State of Wisconsin
DOA-3261 (R08/2003)
s.16.75, Wis. Statutes
PROPOSALS MUST BE SEALED AND ADDRESSED TO:
AGENCY ADDRESS:
PURCHASING SERVICES
DEPARTMENT OF CORRECTIONS
P.O. BOX 7991
MADISON, WI 53707-7991
Remove from proposer list for this commodity/service. (Return this page only.)
Proposal envelope must be sealed and plainly marked in lower corner with due date and Request for Proposal
# EB-4253A Late proposals will be rejected. Proposals MUST be date and time stamped by the soliciting
purchasing office on or before the date and time that the proposal is due. Proposals dated and time stamped in
another office will be rejected. Receipt of a proposal by the mail system does not constitute receipt of a
proposal by the purchasing office. Any proposal which is inadvertently opened as a result of not being
properly and clearly marked is subject to rejection. Proposals must be submitted separately, i.e., not included
with sample packages or other proposals. Proposal openings are public unless otherwise specified. Records
will be available for public inspection after issuance of the notice of intent to award or the award of the
contract. Proposer should contact person named below for an appointment to view the proposal record.
Proposals shall be firm for acceptance for sixty (60) days from date of proposal opening, unless otherwise
noted. The attached terms and conditions apply to any subsequent award.
REQUEST FOR PROPOSAL
Proposals MUST be in this office no later than
THIS IS NOT AN ORDER
December 16, 2013
Public Opening
2:00PM CT
PROPOSER (Name and Address)
Name (Contact for further information)
Name: ____________________________________
Edward Bradley
No Public Opening

Phone
Address:____________________________________
608-240-5572
____________________________________
Nov 11, 2013
Quote Price and Delivery FOB
Description
SOLICITATION OF APPLICATIONS FOR A VENDOR HOSTED ELECTRONIC MEDICAL RECORD PROGRAM FOR WISCONSIN
DEPARTMENT OF CORRECTIONS BUREAU OF HEALTH SERVICES.
You are invited to submit a proposal for Electronic Medical Records (EMR) Program for Wisconsin’s Bureau of Health Services.
The attached Request for Proposal (RFP) contains detailed information regarding the mandatory requirements, technical requirements and other response
requirements for the development of Electronic Medical Records Program. Any vendor that is eligible for funding from the DOC may apply for these funds.
The contract period will be for three years with the DOC having the option to renew for five, one-year periods or portions thereof dependent on performance
during the contract period and the availability of funds.
Questions regarding this RFP should be directed to Edward Bradley at edward.bradley@wisconsin.gov. per the calendar of events in Section 1.8.
Faxed or late proposals will not be accepted. Proposals must be sent via the mail, common carrier or delivery or dropped off in person.
Late proposals will not be accepted, No exceptions. Proposals will be submitted when they have been date/time stamped at the Dept. of
Corrections. You may call Edward Bradley to verify your submission has been received.
If you responded to this RFP previously you must respond again. Your previous submission cannot be used due to changes to the requirements.
Payment Terms:
Destination
Delivery Time: To be determined
We claim minority bidder preference [Wis. Stats. s. 16.75(3m)]. Under Wisconsin Statutes, a 5% preference may be granted to CERTIFIED Minority Business Enterprises. Bidder must be certified by the
Wisconsin Department of Commerce. If you have questions concerning the certification process, contact the Wisconsin Department of Commerce, 5th Floor, 201 W. Washington Ave., Madison, Wisconsin
53702, (608) 267-9550.
We are a work center certified under Wis. Stats. s. 16.752 employing persons with severe disabilities. Questions concerning the certification process should be addressed to the Work Center Program, State Bureau
of Procurement, 6th Floor, 101 E. Wilson St., Madison, Wisconsin 53702, (608) 266-2605.
Wis. Stats. s. 16.754 directs the state to purchase materials which are manufactured to the greatest extent in the United States when all other factors are substantially equal. Materials covered in our bid were
manufactured in whole or in substantial part within the United States, or the majority of the component parts thereof were manufactured in whole or in substantial part in the United States.
Yes
No
Unknown
In signing this proposal we also certify that we have not, either directly or indirectly, entered into any agreement or participated in any collusion or otherwise taken any action in restraint of free competition; that no
attempt has been made to induce any other person or firm to submit or not to submit a proposal; that this proposal has been independently arrived at without collusion with any other proposer, competitor or potential
competitor; that this proposal has not been knowingly disclosed prior to the opening of proposals to any other proposer or competitor; that the above statement is accurate under penalty of perjury.
We will comply with all terms, conditions and specifications required by the state in this Request for Proposal and all terms of our proposal.
Name of Authorized Company Representative (Type or Print)
Title
Signature of Above
Date
Phone
(
Fax
(
Federal Employer Identification No.
)
)
Social Security No. if Sole
Proprietor (Voluntary)
This form can be made available in accessible formats upon request to qualified individuals with disabilities.
RFP EB-4253A
Electronic Medical Records BHS
Due Date: December 16, 2013
Page 2 of 33
TABLE OF CONTENTS
1.0
2.0
3.0
4.0
5.0
6.0
GENERAL INFORMATION ............................................................................................................................. 4
1.1
Introduction and background ................................................................................................................ 4
1.2
Scope of the project .............................................................................................................................. 5
1.3
Procuring and contracting agency ......................................................................................................... 9
1.4
Definitions ............................................................................................................................................ 9
1.5
Clarification and/or revisions to the specifications and requirements ................................................. 10
1.6
Vendor conference .............................................................................................................................. 11
1.7
Reasonable accommodations .............................................................................................................. 11
1.8
Calendar of events .............................................................................................................................. 11
1.9
Contract term and funding .................................................................................................................. 11
1.10
VendorNet registration ....................................................................................................................... 11
PREPARING AND SUBMITTING A PROPOSAL ........................................................................................ 12
2.1
General instructions ............................................................................................................................ 12
2.2
Incurring costs .................................................................................................................................... 12
2.3
Submitting the proposal ...................................................................................................................... 12
2.4
Proposal organization and format ....................................................................................................... 13
2.5
Multiple proposals .............................................................................................................................. 13
2.6
Oral presentations and site visits......................................................................................................... 13
2.7
Demonstrations ................................................................................................................................... 13
2.8
Withdrawal of proposals ..................................................................................................................... 14
PROPOSAL SELECTION AND AWARD PROCESS .................................................................................... 14
3.1
Preliminary evaluation ........................................................................................................................ 14
3.2
Proposal scoring ................................................................................................................................. 14
3.3
Evaluation criteria ............................................................................................................................... 14
3.4
Right to reject proposals and negotiate contract terms ....................................................................... 15
3.5
Award and final offers ........................................................................................................................ 15
3.6
Notification of intent to award ............................................................................................................ 15
3.7
Appeals process .................................................................................................................................. 15
MANDATORY REQUIREMENTS ................................................................................................................. 16
4.1
Vendor Hosted application ................................................................................................................. 16
4.2
Successful Implementation ................................................................................................................. 16
4.3
Certification ....................................................................................................................................... 16
4.4
Computer System Requirements ......................................................................................................... 16
GENERAL REQUIREMENTS…………………………………………………………………………………17
5.1
Organization…………………………………………………………………………………………..17
5.2
Qualifications…………………………………………………………………………………………17
5.3
References…………………………………………………………………………………………….17
TECHNICAL REQUIREMENTS .................................................................................................................... 17
6.1
Information technology ....................................................................................................................... 17
6.2
Clinical requirements .......................................................................................................................... 19
6.3
Ease of Use/User Friendly……………………………………………………………………………..21
2
RFP EB-4253A
Electronic Medical Records BHS
7.0
8.0
9.0
Due Date: December 16, 2013
Page 3 of 33
PRICING .......................................................................................................................................................... 21
7.1
Forms…………………………………………………………………………………………………..21
7.2
Fixed Price Period……………………………………………………………………………………..22
7.3
Inflation Adjustment………………………………………………………………………………… 22
SPECIAL CONTRACT TERMS AND CONDITIONS ................................................................................... 22
8.1
Liquidated Damages ........................................................................................................................... 22
8.2
Prime Contractor ................................................................................................................................. 22
8.3
Executed contract to constitute entire agreement ................................................................................ 22
8.4
Termination of contract ...................................................................................................................... 23
8.5
Subcontracting …….…………………………………………………………………………………..23
STANDARD TERMS AND CONDITIONS .................................................................................................... 24
Standard Terms and Conditions (Requests for Bids/Proposals) (DOA-3054)2………………………………...25
Supplemental Standard Terms and Conditions for Procurements for Services (DOA-3681)............................ 28
10.
REQUIRED FORMS ........................................................................................................................................ 29
ATTACHMENTS:
VENDOR HOSTED COST SHEET
MANDATORY REQUIREMENTS
REQUIRED FORMS
ATTACHMENT A
ATTACHMENT B
3
RFP EB-4253A
Electronic Medical Records BHS
1.0
Due Date: December 16, 2013
Page 4 of 33
GENERAL INFORMATION
1.1
Introduction and Background
Introduction
The Wisconsin Department of Corrections (DOC) is seeking a qualified vendor to provide a Vendor Hosted Electronic Medical Record
(EMR) system to service 38 correctional institutions, centers and selected field offices, approximately 900 health care staff members and
22,000 offenders. The EMR will convert the current system of manual Medical Record documentation on hard copy (paper) records to an
integrated Electronic Medical Record (EMR) to be used by internal and some external DOC customers. The DOC’s vision for the EMR is
to improve the quality, timeliness and effectiveness of patient care by providing real time access to comprehensive clinical information
wherever and whenever needed. The EMR goals are as follows:
 Improve quality of care
 Increased patient safety
 Increased health care staff productivity
 Decreased administrative expenses
 Decreased litigation costs
Background
The Wisconsin Department of Corrections (DOC) is comprised of four Divisions: Division of Adult Institutions (DAI), Division of
Juvenile Corrections (DJC), Division of Community Corrections (DCC), and Division of Management Services. The DOC houses 22,000
offenders incarcerated in DAI facilities and 270 youth committed to DJC facilities by operating 20 DAI institutions, 16 DAI centers and
two DJC facilities across Wisconsin. In Fiscal Year 2013, DAI facilities admitted 12,611 offenders. The DCC supervises approximately
68,000 individuals on probation, parole and extended supervision in the community. DJC supervises over 200 youth in the community
Health care services are currently administered by the Wisconsin Department of Corrections Bureau of Health Services (BHS), which is
located in the DOC Division of Adult Institutions (DAI). BHS is headed by a Director, who reports directly to the Administrator of DAI.
The Bureau Director is assisted by a Medical Director, who also oversees a Dental Director and a Mental Health Director. Offender health
care funding is provided to BHS for staff directly under the direct supervision of BHS, limited term employees (primarily psychiatrists),
adult external health care service contracts including: the University of Wisconsin Hospitals and Clinics, the University of Wisconsin
Medical Foundation, Agnesian Healthcare, which includes the Waupun Memorial Hospital, other local community hospitals and clinics,
and other professional medical services and pharmaceutical costs. All medical claims from external healthcare providers are adjudicated
and paid either electronically or by paper utilizing a contracted third party medical claims administrator (TPA).
DOC funding is provided to BHS for each DAI and DJC institutions and centers, for health care services and staff. Health Services Units
(HSUs) operate in each of the 20 DAI institutions, two DAI minimum security correctional centers serving women, and two DJC
institutions. DAI correctional centers do not contain HSUs, except for the two centers serving women, but instead primarily provide health
care utilizing part time LTE or contracted health care staff. However the DOC will have 39 sites that will go live on EMR.
In the Department’s HSUs, Dental Services Units (DSUs) and Psychological Services Units (PSUs), the management and provision of
health services is currently performed by the following state employees:
Health Care Staff Positions
Correctional Services Manager
Crisis Intervention Worker
Dir. Bureau of Health Services
Dir. of Nursing
DAI/BHS Budget Analyst
Dental Assistant
Dental Hygienist
Dentist Management
Dentist Supervisors
Dentist
LPN
Lab Tech Support Staff
Hemodialysis Technician
MA
Nursing Coordinators
Total Number of Staff
1
7
1
1
1
26
14
1
3
23
53
1
4
51
6
4
RFP EB-4253A
Electronic Medical Records BHS
Nursing Supervisor
Nurse/RN
Nurse Practitioner
Nursing Specialist
Nursing Assistant
Ophthalmic Assistant
Optometrist
Pharmacy Technicians
Pharmacy Technician Supervisor
Pharmacists
Pharmacist Supervisors
Physical Therapists/Occupational
Therapist
Physician Management
Physician Supervisors
Physicians
Physician Assistant
Psychiatrist Management
Psychiatrist Supervisor
Psychiatrist
Psychologist
HSU Coordinators
Medical Program Assistant
DAI/BHS Budget Analyst
BHS Contract Specialist
Office Operations Associates
Health Information Supervisor
Health Information Technician
Due Date: December 16, 2013
Page 5 of 33
29
212
31
5
14
1
6
11
2
11
3
14
2
3
23
2
2
1
30
126
6
42
1
1
42
1
7
Total*
776
*These are approximate numbers. DOC also utilizes contract staff to supplement state staffing levels
WI DOC Technical Environment Overview
The Wisconsin DOC Information Technology (IT) environment which supports BHS is managed and maintained internally by the DOC
Bureau of Technology Management (BTM) with support from the Division of Enterprise Technology (DET), a division with the
Department of Administration.
