Attachment_1_-_Questions_and_Answers_-_Amendment_1_0001.pdf

RFP No. 140D0421R0050 Attachment 1 ‐ Questions and Answers ‐ Amendment 1

# RFP Section Question Response Change to RFP? Description of Change 1 Attachment_2_‐_IDIQ_SOO, Section

6.7.2;

"The offeror is expected to establish a level 3 and level 4 production support desk with the systems, tools, and processes with a single point of contact to support restoration of normal operations; according to agreed Service Levels" Will the government confirm you are providing Level 1 and Level 2 support and it is not in offerors’ scope?

Yes, the Government is providing Level 1 and Level 2 support and it is not in the Offerors' scope.

No N/A

2 Attachment_2_‐_IDIQ_SOO, Section 6.7.2; "The offeror is expected to establish a level 3 and level 4 production support desk with the systems, tools, and processes with a single point of contact to support restoration of normal operations;

according to agreed Service Levels"

"The offeror is expected to establish a level 3 and level 4 production support desk with the systems, tools, and processes with a single point of contact to support restoration of normal operations; according to agreed Service Levels" Will the government confirm you are providing the ITSM incident management tool used for tracking incidents and problems?

The Government will provide the incident management tool used for tracking incidents and problems.

No N/A

3 Attachment_2_‐_IDIQ_SOO, Section 6.7.2;

"The offeror is expected to establish a level 3 and level 4 production support desk with the systems, tools, and processes with a single point of contact to support restoration of normal operations; according to agreed Service Levels" To maintain a single ticketing repository and for efficiency, will the government please confirm the government will provide offerors’ Level 3 and Level 4 support team members read/write access to the ITSM system? If not, please provide information on the existing ITSM system so that adequate costs can be incorporated.

The Government will provide access to the incident management tool used for tracking incidents and problems.

No N/A

4 Attachment_2_‐_IDIQ_SOO, Section 6.7.2;

"The offeror is expected to establish a level 3 and level 4 production support desk with the systems, tools, and processes with a single point of contact to support restoration of normal operations; according to agreed Service Levels" In order to properly size Level 3 and Level 4 support, will the government please provide an expected number of users of the application that offerors can use as a baseline when estimating support staff?

"Coordinate and plan with the PMO appropriate roles and responsibilities in a responsibility matrix to support clear ownership for tasks and decisions " Would the government agree to a Responsible/Accountable/Contributing/Informed (RACI) chart illustrating clear ownership for tasks and decisions to be included as an attachment due to page count limitations?

The expected number of users can be approximated by using the information in Attachment 5 Sample Task Order (Appendix A), multiplying the number of facilities by the number of skills/specialties listed.

The Government does not require Offerors to include a Responsible/Accountable/Contributing/Informed (RACI) chart illustrating clear ownership for tasks and decisions to be included as an attachment in their proposal. The Offeror that is awarded the contract will be required to "Coordinate and plan with the PMO appropriate roles and responsibilities in a responsibility matrix to support clear ownership for tasks and decisions" during execution of the Program.

No N/A

5 Attachment_2_‐_IDIQ_SOO, Change and Configuration Control and Solution Governance, "Coordinate and plan with the PMO appropriate roles and responsibilities in a responsibility matrix to support clear ownership for tasks and decisions " Would the government agree to a Responsible/Accountable/Contributing/Informed (RACI) chart illustrating clear ownership for tasks and decisions to be included as an attachment due to page count limitations?

The Government does not require Offerors to include a Responsible/Accountable/Contributing/Informed (RACI) chart illustrating clear ownership for tasks and decisions to be included as an attachment in their proposal. The Offeror that is awarded the contract will be required to "Coordinate and plan with the PMO appropriate roles and responsibilities in a responsibility matrix to support clear ownership for tasks and decisions" during execution of the Program.

No N/A

6 IDIQ SOO pg 9 Statement says that “Organizational Change Management” is out of scope. Please confirm that this does not include adoption of EHR by clinicians.

The Government believes the information as stated in the Request for Proposals (Attachment 2 ‐ IDIQ SOO Sections 3.3 and 6.3.1) is sufficient to answer this question and guide development of the proposals.

No N/A

7 SOO pdf vs Attachment 4 The SOO pdf contains a breakdown of facilities that equal 504. The stats on Attachment 4 have 527 facilities. Please confirm the correct number of facilities and the breakdown on type of facility.

Attachment 5 ‐ Sample Task Order SOO, Appendix A, “Notional Facility Information and Services” has the correct number of facilities, 527, and the correct breakdown of the type of facility.

No N/A

8 Attachment 4, Row 66 How would you classify the Resident Treatment Center (RTC), inpatient or outpatient setting?

A Residential Treatment Center (RTC) is neither an inpatient (acute care) nor outpatient setting. The IHS/Tribal Regional Treatment Centers operate as extended care facilities, principally for youth experiencing substance use issues.

No N/A

# RFP Section Question Response Change to RFP? Description of Change 9 RFP, page 3, section 5 Will the Government please allow a round of question and answer during Phase II? Per the RFP (page 7), there will not be a second round of questions for Phase 2.

No N/A

10 IDIQ SOO Section 3.3 Out of Scope ‐ "IHS Central Help Desk (ServiceNow) for the installed enterprise"

While this section states that ServiceNow for the Central Help Desk is out of scope, in Section 6.7.2 Service Delivery and Support, it states that "Integration of tiered support resources with IHS’ ServiceNow to support installed capabilities in accordance with IT service management practices on the Information Technology Infrastructure Library V4 (ITIL V4). Services provided should be managed based on the ITIL framework." Does IHS require the EHR solution to have a system integration to ServiceNow? Or will ServiceNow be a separate system entirely that the vendor will use to manage and coordinate support resources?

