ADDENDUM NUMBER ONE
THE UNIVERSITY OF NEW MEXICO HOSPITALS
Purchasing Department
933 Bradbury Dr. SE Ste 3165
Albuquerque, New Mexico 87106
Date: August 30, 2013
Proposal Number: P263-13
Name of Procurement Specialist: Ed Ybarra
Due Date: September 5, 2013 @ 2:00 pm MDT
Addendum # 1: See Below
Notice to all respondents:
Amend the Proposal: Feasibility Study for Liver Transplantation Institute
This addendum becomes part of the Proposal Documents and modifies, as noted below, the
original Bidding Documents.
Question 1: We would like the Owner's definition of a "Liver Transplant Institute" and how it
differs from a Liver Transplant program.
UNMH Response to Question 1: We do not think there is a difference but this was pulled from
the language in the House Memorial Bill 48 which requests that the "Department of Health and
University of New Mexico Hospitals conduct a feasibility study and develop a memorandum of
understanding with other health providers in the state to determine steps necessary to create a
liver transplantation institute in New Mexico" and that the study create plans that can be set into
action to maximize the use of possible funds that the federal government may make available.
Question 2: The Offerer believes that the RFP may be two broad, we can bid the RFP in one of
two ways:
1. To document the need or lack thereof for a Liver Transplant Institute/Program in New
Mexico (please see A below).
2. To document the need or lack thereof for a Liver Transplant program as well as a
complete a financial and operational feasibility study (Please see B below).
We believe that there should be two separate RFP's. We believe that once the decision is made
to move forward, the Offeror's will have better information from the Owner to utilize to establish
the scope of the complete financial and operational feasibility study. Additionally, utilizing two
separate RFP's most likely will result in a cost savings to the Owner. Currently the bid for the
combined costs would have to contain costs to the Owner that may not be necessary if the
information from a report on the Need for a Liver Transplant Institute/Program in New
Mexico. Transplant program budgeting for staffing, evaluation services, OR, Recovery Room
and Floor, pharmacy and supply needs planning, review, and revision cannot be completed until
a decision is made on the location of the program and the projected size of the program.
A.
The Offerer believes that a RFP to document the need or lack thereof for a Liver
Transplant Institute/Program would contain, at a minimum, the following:
• Provide data for consideration of the feasibility and opportunity for opening a Liver
Transplant Institute within the State of New Mexico.
• Provide the regulatory requirements and membership requirements for transplant
programs generally and Liver Transplant Programs specifically, for the United Network for
Organ Sharing/Organ Procurement and Transplantation Network (“UNOS/OPTN”), Centers for
Medicare and Medicaid Services (“CMS”), and the State of New Mexico Membership and
certification processes for a liver transplant program, as applicable.
• Provide data organ availability and patient availability, including the number of organs
and patients currently being sent out of state for care.
• Provide data concerning the patient populations currently under-served or not served at all
by the existing transplant programs.
• Define staff and resources needed to open the program once a physical location for the
Institute has been determined based on patient availability and organ availability.
B. The Offerer believes that once the Owner decides that it wishes to look forward into
opening a Liver Transplant Institute/Transplant Program the RFP would contain, at a minimum,
the following:
• A section on Transplant Center Operational Strategies, including but not limited to:
• Identifying referral sources and marketing appropriately.
• Identifying other surgical and medical services that will help support the transplant
physicians and surgeons salaries.
• Planning for the Medicare Certification Process.
• Contracting with payers before Medicare Certification.
• A section on Transplant Center Financial Strategies, including but not limited to:
• Establishing a operational budget for the Liver Acquisition Cost Center (the Department
that houses the pre transplant evaluation process), the liver post transplant clinic.
• Identifying the impact of a Liver Transplant Program on other operating departments
such as the OR, Pharmacy, Central Supply, Patient Registration, Billing, and Contracting.
• Review of the Medicare Cost Reporting process to help the Owner be assured that the
Medicare dollars that are appropriately available to the Owner are handled appropriately and that
there are no Medicare Cost Reporting Compliance Issues.
• Establishing the financial pro forma for the Transplant Institute/Program.
• A section on Transplant Center patient registration for evaluation, the transplant and post
transplant follow up and the Medicare Organ Acquisition Cost Center requirements.
• Since Medicare has special rules for the pre transplant evaluation process as far as
registration, billing and accounting, a review of the processes to make sure that the Owner does
not get into Compliance trouble.
• Time Studies and other tools to help assure the Owner that all appropriate costs are
being captured.
• How to receive reimbursement for Program Directors through the cost report process.
The items in section B are an example of the type of work that would be bid on in a separate RFP
if the decision is made to move forward.