BTM is responsible for application and technology support of the DOC Central Office in Madison Wisconsin along with all other DOC
facilities located throughout the State of Wisconsin. The DOC computing environment encompasses approximately 11,000 end users
accessing 381 systems / applications/ utilities from over 200 locations in Wisconsin.
DET provides base infrastructure support in the form of statewide voice, data and video telecommunications network management. The
division also provides centralized security, print and email services to multiple state agencies.
The network infrastructure which supports department operations is a comprehensive mix of facility-based LANs supported and
interconnected by a DOC WAN utilizing several types of links and transports.
This infrastructure provides the overall connection between DOC facilities, DOC headquarters, DOA/DET, and the Internet. In addition to
these technologies, BTM employs industry-standard security components to provide a secure, available IT environment for its DOC user
base.
1.2
Scope of the project
1.2.1
Project description and Objectives
The vendor hosted system we are seeking will provide comprehensive EMR functionality including the ability to
communicate with other systems through automated interfaces. Functionalities will include:
1.2.1.1 Patient care charting
1.2.1.2 Disease management
5
RFP EB-4253A
Electronic Medical Records BHS
1.2.1.3
1.2.1.4
1.2.1.5
1.2.1.6
1.2.1.7
1.2.1.8
1.2.1.9
1.2.1.10
1.2.1.11
1.2.1.12
1.2.1.13
1.2.1.14
Due Date: December 16, 2013
Page 6 of 33
Support for family practice, internal medicine, OB/GYN, and mental health care
Order communication and results retrieval
Clinical decision support
Documentation of clinical reasoning and rationale
Workflow automation
Patient scheduling
Fulfillment of prescriptions, medication tracking, delivery, and administration to the patient
Flexible reporting and querying including population health reports, performance indicators, and
utilization statistics
Capturing external documents into the system
Conformance to existing and emerging national vocabulary, format, and messaging standards
HIPAA privacy and security compliance
Dental charting and care management
1.2.2
Needs
The DOC does charge offenders a medical co-pay amount for offender initiated appointments in its health service units,
DOC does not charge offenders or bill organizations for health care services provided to offenders. Billing and charge
capture features are not required. Customization may be required to capture co-pay charges and electronically
communicate them to the offender accounting system.
The Wisconsin Integrated Corrections System (WICS) contains all offender demographic and housing/movement data
along with several other functions. The hosted EMR system must integrate with WICS and have the ability to import and
use offender demographic, movement and other defined data. WICS ‘owns’ the demographic information but the data
must be exchanged between the systems on a real-time basis.
1.2.3
Current operations
Bureau of Health Services
Health Services in the Department of Corrections consists of standardized and specialized units providing medical, dental
and mental health care to all offenders incarcerated in a Division of Adult Institution facility and youth committed to a
Division of Juvenile Corrections facility.
The Bureau of Health Services has Clinical Directors in the areas of medicine, psychiatry, psychology, nursing, pharmacy
and dentistry oversee the practice of the employees, develop programs for care delivery, and monitor the cost of the
programs. Clinical Directors provide prior authorization for all off site non-emergency services for their areas utilizing a
system similar to that of a Health Maintenance Organization (HMO).
Reception Facilities
Upon admission of an offender, health staff in Health Services Units (HSU), Dental Services Units (DSU) and
Psychological Services Units PSU) conduct examinations and evaluations of the medical, dental and mental health status
of each offender. The HSU obtains a medical history and conducts a physical examination that may include laboratory
tests, tests for communicable diseases and/or other diagnostic testing, as appropriate. Prescribing practitioners order
needed medications. Vision is tested and glasses are provided. DSU dentists provide a complete dental examination, as
well as panoramic and bitewing x-rays. PSU staff conduct a mental health screening and evaluation with a focus on the
offender’s potential for self-harm and suicide. Each offender has a standard Medical Record described below.
In addition, health care staff determines the medical, mental health and dental classifications used by the Program Review
Committee of the Bureau of Offender Classification and Movement to determine housing and program assignments.
Reception centers include Dodge Correctional Institution for sentenced male offenders, Taycheedah Correctional
Institution for sentenced female offenders and the two juvenile facilities (Lincoln Hills and Copper Lake Girl Schools)
for committed youth. Milwaukee Secure Detention Facility and Sturtevant Transitional Facility serve as reception
facilities for short-term admissions of adults directly from supervision in the community.
Active DOC Medical Record
The reception facility sets up a new standardized paper-based Medical Record for an offender without a prior stay in a
DOC facility. Upon re-admission of an offender with a prior stay in a DOC facility, the existing Medical Record is reactivated for use during the new stay, unless the old Medical Record has been destroyed as permitted by law. The
standard Medical Record primarily consists of a Medical Chart, Dental Record, Patient Request Folder and a
6
RFP EB-4253A
Electronic Medical Records BHS
Due Date: December 16, 2013
Page 7 of 33
Psychological Services Unit Record. Formal policies direct the content and format of all parts of the Medical Record.
The short-term admissions facilities use a modified version of the Medical Record.
The Medical Records move with patients as they transfer from one DOC facility to another throughout their stay to
document their health care needs and all health care provided to them. Transfer of the Medical Record assists in ensuring
continuity of care during the entire stay of each patient regardless of the number of times a patient transfers between
DOC facilities.
Health Services Units, Psychological Services Units and Dental Services Units handle requests by offenders/youth to
review and/or obtain copies of documents from their Medical Records. They also respond to requests from other
individuals with proper authorization to review and/or obtain copies of documents filed in the Medical Records of
offenders located at their facilities.
Health Service Units
HSUs deliver preventive, ambulatory, emergency, acute, chronic care, health education and professional medical services
to adults/youth in correctional facilities. Services provided on-site by outside contractors includes medical, psychiatric,
nursing, dental, and optometric care as well as pharmaceuticals, rehabilitation services, diagnostic services including
laboratory services, mammograms, digital x-rays and ultrasounds.
HSUs conduct a health screening and record review upon transfer of a patient from one DOC facility to another.
Preventative care is provided for communicable and chronic diseases as well as immunizations against communicable
diseases. Patients obtain health care via appointments either patient initiated (which generates a co-payment charge) or
provider initiated. Patients receive care for chronic health conditions by appointment with on- site or off- site health care
providers. HSU staff offer health education to offenders/youth in prevention, medical conditions, care and treatment.
DOC staff provides emergency care on site or transports the patient to an outside emergency room or to a DOC
contracted specialty or inpatient care provider Specialty care including surgical procedures is completed off-site. Acute
care needs necessitate care to be provided at an off-site hospital.
Offenders residing in minimum-security correctional centers receive health care on-site. The health care staff includes
nurses, nurse practitioners and physicians who are either contractual, Limited Term Employees, DOC employees, or a
combination depending on the center. Nurses triage Health Service Requests submitted by offenders, conduct sick call,
and make arrangements for further care as needed. In addition, nurses refill medications per request of offenders. The
Bureau of Health Services provides direction and oversight to health staff assigned to correctional centers.
Psychological Service Units
Maximum, medium and select medium security Division of Adult Institutions facilities at PSUs that provide
psychological care to offenders. Some PSUs provide psychological coverage to nearby minimum security correctional
centers. Psychologists working in Psychological Services at Division of Juvenile Corrections facilities provide
psychological care to youth. The Division of Community Corrections provides some psychological services to offenders
on community supervision at selected field offices.
Care includes mental health screening, monitoring of symptoms, individual and group therapy, crisis intervention,
psychological testing, in-depth assessments and development of treatment plans. Offenders are placed on clinical
observation status with either constant watch or 15-minute officer checks when suicide risk becomes apparent.
Psychological staff provide consultation to other disciplines including security staff, social workers, and medical staff.
Psychological staff makes determinations whether offenders need to be transferred to the Wisconsin Resource Center
(operated by the Department of Health Services) when mental health needs become more acute and an inpatient level of
care is needed. Psychological staff also participate in multidisciplinary meetings with security, psychiatric, health care,
and social work staff and document the outcome of those meetings.
Dental Service Units
Dental Units provide an array of dental services to offenders at all Division of Adult Institutions, most Centers, and the
two Division of Juvenile Corrections facilities. The DOC also works with local dental offices which provide care for
some outlying correctional centers, and with Marquette University School of Dentistry which provides dental services for
offenders at the Milwaukee-area Centers.
Dental services include oral examination, panoramic and intraoral x-rays (digital and regular film), emergent, urgent and
palliative dental care, hygiene and preventive dental services, restoration of teeth, oral surgery, endodontic and prosthetic
dental care. Access to off-site dental, hospital and medical specialists for consultation and care is available when
necessary via a preauthorization (Class III) process.
7
RFP EB-4253A
Electronic Medical Records BHS
Due Date: December 16, 2013
Page 8 of 33
Offenders are generally placed on wait lists for routine and hygiene care. The length of time an offender may wait for
routine dental care varies across the facilities but ranges from two weeks to almost two years. Maintenance of the
offender’s position on these wait lists, including when transferring between the different DOC facilities, is critical to
provision of fair access to dental services. All offenders are placed on a recall system for hygiene and preventive care.
Additionally, those offenders having chronic medical conditions are placed on a recall for general dental care.
Dental Services maintains extensive documentation/statistics on procedures provided by provider and by facility;
performance measures related to the requests for care, the treatment provided, wait times; and other measures. Fee
schedules using standard Dental CDT codes track the dollars of service provided in each category of service; dollars per
hour per provider; and other production measures. Expense (budget) and accounting data is maintained to evaluate the
dollars produced against the costs to provide the care. Data collection is an essential component used in the management
of Dental Services.
Dental staff provides consultation to other disciplines including security staff, social workers and PRC, and collaborate
with medical staff to provide total patient care.
Hemodialysis Units
DOC has hemodialysis units located at Dodge Correctional Institution and Fox Lake Correctional Institution that provide
hemodialysis to a maximum of eighteen adult male patients. Specially trained DOC nurses provide the on- site
hemodialysis services. A nephrologist under contract with the DOC makes regular site visits and oversees the treatment
of patients with end stage renal disease.
Infirmary
The Infirmary at Dodge Correctional Institution provides patients with 24- hour skilled nursing care, rehabilitative
services, and supervision that cannot be provided in other DOC facilities. Infirmary patients do not require care in an
acute hospital setting. The Infirmary has the capacity for 54 male patients and 6 female patients. Five rooms are
negative pressure cells.
BHS Central Pharmacy
The Department operates a central pharmacy in Waupun, Wisconsin, that uses QS1 pharmacy management software and
receives prescriptions from all correctional facilities. Pharmaceuticals are packaged in blister packs for security
purposes, and sent via UPS to the facility Health Service Units for further processing and distribution by the DOC health
care staff.
The Department purchases pharmaceuticals via a group purchasing organization resulting in significant savings on
pharmaceuticals being used. DOC has a drug formulary managed by a Pharmacy and Therapeutics Committee.
Approximately 871,000 prescriptions were processed in fiscal year 2013, 845,000 in fiscal year 2012..
Telemedicine
The Department uses telemedicine for some off-site specialty medical appointments to eliminate the need for
transportation and escort to community health facilities that may be several hours away from the DOC facility in which
the patient resides. The DOC performed 800 telemedicine specialty visits in FY 2013.
In addition, DOC psychiatrists have been conducting psychiatry appointments via telemedicine for nearly four years. The
number of appointments continues to increase with the expectation of 3,500 to 4,000 appointments per year.
Additional Specialty Health Services and Interfaces
Specialty services for orthopedics and oral surgery have been established at Dodge Correctional Institution. Optical
Coherence Topography eye imaging exams are provided at designated Health Service Units. Offenders are transported
for appointments from nearby DOC facilities thereby reducing trips to offsite care providers located a far distances.