The reference in Section 3.3 to ServiceNow is to the use of ServiceNow in the already installed enterprise. The level of EHR integration to ServiceNow is left to the Offeror. The Government's choice of objectives in the Statement of Objectives was meant to provide the Offerors the highest degree of flexibility in meeting the Government's modernization objectives. Proposals should advocate the choices and strategy that meet the objectives as stated.

No N/A

11 IDIQ SOO Out of Scope ‐ "Legacy data management”

While certain organizational and patient data will be required to be incorporated into and validated in the modernized solution, extraction and staging of that data from legacy systems in preparation for migration will be managed separately."

IHS does reference data migration activities in section 6.2 under Implementation Planning as well as 6.4 Data Management, so it seems that the vendor will be responsible for some data migration activities. Can the government clarify what are the vendor's responsibilities for data migration, especially where it concerns the legacy RPMS data?

The Offeror will be required to extract data from an IHS data repository, not directly from legacy systems. The Government expects the Offeror to transform and load the data into the new EHR system and back to the IHS data repository.

No N/A

12 Volume 3 Section 2 Factor 3 & Factor

IHS has acknowledged that aging infrastructure is a known risk for deploying a new EHR;

are infrastructure‐related upgrades part of the planned task orders for this bid or will a separate solicitation/s be issued for infrastructure? If separate, how should a vendor account for that dependency to be compliant with Factor 3 (Architecture) & Factor 4 (Implementation)?

Infrastructure upgrades are out of scope for this acquisition, as specified in Attachment 2 IDIQ SOO section 3.3, apart from the exceptions noted in Attachment 2 IDIQ SOO Section 3.1.

To account for infrastructure upgrades that are dependent on Factor 3 (Architecture) and Factor 4 (Implementation), the Offerors should specify minimum infrastructure requirements necessary to support their proposed solution.

No N/A

13 Volume 5 Section 1 Price Assumptions Can IHS provide a number of anticipated unique users and a number of anticipated concurrent users at full implementation for purposes of assumptions and scaling? How does IHS anticipate deployment to take place—geographically in phases, limited capability initially for all sites, etc?

The Government will not be defining a requirement for deployment. The Government believes the information as stated in the Request for Proposals, Attachment 5 ‐ Sample TO SOO and Attachment 5 ‐ Sample TO SOO ‐ Appendix A is sufficient to answer this question and guide development of the proposals.

No N/A

14 Volume 2 Section 3 Factor 3 & Factor

Will legacy data migration be part of the planned scope of work for this solicitation or separate future solicitation?

The Offeror will be required to extract data from an IHS data repository, not directly from legacy systems. The Government expects the Offeror to transform and load the data into the new EHR system and back to the IHS data repository.

No N/A

15 Volume 2 Section 3 Factor 3 & Factor

Will the legacy RPMS system require enhancement, stabilization, and standardization of data in parallel and as part of preparation for deployment of the new EHR under this solicitation or will those activities become one or more separate future solicitations? If separate, should a vendor response document include assumptions around dependent tasks?

RPMS capabilities are out of scope for this solicitation. No N/A

16 IDIQ SOO Appendix A & B Should vendors build in pricing for all interfaces listed or are these informational only to this solicitation with interfaces managed per task orders for the IDIQ over time?

Offerors should build in pricing for all interfaces listed. No N/A

17 Volume 2 Section 3 Factor 4 Will IHS continue to maintain and enhance RPMS for the duration of the deployment of the new EHR solution under this IDIQ or as separate and ongoing solicitations?

RPMS sustainment is out of scope for this solicitation. No N/A

18 SOO 2.4 Will IHS consider approaches that leverage the existing RPMS system as an element of the new modern EHR solution or is full replacement the only approach being considered?

This solicitation is for the replacement of RPMS (see Attachment 2 ‐ IDIQ SOO, Appendix A ‐ "Clinical and Business Processes").

No N/A

19 Statement of Objectives 6.4.3 Data Analytics & Reporting

Does IHS require the ability to access and abstract data using existing data analytics tools and business intelligence solutions or will a vendor be providing all data views and analytics?

The Government expects Offerors to provide an analytics solution for users in the delivery of health care.

# RFP Section Question Response Change to RFP? Description of Change 20 6 The RFP Sub‐factor 4.2 Implementation, Training and Go‐Live Processes addresses the need for training and proficiency assessment of end users. Does IHS have specific reporting requirements for training prior to system deployments? Does IHS plan to implement goals or targets for total number of users trained or will the vendor recommend this?

There is no reporting requirement for training prior to system deployments. The Government's choice of objectives in the Statement of Objectives was meant to provide the Offerors the highest degree of flexibility in meeting the modernization objectives. Proposals should advocate the choices and strategy that meet the objectives as stated.

No N/A

21 6 For end users, are there any known requirements defining if the vendor will be responsible for any contract tracing protocol? If not, would the program be open to the vendor establishing protocols with the program ahead of deployment travel and engagements?

There is no requirement for contact tracing. The Government's choice of objectives in the Statement of Objectives was meant to provide the Offerors the highest degree of flexibility in meeting the modernization objectives. Proposals should advocate the choices and strategy that meet the objectives as stated.

