09.11_Attachment_A_-_PWS.docx

Department of Homeland Security (DHS) – U.S. Immigration and Customs Enforcement (USICE) - eHR Enterprise License and Support

U.S. Immigration and Customs Enforcement (ICE)

Attachment A:

ICE electronic Health Records (eHR) Performance Work Statement (PWS)

Office of the Chief Information Officer (OCIO)

April 24, 2019 Washington, DC

Procurement Sensitive.

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TABLE OF CONTENTS

Department of Homeland Security (DHS) – U.S. Immigration and Customs Enforcement (USICE) - eHR Enterprise License and Support i

PROJECT TITLE

Performance Works Statement (PWS) for ICE electronic Health Records (eHR) Enterprise License, Software License and Support.

Background The Department of Homeland Security (DHS) Immigration and Customs Enforcement (ICE) Office of Enforcement and Removal Operations (ERO) enforces the nation’s immigration laws in a fair and effective manner. ERO identifies and apprehends removable aliens, detains these individuals when necessary and removes illegal aliens from the United States. In fulfilling this mission, ERO is concerned with the wellbeing of the thousands of undocumented immigrants who are processed through its detention facilities each year. ICE Health Service Corps (IHSC) serves as the health authority for ICE / ERO on all matters related to detainee health care. ICE / ERO / IHSC healthcare includes several distinct activities and services required by DHS to support the enforcement of immigration law and maintain national security.

ICE acquired the eHR system to increase operational efficiency, enhance reporting capabilities, and improve the quality of detainee health care. The U.S. Public Health Service officers and contract medical professionals that comprise the IHSC use the eHR. Program management and execution for the eHR system is led by the ICE Office of the Chief Information Officer (OCIO). The ICE / OCIO eHR Program Office ensures the operation and maintenance of the eHR system. The eHR system is comprised of eClinicalWorks (eCW), Kalos CIPS™ Correctional Institution Pharmacy Software, KALOS eMARt Medication Administration Record software, Open Dental Software (for charting), Schick Dental (for imaging) and MedPAR2 Medical Payment software. This PWS does not include a request for correctional pharmacy, medication, dental or medical payment software but requires the vendor’s eHR to be able to interface with KALOS software as well as the Open Dental, Schick Dental and ICE’s custom developed medical payment system. The vendor’s software product is required to be certified by the Office of the National Coordinator for Health Information Technology (ONC-HIT), which requires the vendor to maintain certified functionality during system integration through continuous testing. Also, the vendor is required to be certified by Certification Commission for Healthcare Information Technology (CCHIT) standards, and examined for functionality, compatibility with other Health IT systems (Ambulatory, Inpatient, Emergency department, behavioral health, Long Term and Post-Acute Care, electronic prescriptions), and security. Further, the eHR system consists of interfaces to internal, external, and archival data sources.

Scope of Work The objective of this PWS is to procure the Contractor’s eHR correctional version software licenses and support to meet the medical health care support needs of the IHSC to ensure high quality health care of the ICE detainees. This overall scope consists of the following:

· eHR Enterprise Licenses

· eHR Tier 3 Support

· eHR Upgrades & Enhancements

· eHR Patient Portal Applicable Policies and Standards The Contractor shall comply with the latest version of all technology standards and architecture policies, processes, and procedures applicable to the ICE IT environment. These publications are available on request and include, but are not limited to, the following:

· DHS 4300A Sensitive Systems Handbook

· DHS 4300A Sensitive Systems Policy Directive

· DHS 4300B National Security Systems Handbook

· DHS Management Directive (MD) 4300, IT Systems Security Publication

· DHS MD 4010.2, Section 508 Program Management Office & Electronic and Information Technology Accessibility

· Section 508 1194.2, Section 508 of the Rehabilitation Act (29 U.S.C. 794d), as amended by the Workforce Investment Act of 1998 (P.L. 105-220)

· Privacy Act of 1974 Product Description and tasks IHSC provides different services to the detainee population. These services are reflected in the different ways or accesses that IHSC will use the eHR. Below are the roles and responsibilities of the ICE health providers who will be using the eHR. The vendor’s eHR must have different levels of roles and functionality for the different health care providers who will be using the system.

ICE “provider” users have the most comprehensive and widespread need of the eHRs functionality. They must be able to record prescriptions or issue medications for the patient using the eHR. “Provider” roles include Doctor of Medicine (MD, DO), Physician Assistant (PA), Nurse Practitioner (NP), Psychiatrist (PS), and Dentist (DDS, DMD). Registered Nurse (RN) roles shall also be considered part of the “provider” license count due to their ability to issue over the counter medications through the eHR.