Current medical device manufacturers include: Burdick and Welch-Allyn (EKG), Baxter, Welch-Allyn (vital signs
monitors), Jaeger and Welch Allyn (Spirometry), Nellcor Puritan Bennett (Pulse Oximeters). A vendor by the name of
Mobile X handles provides our Digital Medical Imaging.
Management of Inactive Medical Record
8
RFP EB-4253A
Electronic Medical Records BHS
Due Date: December 16, 2013
Page 9 of 33
Central Medical Records (CMR) at Dodge Correctional Institution for males and Inactive Women’s Medical Records
(IWMR) at Taycheedah Correctional Institution for females receive, track and store inactive Medical Records for
offenders no longer incarcerated in a DAI facility or committed to a DJC facility. As of mid-2010 CMR currently has
over 12,000 lineal feet of Medical Records in storage. CMR and IWMR re-activate existing Medical Records upon readmission of an offender to a DOC facility, destroy Medical Records as permitted under federal and state law, and
respond to hundreds of requests per month for information from the inactive Medical Records pursuant to federal and
state confidentiality laws. Requests come from community health care providers, Social Security Administration,
attorneys, governmental agencies, former offenders, family members, and others.
1.3
Procuring and contracting agency
This Request for Proposal (RFP) is issued by the Wisconsin Department of Corrections, Division of Procurement which
is the sole point of contact for the State of Wisconsin during the selection process. The person responsible for managing
the procurement process is Edward Bradley.
The contract resulting from this RFP will be administered by the Wisconsin Department of Corrections. The contract
will be managed by Edward Bradley and administrated by David Schuller.
1.4
Definitions
The following definitions are used throughout the RFP.
ActiveX:
ARO:
ASP:
Availability
BHS:
Bidder:
BTM:
CD:
CO:
Framework for defining reusable software components in a programming language
After Receipt of Order
Application Service Provider
The time the Application, System and Utilities are operable and accessible to Authorized Users.
Bureau of Health Services
Firm submitting a bid in response to this Request for Bid
Bureau of Technology Management of the DOC
Compact Disc
Central Office - Administrative offices for the Department of Corrections located at 3099 E.
Washington Avenue, Madison, WI, 53704
CITRIX:
Computing SW products from Citrix Systems Inc which facilitate remote access to computer
applications
CONTRACTOR: Successful vendor awarded the contract
DAI:
Division of Adult Institutions - administers state-operated correctional facilities for convicted and
sentenced persons throughout Wisconsin
DCC:
Division of Community Corrections - supervises convicted offenders outside of correctional facilities in
communities throughout Wisconsin
DCI:
Dodge Correctional Institution
DEPARTMENT: Wisconsin Department of Corrections
DET:
Division of Enterprise Technology in the Department of Administration
DICOM:
Digital Imaging and Communications in Medicine
DJC:
Division of Juvenile Corrections - operates three correctional facilities for youth adjudicated delinquent
and supervises delinquents in the community
DOA:
Department of Administration has statutory authority [Wis. Stats. Chapter 16] to define, regulate and
delegate all aspects of procurement of commodities and services for state agencies.
DOC:
Department of Corrections - also referred to as the department
DS3:
Digital Signal 3
DSL:
Digital Subscriber Line
DSU:
Dental Services Unit providing dental care in a DOC facility
EHR:
Electronic Health Record, same as EMR
EMR:
Electronic Medical Record, same as EHR
FERPA:
Family Educational Rights and Privacy Act
HCR:
Medical Record - official record set documenting health care needs of persons in DAI and DJC
facilities and health care provided to those persons
HIPAA:
Health Insurance Portability and Accountability Act
HSU:
Health Service Unit providing medical/psychiatric services in a DOC facility
INFIRMARY: Medical unit at Dodge Correctional Institution providing 24- hour care to offenders
OFFENDER: Person convicted and sentenced to a DOC Division of Adult Institution facility
IP:
Internet Protocol
9
RFP EB-4253A
Electronic Medical Records BHS
Due Date: December 16, 2013
Page 10 of 33
IPSec:
ISDN:
IT:
JAVA:
LAN:
LDAP:
LTE:
MBE:
MUST:
OFFENDER:
Internet Protocol Security
Integrated Services Digital Network
Information Technology
Computer programming language developed by Sun Microsystems, Inc.
Local Area Network
Lightweight Directory Access Protocol
Limited Term Employee
Minority Business Enterprise
Requirement is mandatory
Person on correctional supervision in the community; also sometimes used to refer to a person in a DAI
or DJC facility
ODBC:
Open Database Connectivity - a standard software interface for accessing database management
systems
ONC
Office of the National Coordinator for Health Information technology
PACS:
Picture Archiving and Communication Systems
P-Card:
Procurement Card (State credit card)
PDA:
Personal Digital Assistant
PDF:
Portable Document Format
PHI:
Protected Health Information
PROPOSER: A firm submitting a proposal in response to this RFP.
PSU:
Psychological Services Unit providing psychological care in a DOC facility
PURCHASING: DOC’s Purchasing Services Section
QS1:
Software program used by the Central Pharmacy
RFID:
Radio Frequency Identification
RFP:
Request for Proposal
SOAP:
Subjective, Objective, Assessment and Plan – components of a Progress Note in a Medical Record
SHALL:
Requirement is mandatory
SHOULD:
Desirable but not mandatory
STATE:
State of Wisconsin
TCI/IP:
Transmission Control Protocol/Internet Protocol
TELEMEDICINE: Medical and psychiatric appointments conducted by electronic media.
VENDOR:
Firm submitting a proposal in response to this Request for Bid
VENDORNET: State of Wisconsin solicitation website
VENDOR
HOSTED:
The EMR system is fully supported by the Proposer, operating with the Unites States , including
running on computer servers supplied and managed by the Proposer or on servers available to the
Proposer as a contracted service, but still the responsibility of the Proposer.
WAN:
Wide Area Network
WCCS:
Wisconsin Correctional Center System - a system of small minimum security centers located around the
state which offer work-release options to male offenders to prepare them for release
WICS:
Wisconsin integrated Correctional System that manages the movement of offenders
WWCS:
Wisconsin Women’s Correctional System - - a system of small minimum security centers located
around the state which offer work-release options to female offenders to prepare them for release
YOUTH:
Person committed to a DJC facility or under DJC supervision in the community.
1.5
Clarification and/or revisions to the specifications and requirements
Any questions concerning this RFP must be submitted in writing on or before
November 25, 2013 to:
Wisconsin Department of Corrections
Division of Management Services
Edward Bradley, Contract Analyst
3099 E. Washington Ave
Madison, WI. 53707
Phone: 608-240-5572
Fax: 608-240-3342
Email: edward.bradley@wisconsin.gov
10
RFP EB-4253A
Electronic Medical Records BHS
Due Date: December 16, 2013
Page 11 of 33
Vendors are expected to raise any questions, exceptions, or additions they have concerning the RFP DOCUMENT at this
point in the RFP process. If a vendor discovers any significant ambiguity, error, conflict, discrepancy, omission, or other
deficiency in this RFP, the vendor should notify immediately the above named individual of such error and request
modification or clarification of the RFP.
In the event that it becomes necessary to provide additional clarifying data or information, or to revise any part of this
RFP, revisions/amendments and/or supplements will be provided to all recipients of this initial RFP.
Each proposal is predicated upon the requirements, terms, and conditions of this RFP and any supplements or revisions
thereof.
Any contact with State employees concerning this RFP is prohibited, except as authorized by the RFP manager
during the period from date of release of the RFP until the notice of intent to contract is released.
1.6
Vendor conference
There will not be a proposer conference call .
1.7
Reasonable Accommodations
The DOC will provide reasonable accommodations, including the provision of informational material in an alternative
format, for qualified individuals with disabilities upon request. If you think you need accommodations at a bid
opening/vendor conference, contact Edward Bradley via email at edward.bradley@wisconsin.gov.
1.8
Calendar of events
Listed below are specific and estimated dates and times of actions related to this Request for Proposal (RFP). The
actions with specific dates must be completed as indicated unless otherwise changed by the State. In the event that the
State finds it necessary to change any of the specific dates and times in the calendar of events listed below, it will do so
by issuing an amendment to this RFP on Vendornet. In order for a proposer to receive the amendments, the proposer
must be signed up on Vendornet prior to the posting of the proposal.
DATE
November 11,2013
November 25,2013
NA
November 27.2013
December 16, 2013
TBS
February, 2014
April, 2014
EVENT
Date of issue of the RFP
Last day for submitting written questions
Vendor Conference Call Section 1.6
Answers to written questions posted to VendorNet(Estimate)
Proposals due from vendors
Oral presentations/Demonstrations (if required)
Notification of intent to award sent to vendors (Estimate)
Contract start date (Estimate)
1.9
Contract term and funding
The contract initial term will be for three years, with options to extend the contract for five, additional one-year renewals.
Renewal(s) beyond the initial contract term is contingent upon the performance of the contractor during the contract
period and upon availability of funds. These will be automatic renewals, unless the State elects to exercise a termination
option. Contracts will be reviewed by the DOC before a decision is made. Any renewal(s) must be authorized by mutual
written agreement of the proposer and the State.
1.10
VendorNet registration
Department of Administration and State Bureau of Procurement policies no longer require maintenance of bidder’s lists
or individual notification n of vendors on bidders’ lists. In addition, there is no requirement to post solicitations for
bids/proposals in the Legal Notices of the Official State Newspaper. Vendors who fail to register with VendorNet may
not receive notification of procurement solicitations including amendments or cancellations.
The State of Wisconsin’s purchasing information and vendor notification service is available to all businesses and
organizations that want to sell to the state. Anyone may access VendorNet on the Internet at http://vendornet.state.wi.us
to get information on state purchasing practices and policies, commodities and services that the state buys, and tips on
selling to the state. Vendors may use the same Web site address for inclusion on the bidders list for commodities and
services that the organization wants to sell to the state. A subscription with notification guarantees the organization will
receive an e-mail message each time a state agency, including any campus of the University of Wisconsin System, posts a
11
RFP EB-4253A
Electronic Medical Records BHS
Due Date: December 16, 2013
Page 12 of 33
request for bid or a request for proposal in their designated commodity/service area(s) with an estimated value over
$50,000. Organizations without Internet access receive paper copies in the mail. Increasingly, state agencies also are
using VendorNet to post simplified bids valued at $50,000 or less. Vendors also may receive e-mail notices of these
simplified bid opportunities.
To obtain information on the state’s bidder registration, visit the VendorNet Web site at http://vendornet.state.wi.us or
call the VendorNet Information Center (1-800-482-7813). In the Madison area, call 608-264-7898.
Make sure to select all the appropriate NIGP (Commodity) Codes. Bid lists are generated by NIGP codes.
Consider using a generic email address that is accessed or delivered to multiple recipients (example:
bids@xyzcompany.com). This will insure that the bid notice is received.
2.0
PREPARING AND SUBMITTING A PROPOSAL
2.1
General instructions
The evaluation and selection of a contractor and the contract will be based on the information submitted in the vendor's
proposal plus references and any required on-site visits or oral interviews/demonstrations. Failure to respond to each of
the requirements in the RFP may be the basis for rejecting a response.
Elaborate proposals (e.g., expensive artwork), beyond that sufficient to present a complete and effective proposal, are not
necessary or desired.
2.2
Incurring costs
The State of Wisconsin is not liable for any cost incurred by proposers in replying to this RFP.
2.3
Submitting the proposal
Proposers must submit one original and one entire copy (including the cost proposal in a separate document)on CDROM or flash drive. (NOTE: any information deemed confidential MUST be in a separate folder marked
“confidential” on the CD-ROM. Any open records requests will receive a copy of the CD-ROM minus the
documents inside the confidential folder.) of all materials required (MS Word or Adobe format) for acceptance of their
proposal no later than 2:00 PM Central Time December 16, 2013 to the following individual:
USPS ADDRESS:
DEPARTMENT OF CORRECTIONS
EDWARD BRADLEY/PURCHASING SERVICES
P.O. BOX 7991
MADISON, WI 53707-7991
COMMON CARRIER ADDRESS:
DEPARTMENT OF CORRECTIONS
EDWARD BRADLEY/PURCHASING SERVICES
3099 EAST WASHINGTON AVENUE
MADISON, WI 53704-4338
All proposals must be time-stamped as accepted at the Dept. of Corrections site by the specified time stated above.
Proposals not stamped by the due date and time will not be accepted. The front reception desk and the mailroom desk
have time/date stamps at the DOC. Receipt of a proposal by the State mail system does not constitute receipt of a
proposal for purposes of this RFP. Vendors should send their proposals with sufficient time for unexpected or
unanticipated delays in the mail or delivery system.