No N/A

22 6 What role will the vendor have in change management? Will the vendor own or support change management planning and activities that another vendor or client will own? If the vendor takes a supporting role, how will coordination, and roles and responsibilities be documented and recommended?

The change management objectives that are within the scope of this contract are defined in IDIQ SOO, Section 6.7.3. Proposals should advocate the choices and strategy that meet the objectives as stated.

No N/A

23 7 The government has indicated that MITRE is providing acquisition support (RFP Page 16).

Will MITRE provide the financial management support described in the SOO (Section 6.9.1, SOO Page 24) or will the selected implementation contractor provide this support?

The selected implementation contractor will be required to provide the financial management support described in Attachment 2 ‐ IDIQ SOO Section 6.9.1.

No N/A

24 RFP Sec. 4, p. 2 For estimating purposes, please provide a start date for the IDIQ rates. Industry can assume, for estimating purposes, that Year 1 IDIQ rates will start sometime during the Q3 2023 timeframe (July‐ September 2023).

No N/A

25 RFP Sec. 6, Phase I Proposal Content,

p. 4

Please confirm that attachments in the Phase I proposal (for example, Capability Checklist) should be submitted as standalone files.

The completed copy of Attachment 4, EHR Capability Checklist, shall be submitted as a standalone Excel spreadsheet. The rest of Volume I (Sections 1 ‐ 4) can be submitted as one PDF. That said, please ensure the page numbering of Volume I, Section 4 is clear so that the Government can easily determine that it is within the RFP's stated page limits.

No N/A

26 RFP Sec. 6, Phase I Proposal Content,

p. 4

Please confirm that front matter in the Phase I proposal (e.g., cover, table of contents, acronym list, etc.) is excluded from page count.

Yes, it is excluded from the page count. No N/A

27 RFP Sec. 6, Volume I, Section 3:

Completed FAR Provisions, p. 5

The list of FAR provisions in the instructions for Volume I, Section 3: Completed FAR Provisions includes FAR 52.212‐3 – Offeror Representations and Certifications‐ Commercial Items (Jan 2021). However, Section 8, Solicitation Provisions and Clauses, includes FAR 52.212‐3 – Offeror Representations and Certifications‐Commercial Products and Commercial Services (May 2022). Please confirm that the more recent provision in Section 8 should be completed for the Phase I proposal.

Yes, Offerors must complete the version of FAR 52.212‐3 dated May 2022. The date has been fixed in the RFP.

Yes See amendment to RFP.

28 Volume I, Section 4: Factor 1 – EHR Capability and Experience (Phase I), p.

Please confirm that the statement on page 19, Factor 6 – Past Performance (Phase II):

"For the purpose of this evaluation the term 'Offeror' is inclusive of the prime and subcontractors for which past performance will be evaluated," also applies to Factor 1 (including Sub‐factors 1.1 and 1.2) such that the evaluation will take into account EHR Capability, Experience, and Past Performance of both the prime and subcontractors that will perform major or critical aspects of the requirement.

Yes, the term "Offeror" is inclusive of the prime and its proposed subcontractors.

No N/A

29 Volume I, Section 4: Factor 1 – EHR Capability and Experience (Phase I), p.

Please confirm that consistent with Factor 6 – Past performance, the two submitted examples for Sub‐factor 1.2 “Enterprise Experience” can be from the offeror (inclusive of the prime and subcontractors including the EHR provider).

Yes. No N/A

30 RFP Sec. 6, Sub‐factor 1.1 EHR Capability, p. 5

In what section or attachment should Offerors submit the affirmation by an authorized representative that the proposed EHR solution offers the capabilities as cited in the completed checklist?

Offerors can either submit this as a separate document or include it as a tab within their completed copy of Attachment 4. Either way, this affirmation will not count against the stated page limits.

No N/A

31 RFP Sec. 6, Phase II Proposal Content,

p. 7

Please confirm that attachments in the Phase II proposal (for example, IDIQ PWS, Sample Task PWS, and Subcontracting Plan) should be submitted as standalone files.

Yes, please submit each completed attachment as a standalone file.

# RFP Section Question Response Change to RFP? Description of Change 32 RFP Sec. 6, Phase II Proposal Content,

p. 7 Please confirm that front matter in the Phase II proposal (e.g., covers, tables of contents, acronym lists, etc.) is excluded from page count.

Yes, it is excluded from the page count. No N/A

33 RFP Sec. 6, Phase II Proposal Content,

p. 7

Volume IV (Technical) has a page limit of 20 pages. Factor 6 (described on page 11) requires submittal of PPQs directly to the Contracting Officer by the reference and the optional submittal of consent letters with the proposal. Factor 7 (described on page 12) requires submittal of Attachment 9 – HHS Subcontracting Plan Template with the proposal. Please clarify how the page limit applies to Volume IV.

There is no page limit associated with the submission requirements for Factor 6 ‐ Past Performance. The stated page limit for Volume IV only applies to Factor 7 ‐ Subcontracting Plan.

No N/A

34 RFP Sec. 6, Phase II Proposal Content,

p. 7

Volume IV (Technical) has a page limit of 20 pages. Please confirm that Attachment 9 – HHS Subcontracting Plan Template is excluded from the page limit.

Per the response to Question #33, the page limit for Factor 7 is 20 pages. This page limit includes the completed copy of Attachment 9 ‐ HHS Subcontracting Plan Template.

