Description

Amendment 1 - Added new list to Buyer Attachment 2 both file types Amendment 2 - Added Internal Health Department contact. PRE-PROPOSAL CONFERENCE                                        There will not be a pre-proposal conference for this Sourcing Event. ITEMS TO SUBMIT AS SUPPLIER ATTACHMENTS FOR THIS RFP: Proposal Your Proposal must be a Word or PDF document; computer generated or typewritten, single spaced, space-and-a-half or double spaced, formatted for 8.5” x 11” paper. All pages should be numbered. Margins should be at least ½ inch on all sides. Font size can be no smaller than 10 points. Proposals using smaller font sizes or smaller margins may be rejected. The Proposer is required to submit a written narrative for each question asked in the Buyer Attachments 1 - RFP Proposal Questions. Both a PDF version and Word Document version are provided to assist you in responding to the questions in Group 2. Use either of these files to respond to Group 2.1 Programmatic Questions and Group 2.2, Responsible Business Practice Questions, submitting your response as a complete proposal response and upload as a "Supplier Attachment" in the Sourcing Event. Proposers will also upload a completed Buyer Attachment 2 - Price Sheet (either PDF or Excel) as a "Supplier Attachment" in the Sourcing Event. An Excel spreadsheet version is provided to help calculate the total amount and a PDF version is provided for reference. Proposers must respond to all the questions listed in the Buyer Attachments 1 - RFP Proposal Questions. The format for each question response should be as follows: the group number, question number and title (example: Group 2.1.1 Company Profile) and then provide their written response. Proposer should not restate the entire evaluation criteria with its response. IMPORTANT GUIDANCE REGARDING PROPOSER RESPONSES Buyer Attachment 1 - RFP Proposal Questions (Written Narrative) - Proposal page limit is 12 pages. This equates to not more than 6 sheets of paper that are printed on each side, or 12 pages printed on only one side. We recommend that you not use cover sheets or any extra materials as these will count as pages. Excess pages will be removed and will not be evaluated.  After uploading the proposal, Proposers must check the “Yes” button for each question in the Programmatic and Responsible Business Practice Questions sections of the RFP. Buyer Attachment 2 - Price Sheet is a separate attachment uploaded into the Supplier Attachment Section and will not be counted as part of the 12 page limit. SERVICE DESCRIPTION, FUNDING AND CONTRACTING INFORMATION PURPOSE AND OVERVIEW The Multnomah County Health Department (MCHD), Integrated Clinical Services (ICS) is seeking Proposers from whom it may purchase Radiology Consultation and X-ray services.  Services are intended to assist in the service delivery of patients of MCHD, therefore other divisions of the Health Department may also use the contract resulting from this RFP as necessary This service is not new to the County and is currently being provided. Major service components include: Services requested but not limited to: XRs, MRI, Ultrasound, Digital Mammography, PET/CT, Breast Ultrasound and Bone Densitometry Provide Reports for referrals through interface Provide notification to ordering physician in the event of critical findings  INTRODUCTION AND PROGRAM HISTORY MCHD has eight Primary Care Health Centers in addition to 8 Student Health Centers. MCHD has ordered approximately 5,616 Imaging Referral Orders in the calendar year of 2019.  The proposer must have adequate capacity to accommodate referrals from multiple programs within MCHD. MCHD provides care to underserved, low-income, incarcerated and uninsured residents of Multnomah County. MCHD Primary Care Health Centers provide patient centered care using the Medical Home model and is Joint Commission Accredited. As a provider to a diverse patient population, language interpretation is an important component in providing comprehensive services for patients. The proposer must be able to schedule appointments with MCHD patients in response to referrals received. It is highly desirable that appointment times outside of general business hours of Monday through Friday 8:00 am – 5:00 pm can be offered. Proposer must be able to provide MRI, Ultrasound, Digital Mammography, PET/CT, Breast Ultrasound, Bone Densitometry, diagnostic reports, consultation and stat services when requested. GOALS, VALUES AND OTHER IMPORTANT CONSIDERATIONS The goal of seeking an external source for X-ray and radiology consultation is to improve quality, consistency and appropriateness of radiology services for Health Department patients. Patient X-ray and radiology needs exceed the scope of services provided by MCHD. Listed among the core values of MCHD is