To ensure confidentiality of the document, all proposals must be packaged, sealed and show the following information on
the outside of the package:
—Proposer's name and address
—Request for proposal title
—Request for proposal number
—Proposal due date
The Cost Proposal must be sealed and submitted as a separate part of the proposal and is due to the addressee on the due
date and time noted above. The electronic copy of the cost proposal must be in a separate file that is clearly marked as
the cost proposal for the RFP. This file will only be opened when/if the vendor’s cost proposal is considered. The outside
of the envelope must be clearly labeled with the words:
-- “Cost Proposal”
12
RFP EB-4253A
Electronic Medical Records BHS
Due Date: December 16, 2013
Page 13 of 33
-- Proposer’s name and address
-- Request for proposal title
-- Request for proposal number
-- Proposal due date
Cost Proposals must be received at the same time as the remainder of the proposal as stated above.
2.4
Proposal organization and format
Proposals should be typed and submitted on 8.5 by 11 inch paper bound securely. Proposals should be organized and
presented in the order and by the number assigned in the RFP. Proposals must be organized with the following headings
and subheadings below. Each heading and subheading should be separated by tabs or otherwise clearly marked. The
RFP sections which should be submitted or responded to are:
PROGRAM PROPOSAL FORMAT (EXAMPLE)
TABS
Tab 1
Tab 2
Tab 3
Tab 4
SECTIONS/ATTACHMENTS
Cover page (DOA-3070)
Introduction
Mandatory Requirements
General Requirements
Technical Requirements
Information Technology Requirements
Clinical Requirements
Ease of Use/ User Friendly
Tab 5.
Tab 6
Tab7
5.1
5.2
5.3
Required forms
Tab8
Designation of Confidential and Proprietary Information
Vendor Information
Vendor Reference
Insurance Document
Cost Sheet
Tab 9
Financial Information
Tab 10
Misc. Information
Tab 11
9.0
Attachment B
Attachment A
The vendor must submit its Cost Proposals based on providing a Vendor hosted solution on the forms provided in
Attachments A according to the instructions provided. Failure to provide any requested information in the prescribed
format may result in disqualification of the proposal.
No mention of the cost proposal may be made in the response to the technical requirements of this Request for Proposal.
2.5
Multiple proposals
Multiple proposals from a vendor will be permissible; however, each proposal must conform fully to the requirements for
proposal submission. Each such proposal must be submitted separately and labeled as Proposal #1, Proposal #2, etc. on
each page included in the response. Alternate acquisition plans do not constitute multiple proposals.
2.6
Oral presentations and site visits
Top scoring vendors based on an evaluation of the written proposal may be required to participate in interviews and/or
site visits to support and clarify their proposals, if requested by the State. The State will make every reasonable attempt
to schedule each presentation at a time and location that is agreeable to the proposer. Failure of a proposer to interview
or permit a site visit on the date scheduled may result in rejection of the vendor's proposal.
2.7
Demonstrations
Top-scoring vendor(s) as determined by the evaluation team may be required to demonstrate their product(s) and/or
service(s) at a State site. DOC IT will need advance notice prior to the demo to assure product(s) can be demonstrated on
DOC intranet or internet. The State will furnish detailed specifications concerning the demonstration site and the
particular test it will use to exercise the vendor's product(s) and/or service(s). Failure of a vendor to furnish the
13
RFP EB-4253A
Electronic Medical Records BHS
Due Date: December 16, 2013
Page 14 of 33
product(s) and/or service(s) it has proposed for demonstration within the time constraints of the preceding paragraph may
result in rejection of that proposal. Failure of any product(s) and/or service(s) to meet the State's specified requirements
during the demonstration may result in rejection of the vendor's proposal.
The successful demonstration of the vendor's product(s) and/or service(s) does not constitute acceptance by the State.
Any product(s) and/or service(s) furnished by the vendor for the purposes of this demonstration must be identical in every
respect to those which will be furnished if a contract results.
2.8
3.0
Withdrawal of proposals
Proposals shall be irrevocable until contract award unless the proposal is withdrawn. Proposers may withdraw a proposal
in writing at any time up to the proposal closing date and time or upon expiration of 30 days after the due date and time if
received by the RFP project manager. To accomplish this, the written request must be signed by an authorized
representative of the proposer and submitted to the RFP project manager. If a previously submitted proposal is
withdrawn before the proposal due date and time, the proposer may submit another proposal at any time up to the
proposal closing date and time.
PROPOSAL SELECTION AND AWARD PROCESS
3.1
Preliminary evaluation
The proposals will be reviewed initially to determine if mandatory requirements are met. Failure to meet mandatory
requirements may result in rejection of the proposal. In the event that all vendors do not meet one or more of the
mandatory requirements, the State reserves the right to continue the evaluation of the proposals and to select the proposal
which most closely meets the requirements specified in this RFP.
3.2
Proposal scoring
The cost proposals piece will be calculated with the most points awarded to the proposal with the lowest cost. Other cost
proposals will be prorated points that correlate to those assigned to the lowest cost proposal.
Proposals that meet the mandatory requirements will be reviewed by an evaluation committee and scored against the
stated criteria. Proposer is not to contact any member of the evaluation committee except at the procurement leads
direction. The committee may review references, request interviews, and/or conduct on-site visits and use the results in
scoring the proposals. Proposals from certified Minority Business Enterprises may have points weighted by a factor of
1.00 to 1.05 to provide up to a five percent (5%) preference to these businesses (Wis. Stats. 16.75(3m)). The evaluation
committee's scoring will be tabulated and proposals ranked based on the numerical scores received.
3.3
Evaluation criteria
The proposals will be scored using the following criteria:
POINTS
MANDATORY REQUIREMENTS
YES or NO
PERCENT
GENERAL REQUIREMENTS
100
9.1%
TECHNICAL REQUIREMENTS
800
72.7%
Information Technology Requirements
Clinical Requirements
Ease of Use/ User Friendly Requirements
150
450
200
13.6%
41.0%
18.1%
COST PROPOSAL
200
18.2%
TOTAL
1100
100%
Only proposals that meet the mandatory requirements and complete the required forms will have their proposals scored.
14
RFP EB-4253A
Electronic Medical Records BHS
Due Date: December 16, 2013
Page 15 of 33
The points stated above for each criterion shall be the maximum amount awarded for each category. "Cost", for scoring
purposes in this instance, means the total cost of implementing this service. After the final grading of the proposal
requirements, cost will be prorated with the lowest cost proposal given the highest score for that part of the category.
Other cost proposals will receive prorated scores based on the proportion that the cost varies from the lowest cost. The
formula will be as follows:
Lowest Total Cost (Constant)
X 200 points
Next Lowest Proposer Total Cost
= Prorated score for
the Cost Component
Information
Calculation of points awarded to subsequent proposals will use the lowest bid amount as a constant numerator and the
dollar amount of the agency being scored as the denominator (results will always be less than one). The result is
multiplied by the maximum number of points for Cost (200pts).
The evaluation team will make a decision after scoring the General Requirements and determine the number of proposers
that will move on to have the Technical Requirements scored. DOC will be the sole source to determine if a proposer
moves on to become a top scoring proposer that is asked to participate in the demonstration, interview and/or site visit..
Based upon the findings of the reference checks, site review, interviews and/or presentation, al point values may be
changed.
The top scoring proposal will be deemed to best meet the needs of DOC.
3.4
Right to reject proposals and negotiate contract terms
The State reserves the right to reject any and all proposals. The State may negotiate the terms of the contract, including
the award amount, with the selected proposer prior to entering into a contract. If contract negotiations cannot be
concluded successfully with the highest scoring proposer, the agency may negotiate a contract with the next highest
scoring proposer.
3.5
Award and final offers
The State will compile the final scores (general, technical and cost) for each proposal. The award will be granted in one
of two ways. The award may be granted to the highest scoring responsive and responsible proposer. Alternatively, the
highest scoring proposer or proposers may be requested to submit final and best offers. If final and best offers are
requested by the State and submitted by the vendor, they will be evaluated against the stated criteria, scored and ranked
by the evaluation committee. The award then will be granted to the highest scoring proposer. However, a proposer
should not expect that the State will request a final and best offer and therefore should submit their best proposal when
originally submitted.
3.6
Notification of intent to award
All vendors who respond to this RFP will be notified in writing of the State's intent to award the contract(s) as a result of
this RFP.
After notification of the intent to award is made, and under the supervision of agency procurement staff, copies of
proposals will be available for public inspection from 8:00 a.m. to 4:00 p.m. at 3099 E. Washington Ave, Madison,
Wisconsin. Proposers should schedule reviews with Edward Bradley at (608) 240-5572.
3.7
Appeals process
Notices of intent to protest and protests must be made in writing to the head procuring agency. Protestors should make
their protests as specific as possible and should identify statutes and Wisconsin Administrative Code provisions that are
alleged to have been violated.
The written notice of intent to protest the Intent to Award a Contract must be filed with:
EDWARD F. WALL, SECRETARY
DEPARTMENT OF CORRECTIONS
PO BOX 7925
MADISON WI 53707 7925
15
RFP EB-4253A
Electronic Medical Records BHS
Due Date: December 16, 2013
Page 16 of 33
And be received in the office above within five (5) working days after the notice of intent to award is issued. The written
protest must be received in the office above within ten (10) working days after the notice of intent to award is issued.
Copies of the notice of intent to protest and the written protest should be sent to the Purchasing Section Chief at the same
address.
The decision of the head of the procuring agency may be appealed to the Secretary of the Department of Administration
within five (5) working days of issuance, with a copy of such appeal filed with the procuring agency, and provided the
appeal alleges a violation of statute or a provision of a Wisconsin Administrative Code.
4.0
MANDATORY REQUIREMENTS
The following are mandatory requirements. Proposers not meeting these requirements will be eliminated from the evaluation
process. The only exception that would be applied, is if none of the proposers are able to comply with a given requirement or
condition. Purchasing reserves the right to amend that specification or condition.
 Respond to the mandatory’s below and complete Attachment B at the end of this document.
The EMR system must include, at a minimum, the following system requirements:
4.1 Vendor-Hosted Application
The EMR solution proposed by the vendor is vendor-hosted Software as a Service (SaaS) solution operated, maintained and
supported in the United States by the vendor at a secure, US-based Tier 3 secure data Center and accessed by DOC over the
Internet.
4.2 Successfully implemented
Vendor has successfully implemented an EMR system within a secure setting (examples federal, state prison, local jail, etc.).
 Provide supporting documentation, Be sure to include the types of facilities, locations, served, etc.
4.3 Certification
The CMS Medicare and Medicaid EHR Incentive Programs provide a financial incentive for the Meaningful Use of Certified EHR
Technology. Meaningful Use establishes the requirements for providers to show they are using CEHRT in ways that can be
measured significantly in quality and quantity. DOC’s EHR must be certified to enable interoperability with other health care
providers’ EHR technology, and DOC providers intend to participate in meaningful use. Therefore the following are mandatory:
4.3.1
The EHR technology proposed by the vendor must be Certified EHR Technology (CEHRT) in accordance with the
definition provided in 45 CFR Part 170.102 required for Stage 1 and Stage 2 of meaningful use in calendar year 2014 and
subsequent years.
4.3.2
If the vendor’s CEHRT or any third-party CEHRT proposed by the vendor is presently only certified for the 2011 Edition
EHR certification criteria, vendor must provide proof that certification to the 2014 Edition certification criteria is in progress, the
date certification will be completed, and affirmation in writing the upgrade to the 2014 Edition of its proposed products is included
in its cost proposal (i.e., there will be no additional costs to DOC for the upgrade beyond what is included in the cost proposal).
4.3.3
Vendor must provide a list of the EHR technology products proposed, including product name, product version, and the
Certified Health IT Product List (CHPL) Product number, so the Department can verify vendor’s response to this mandatory
requirement.
4.3.4
Vendor must agree to maintain certification of its products at the levels required for provider participation in the
Medicare and Medicaid EHR Incentive Programs.
4.4 Computer System Requirements:
4.4.1 The proposed solution must function on a Windows 7.32 bit SP1 Desktop Operating System
4.4.2 The proposed solution must function with Microsoft Internet Explorer 8 or newer
4.4.3 The proposed solution must function for DOC users whose access is limited to that of Standard User in the User Account
Control (UAC) setting on their DOC desktops.