No N/A

35 RFP Sec. 6, Volume IV, Section 1:

Factor 6 – Past Performance (Phase II), p. 11

Will the government permit Offerors to submit a past performance narrative in Volume IV, separate from the PPQ, to support the evaluation of relevancy?

No separate narrative from the PPQ is permitted. Offerors are given an opportunity to explain the record via Part J / Section A of the PPQ. The PPQ has been updated.

Yes See Attachment 8 ‐ Past Performance Questionnaire ‐ Amendment 1.

36 RFP Sec. 6, Volume IV, Section 1:

Factor 7 – Subcontracting Plan (Phase II), p. 12

The government has provided a small business goal as a percentage of total contract value and additional HHS goals as a percentage of total subcontracted value. Given the IDIQ nature of this contract, will the government provide a contract value for the 5‐year base period and the options to enable calculation of a total contract value for the purpose of completing Factor 7 – Subcontracting Plan?

For the purposes of submitting Factor 7 with their Phase 2 proposal, OTSB Offerors shall use their Total Evaluated Price from the Sample Task Order as the "Total Contract Value" in order to calculate the necessary small business subcontracting dollar amounts in Attachment 9. A final HHS Subcontracting Plan, to include actual subcontracting dollar amounts, will be agreed upon at time of IDIQ award once the IDIQ ceiling value has been determined. Factor 7 in the RFP has been updated with this information.

Yes See amendment to RFP.

37 Attachment 2, Sec. 6.4, p. 16 Section 6.4 states, “…all data in the Health IT Modernization solutions will be freely available to IHS, and to Tribal and Urban partners in accordance with applicable agreements executed as part of their tenancy on the shared solution, in accessible and non‐proprietary formats”.

Is the IHS requirement that a participating Tribe only have access/visibility to data owned by that Tribe or will each participating Tribe (and IHS) be able to view/access data from across all participating Tribes? i.e., the latter allowing for robust population health and supporting use‐cases where patients visit facilities across Tribal care sites.

In support of quality and coordination of care, appropriately credentialed users at all facilities where a patient is registered will have access to that patient's data in the shared enterprise EHR, wherever the care was delivered.

No N/A

38 Attachment 2, Sec. 6.4.4, p. 18 This section refers to Section 3.2. Please confirm that the intended reference is Section 3.3, Out of Scope.

Yes, Attachment 2 ‐ IDIQ SOO, Section 6.4.4, page 18 should reference Section 3.3 ‐ Out of Scope. This has been fixed.

Yes See Attachment 2 ‐ IDIQ SOO ‐ Amendment 1.

39 Attachment 4 Is replacement of VistA PACS a requirement of this solicitation? If so, do you require a vendor neutral archive?

The Government expects to replace the current solution ‐ VistA Imaging ‐ for the management of medical images under this contract. Refer to Attachment 2 ‐ IDIQ SOO, Appendix A ‐ "Clinical and Business Processes".

No N/A

40 Attachment 2, Sec. 6.8.2, p. 23 Please clarify the definition of multi‐tenant and how that it will be used for individual tribes versus an area of multiple tribes in a single region.

In the multi‐tenant approach, each federal Service Unit and participating tribal or urban Indian organization will have tenancy on the shared infrastructure. The expectation is that users providing care to patients who are shared between tenants will have access to that patient's information across the shared infrastructure in support of quality and coordination of care.

Tenants will manage how their organizations' data are used by IHS for analytics and reporting purposes.

No N/A

41 Attachment 2, Sec. 8.0, p. 25 Since the place of performance for “all other performance (unrelated to sites) shall be at the Contractor facility”, please confirm that telecommuting is acceptable.

Yes, telecommuting is acceptable. The Government's choice of objectives in the Statement of Objectives was meant to provide the Offerors the highest degree of flexibility in meeting the modernization objectives. Proposals should advocate the choices and strategy that meet the objectives as stated.

# RFP Section Question Response Change to RFP? Description of Change 42 Attachment 3 The content in the IDIQ PWS Template is the same content as the Sample TO PWS

Template. Does the Government intend to reissue the IDIQ PWS Template with an outline specific to the IDIQ SOO?

Yes. An incorrect version of Attachment 3 was provided with the original posting of the RFP. The correct version is provided with this amendment.

Yes See Attachment 3 ‐ IDIQ Performance Work Statement (PWS) Template ‐ Amendment 1.

43 Attachment 5, Sec. 1.0, p. 1 To ensure Offerors have sufficient detail to develop robust Sample Task Order pricing proposals, can the government provide estimated or notional user and provider counts for notional Service Units A B and C?

The Government believes the information as stated in the Request for Proposals, Attachment 5 ‐ Sample TO SOO and Attachment 5 Sample TO SOO ‐ Appendix A is sufficient to answer this question and guide development of the proposals.

No N/A

44 Attachment 10, Tab A Since SCLS labor categories need to be identified in Attachment 10, does FAR 52.222‐41 apply? If so, will the Government provide Wage Determination registers after award?

FAR 52.222‐41 will only apply if 1) the Offeror identifies any proposed labor categories as covered by SCLS and 2) the Government concurs with this assertion. If it’s been determined that FAR 52.222‐41 applies to the IDIQ, the appropriate Wage Determination will be incorporated at time of award.

No N/A

45 Attachment 10, Tab C Will the government confirm that the non‐labor listed in Attachment 10 Tab C (licenses, cloud services, etc.) are fixed unit rates and may include fee even if issued under a T&M task order?