to honor the diversity of the individuals and communities we serve. MCHD believes in partnerships to improve the health of our communities and to continuously improve the quality of our work. MCHD emphasizes prevention, health promotion and early intervention. Primary Care provides interpretation services in person or by phone to non-English speaking and hearing impaired patients when possible in an effort to ensure patients receive comprehensive care. Primary care utilizes EHR; a strong candidate would have digital imaging capability that enhances diagnostic results which would increase efficiency by which electronic imaging could interface with Epic, resulting in time savings for providers and support staff in the management of reports received from the Contractor. TARGET POPULATION SERVED Primary Care Health Centers had approximately 196,909 thousand visits in the past year. Criteria for diagnostic evidence and imaging type used is set by the MCHD Medical Director and has been based on the American College of Radiology, Appropriateness Criteria. Rarely ordered from MCHD providers would be patients needing: Abdominal, Ribs, Scoliosis Survey, Skull, Sinus, Facial, Soft Tissue, Mass r/o, Thoracic Lumbar Spine and Non-great Toe images. GEOGRAPHIC BORDERS/LIMITATIONS & SERVICE AREAS All Proposers must have a service location within Multnomah County. When possible we offer referral services closest to our patient’s home address or the Health Center in which they are assigned. Services will be restricted to the area described below. West: County Boundary  East:  County Boundary North: County Boundary South: From the Fremont Bridge over the Willamette River to intersection of Thurman Street and NW 14th, then South down NW 14th Ave to Pettygrove Street, then, East to 12th Ave, then South to West Burnside Street, then, West on Burnside to SW Vista Avenue; then, South on SW Vista Avenue to SW Canyon Rd;, Highway 26 Sunset Highway); then An approximate southerly line from the Zoo Exit to SW Patton Road; then, West on SW Patton Road to where it runs into SW Scholls Ferry Road following it to the West County Boundary. MCHD Locations are as follows: Primary Care Health Centers: Health Services Center 619 NW 6th Avenue 3rd Floor Portland, OR 97209 Mid County Health Center 12710 SE Division Portland, OR 97236 East County Health Center 600 NE 8th St, #300, Gresham, OR 97030 North Portland Health Center 9000 N Lombard St. Portland, OR 97203 La Clinica de Buena Salud 6736 NE Killingsworth St. Portland, OR 97218 Northeast Health Center 5329 NE MLK Jr. Blvd Portland, OR 97211 Rockwood Community Health Center 2020 SE 182nd Ave. Portland, OR 97233 Southeast Health Center 3653 SE 34th Ave. Portland, OR 97202-3034 Student Health Centers: Cleveland High School 3400 SE 26th Ave. Portland, OR 97212 Grant High School 2245 NE 36th Ave. Portland, OR 97212 Jefferson High School 5210 N Kerby St. Portland, OR 97217 Madison @ Marshall High School 3905 SE 91st Ave. Portland, OR 97266 Roosevelt High School 6941 N Central St. Portland, OR 97203 David Douglas High School 1034 SE 130th Ave. Portland, OR 97233 Franklin High School 5405 SE Woodward St Portland, OR 97206 Parkrose High School 12003 NE Shaver St Portland, OR 97220 Reynolds High School 1698 SW Cherry Park Rd, Troutdale, OR 97060 Communicable Disease 619 NW 6th Avenue, 2nd Floor; Portland, OR 97209 Corrections Health including Juvenile Detention Services Clients will not be referred to the Contractor site.  Images will be sent to the Contractor for diagnostic services and reports. FUNDING Multnomah County Health Department has an annual budget mixed with federal, state and local funding for geographic area services. The current allocation policy provides for a base allocation plus additional funds allocated on a formula basis. The formula directs funds to service areas with greater needs, taking into account multiple factors such as: 60+ population in the district; Ethnic population in district; Income level e.g., poverty rate; Frailty (age and mobility related); Service authorization to clients based on risk; and Grandparents parenting children. Additional weight is given to populations who are living below the Federal Poverty Line and those who constitute minority and underserved populations. The source of data for the allocation policy and formula is from the Census Bureau. Funding of the work described in this RFP is not guaranteed. Fluctuations in funding year to year should be expected. The County cannot assure that any particular level of work will be provided and the contract will permit the County to add or remove work as necessary depending on availability of funding. SCOPE OF SERVICES Services shall consist of the following: Imaging Order Process MCHD referrals for imaging services  (“Referral” is a Provider request