16
RFP EB-4253A
Electronic Medical Records BHS
Due Date: December 16, 2013
Page 17 of 33
4.4.4 Vendor has conducted a HIPAA Security Risk Assessment for its data center(s) and proposed solution’s administrative,
technical, and physical safeguards.
 Provide a copy of the Risk Assessment and/or SAS-70 report.
4.4.5 Vendor acknowledges DOC has full ownership of all DOC data in the EMR and agrees that all DOC data will be returned to
the DOC if the contract is terminated for any reason. Return of the data includes providing data in an industry standard format,
current at the time, either to DOC or to a DOC designated vendor and assisting with any required data verification to ensure data is
complete and useable. This will be at the expense of the vendor.
5.0 GENERAL REQUIREMENTS
5.1 Organization
 Describe your company’s experience and capabilities in providing EMR solutions. Be sure to include any specific
correctional environment (or closely related) experience. Be specific and identify projects, unique locations, number of
offenders, dates, length of time, and measureable results. Be sure to include the number of patients served by the system
and the number of medical providers accessing and/or entering information into the system.

If the submitted proposal is one of the proposals selected for final evaluation the proposer will be asked to supply the
most recent 3 years of audited financial data (Income statement, Balance Sheet and Cash Flow Statements). Failure to
provide this information as requested or providing information that does not show financial stability may be grounds for
rejection of the proposal.

If the submitted proposal is one of the proposals selected for final evaluation, the vendor will be asked to list any pending
or closed litigation where your company was the defendant or respondent that has happened in the last three years. Failure
to provide this information as requested or providing information that shows litigation that could adversely affect the ability
of the vendor to perform the duties of this contract may be grounds for rejection of the proposal.
5.2 Vendor Qualifications
 Provide a list of locations where EMR systems have been successfully implemented. Describe the type of setting in which
the system was implemented. DOC is requesting that the vendor have a minimum of 3 years of experience in providing
EMR services in a correctional-type environment. Proposals that have experience in an environment most similar to that of
DOC will score the most points in this section. Description of the settings should include the number of inmates served,
distinct geographical locations, etc.

Submit resumes of all key personnel who will be assigned to this contract. This should include but not be limited to:
Project Manager, Technical Support Expert, Implementation Team members.

Describe in detail an implementation of an EMR system done using the system that you are proposing(the actual
version).The example should be one that mirrors the size and scope of what DOC is looking for.
5.3 Vendor References
 Provide a list of all customers that have EMR system currently or where you have had contracts in place for the last three
years. Indicate on your list which customers are a correctional system (or similar). The list must include contact
information, including phone numbers and email addresses of all contacts. Points will be awarded based on the information
received from the reference checks. DOC reserves the right to choose which vendors will have reference checks conducted.
If DOC cannot contact references chosen due to invalid information, it may affect the point values assigned to this section.
6.0
TECHNICAL REQUIREMENTS
It is the responsibility of the proposer to completely describe and discuss in their proposal each requirement. Failure of the
proposer to respond fully to a minimum requirement in Section 5.0 or 6.0 in a responsible, responsive manner may result in a low
score as determined by the evaluation team.
6.1 Information Technology Requirements
 Desktop Software Requirements
List any browser plug-ins, add-ons and Active-X components required by the proposed solution.
17
RFP EB-4253A
Electronic Medical Records BHS
Due Date: December 16, 2013
Page 18 of 33
List any third-party software applications, such as office automation applications, image display tools, and graphics packages
required by the solution.
 Desktop Hardware Requirements
List the desktop system requirements such as processor speed, memory required, video cards needed for the EMR to function
properly.
 Cloud Computing
Can the proposed EMR, if being run as Software as a Service (SaaS) or Cloud Computing, be made accessible to DOC in a
consistent, limited IP range? This allows DOC to make the vendor application available for staff access through DOC internet
filtering software.
 Upgrades and Patches
Describe the frequency of, and process for communicating, system changes such as patches, functionality changes or version
upgrades.
Describe the process for making changes available to users in a test environment for review before the changes are
implemented in the hosted EMR.
 General Usability Requirements
Describe system usability features such as how a patient can be found in the system (search by name, ID number), multiple
user functionality on the same chart, utilization of edit reminders, i.e. drug ABC needs a lab value.
 Application Security Requirements
Describe key application security features such as, role based access controls, logs of system activity by user, system timeouts
for inactivity, etc. Indicate if role-based security applies down to the field level or applies only at the screen level.
 System Security Requirements
Contractor shall provide a secure environment for the application, data and any hardware and software, including servers,
network and data components.
o Describe security controls in place relative to external connections to the World Wide Web such as
intrusion detection and countermeasures that shall detect and terminate any unauthorized activity prior to
accessing the EMR or its data.
o Describe the firewall(s) used and how they will protect against network intrusions
o Describe the virus protection process
o Describe physical security measures such as securing all data on a secure server, in locked data cabinets
within a secure facility.
o Describe where and how data encryption is employed, including but not limited to, encrypted data at rest,
tables, and attributes.
o Describe the process for notifying DOC in the event of a computer system security breach which did or
could impact DOC data.
 Audit Requirements
Describe what reports and/or analysis tools are available to support an audit of user activity in the system. For example alerts
on policy violations.
 Archive, Backup and Recovery
Describe the disaster recovery capability and processes in place such as: physical location of redundant data centers,
frequency of scheduled backups, if backups are stored in a secure off-site location, time to restore the system and use of
system during these times.
Describe how frequently you perform trial runs of your disaster recovery plan.
 Interfaces and Interoperability
Describe capability the system has for uploading and associating data files (MS-Word, comma delimited, etc.) to patients.
These files will include test results, scans of outside provider records, transcription files, radiology images etc.
Describe the level of mobile device application support of the EMR, to include but not be limited to, Apple iOS and Android
devices. Also describe plans to add additional interfaces or other technologies into the system in the future.

Data Exchange
18
RFP EB-4253A
Electronic Medical Records BHS
Due Date: December 16, 2013
Page 19 of 33
DOC uses a variety of vendors for services such as medical imaging, dictation and medical lab testing. These vendors have
computer systems which hold DOC data that may need to be accessed from or loaded into the EMR. DOC also manages
several vendors and internally developed computer systems such as our offender management system, WICS, that will need
exchange data with or supply data to the EMR.
o The EMR must have the capability to exchange data with these systems both in real time using industry
standard web services and in batch using FTP and/or SFTP.
o The infrastructure provided for the data exchange must be scalable for future DOC needs.
o Describe the data exchange logic or provide the technical documentation that is shared with customers
who need to exchange data with the EMR.
 Support Requirements
Describe end user support available to customers including help desk hours of operation and after hours contact procedures .
Also note if user manuals and/or help text are accessible on line from the application and in hard copy.

Operational Implementation of the EMR
Describe your process of installation and implementation of an electronic medical record system. Use a GANTT chart
showing the steps and projected length of time to complete each implementation step for approximately 40 institutions.
 Training
Describe your user training process during implementation and on-going training for software updates, new staff, etc.
Describe the Documentation provided for new releases, to include but not be limited to, user guides, help systems, and
training.
 User Input and Feedback
Describe the availability of local and national user groups and user conferences available to users of your EMR.
Describe the process for users to supply input to future product releases.
 System Operation and Performance
Describe how you monitor and ensure 99.95% or better Availability in any given month.
6.2 Clinical Requirements
A. General
 Describe capabilities for providing summary screens that display an offender’s essential medical, mental health
and/or demographic information.
 Describe capabilities for intake screening.
 Describe capabilities for creating, maintaining and updating patient problem lists.
 Describe capabilities for providing work (or task) lists that show items needing completion or review such as lab
results, reports, items needing signature and follow-up items.
 Describe capabilities for recording and displaying patient allergies and adverse reactions, including both
medications and non-drug agents.
 Describe capabilities for documenting immunizations and screenings for conditions such as TB, HIV, STDs, pap
smears, mammograms, prostate and/or testicular exams, tetanus, Hepatitis A and B, influenza and pneumovax.

Describe capabilities for discharge planning, including generation of referrals, alerts and/or reports to DOC staff who
need to complete steps in the discharge planning process.

Describe capabilities for documenting medical and mental health rounds in a segregation unit. Is there a mechanism
to document these brief visits in a rapid and efficient manner for a large numbers of offenders?
Describe capabilities for documenting group activities such as mental health treatment or offender programming (i.e.
are there capabilities to rapidly input data into the record of multiple offenders?).
Describe capabilities for documenting special status / need such suicide risk, suicide watch, property restrictions or
more frequent observation.


B. Terminology
 Describe capability to integrate and use IDC and HCPC codes for diagnosis and treatment.
 Describe capabilities for using nursing terminology for diagnoses, interventions and outcomes.
 Describe capabilities for using DSM-5 psychiatric diagnoses.
19
RFP EB-4253A
Electronic Medical Records BHS
Due Date: December 16, 2013
Page 20 of 33
C. Scheduling and patient visits
 Describe how offender requests for health care are generated, routed, tracked and documented. Can offenders
submit requests electronically? How do requests lead to sick call appointments?
 Describe scheduling capabilities, including those for general medicine, dental, mental health, nursing, specialty
appointments (optometry, podiatry and chronic diseases) and ancillary services (laboratory and X-ray).
 Describe the flexibility of the scheduling package in terms of appointment types, length of time of appt.,
availability, tracking off-site appointments and rescheduling.
D. Order Entry
 Describe the provider order entry system and how orders are routed from entry by a provider to execution of the
order. Include medications, diet orders, lab tests, referrals to other providers and requests for utilization review.
 Describe capabilities for providers to use / generate order sets to streamline the order entry process.
 Describe capabilities for providing alerts to providers as they write orders, such as drug allergies, drug
interactions, therapeutic duplication, dosage outside of recommended range and drug food interactions.
E. Results Posting for Diagnostic Services
 Laboratory and diagnostic imaging (X-ray and ultrasound) are provided by contracted entities. Describe
capabilities for incorporating the results into the health record including any interfaces necessary to do so.
 Describe the capabilities to incorporate ECG tracings, Spirometry and other on-site diagnostic testing into the
EMR.
 Describe capabilities for notification of providers of any new laboratory or diagnostic results in the chart.
F.
Medication Administration
 Describe capabilities for documenting the administration of medications (or immunizations) to offenders by
correctional officers or nurses. Include capabilities for recording, tracking and auditing medication administration
records.
 What methods are used to make the process of medication administration rapid and efficient with a minimum of
mouse clicks, text entry fields and/or screens?
 Describe the process for medication renewals and/or refills, including any alerts that indicate refills are needed.
 Describe capabilities for distinguishing between officer-controlled medications and medications kept by offenders
in their cells.
 Describe capabilities for supporting a pre-approval process for restricted or non-formulary medications, including
review/approval by a supervisor prior to filling a prescription.
G. Graphing and Scanning
 Describe capability to graph clinical parameters over time (e.g., lab, vital signs including BMI).
 Describe capability to scan relevant clinical documents from community and off-site providers into the appropriate
place in the medical record.
H.
Clinical Decision Support
 Provide a description of any clinical decision support systems provided with the EMR that would provide
assistance in diagnosis and/or appropriate treatment for the practitioner and may include preventive care.
 Describe the system’s capability for facilitating communication between health care staff within the application
(electronic messaging or an inbox) and security features.
 Describe any discipline-specific templates that support clinical practice, including but not limited to primary care,
psychiatry, optometry and psychology.
I.
Patient Education Services
 Describe capabilities for patient education services, including printing of appropriate material for medications,
immunizations, medical conditions, oral hygiene, discharge planning etc. Describe if there is ability to create,
review or edit patient education materials and if available in Spanish.
J.
Reporting
 Describe system capabilities to provide standard management reports by facility, health care service areas and
across disciplines/specialties.
 Describe capabilities to develop continuous quality improvement (CQI) auditing and reporting.
 Describe ability to provide ad-hoc reports that can be written by DOC staff independent of vendor assistance.
20
RFP EB-4253A
Electronic Medical Records BHS
Due Date: December 16, 2013
Page 21 of 33
K. Forms
 Describe the use of forms or templates in your system and the ability to incorporate WI-DOC forms and/or encounter
templates into the system with and without vendor assistance.
 Are designated DOC staff able to create and modify forms and/or encounter templates without vendor assistance? If
Yes, what are the training and time requirements to do so?
L. Dental Health Services
 Is a subcontracted entity used for the dental module?
 Describe the integration with the entire EMR
 Describe the method of documenting the oral examination and how it is displayed.
 Describe the use of forms, progress notes and use of digital radiography within the system.
 Describe how Dental scheduling is incorporated in the system.