ICE “mid-level” users provide limited patient care, so they do not have the comprehensive rights and privileges of the “provider” users. However, they must have the ability to lock notes. “Mid-level” roles include Psychologists, Social Workers, and Dieticians.

ICE “non-provider” users must also be able to lock notes. These users include Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN).

ICE “administrative” users have a need, primarily to review and search data within the eHR system. These users include Pharmacists, Health Service Administrator (HSA), Certified Nurse Assistant, Pharmacy Technician, Medical Records Technician (MRT), Epidemiology, Registered Health Information Administrator, Health Informaticist, System Administrator / Analyst, and Management.

Table 1 - Summary of Type / Role and Number of Users Each

eHR Tier 3 Support Contractor Tier 3 support shall include an eHR Enterprise Implementation Specialist (EIS) resource that has subject matter expertise with the configuration of correctional process flows from the vendor’s eHR and system administration of its eHR. Support shall include assisting ICE Government and technical support contract employees with the operations and maintenance (O&M) of its eHR. On-site support resources shall have access to eHR technical staff on an as-needed basis.

The Contractor’s product shall utilize business objects that will be used to develop numerous reports for ICE. The Contractor shall also provide an eBO Developer to support ICE. The vendor’s EIS and eBO shall include the following roles and responsibilities:

Role Description

· The EIS is actively engaged in end-user interaction, workflow analysis, design, build, superuser training, on-site support, post go-live site assessment, adoption measurement and assistance to implement the eCW eHR solution and its various add-on modules.

· The eHR EIS shall also work with Customer and execute their pre- & post implementation phase approach and their adoption vision including risk and issue identification, mitigation and resolution. The EIS will travel to each site to meet with end users and act as primary contact for the end users.

· The EBO developer shall provide eBO support to the Customer.

Responsibilities

· Acts as staff augmentation for practice to assist with practice-side project deliverables during pre- or post-implementation phase(s).

· Conducts practice-specific workflow analysis design and key decision-making including gap analysis.

· Serves in a consultant role with the steering committee or project leads that make critical decisions in defining new/updating current goals/workflows for usage of eHR efficiently in the practice environment.

· Provides tips in designing office IT design layout, concerning devices, printers, and scanners deployments.

· Executes implementation tasks for assigned practices following the standard implementation procedures.

· Documents eHR workflows/cheat sheets for different scenarios to provide support.

· Develops training plan and knowledge transfer to training teams who then train the practice staff and physicians.

· Functions as primary liaison between the practice and support departments/teams.

· Identifies workflow/setup related red flags to the project and support teams’ pre-production and post-production environment. Provides regular status reports to key Program Managers and end-users.

· Drives resolution to end-user issues. Works with all parties to prioritize problems and offer solutions.

· Ensures all deliverables, projects, and requirements are provided within the specified amount of time and performed at an expert level of proficiency.

· Provides focused group training (eHR 101/Superuser Training) and supports appropriate use of the application, utilizing expert knowledge of the physician clinical workflows. End-user and go-live training will need to be conducted by eHR trainer(s) and not EIS(s).

· Works with physicians, business staff, IT team and other clients to understand and research customization requests.

· Provides on-site go-live support and works with the support team to provide guidance on Helpdesk best practices.

· Establishes and monitors Key Performance Indicators (KPI) that include optimization success criteria and measures the competency of Eligible Professionals (EP) in practice for Meaningful Use (MU) workflows to meet specified thresholds.

· Provides ongoing Helpdesk management, working hands-on with live sites and end users to answer and address any application related questions and issues. Works as a practice and IS/IT team liaison with eHR Support Account Management team to follow up and bring resolution to open cases (e.g., how-to and break-fix).

· Drives the Initiation, Planning, Execution and Measurement phases that will help the practice/enterprise adopt add-on modules of eHR and its Partners which include (but are not limited to) Patient Portal, Patient Kiosk, eClinicalMessenger, eCliniMobile, eClinicalP2P, eClinicalTouch, Scribe, eEHX, IMO, Patient Education, etc.

· Modifies existing eBO reports

· Develops new eBO reports

· Adds new fields that are not currently being captured in COGNOS when revising or developing new eBO reports eCW Patient Portal To facilitate compliance with ICE Performance Based National Detention Standards (PBNDS), ICE requires that detainees leaving custody may gain access to their medical record through a patient portal. The patient portal shall be accessible via the Internet with a standard supported web browser (e.g., Chrome, Internet Explorer, Firefox, Safari).