for MCHD patient to see outside specialty provider for services detailed in the request for X-ray.) ●     MCHD medical providers must provide an order that includes the following:  Body part and modality  Signs and symptoms   STAT and other report specifics, when required  Outside study information when relevant      Demographic information and number to reach patient for appointment scheduling            When available, patient’s insurance carrier, name of insurer, policy number, patient membership insurance number, and address of insurance company Schedule appointments with MCHD patients and/or MCHD staff on behalf of the patient in accordance with referral order from the provider. Consult with MCHD staff regarding patients who did not show up for their referral appointment. Provide reports on referrals through interface which includes the following: ●     Most likely differential diagnosis when pathology is present ●     Client name and aliases ●     Client date of birth ●     Client Identification ●     Name of ordering provider ●     Name of ordering facility ●     Pertinent comment ●     Date image was taken ●     Date image was read ●     Radiologist signature (e-signature acceptable) Provide STAT service when requested, the report shall be ready within 2 working hours of the patient visit with the Contractor. Routine X-rays; report shall be ready within 24 working hours of the patient visit Provide verbal notification to ordering physician in the event of critical findings Provide radiologic consultation Digitize and read plain X-ray image received from MCHD; X-ray image provided to Contractor that was not generated by Contractor (“Outside EXECUTED Image”) is subject to quality review by Contractor radiologists.   MCHD will make every effort to correct any substandard Outside Image reported to MCHD by Contractor.  Ancillary Services: Provide adequate accommodation for TB positive patients to mitigate exposure to the population.  Print hard copy CXR for active TB client or as ordered by MCHD Providers. Provide language interpretation TECHNOLOGY                 1.1.        Bi-directional interface to allow MCHD Clinical staff to electronically send image order and ability to receive image results via current OCHIN HL7 (https://www.hl7.org/) into the OCHIN EMR.                 1.2.        Bi-directional interface shall work with EMR vendor to implement a bi-directional interface that meets EMR specifications                             1.2.1.        24/7 uptime                             1.2.2.        OCHIN Standard outgoing orders (ORM)                             1.2.3.        OCHIN Standard Incoming results (ORU)                             1.2.4.        Interface to Contractor shall provide MCHD with the following functionality:                                         1.2.4.1.        Submit Orders electronically from within EPIC                                         1.2.4.2.        View results electronically from within EPIC                                         1.2.4.3.        View diagnostic images from within EPIC                                                     1.2.4.3.1.        Image Access: Image Link accepted with incoming results (per OCHIN Addendum for image link for radiology interfaces)                             1.2.5.        Standard Application build to support interface connection                             1.2.6.        Project Coordination, testing, and training to support and implement project                 1.3.        Storage: Image storage/access including login credentials to access                 1.4.        7.) Data Retention as described by MCHD or by Oregon Law which ever is longer:                 1.5.        Primary Care Retention: Retain 10 years after last service                 1.6.        Dental Retention: Retain 10 years after last service                 1.7.        Tuberculosis Case Files: Retention: Retain 70 years after last service                 1.8.        Adult Inmate Medical Case Records: Retention: Retain 10 years after inmate release                 1.9.        Juvenile Medical Case Records: Retention: Retain 10 years after last service              1.10.        Contractor shall meet the following OCHIN Technical Specifications:                          1.10.1.        OCHIN Outgoing Generic Ancillary Orders (ORM) interface                          1.10.2.        OCHIN Standard Incoming Results (ORU) interface                          1.10.3.        OCHIN Standard HL7 Incoming ORU Specification Addendum for Adding Image Link to Radiology Interfaces                          1.10.4.        OCHIN Application and Compendium Requirements              1.11.        