For the purposes of evaluation and award of the IDIQ, Offerors shall submit their non‐labor unit rates via Tab C on a T&M basis which means that fee is not allowable. After award, if future orders for non‐labor items are issued on a Firm Fixed Price basis, the IDIQ contractor may be afforded the opportunity to apply fee in those instances.

No N/A

46 Attachment 10, Tab C Will the government confirm that travel costs should not be proposed as fixed unit rates in Tab C?

While travel is included within the scope of this IDIQ, Offerors shall not submit travel costs in Tab C.

No N/A

47 Attachment 10, Tab D Will the Government consider issuing travel costs as a not‐to‐exceed (NTE) value for the Sample Task Order for evaluation purposes?

The Government is not providing a NTE value for travel costs for the purposes of the Sample Task Order.

No N/A

48 Attachment 10, Tab D; Sample TO

SOO

If a NTE value is not provided for travel for the sample task order, will the government provide additional detail to enable offerors to estimate travel costs?

The Government is not asking Offerors to estimate travel costs for the purposes of the sample task order. This is because the Government anticipates travel costs to have a minimal impact on the costs to the Government for the sample task order.

No N/A

49 Attachment 10, Tab D The PWS task numbers in Tab D do not match the PWS task paragraph numbers in the Sample TO PWS Template. For example, Enterprise Implementation Planning is labelled

1.2.2.1 in Tab D and 1.1.1.1 in the template. May the Offeror update the task paragraph numbers in Column A of Tab D to match the task paragraph numbers the submitted Sample TO PWS?

The task paragraph numbers in Attachment 10 ‐ Pricing Table (Tab D) have been changed to match the task paragraph numbers in Attachments 6 ‐ Sample TO PWS.

Yes See Attachment 10 ‐ Pricing Table ‐ Amendment 1.

50 Attachment 10, Tab D To enable assessment risk, please provide the contract type (FFP, T&M, or LH) for the Sample TO.

For the purposes of the Sample Task Order, please assume a Time & Materials contract type.

No N/A

51 Attachment 10, Tab D Should Offerors include the overall management team who will lead the program (e.g., Program Director, Deputy Program Director, Quality Assurance, Task Order Management, etc.) in our sample TO pricing or will these activities be included in a separate task order?

Yes, the pricing for the Sample Task Order (TO) should include all costs required to meet the objectives of the Sample TO.

No N/A

52 Attachment 10, Tab D For Contract Personnel, is the government asking Offerors to estimate the billable hours required for the background investigations and Security Clearances for all contract personnel (1.2.9.3)?

Hours associated background investigations and/or clearances should not be included in Tab D for the Sample Task Order Price Table.

# RFP Section Question Response Change to RFP? Description of Change 53 Attachment 10, Tab D May Offerors add columns to Tab D to list IDIQ rates, discounts, proposed Task Order rates, and hours/quantity by year since the period of performance exceeds 12 months and requires IDIQ rates from Years 1 through 3?

The sample task order consists of two performance periods: 1) non‐ severable tasks associated with the planning, build, Go‐Live, and Post‐Go‐Live of the EHR solution for three service units (estimated to be 18 months), and 2) a severable task for O&M support (estimated to be 12 months). Offerors shall use the same set of rates for the non‐severable tasks, regardless of length. If Offerors choose to deviate and extend the severable O&M task beyond 12 months, then yes, the Offeror may add columns to account for different pricing information by year.

The Government has added columns to account for IDIQ rate, discounts, and proposed Task Order rates to Tab D.

Yes See Attachment 10 ‐ Pricing Table ‐ Amendment 1.

54 general Are you looking for multiple licenses in the region sharing a database or do you want more autonomy for each clinic.

The Government believes the information as stated in the Request for Proposals, Attachment 2 ‐ IDIQ SOO Section 3.1 ‐ Scope of Acquisition is sufficient to answer this question and guide development of the proposal.

No N/A

55 general System scope includes IHS ambulatory clinics and/or hospitals (inpatient)? The Government believes the information as stated in the Request for Proposals (Attachment 5 Sample Task Order SOO, Appendix A ‐ Notional Facility Information and Services) is sufficient to answer your question and guide your development of the proposal.

No N/A

56 IDIQ SOO 3.3 In addition to the federally managed PMO will there be an additional PMO contract? Yes, the Government anticipates awarding a PMO contract that is separate from this IDIQ.

No N/A

57 IDIQ SOO 3.3 and 6.3

PMP

There is overlap in the described functions (PMO, training, outreach) for the product systems integrator, PMO, and OCM. How does the gov’t differentiate the responsibilities so that the tasks can be done to support success?

The Government understands the scope of responsibilities of the product systems integrator. The Government PMO will provide oversight and integration of training and outreach.

The Government believes the information as stated in the Request for Proposals, (Sections 3.3 and 3.6 of Attachment 2 ‐ IDIQ SOO) is sufficient to answer this question and guide development of the proposal.

No N/A

58 IDIQ SOO 6.3 What are the responsibilities of the product vendor for training vs. the OCM vendor for training?

The Government believes the information as stated in the Request for Proposals (Sections 3.3 and 3.6 of Attachment 2 ‐ IDIQ SOO) is sufficient to answer this question regarding the training responsibilities of the product vendor and guide development of the proposal. The Government will not be defining requirements for the OCM vendor as organizational change management services are out of scope for this solicitation.