M. Pharmacy
 Describe your system’s capabilities for the following:
o Supports use of a tiered formulary system.
o Supports ability to “hold” or “profile” medication as well as dispense them.
o Supports ability to generate a paper Medication Administration Record (MAR).
o Supports ability to automatically discontinue orders on a specified date.
o Supports ability to view and sort a patient profile by varying fields (drug name, written date, stop date, etc.).
o Supports ability to flag duplicate therapy and recognize drug-drug, drug-food, drug-disease, drug-age, drugherbal interactions, as well as alerting to pregnancy and lactation precautions.
o Supports ability to recognize and alert for low and high dose regimes.
o Supports ability to generate barcodes (such as NDC number or Prescription number).
o Supports interface with pharmaceuticals and supplies, with maximum and minimum inventory levels as well as
reorder levels.
o Support a perpetual inventory for pharmaceuticals and supplies, setting minimum and maximum levels by items
as the auto reorder point.
o Support exporting of pharmacy data as a text file (.txt)
o Supports a large daily volume of prescription order processing of >3000 per day.
o Supports the ability to interface with automated dispensing cabinets such as Pyxis.
o Support the use of unique identifies using a bar code or other methods for monitoring inventory levels.
o Supports robust reporting, including but not limited to DEA controlled drug dispensing data, drug specific and
AHFS therapeutic category dispensing data, on/off formulary usage, prescriber-and site-specific drug utilization,
etc.
o Supports activities related to being a ‘Contract Pharmacy” or “Covered Entity” for 340B Pharmacy Program.
o Support thr use of TALL Man lettering as defined by the FDA
6.3
Ease of Use / User Friendly

Describe the features of your system that enhance ease of use, efficiency and productivity. These might include:
o
o
o
o
o
o
o
o
o
o
o
o
7.0
Typefaces and fonts that are easy to read.
Meaningful use of color and shading
Simplicity (clear and clean screen design, lack of visual clutter, concise display of information)
Natural and intuitive screen navigation
Simple and intuitive organization of EMR components
Screens organized by meaningful relationships (e.g. lab results are displayed with a medication list)
Minimal steps (cursor clicks or keyboard strokes) to accomplish tasks or navigate screens
Preservation of context (minimal visual interruptions such as screen changes or dialogue boxes)
Minimal use of modes (such as viewing mode versus text entry mode)
Efforts to minimize scrolling or use of exploding menus
Use of default values or auto-completion of data
Forgiveness (i.e. mistakes can be changed and/or recovered)
PRICING
21
RFP EB-4253A
Electronic Medical Records BHS
8.0
Due Date: December 16, 2013
Page 22 of 33
7.1
All proposers are to be submitted by the full completion of attachments A&B. Failure to compete the cost sheets may be
reason not to accept the proposal submitted.
7.2
Fixed price period
All prices, costs, and conditions outlined in the proposal shall remain fixed and valid for acceptance for first two years of
the contract and not increase unless agreed by both parties.
7.3
Inflationary adjustment
The contractor may receive an inflationary adjustment after year two. This increase will be based on the CPI index for
software or information technology unless otherwise agreed by both parties.
SPECIAL CONTRACT TERMS AND CONDITIONS
8.1
Liquidated damages
The contractor acknowledges that damages will be incurred by the agency, in an amount determined by the Department.
The contractor agrees that the Department should have the right to liquidate such damages, through deduction from the
contractor's invoices, in the amount equal to the damages incurred, or by direct billing to the contractor. These damages
will apply to contractor unless DOC is the reason for the damage.
Liquidated damages will be applied for failure to meet standards in each of the following areas:
(a) Full system installation, training and implementation (38 sites) delay will be assessed at $2,500 per unit per day after
24 months.
(b) Trouble reporting and resolution delays after 48 hours will be assessed $200 per unit per day.
(c) Out of box failure rate will be assessed at $200 per unit/per day until properly working unit is received at appropriate
location
(d) Unexcused System Software downtime will be assessed at $1,000 per unit per day.
8.2
Prime contractor and minority business subcontractors
The prime contractor will be responsible for contract performance when subcontractors are used. However, when
subcontractors are used, they must abide by all terms and conditions of the contract. If subcontractors are to be used, the
proposer must clearly explain their participation.
The State of Wisconsin is committed to the promotion of minority business in the state's purchasing program and a goal
of placing five per cent of its total purchasing dollars with certified minority businesses. Authority for this program is
found in ss. 15.107(2), 16.75(4), 16.75(5) and 560.036(2), Wisconsin Statutes. The contracting agency is committed to
the promotion of minority business in the state's purchasing program.
The State of Wisconsin policy provides that minority-owned business enterprises certified by the Wisconsin Department
of Commerce, Bureau of Minority Business Development should have the maximum opportunity to participate in the
performance of its contracts. The supplier/contractor is strongly urged to use due diligence to further this policy by
awarding subcontracts to minority-owned business enterprises or by using such enterprises to provide goods and services
incidental to this agreement, with a goal of awarding at least five percent of the contract price to such enterprises.
The supplier/contractor shall furnish appropriate quarterly information about its effort to achieve this goal, including the
identities of such enterprises certified by the Wisconsin Department of Commerce and their contract amount.
A listing of certified minority businesses, as well as the services and commodities they provide, is available from the
Department of Administration, Office of the Minority Business Program, 608/267-7806. The listing is published on the
Internet at: http://www.doa.state.wi.us/dsas/mbe/index.asp.
8.3
Executed contract to constitute entire agreement
In the event of contract award, the contents of this RFP (including all attachments), RFP addenda and revisions, and the
proposal of the successful proposer, and additional terms agreed to, in writing, by the agency and the contractor shall
22
RFP EB-4253A
Electronic Medical Records BHS
Due Date: December 16, 2013
Page 23 of 33
become part of the contract. Failure of the successful proposer to accept these as a contractual agreement may result in a
cancellation of award.
The following priority for contract documents will be used if there are conflicts or disputes.
State of Wisconsin standard terms and conditions
Final Signed Contract including amendments
Official State of Wisconsin Purchase Order
Proposer’s written bid document
State of Wisconsin Request for Proposal, including any amendments;
Other exhibits/attachments
8.4
Termination of contract
8.4.1
Failure of the DOC to comply with the Contract should provide the sole cause for which the Contractor is
entitled to terminate the Contract. The Contractor should notify the DOC in writing within thirty (30) days after
the Contractor becomes aware of the alleged noncompliance with a complete description of the same. If the
DOC does not, within sixty (60) days after its receipt of the Contractor’s notice, either (i) effect a cure or (ii) if
the noncompliance is not one that can reasonably be cured within sixty (60) days, develop a plan to cure the
noncompliance and diligently proceed according to that plan until a cure is effected, then the Contractor may
terminate this Agreement for cause by providing one hundred twenty (120) day written notice to the DOC.
Thus, if the DOC is not in compliance with the Contract and fails to cure such noncompliance, the Contractor
may terminate this Contract, at the earliest, one hundred eighty-one (181) days after the DOC first receives the
Contractor’s notice of noncompliance. The Contractor may not terminate this Agreement without cause unless
express written consent to do so is provided by DCC-MC.
8.4.2
The DOC may terminate this Contract at any time, with or without cause, and without penalty by delivering
thirty (30) days’ written notice to the Contractor. The DOC reserves the right to cancel any contract in whole or
in part without penalty due to non-appropriation of funds.
8.4.3
In the event that the Contract is terminated for any reason whatsoever, the DOCs liability should be limited to
the pro rata cost of the Contractor services and/or deliverables approved and satisfactorily provided as of the
effective date of termination and the Contractor will refund to the DOC, within fourteen (14) days of the
effective date of termination, all payments made hereunder by the DOC to the Contractor for the Contractor
services and/or deliverables not completed or not accepted by the DOC.
8.4.4
8.5
The rights and remedies of the DOC provided in this Section should not be exclusive but are in addition to any
other rights and remedies provided by law or under this Contract.
8.4.5
Upon termination or expiration of this Contract, each party should forthwith return to the other all papers,
materials, and other properties of the other, held by each for purposes of execution of this Contract; provided,
however, the DOC should be entitled to retain a copy of any completed or partially completed deliverables,
as well as any other project records the DOC is required to retain under the State of Wisconsin’s records
retention requirements. In addition, each party will assist the other party in the orderly termination of this
Contract and the transfer of all aspects hereof, tangible or intangible, as may be necessary for the orderly,
non-disrupted business continuation of each party.
8.4.5
The DOC should be entitled to recover all costs including, without limitation, the DOC’s own administrative
costs, related to obtaining and providing replacement services and/or deliverables which could not be provided
or completed due to either Contractor’s termination of the Contract for any reason prior to the expiration of the
original or, if applicable, extended Contract term or the DOC’s termination of the Contract due to Contractor’s
failure to comply with the Contract. The rights and remedies of the DOC provided herein should not be
exclusive but are in addition to any other rights and remedies provided by law or elsewhere in the Contract.
SUBCONTRACTING
Any Contract resulting from this bid shall not be, in whole or in part, subcontracted, assigned, or otherwise transferred to
any other Contractor without prior written approval by Purchasing Services.
23
RFP EB-4253A
Electronic Medical Records BHS
9.0
Due Date: December 16, 2013
Page 24 of 33
8.5.1
The Contractor shall be directly responsible for any subcontractor’s performance and work quality when used by
the Contractor to carry out the scope of the job.
8.5.2
Contractor must assure subcontractors abide by all terms and conditions under this Contract.
If subcontractors are to be used, the Contractor must clearly explain their participation and the country out of
which they work..
STANDARD TERMS AND CONDITIONS
The State of Wisconsin reserves the right to incorporate standard State contract provisions into any contract negotiated with any
proposal submitted responding to this RFP (Standard Terms and Conditions (DOA-3054)). Failure of the successful proposer to
accept these obligations in a contractual agreement may result in cancellation of the award. (or)
The State of Wisconsin reserves the right to incorporate standard State contract provisions into any contract negotiated with any
proposal submitted responding to this RFP (Standard Terms and Conditions (DOA-3054) and Supplemental Standard Terms and
Conditions for Procurements for Services (DOA-3681)). Failure of the successful proposer to accept these obligations in a
contractual agreement may result in cancellation of the award.
24
Wisconsin Department of Administration
Chs. 16, 19, 51
DOA-3054 (R10/2005)
Page 1 of 3
Standard Terms And Conditions
(Request For Bids / Proposals)
1.0
2.0
3.0
4.0
SPECIFICATIONS: The specifications in this request are the
minimum acceptable. When specific manufacturer and model
numbers are used, they are to establish a design, type of
construction, quality, functional capability and/or performance
level desired. When alternates are bid/proposed, they must be
identified by manufacturer, stock number, and such other
information necessary to establish equivalency. The State of
Wisconsin shall be the sole judge of equivalency.
Bidders/proposers are cautioned to avoid bidding alternates to the
specifications which may result in rejection of their bid/proposal.
ACCEPTANCE-REJECTION:
The State of Wisconsin
reserves the right to accept or reject any or all bids/proposals, to
waive any technicality in any bid/proposal submitted, and to
accept any part of a bid/proposal as deemed to be in the best
interests of the State of Wisconsin.
Bids/proposals MUST be date and time stamped by the soliciting
purchasing office on or before the date and time that the
bid/proposal is due. Bids/proposals date and time stamped in
another office will be rejected. Receipt of a bid/proposal by the
mail system does not constitute receipt of a bid/proposal by the
purchasing office.
DEVIATIONS AND EXCEPTIONS: Deviations and exceptions
from original text, terms, conditions, or specifications shall be
described fully, on the bidder's/proposer's letterhead, signed, and
attached to the request. In the absence of such statement, the
bid/proposal shall be accepted as in strict compliance with all
terms, conditions, and specifications and the bidders/proposers
shall be held liable.
9.0
METHOD OF AWARD: Award shall be made to the lowest
responsible, responsive bidder unless otherwise specified.
10.0
QUALITY: Unless otherwise indicated in the request, all
material shall be first quality.
Items which are used,
demonstrators, obsolete, seconds, or which have been discontinued
are unacceptable without prior written approval by the State of
Wisconsin.
ORDERING: Purchase orders or releases via purchasing cards
shall be placed directly to the contractor by an authorized agency.
No other purchase orders are authorized.
11.0
PAYMENT TERMS AND INVOICING:
The State of
Wisconsin normally will pay properly submitted vendor invoices
within thirty (30) days of receipt providing goods and/or services
have been delivered, installed (if required), and accepted as
specified.
QUANTITIES: The quantities shown on this request are based
on estimated needs. The state reserves the right to increase or
decrease quantities to meet actual needs.