Contractor shall provide implementation and support services that are needed in order to successfully provide the technology and services referenced in this RFP. This may include, but is not limited to: customization, design, coding, and testing of new software/interfaces/reports, business process analysis, system configuration, as well as end-user training, go-live, and post go-live support. If hardware/software installation is involved, this includes assistance with that installation and configuration.              1.12.        Contractor shall comply with industry and regulatory security standards and best practices.              1.13.        Contractor shall host the hardware & software that is needed to facilitate the bi-directional interface.  2. Privacy                             2.1.1.        Comply with all requirements of Multnomah County’s standard Business Associate Agreement (BAA) without modification (see attached BAA)                             2.1.2.        Maintain system security to protect patient health information as required by HIPAA (please also refer to BAA attachment)                             2.1.3.        Ensure policies are in place with subcontractors to protect patient health information as required by HIPAA. STAFFING AND CREDENTIALING Contractor is responsible for maintaining staffing and credentialing in accordance with The Health Resources and Services Administration requirements.  HRSA is an agency of the U.S. Department of Health and Human Services. FISCAL REQUIREMENTS AND REPORTING Billing services: The County will negotiate final pricing and associated reports with the selected supplie during contract negotiations. Plain X-Ray All patient balances outstanding for plain X-Ray after all insurance resources have been exhausted are the responsibility of Multnomah County.  No Multnomah County patient will be billed directly by Contractor for services rendered for plain X-Ray. Specialty X-Ray MCHD will refer insured patients to Contractor for Specialty X-ray by physician when it is determined necessary for the care of the patient.   Costs for uninsured and insured patients shall be the same. Specialty X-ray costs are the responsibility of the patient and insurance carrier. Multnomah County does not pay for Specialty X-ray or its associated diagnostics. All invoices to the County must include the following: Vendor Number Patient Last Name, First Name, Middle Initial Patient Medical Record Number Date of service Image Name Unit cost of image Primary payer’s name, payment and adjustment (include per line item code) Secondary payer’s name, payment and adjustment FPL applied Balance Due Invoice number (separated by clinic number) invoice date Vendor name and address, Multnomah County contract number, Description of goods and/or services delivered, Detail units of measure, price per unit, extended amount per line items; Total invoice amount.  Multnomah County will qualify self-pay patients in accordance with the Federal Poverty Guidelines from the U.S. Department of Health and Human Services (HRSA).  For patients whom the County has qualified under the sliding fee discount scale, the Contractor shall offer a sliding fee option per HRSA guidelines.  Sliding Fee Scale Tier 1: 0-100% pay 0.00 Tier 2: > 100-133% receive 75% discount             Tier 3: >133-167% receive 50% discount Tier 4: >167-200% receive 25% discount Tier 5: >200% No Discount  Contractor agrees to bill the patients’ primary and secondary insurance before billing Multnomah County Health Department (MCHD) for applicable services.   Before invoicing MCHD the balance for any denied claims by third party payers, the Contractor shall make reasonable efforts to correct any claim errors and omissions and re-invoice the responsible payer with a corrected claim.  FPL shall be applied to the patient's invoice prior to invoicing MCHD for the balance of applicable services.    Contractor agrees that payments received from Medicaid and Medicare constitute payment in full.   COLLECTIONS  Contractor agrees not to send patients to an outside collections’ agency for those balances that are the responsibility of Multnomah County.  Multnomah County is responsible for the payment of Plain X-rays.  For outstanding balances that may be the responsibility of the patient i.e Specialty X-ray, Contractor agrees to contact MCHD Business Services for assistance in resolution of the unpaid amount, at least 30 days before sending balances to an outside collection agency.  