recommended award. During the period of performance for multi-year contracts, the Modern EHR for MDH Healthcare Facilities Solicitation #: MDH/OPASS 21-18251 RFP Document RFP for Maryland Department of Health Page 28 of 117 Contractor shall provide certificates of insurance annually, or as otherwise directed by the Contract Monitor. 3.6.6 Subcontractor Insurance The Contractor shall require any subcontractors to obtain and maintain comparable levels of coverage and shall provide the Contract Monitor with the same documentation as is required of the Contractor. 3.7 Security Requirements The following requirements are applicable to the Contract: 3.7.1 Employee Identification A. Contractor Personnel shall display his or her company ID badge in a visible location at all times while on State premises. Upon request of authorized State personnel, each Contractor Personnel shall provide additional photo identification. B. Contractor Personnel shall cooperate with State site requirements, including but not limited to, being prepared to be escorted at all times, and providing information for State badge issuance. C. Contractor shall remove any Contractor Personnel from working on the Contract where the State determines, in its sole discretion, that Contractor Personnel has not adhered to the Security requirements specified herein. D. The State reserves the right to request that the Contractor submit proof of employment authorization of non-United States Citizens, prior to commencement of work under the Contract. 3.7.2 Security Clearance / Criminal Background Check A. A criminal background check for any Contractor Personnel shall be completed prior to each Contractor Personnel providing any services under the Contract. B. The Contractor shall obtain at its own expense a Criminal Justice Information System (CJIS) State and federal criminal background check, including fingerprinting, for all Contractor Personnel listed in sub-paragraph A. This check may be performed by a public or private entity. C. The Contractor shall provide certification to the Department that the Contractor has completed the required criminal background check described in this RFP for each required Contractor Personnel prior to assignment, and that the Contractor Personnel have successfully passed this check. D. Persons with a criminal record may not perform services under the Contract unless prior written approval is obtained from the Contract Monitor. The Contract Monitor reserves the right to reject any individual based upon the results of the background check. Decisions of the Contract Monitor as to acceptability of a candidate are final. The State reserves the right to refuse any individual Contractor Personnel to work on State premises, based upon certain specified criminal convictions, as specified by the State. E. The CJIS criminal record check of each Contractor Personnel who will work on State premises shall be reviewed by the Contractor for co