The Offerer requests clarification from the Owner as to what type of Feasabliity study it is
interested in:
• To document the need or lack thereof for a Liver Transplant Institute/Program in New
Mexico.
• To document the need or lack there of for a Liver Transplant program as well as a complete a
financial and operational feasibility study.
Response to Question 2: Based on the above language (response to question 1) pulled directly
from the HB48, we believe that the bill asks for a feasibility study that should include a financial
as well as an operational feasibility study. UNMH understands that a location for a program
would need to be made which is part of the information that we are seeking. Where would the
best location for the program be? There is a belief in the community that the organ sharing
rules favor the opening of a liver transplant institute in New Mexico. We are seeking
information to confirm that belief. In addition we are seeking information on the financial
viability/impact for this program based on payer sources for the potential candidates.
Question 3: Deliverables for the Feasibility Study: Should the scope of the proposal include
potential implementation of a liver transplant program? Or is the proposal to address only the
feasibility of starting a liver transplant program?
Response to Question 3: House Memorial Bill 48 requests that the "Department of Health and
University of New Mexico Hospitals conduct a feasibility study and develop a memorandum of
understanding with other health providers in the state to determine steps necessary to create a
liver transplantation institute in New Mexico" and that the "study create plans that can be set into
action to maximize the use of possible funds that the federal government may make available."
UNMH believes that it is asking for the feasibility of starting a program and the potential
financial and operational impact of implementation.
Question 4: Section 1.1: Scope of Work: What role will the Department of Health have in
evaluation and development of the proposed Liver Transplantation Institute?
Response to Quesetion 4: Please see above response to question 3.
Question 5: Section 1.1: Scope of Work: Is the feasibility study limited to a transplant
program located at UNMH?
Response to Question 5: Within the RFP, we asked for the feasibility study to include a
recommendation on where the transplant program should be located based on the assessment.
Question 6: Section 1.1: Scope of Work: With respect to the memorandum of understanding
(MOU), would the MOU include any providers outside of the UNMH Health System?
Response to Question 6: Please see above response to question 3 and the language within
HB48.
Question 7: Section 1.1: Scope of Work: With respect to maximizing federal funds, are
federal funds limited to federal insurance payors such as Medicare, Medicaid, and Tricare or are
there other federal funds anticipated by the Department of Health and UNMH such as American
Recovery and Reinvestment Act (ARRA stimulus funds) that should be included in the
feasibility study? If so, can you provide any information on the type and amount of such
funding?
Respones to Question 7: UNMH does not have this information.
Quesiton 8: Sections 3.1.9 and 3.2.15: “What is your company’s problem resolution
process?” Can you please clarify what type of problem(s) you are referring to in each section
and if/how they differ?
Response to Question 8: For example, what is your company’s approach to dealing with issues
and problems that may be encountered during the feasibility study? Does your company have
clearly defined steps to address the issues known and unknown whether internal to your
company or with external constituents. How expeditiously are your problems resolved?
Question 9: Section 3.2.10: “If your products/approaches are not the incumbent, propose an
approach to the skills, processes and practices “conversion” that will have to take place.
Describe the implementation process including needed resources at UNMH, length of
implementation and support to the organization after implementation.” Can you please clarify
what this means and the information you’re asking for as it relates to this proposal for a liver
transplant feasibility study?
Response to question 9: What will your approach include if awarded this RFP? For example,
does your company have a plan that will show your efforts to effectively meet UNMH needs as
called for in this RFP? How will you work with the required personnel to ensure a smooth
transition into your service offering? Do you have a plan to effectively communicate your
service offering to UNMH and the community?
Question 10. Section 3.2.13: “UNMH can be a partner in demand planning to the extent that
Offeror makes detailed sales and moves historical data electronically available. What historical
information can your company provide? Sample reports include but are not limited to the
following….” Can you please clarify what this means and the information you’re requesting as
it relates to this proposal for a liver transplant feasibility study?
Response to Question 10: If awarded this RFP, UNMH may request these types of reports to
support the invoice and any information your company provides to UNMH regarding the
Feasibility Study.
Question 11: Section 3.3.13: “Describe how your company will assist us in identifying areas
for improvement.” Are the areas for improvement to start and sustain a liver transplant
program or something else?
Response to question 11: UNMH’s expectation is for your company to help identify and
provide assistance in areas where there is room for improvement as we start working together on
the Feasibility study if awarded this RFP. How will your company assist us in identifying these
areas? As your company identifies any areas of improvement, how is that communicated to
UNMH?
Acknowledge receipt of this Addendum in the space provided in Exhibit A. Failure to do so may
subject Offeror to disqualification.
All other provisions of the Proposal Documents shall remain unchanged. This addendum is
hereby made a part of the Proposal Documents to the same extent as those provisions contained
in the original documents and all itemized listing thereof.