No N/A

59 Phase II

RFP

Section 6, page 11, last bullet, and Attachment 8‐Past Performance Questionnaire

REF: On page 11, the bullet at the bottom of the page states, “Each record shall be completed in accordance with Attachment 8 …” QUESTION(s): We understand that the government is requesting the PPQ (Attachment 8) part A as part of the separately completed PPQ once our referenced customer has complete part B. Please confirm bidders should also include (Attachment 8) PPQ, Section A as part of the Offeror’s electronically submitted proposal so the Government is aware that the PPQ process has been initiated.

Part A of the PPQ should be completed first by Offerors then submitted to their reference for the completion of Part B. The Offeror's reference will then submit to the Government the completed PPQ (Parts A & B).

# RFP Section Question Response Change to RFP? Description of Change 60 Phase II RFP

Section 6, page 12, first full paragraph REF: On page 12, the first full paragraph states, “The Offeror shall submit consent letters executed by each subcontractor, teaming partner, and/or joint venture partner…” QUESTION(s): Please confirm that consent letters are only required for subcontractors and partners submitting past performance records as part of the Phase II proposal (e.g.

One of the maximum of three past performance records).

Please also confirm that the consent letters are outside the 20‐page limit for Phase II, Volume IV (Technical)

This is correct. Consent letters are only required for subcontractors and partners who have past performance records submitted on their behalf as part of the Offeror's Phase 2 proposal. The consent letters do not count against the 20‐page limit for Phase 2, Volume

IV.

No N/A

61 Phase II

RFP

Section 6, page 22, Factor 8‐Price and Attachment 10‐Pricing Tables

REF: The Total Evaluated Price for purposes of award will be determined by the total calculation identified in the submission for Attachment 10 / Tab D – Sample Task Order Price Table.

Attachment 10 Tab D contains inputs for non‐labor items associated with the Sample Task Order.

QUESTION(s): Can the Government please clarify whether labor and non‐labor inputs for Attachment 10, Tab D is intended to include all price elements for designing, building, and implementing the enterprise solutions in addition the incremental price components attributed to only the facilities size and types included in the Sample Task Order SOO?

For the purpose of comparing and evaluating equivalent non‐labor price component attributed to software licenses to meet the requirements contained in the Sample Task Order SOO, would the Government consider incorporating direction to the bidders to use a specific volume discount tier from Attachment 5 – Sample Task Order SOO, Attachment A, tab C?

Can the Government share additional details regarding their methodology and process of evaluation of best value by extrapolating pricing for full deployment beyond the Sample

TO?

This would help draw out economies of scale realized across the enterprise for future deployments as the sample task order would not be representative of future go‐lives since it would include a high degree of non‐recurring costs.

The labor and non‐labor inputs for Attachment 10 should include all work to support the Sample Task Order SOO and the Offeror's completed Sample Task Order PWS.

The Government will not be prescribing specific volume discount tiers since the Government expects various innovative approaches to be proposed by industry.

The Total Evaluated Price for the purposes of award will be based on the completion of Tab D. The Government will not be extrapolating pricing beyond the Sample TO when making its award decision.

Please note that the Sample Task Order is meant to be representative of the type of work to be performed over the course of the 10‐year period of performance. This includes cost categories ranging from the design and build of the EHR solution to the deployment and post‐deployment support required. By covering all these critical cost elements, the sample task order will assist the Government in accurately assessing the probable types of costs of performing the required services. That said, it is not meant to be inclusive of all the work to be performed from a quantitative perspective. In order words, it does not encompass every future site deployment for the 10‐year period of performance since the quantity and type is yet to be determined.

By including a group of notional sites in the Sample Task Order, the Government will be able to assess each Offeror’s probable deployment costs which is one of the goals of the sample task order.

No N/A

62 Phase II Attachment 5‐Sample TO Statement of Objectives, Section 4.3, page 4

REF: Provide training for IHS‐identified specialists (estimated to be 20 SMEs for the purposes of this SOO) to formally certify IHS‐identified specialists on solution systems.

This will better enable IHS staff to work with offeror solution engineers in implementing IHS workflows.

QUESTION(s): Can the Government please expand on the expectations included in the requirement to “…to formerly certify IHS identified specialists…”?

Can the Government include additional detail as to the organizational reporting structure, anticipated roles, skill levels and areas of expertise or specialty of the referenced SME’s? This will assist in determining specific training and certification modules and activities required to fully meet this objective. For example, are these SME’s across Administrative, Technical and/or Clinical roles, and what level (e.g. Mid‐Level, Senior. or Advanced)

The Government anticipates providing senior‐level Subject Matter Experts (SMEs) across Administrative, Technical, and/or Clinical roles for training and certification on Solution systems.

# RFP Section Question Response Change to RFP? Description of Change 63 Phase II

RFP, Section 6, (b), page 8 REF: The video instructions states “b) Videos should include sufficient narration to facilitate the Government’s understanding of the scenario being presented, to include the process and/or step being demonstrated.

QUESTION(s): Will the government allow inclusion of a presenter or other virtual/visual assistant in addition to the EHR software on screens?

Will the government allow for transition of devices (e.g. laptop or cart display/monitor to a Tablet) during the presentation of the EHR software screens?

Can the government confirm that “Have a resolution no smaller than 720p” means that the video resolution must be 720p or greater?

The Government believes that the information as stated in the Request for Proposals (RFP Volume III, Section 1: Factor 2 – User Acceptance (Phase II) on page 8) is sufficient to answer this question and guide development of the proposal: "Real‐time demonstration that shall be an audio/video capture of the EHR software only."

Yes, the Government will allow for transition of devices during the presentation of the EHR software screens.