5.0
DELIVERY: Deliveries shall be F.O.B. destination freight
prepaid and included unless otherwise specified.
6.0
PRICING AND DISCOUNT: The State of Wisconsin qualifies
for governmental discounts and its educational institutions also
qualify for educational discounts. Unit prices shall reflect these
discounts.
6.1
6.2
6.3
7.0
8.0
Invoices presented for payment must be submitted in accordance
with instructions contained on the purchase order including
reference to purchase order number and submittal to the correct
address for processing.
A good faith dispute creates an exception to prompt payment.
12.0
Unit prices shown on the bid/proposal or contract shall be
the price per unit of sale (e.g., gal., cs., doz., ea.) as stated
on the request or contract. For any given item, the
quantity multiplied by the unit price shall establish the
extended price, the unit price shall govern in the
bid/proposal evaluation and contract administration.
TAXES: The State of Wisconsin and its agencies are exempt
from payment of all federal tax and Wisconsin state and local
taxes on its purchases except Wisconsin excise taxes as described
below.
The State of Wisconsin, including all its agencies, is required to
pay the Wisconsin excise or occupation tax on its purchase of
beer, liquor, wine, cigarettes, tobacco products, motor vehicle
fuel and general aviation fuel. However, it is exempt from
payment of Wisconsin sales or use tax on its purchases. The
State of Wisconsin may be subject to other states' taxes on its
purchases in that state depending on the laws of that state.
Contractors performing construction activities are required to pay
state use tax on the cost of materials.
Prices established in continuing agreements and term
contracts may be lowered due to general market
conditions, but prices shall not be subject to increase for
ninety (90) calendar days from the date of award. Any
increase proposed shall be submitted to the contracting
agency thirty (30) calendar days before the proposed
effective date of the price increase, and shall be limited to
fully documented cost increases to the contractor which
are demonstrated to be industrywide. The conditions
under which price increases may be granted shall be
expressed in bid/proposal documents and contracts or
agreements.
13.0
14.0
In determination of award, discounts for early payment
will only be considered when all other conditions are equal
and when payment terms allow at least fifteen (15) days,
providing the discount terms are deemed favorable. All
payment terms must allow the option of net thirty (30).
UNFAIR SALES ACT: Prices quoted to the State of Wisconsin
are not governed by the Unfair Sales Act.
25
GUARANTEED DELIVERY: Failure of the contractor to
adhere to delivery schedules as specified or to promptly replace
rejected materials shall render the contractor liable for all costs in
excess of the contract price when alternate procurement is
necessary. Excess costs shall include the administrative costs.
ENTIRE AGREEMENT:
These Standard Terms and
Conditions shall apply to any contract or order awarded as a
result of this request except where special requirements are stated
elsewhere in the request; in such cases, the special requirements
shall
apply.
Further,
the
written
DOA-3054
Page 2 of 3
contract and/or order with referenced parts and attachments shall
constitute the entire agreement and no other terms and conditions
in any document, acceptance, or acknowledgment shall be
effective or binding unless expressly agreed to in writing by the
contracting authority.
15.0
16.0
19.3
APPLICABLE LAW AND COMPLIANCE: This contract
shall be governed under the laws of the State of Wisconsin. The
contractor shall at all times comply with and observe all federal
and state laws, local laws, ordinances, and regulations which are
in effect during the period of this contract and which in any
manner affect the work or its conduct. The State of Wisconsin
reserves the right to cancel this contract if the contractor fails to
follow the requirements of s. 77.66, Wis. Stats., and related
statutes regarding certification for collection of sales and use tax.
The State of Wisconsin also reserves the right to cancel this
contract with any federally debarred contractor or a contractor
that is presently identified on the list of parties excluded from
federal procurement and non-procurement contracts..
ANTITRUST ASSIGNMENT: The contractor and the State of
Wisconsin recognize that in actual economic practice,
overcharges resulting from antitrust violations are in fact usually
borne by the State of Wisconsin (purchaser). Therefore, the
contractor hereby assigns to the State of Wisconsin any and all
claims for such overcharges as to goods, materials or services
purchased in connection with this contract.
17.0
ASSIGNMENT: No right or duty in whole or in part of the
contractor under this contract may be assigned or delegated
without the prior written consent of the State of Wisconsin.
18.0
WORK CENTER CRITERIA: A work center must be certified under s. 16.752, Wis. Stats., and must ensure that when
engaged in the production of materials, supplies or equipment or
the performance of contractual services, not less than seventy-five
percent (75%) of the total hours of direct labor are performed by
severely handicapped individuals.
19.0
sets forth the provisions of the State of Wisconsin's
nondiscrimination law.
20.0
PATENT INFRINGEMENT: The contractor selling to the State
of Wisconsin the articles described herein guarantees the articles
were manufactured or produced in accordance with applicable
federal labor laws. Further, that the sale or use of the articles
described herein will not infringe any United States patent. The
contractor covenants that it will at its own expense defend every
suit which shall be brought against the State of Wisconsin
(provided that such contractor is promptly notified of such suit,
and all papers therein are delivered to it) for any alleged
infringement of any patent by reason of the sale or use of such
articles, and agrees that it will pay all costs, damages, and profits
recoverable in any such suit.
21.0
SAFETY REQUIREMENTS: All materials, equipment, and
supplies provided to the State of Wisconsin must comply fully
with all safety requirements as set forth by the Wisconsin
Administrative Code and all applicable OSHA Standards.
22.0
WARRANTY: Unless otherwise specifically stated by the
bidder/proposer, equipment purchased as a result of this request
shall be warranted against defects by the bidder/proposer for one
(1) year from date of receipt. The equipment manufacturer's
standard warranty shall apply as a minimum and must be honored
by the contractor.
23.0
INSURANCE RESPONSIBILITY: The contractor performing
services for the State of Wisconsin shall:
NONDISCRIMINATION / AFFIRMATIVE ACTION: In
connection with the performance of work under this contract, the
contractor agrees not to discriminate against any employee or
applicant for employment because of age, race, religion, color,
handicap, sex, physical condition, developmental disability as
defined in s. 51.01(5), Wis. Stats., sexual orientation as defined
in s. 111.32(13m), Wis. Stats., or national origin. This provision
shall include, but not be limited to, the following: employment,
upgrading, demotion or transfer; recruitment or recruitment
advertising; layoff or termination; rates of pay or other forms of
compensation; and selection for training, including apprenticeship. Except with respect to sexual orientation, the contractor
further agrees to take affirmative action to ensure equal
employment opportunities.
19.1
19.2
Contracts estimated to be over fifty-thousand dollars
($50,000) require the submission of a written affirmative
action plan by the contractor. An exemption occurs from
this requirement if the contractor has a workforce of less
than twenty-five (25) employees. Within fifteen (15)
working days after the contract is awarded, the contractor
must submit the plan to the contracting state agency for
approval. Instructions on preparing the plan and technical
assistance regarding this clause are available from the
contracting state agency.
24.0
The contractor agrees to post in conspicuous places,
available for employees and applicants for employment, a
notice to be provided by the contracting state agency that
26
Failure to comply with the conditions of this clause may
result in the contractor's becoming declared an "ineligible"
contractor, termination of the contract, or withholding of
payment.
23.1
Maintain worker's compensation insurance as required by
Wisconsin Statutes, for all employees engaged in the
work.
23.2
Maintain commercial liability, bodily injury and property
damage insurance against any claim(s) which might occur
in carrying out this agreement/contract.
Minimum
coverage shall be one million dollars ($1,000,000) liability
for bodily injury and property damage including products
liability and completed operations. Provide motor vehicle
insurance for all owned, non-owned and hired vehicles that
are used in carrying out this contract. Minimum coverage
shall be one million dollars ($1,000,000) per occurrence
combined single limit for automobile liability and property
damage.
23.3
The state reserves the right to require higher or lower
limits where warranted.
CANCELLATION: The State of Wisconsin reserves the right
to cancel any contract in whole or in part without penalty due to
nonappropriation of funds or for failure of the contractor to
comply with terms, conditions, and specifications of this contract.
DOA-3054
Page 3 of 3
25.0
VENDOR TAX DELINQUENCY: Vendors who have a
delinquent Wisconsin tax liability may have their payments offset
by the State of Wisconsin.
26.0
PUBLIC RECORDS ACCESS: It is the intention of the state to
maintain an open and public process in the solicitation,
submission, review, and approval of procurement activities.
Material Safety Data Sheet for each item with the shipped
container(s) and one (1) copy with the invoice(s).
31.0
PROMOTIONAL ADVERTISING / NEWS RELEASES:
Reference to or use of the State of Wisconsin, any of its
departments, agencies or other subunits, or any state official or
employee for commercial promotion is prohibited. News releases
pertaining to this procurement shall not be made without prior
approval of the State of Wisconsin. Release of broadcast e-mails
pertaining to this procurement shall not be made without prior
written authorization of the contracting agency.
32.0
HOLD HARMLESS: The contractor will indemnify and save
harmless the State of Wisconsin and all of its officers, agents and
employees from all suits, actions, or claims of any character
brought for or on account of any injuries or damages received by
any persons or property resulting from the operations of the
contractor, or of any of its contractors, in prosecuting work under
this agreement.
33.0
FOREIGN CORPORATION: A foreign corporation (any
corporation other than a Wisconsin corporation) which becomes
a party to this Agreement is required to conform to all the
requirements of Chapter 180, Wis. Stats., relating to a foreign
corporation and must possess a certificate of authority from the
Wisconsin Department of Financial Institutions, unless the
corporation is transacting business in interstate commerce or is
otherwise exempt from the requirement of obtaining a certificate
of authority. Any foreign corporation which desires to apply for
a certificate of authority should contact the Department of
Financial Institutions, Division of Corporation, P. O. Box 7846,
Madison, WI 53707-7846; telephone (608) 261-7577.
34.0
WORK
CENTER
PROGRAM:
The
successful
bidder/proposer shall agree to implement processes that allow the
State agencies, including the University of Wisconsin System, to
satisfy the State's obligation to purchase goods and services
produced by work centers certified under the State Use Law,
s.16.752, Wis. Stat. This shall result in requiring the successful
bidder/proposer to include products provided by work centers in
its catalog for State agencies and campuses or to block the sale of
comparable items to State agencies and campuses.
35.0
FORCE MAJEURE: Neither party shall be in default by reason
of any failure in performance of this Agreement in accordance
with reasonable control and without fault or negligence on their
part. Such causes may include, but are not restricted to, acts of
nature or the public enemy, acts of the government in either its
sovereign or contractual capacity, fires, floods, epidemics,
quarantine restrictions, strikes, freight embargoes and unusually
severe weather, but in every case the failure to perform such must
be beyond the reasonable control and without the fault or
negligence of the party.
Bid/proposal openings are public unless otherwise specified.
Records may not be available for public inspection prior to
issuance of the notice of intent to award or the award of the
contract.
27.0
28.0
PROPRIETARY INFORMATION: Any restrictions on the
use of data contained within a request, must be clearly stated in
the bid/proposal itself. Proprietary information submitted in
response to a request will be handled in accordance with
applicable State of Wisconsin procurement regulations and the
Wisconsin public records law. Proprietary restrictions normally
are not accepted. However, when accepted, it is the vendor's
responsibility to defend the determination in the event of an
appeal or litigation.
27.1
Data contained in a bid/proposal, all documentation
provided therein, and innovations developed as a result of
the contracted commodities or services cannot by
copyrighted or patented. All data, documentation, and
innovations become the property of the State of
Wisconsin.
27.2
Any material submitted by the vendor in response to this
request that the vendor considers confidential and
proprietary information and which qualifies as a trade
secret, as provided in s. 19.36(5), Wis. Stats., or material
which can be kept confidential under the Wisconsin public
records law, must be identified on a Designation of
Confidential and Proprietary Information form (DOA3027). Bidders/proposers may request the form if it is not
part of the Request for Bid/Request for Proposal package.
Bid/proposal prices cannot be held confidential.
DISCLOSURE: If a state public official (s. 19.42, Wis. Stats.),
a member of a state public official's immediate family, or any
organization in which a state public official or a member of the
official's immediate family owns or controls a ten percent (10%)
interest, is a party to this agreement, and if this agreement
involves payment of more than three thousand dollars ($3,000)
within a twelve (12) month period, this contract is voidable by
the state unless appropriate disclosure is made according to s.
19.45(6), Wis. Stats., before signing the contract. Disclosure
must be made to the State of Wisconsin Ethics Board, 44 East
Mifflin Street, Suite 601, Madison, Wisconsin 53703 (Telephone
608-266-8123).