PERFORMANCE MEASURES/PERFORMANCE CONTRACTING Final performance measures will be negotiated between the program office and the selected Proposer. Business measures such as receiving reports within designated time frame as specified within the contract are to be expected. Other measures can encompass: employing credentialed staff, sustaining green practices, assuring continuity after hours and communicating to MCHD in cases of critical findings. CONTRACT NEGOTIATION The County will initiate contract negotiations with the responsive and responsible Proposer with the highest scoring proposal. Multnomah County may, at its option, elect to negotiate general contract terms and conditions, services, pricing, implementation schedules, and such other terms as the County determines are in the County’s best interest. If negotiations fail to result in a contract, the County reserves the right to terminate the negotiations and initiate contract negotiations with the next highest scoring responsive and responsible Proposer. This process may continue until a contract agreement is reached. CONTRACT AWARD Through this RFP process, the County is seeking to award a minimum of one contract up to one year. The County shall have the option to renew this contract for four additional one year period(s). Proposer(s) whose Proposal the County determines is most advantageous to the County based on the evaluation process and evaluation factors described in this RFP. Multnomah County strongly encourages the participation of Minority-Owned, Women-Owned, and Emerging Small Businesses and Organizations in providing these services. COMPENSATION AND METHOD OF PAYMENT County agrees to pay Contractor for the performance of services. Payment shall be based upon negotiated terms. Proposer will submit an invoice for services rendered within 45 days of service delivery to MCHD Business Services. MCHD will pay for services rendered by County standard 30 day term. Fee increases are not allowed in the first year of the contract. After the first year, all fee increases shall be agreed upon by both parties at contract renewal; County reserves the right to accept or reject fee increases. County certifies that sufficient funds are available and authorized to finance the costs of services obtained through this RFP. In the event that funds cease to be available to County, both parties may terminate the agreement or by mutual agreement may reduce Agreement funding accordingly; County will notify Contractor upon notification from funding source. Reduction or termination will not affect payment for expenses incurred prior to the effective date of such action. COOPERATIVE PURCHASING    Other public agencies may establish contracts or price agreements directly with the awarded contractor under the terms, conditions and prices of the original contract Pursuant to ORS 279A.215 and agreement by the selected Contractor to extend the terms, conditions and prices of the original contract.  INSURANCE REQUIREMENTS The table below states the minimum insurance required of a Contractor to provide this service. Additional insurance coverage may be required depending on the key features of service delivery chosen by the Contractor. Final insurance requirements will be subject to negotiation between, and mutual agreement of, the parties prior to contract execution and recorded in Exhibit 2 of the contract. The minimum insurance coverage stated below supersedes requirements listed in Exhibit 2 of the Sample Contract where they are different. The County shall be listed as an Additional Insured on the GL policy by Endorsement.   Minimum insurance requirements: Type of Insurance  Per Occurrence Aggregate Professional Liability              $5 Million   $5 Million Commercial Gen Liability   $1 Million   $2 Million Commercial Auto Liability     Workers Compensation          Required        MINIMUM REQUIREMENTS At the time of proposal submission, Proposers must meet the following minimum requirements. Failure to provide any of the required documents or meet any of the below requirements shall result in rejection of the proposal. The Proposal response must be received by Multnomah County Purchasing no later than 4:00 P.M. local Portland time on the proposal submission deadline. Proposer Representations and Certifications The Proposer must certify that they agree to the Proposers Representation and Certification terms in the Prerequisite page of the Sourcing Event.  At the time of Contracting, Proposers must meet the following minimum requirements. Failure to provide any of the required documents or meet any of the below requirements shall result in cancellation of the contract Proposers must be legal entities, currently registered to do business in the State of Oregon (per ORS 60.701). Proposers must submit verification that all insurance requirements are met. Proposers must have a completed Pre-Award Risk Assessment if federal funds are used for this Sourcing Event. (See Procedural Instructions in the Buyer Attachments page of this Sourcing Event)

Attachments

This project has the following solicitation documents. You will need to visit the agency's original website to download these documents.

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