Yes, "Have a resolution no smaller than 720p" means that the video resolution must be 720p or higher.

No N/A

64 Phase I RFP Section 6, Volume I, Section 3:

Completed FAR Provisions, page 5, 1st paragraph

REF: …“(see Section 7 of this RFP..”

QUESTION(s): Can the government confirm that this should read ”(see Section 8 ‐ Solicitation Provisions and Clauses of this RFP…)” ?

Correct, this should state "see Section 8." The RFP has been updated to address this error.

Yes See amendment to RFP.

65 Phase II Attachment 2‐ IDIQ SOO, Section 5.0, 11th bullet, REF: The 11th bullet states “Quality measurements as outlined in Appendix C including the use of the HL7 Clinical Quality Language (CQL) standard….

QUESTION(s): Since PATH is not a CMS standard, is the expectation that the recommended solution for the PATH items should be built into the system or should the system just have the capability to capture customized defined metrics to help measure the PATH items?

The Government expects the Offeror to maintain alignment with the latest eCQMs as published by HHS/CMS. The Government will continue to use various ways of reporting the provision of care.

Appendix C describes how IHS currently reports on various metrics, including eCQMs and others. Offerors' proposals are expected to include recommended strategies and/or approaches for meeting these reporting requirements.

No N/A

66 Phase I/II RFP, Section 1 Overview, pages 1‐2

REF: The government anticipates awarding the first task order approximately four to six months after award of the IDIQ.

QUESTION(s): Does the Government anticipate that each TO issued will require a separate proposal, including negotiations, at the task order level?

Can the Government provide an estimate of when they intend to award the IDIQ and explain their methodology for delaying the initial task order 4 – 6 months post award?

Does the Government anticipate contract start‐up activities to occur during this time?

Yes, each task order will include a separate solicitation and require a separate proposal. Negotiations may or may not be required.

The Government intends to award the IDIQ in FY23 but is not able to provide a more exact timeframe at this time. Because the first task order is not being issued at the same time as the IDIQ award, it will likely take 4‐6 months to award it.

The Government does not anticipate requiring contract start‐up activities before the first task order is awarded.

No N/A

67 Phase I

RFP,

Section 6, pages 6‐7

REF: The government will issue advisory notifications to all Offerors which will indicate the Government’s recommendation to proceed or not to proceed with a Phase II proposal.

QUESTION(s): Can the Government provide an estimate of the timing between evaluation of the proposals and issuance of advisory notifications?

Will the Government disclose, within the advisory notice, how many bidders submitted Phase 1 Proposals along with how many of those offerors received a recommendation to proceed with a Phase II proposal?

Will the Government provide scores assigned to bidders among the most highly rated against the evaluated factors or other information as part of their advisory notification?

Does the Government anticipate or contemplate affording Phase I bidders a debrief of their evaluated Phase I proposal discussing strengths or weaknesses that the Government would like highlighted or addressed in greater detail under the resultant Phase II proposal?

The Government estimates that it will take approximately four weeks to complete its evaluation of Phase 1 proposals and issue the advisory downselect notifications.

The Government will not disclose the number of Offerors that submitted a Phase 1 proposal or disclose the number of Offerors who received a recommendation to proceed to Phase 2.

The Government will not disclose the rationale used to determine whether an Offeror is among the most highly rated.

The Government is not using a firm downselect process so a debrief will not be provided after the completion of Phase 1. A debrief may be requested by Unsuccessful Phase 2 Offerors in accordance with FAR 15.506 after they have received notification of contract award.

# RFP Section Question Response Change to RFP? Description of Change 68 Phase II

Attachment 2‐IDIQ SOO, Section 2.2, last paragraph, page 5

REF: The IHS Office of Information Technology (OIT) develops and updates the system regularly, issuing patches that are installed on each instance by local staff.

QUESTION(s): Will the Government tell the Offerors how many instances of RPMS are currently in use?

The Government does not expect the Offeror to maintain the legacy systems. Therefore, we believe the number of RPMS instances is not relevant.

No N/A

69 Phase II Attachment 2‐IDIQ SOO, Section 2.3, 2nd paragraph, page 6

REF: As IHS proceeds with replacement of RPMS (see below), Tribes and UIHPs that presently use RPMS may elect to continue to use the IHS‐selected solution in a multi‐ tenant environment or may choose to adopt different Health IT solutions.

QUESTION(s): Can the Government identify how many additional instances there are of non‐RPMS EHR’s are in use within IHS and among Sovereign Tribal Nations including the name of the commercial EHR that is in use and how many facilities and types are served by these commercial EHR instances?

Does the Government anticipate the selected contractor will play a role in assisting Tribes and UIHPS in transitioning to different EHR solutions than the HIT EHR Modernization solution selected under the RFP?

Will IHS provide a list of the systems in use as well as the volume of care and/or number of patients being provided care in these other EHR systems?

The Government will not be defining a requirement for the modernization of non‐RPMS EHRs. If a site decides to participate in the IHS modernization initiative, the site's legacy system will be replaced.

No, the selected contractor will not be responsible for assisting Tribes and UIHPS in transitioning to different EHR solutions.

The number of Tribes and UIHPS using different commercial systems, and the products in use, is not relevant to this solicitation.

While some of those organizations may choose to migrate to the IHS enterprise solution at some point, that number is not predictable at this time.

No N/A

70 Phase II Attachment 2‐IDIQ SOO, Section 3.3, 4th bullet, page 9

REF: Organizational Change Management (OCM) services.