State classified and former employees and certain University of
Wisconsin faculty/staff are subject to separate disclosure
requirements, s. 16.417, Wis. Stats.
29.0
RECYCLED MATERIALS:
The State of Wisconsin is
required to purchase products incorporating recycled materials
whenever technically and economically feasible. Bidders are
encouraged to bid products with recycled content which meet
specifications.
30.0
MATERIAL SAFETY DATA SHEET: If any item(s) on an
order(s) resulting from this award(s) is a hazardous chemical, as
defined under 29CFR 1910.1200, provide one (1) copy of a
27
State of Wisconsin
Department of Administration
Division of Agency Services
Bureau of Procurement
DOA-3681 (01/2001)
ss. 16, 19 and 51, Wis. Stats.
Supplemental Standard Terms and Conditions
for Procurements for Services
1.0
2.0
ACCEPTANCE OF BID/PROPOSAL CONTENT: The contents of the bid/proposal of the successful contractor will become
contractual obligations if procurement action ensues.
3.2
CERTIFICATION
OF
INDEPENDENT
PRICE
DETERMINATION:
By signing this bid/proposal, the
bidder/proposer certifies, and in the case of a joint bid/proposal,
each party thereto certifies as to its own organization, that in
connection with this procurement:
2.1
The prices in this bid/proposal have been arrived at
independently, without consultation, communication, or
agreement, for the purpose of restricting competition, as to
any matter relating to such prices with any other
bidder/proposer or with any competitor;
2.2
Unless otherwise required by law, the prices which have
been quoted in this bid/proposal have not been knowingly
disclosed by the bidder/proposer and will not knowingly be
disclosed by the bidder/proposer prior to opening in the
case of an advertised procurement or prior to award in the
case of a negotiated procurement, directly or indirectly to
any other bidder/proposer or to any competitor; and
2.3
No attempt has been made or will be made by the
bidder/proposer to induce any other person or firm to
submit or not to submit a bid/proposal for the purpose of
restricting competition.
2.4
Each person signing this bid/proposal certifies that: He/she
is the person in the bidder's/proposer's organization
responsible within that organization for the decision as to
the prices being offered herein and that he/she has not
participated, and will not participate, in any action contrary
to 2.1 through 2.3 above; (or)
4.0
DUAL EMPLOYMENT: Section 16.417, Wis. Stats., prohibits
an individual who is a State of Wisconsin employee or who is
retained as a contractor full-time by a State of Wisconsin agency
from being retained as a contractor by the same or another State of
Wisconsin agency where the individual receives more than $12,000
as compensation for the individual’s services during the same year.
This prohibition does not apply to individuals who have full-time
appointments for less than twelve (12) months during any period of
time that is not included in the appointment. It does not include
corporations or partnerships.
5.0
EMPLOYMENT: The contractor will not engage the services of
any person or persons now employed by the State of Wisconsin,
including any department, commission or board thereof, to provide
services relating to this agreement without the written consent of
the employing agency of such person or persons and of the
contracting agency.
6.0
CONFLICT OF INTEREST: Private and non-profit corporations
are bound by ss. 180.0831, 180.1911(1), and 181.0831 Wis. Stats.,
regarding conflicts of interests by directors in the conduct of state
contracts.
7.0
RECORDKEEPING AND RECORD RETENTION:
The
contractor shall establish and maintain adequate records of all
expenditures incurred under the contract. All records must be kept
in accordance with generally accepted accounting procedures. All
procedures must be in accordance with federal, state and local
ordinances.
He/she is not the person in the bidder's/proposer's
organization responsible within that organization for the
decision as to the prices being offered herein, but that
he/she has been authorized in writing to act as agent for the
persons responsible for such decisions in certifying that
such persons have not participated, and will not participate
in any action contrary to 2.1 through 2.3 above, and as their
agent does hereby so certify; and he/she has not
participated, and will not participate, in any action contrary
to 2.1 through 2.3 above.
3.0
The contracting agency shall have the right to audit, review,
examine, copy, and transcribe any pertinent records or documents
relating to any contract resulting from this bid/proposal held by the
contractor. The contractor will retain all documents applicable to
the contract for a period of not less than three (3) years after final
payment is made.
DISCLOSURE OF INDEPENDENCE AND RELATIONSHIP:
3.1
those activities of the potential contractor will not be
adverse to the interests of the state.
Contractors shall agree as part of the contract for services
that during performance of the contract, the contractor will
neither provide contractual services nor enter into any
agreement to provide services to a person or organization
that is regulated or funded by the contracting agency or has
interests that are adverse to the contracting agency. The
Department of Administration may waive this provision, in
writing, if those activities of the contractor will not be
adverse to the interests of the state.
Prior to award of any contract, a potential contractor shall
certify in writing to the procuring agency that no
relationship exists between the potential contractor and the
procuring or contracting agency that interferes with fair
competition or is a conflict of interest, and no relationship
exists between the contractor and another person or
organization that constitutes a conflict of interest with
respect to a state contract.
The Department of
Administration may waive this provision, in writing, if
8.0
28
INDEPENDENT CAPACITY OF CONTRACTOR: The parties
hereto agree that the contractor, its officers, agents, and employees,
in the performance of this agreement shall act in the capacity of an
independent contractor and not as an officer, employee, or agent of
the state. The contractor agrees to take such steps as may be
necessary to ensure that each subcontractor of the contractor will be
deemed to be an independent contractor and will not be considered
or permitted to be an agent, servant, joint venturer, or partner of the
state.
10.0
REQUIRED FORMS
The following forms must be completed and submitted with the proposal in accordance with the instructions given in
Section 2.4.
Vendor Implementation Plan (Page 19)
Mandatory Requirements (Section 4.0)
Designation of Confidential and Proprietary Information (DOA-3027, page 29)
Vendor Information (DOA-3477, Page 30)
Attachments A –B
29
STATE OF WISCONSIN
DOA-3027 N(R01/98)
DESIGNATION OF CONFIDENTIAL AND PROPRIETARY INFORMATION
The attached material submitted in response to Bid/Proposal#EB-4253A includes proprietary and confidential
information which qualifies as a trade secret, as provided in s. 19.36(5), Wis. Stats., or is otherwise material that can be
kept confidential under the Wisconsin Open Records Law. As such, we ask that certain pages, as indicated below, of this
bid/proposal response be treated as confidential material and not be released without our written approval.
Prices always become public information when bids/proposals are opened, and therefore cannot be kept
confidential.
Other information cannot be kept confidential unless it is a trade secret. Trade secret is defined in s. 134.90(1)(c), Wis.
Stats. as follows: "Trade secret" means information, including a formula, pattern, compilation, program, device, method,
technique or process to which all of the following apply:
1. The information derives independent economic value, actual or potential, from not being generally known to, and
not being readily ascertainable by proper means by, other persons who can obtain economic value from its
disclosure or use.
2. The information is the subject of efforts to maintain its secrecy that are reasonable under the circumstances.
We request that the following pages not be released
Section
Page #
Topic
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
IN THE EVENT THE DESIGNATION OF CONFIDENTIALITY OF THIS INFORMATION IS CHALLENGED, THE
UNDERSIGNED HEREBY AGREES TO PROVIDE LEGAL COUNSEL OR OTHER NECESSARY ASSISTANCE TO DEFEND
THE DESIGNATION OF CONFIDENTIALITY AND AGREES TO HOLD THE STATE HARMLESS FOR ANY COSTS OR
DAMAGES ARISING OUT OF THE STATE'S AGREEING TO WITHHOLD THE MATERIALS.
Failure to include this form in the bid/proposal response may mean that all information provided as part of the bid/proposal response
will be open to examination and copying. The state considers other markings of confidential in the bid/proposal document to be
insufficient. The undersigned agrees to hold the state harmless for any damages arising out of the release of any materials unless they
are specifically identified above.
Company Name
___________________________________________
Authorized Representative
___________________________________________
Signature
Authorized Representative
___________________________________________
Type or Print
Date
___________________________________________
This document can be made available in accessible formats to qualified individuals with disabilities.
30
STATE OF WISCONSIN
Bid / Proposal #
EB-4253A
DOA-3477 (R05/98)
Commodity / Service
ELECTRONIC MEDICAL RECORD
VENDOR INFORMATION
1.
BIDDING / PROPOSING COMPANY NAME
FEIN
Phone
(
)
Toll Free Phone
FAX
(
)
E-Mail Address
(
)
Address
City
2.
State
Zip + 4
Name the person to contact for questions concerning this bid / proposal.
Name
Title
Phone
(
)
Toll Free Phone
FAX
(
)
E-Mail Address
(
)
Address
City
3.
State
Zip + 4
Any vendor awarded over $50,000 on this contract must submit affirmative action information to the department. Please
name the Personnel / Human Resource and Development or other person responsible for affirmative action in the
company to contact about this plan.
Name
Title
Phone
(
)
Toll Free Phone
FAX
(
)
E-Mail Address
(
)
Address
City
4.
State
Zip + 4
Mailing address to which state purchase orders are mailed and person the department may contact concerning orders and
billings.
Name
Title
Phone
(
)
Toll Free Phone
FAX
(
)
E-Mail Address
(
)
Address
City
5.
State
Zip + 4
CEO / President Name
This document can be made available in accessible formats to qualified individuals with disabilities.
31
ATTACHMENT “A”
COST SHEET FOR A VENDOR HOSTED SYSTEM
EB- 4253A
ELETRONIC MEDICAL RECORD
Date ________________
Proposer Company Name__________________________
Person Completing Cost Sheet______________________
950 users will be using this Vendor Hosted Electronic Medical Record system. The price for the total system shall
include joint installation with the Bureau of Technology Management and awarded vendor. The proposer cost will
include training, upgrades, installation, implementation, maintenance and ongoing support.
Respondent shall quote the following Pricing Schedule in accordance with requirements of this RFP. The quoted
price shall include a hosted option for up to eight years per the term on the contract. The proposed program will be
fully implemented in 24 months starting with the implementation of CPOE for the Pharmacy (males and females)
then the four women institutions located in Southeastern portion of Wisconsin. The implementation will cover a total
of 38 sites in Wisconsin.
Year one annual cost to include training, implementation,
Maintenance, licenses and support:
$_______________________
Year two annual cost to include training, implementation,
maintenance and support:
$_______________________
Year three annual cost for maintenance and support
$_______________________
Year three annual cost for maintenance and support:
$_______________________
Year four annual cost for maintenance and support
$_______________________
Year five annual cost for maintenance and support
$_______________________
Year six annual cost for maintenance and support
$_______________________
Year seven annual cost for maintenance and support
$_______________________
Year eight annual cost for maintenance and support
$_______________________
EIGHT-YEAR TOTAL COST
Time and material cost for customizations or special reports per hr.
32
$________________________
$ __________________/hour
ATTACHMENT B
EB-4253A ELECTRONIC MEDICAL RECORD
MANDATORY REQUIREMENTS
INSTRUCTIONS: Indicate below by circling YES or NO whether your company meets the mandatory
requirement or not. The numbers correlate with the sections in the proposal, your answer should reflect a
response to that entire section.
4.1 The EMR system must be a Vendor hosted solution supported by the Proposer and accessed by DOC
YES
NO
4.2 Vendor has successfully implemented an EMR within a secure setting.
YES
NO
4.3 The EMR system must be able to accommodate a minimum of 950 concurrent users per day at
any given time.
YES
NO
4.4.1 THE EHR technology proposed must be CEHRT in calendar year 2014 and subsequent years
YES
NO
4.4.2 Proof must be provided that 2014 certification is in progress
YES
NO
4.4.3 Provide a list of EHR technology products proposed with CHPL Product number
YES
NO
4.4.4 Certification levels are required so DOC can participate in the Medicare and Medicaid HER Incentive
Programs
YES
NO
4.5.1 The proposed solution must function on a Windows 7 32 bit SP1 Desktop Operating System
YES
NO
4.5.2 The proposed solution must function with Microsoft Internet Explorer 8 or newer
YES
NO
4.5.3 The proposed solution must function for DOC users whose access is limited on their desktops
YES
NO
over the internet
4.5.4 The Proposer has conducted a HIPAA Security Risk Assessment
YES
4.5.5 The Proposer acknowledges DOC has full ownership of all DOC data in the EMR and agrees that all DOC YES
Data will be returned to the DOC if the contract is terminated for any reason. Return of data includes
providing data in an industry standard format, current at the time either to DOC or to a DOC designated
vendor and assisting with any required data verification to ensure data is complete and useable. This process
will be at the expense of the Proposer.
33
NO
NO