OCM activities will be carried out through a separate organizational unit reporting to the IHS Health IT Modernization PMO. The IDIQ vendor and OCM organization will collaborate on specific areas of shared responsibility.

QUESTION(s): Does the Government anticipate the PMO and OCM vendors to be selected and in place before this solicitation is awarded?

For example, does the Government anticipate negotiating and monitoring Associate Contract Agreements or some similar contractual instrument to facilitate cohesion and collaboration across all contracts related to the HIT EHR Modernization effort ?

While the Government intends to award the separate PMO & OCM contracts in advance of this IDIQ, it is not guaranteed.

The Government expects full cooperation among all contractors that will be supporting IHS's HIT modernization efforts but does not have details on Associate Contract Agreements at this time.

No N/A

71 Phase II Attachment 2‐IDIQ SOO, Section 3.3, 4th bullet, page 9

REF: Organizational Change Management (OCM) services.

OCM activities will be carried out through a separate organizational unit reporting to the IHS Health IT Modernization PMO. The IDIQ vendor and OCM organization will collaborate on specific areas of shared responsibility.

QUESTION(s): Does the Government contemplate a separate contract for Infrastructure modernization and If so, does the Government anticipate the infrastructure vendors to be selected and in place before this solicitation is awarded?

For example, does the Government anticipate negotiating and monitoring Associate Contract Agreements or some similar contractual instrument to facilitate cohesion and collaboration across all contracts related to the HIT Modernization effort?

The Government does not have information regarding infrastructure modernization at this time. The Government believes the information as stated in the Request for Proposals (Attachment 2‐IDIQ SOO, Section 3.3) is sufficient to answer this question and guide development of the proposal.

No N/A

72 Phase II Attachment 2‐IDIQ SOO Appendix C

REF: Data contained within Appendix C

QUESTION(s): Can the Government confirm that the data contained in Appendix C is up to date or do they contemplate refreshing this data prior to or after awarding a contract for HIT EHR Modernization

The Government expects the Offeror to maintain alignment with the latest eCQMs as published by HHS/CMS. The Government will continue to use various ways of reporting the provision of care.

Appendix C describes how IHS currently reports on various metrics, including eCQMs and others. Offerors' proposals are expected to include recommended strategies and/or approaches for meeting these reporting requirements.

No N/A

73 Phase I

RFP

General question

QUESTION(s): Excluding the Demo, will the Government accept Times New Roman, 11‐ point font for the text of the proposal and a font no smaller than 10 point font for tables, graphics, and drawings?

Yes, the Government will accept this. No N/A

# RFP Section Question Response Change to RFP? Description of Change 74 Phase I

RFP

Section 5, page 3

REF: Questions and Answer are due at 9:00 am ET and Phase I response is due at 5:00 pm

ET.

QUESTION(s): Since the questions and RFP responses are both electronic submissions, would the Government please clarify whether the intent of referring to ET is to distinguish the local time for Washington, DC at the time of submission regardless of daylight savings time or standard time?

Yes, use the local time for Washington, DC at the time of proposal submission regardless of daylight savings time or standard time.

No N/A

75 Phase II Attachment 2‐IDIQ SOO, Section 3.3, And Section 6.4.1, 1st bullet, page 17

REF: Section 3.3 states that “extraction and staging of that data from legacy systems in preparation for migration will be managed separately” & section 6.4.1 calls for “extraction” as a part of providing “a full range of data migration capabilities”.

QUESTION(s): Would the Government provide clarity on specific data migration and conversion strategies that the offerors should assume? Specifically with respect to where the offers should expect to “extract” data, and what the offers should expect when legacy data is “staged and prepared for migration”.

The Offeror will be required to extract data from an IHS data repository, not directly from legacy systems. The Government expects the Offeror to transform and load the data into the new EHR system and back to the IHS data repository.

No N/A

76 Phase II Attachment 2‐IDIQ SOO, Section 5.0, 5th bullet, page 11

REF: Section 5.0 “…home settings to include connectivity with consumer health monitoring and data solutions.”

QUESTION(s): Would the Government provide clarifying information on the assumptions and expectations of “consumer health monitoring” data and “data solutions”? This market domain is fairly broad, ranging from Patient Generated Health Data to Remote Patient Monitoring and any additional detail from the Government would assist in estimating the level of effort and necessary technology components.

The Government will not be defining a requirement for consumer health monitoring data or data solutions. The Government is looking for Offerors to help build the best possible EHR. The choice of objectives in the Statement of Objectives was meant to provide the offerors the highest degree of flexibility in meeting the modernization objectives. Proposals should advocate the choices and strategy that meet the objectives as stated.

No N/A

77 Phase II Attachment 2‐IDIQ SOO, Section 6.4.2, 3rd bullet, page 17

REF: Section 6.4.2 “Provides privacy‐preserving patient identity management technologies that ensure accuracy in patient identity matching…”.

QUESTION(s): Would the Government clarify expectations for the inclusion of any government‐required system integrations, policy or regulatory requirements to perform this function?

For example, The contractor may be required to interface with the Government’s Master Patient Index or other systems utilizing unique patient identifiers.

Does the Government have a set of Interface Control Design Documents for the current RPMS system that could be made available to Offerors along with the advisory notices related to progressing to the Phase II proposal?

The Government expects Offerors to provide a solution for the Master Patient Index (MPI). Refer to Attachment 2 ‐ IDIQ SOO, Appendix A “Clinical and Business Processes”.

The Government does not have an…