The detainee record within the patient portal shall be created on a final book-out, as triggered by the eHR manual discharge module. During the discharge process, the username and password shall be automatically generated with a printable letter that provides instructions to the detainee on how to access the patient portal in multiple languages (English, Spanish, French, Portuguese, Russian, Somali, Vietnamese, Chinese, Arabic).

To reduce complexity in establishing a detainee username, an ICE identifier (e.g. A# or Subject ID) shall be used with no dependency on establishing an email account. An email address shall only be used as an optional field after the detainee’s first login to the patient portal to support account management issues.

Upgrades and Enhancements The Contractor’s correctional version of its electronic Health Records product shall be upgraded with similar enhancements as its commercial version. The Contractor shall allot eighty ninety (80) calendar days for User Acceptance Testing (UAT) within IHSC’s test environment of its planned new correctional product release. At the end of the 80 calendar days of UAT, the Contractor will determine functionality that has been fully tested and deploy a new release consisting of fully tested new functionality. The Contractor shall aim to deploy new semi-yearly releases of its correctional version. The Contractor shall maintain all existing legacy data and IHSC’s Configurations, Item Keys, and settings during the upgrade. All existing interfaces will be maintained.

When assessing the list of enhancements requested by IHSC, see Table 2 below, the contractor will provide the estimated release number that a specific item will be deployed (e.g. next semi-yearly release, next annual release). If a promised enhancement is not completed within the next annual release, an analysis of issues related to that functionality will be done by the vendor and provided to IHSC. IHSC will then have the option of either revising the requirements for that functionality at no additional cost to IHSC or removing the requirement and receiving reduction to the estimated total cost of the enhance because of the work that the Contractor could not deliver within their next annual release estimate.

The following upgrades / enhancements shall be assessed for the next correctional product upgrade that will be available commercially to all correctional licensees. Upgrades / enhancements requested by IHSC during the contract’s period of performance shall not be considered a customized version of the product or a ‘one off’ version that is only available for ICE use. All IHSC requested enhancements shall be vetted by the Contractor’s correctional users’ group and the Contractor to ensure that the requested enhancements are consistent with the vendor’s and correctional users’ needs. The Table, below, lists the enhancement requests of IHSC for the next correctional release:

Table 2 – List of Enhancement Requests

1.Pt Label (from hub) – does not generate a bar code by default. Only prints a label with the pt. details (as specified by the tags). Does not/will not work with the pt. look up screen for search (as there is nothing to scan).

2.Wrist Band label – This is configured differently than the pt. hub labels. A barcode is generated which is defaulting to the A number. It does work with the pt. look up screen to search as the pt. look up screen does not have the bar code reader technology. This will work in the eMAR screen as per the design by using the BCMA process (Bar Coding Medication Administration).

Add the date/time and provider name under each medication for who “prepared” the med and who “e-prescribed” the med. This data is already kept in the logs, so ECW currently tracks it. We want it visible on the note for auditing purposes.

Add Patient identifiers (name, DOB, A#) on pictures uploaded to progress note Add the detainee’s A# to the patient identifiers that are automatically stamped on the photo; currently what gets stamped on the photo is the name, DOB and the account number.

2) Providers without prescribing privileges should not be able to modify medications

3) Medication orders should not be import-able from previous/other patient encounters (treatment link should not be merged via a patient-specific template)

without additional steps. When the nonformulary request form is printed out, the response entered in section 4 gets cut off.

Formulary Request Form Lengthen text area to replicate section #2. Currently when you type into #4, the text becomes hidden if it is longer than the underlined area Request form.

-Forms provided be uploaded into letter area and autofill name and A# -Signatures and initials of staff to be loaded so they can be dropped and dragged to the required location -Current date auto populates where required -Cursor drops to signature field automatically

Benefits of above are:

-saved paper, toner and printer -no need for MRT review -saved time and money for scanning

The Quality Assurance Surveillance Plan (QASP) will be developed within 30 days after contract award.

GOVERNMENT furnished equipment (GFE) ICE will provide GFE as necessary to support all Tier 3 and Upgrades and Enhancements efforts. Any equipment furnished by the Government to the Contractor to perform work under this contract shall be returned to the Government at the end of the period of performance. All training materials, policies, procedures, and electronic work products generated because of this contract becomes the property of ICE.

The Contractor shall keep an inventory of GFE, which shall be made available to the Contracting Officer’s Representative (COR) and Government Call Monitor upon request. The Government will provide basic equipment (e.g., laptops, desktops, VPN tokens) in accordance with the contract. The Contractor shall insure all GFE is listed in ICE’s Property Inventory System (Sunflower) within 48 hours of receipt.

place of performance Work, meetings and briefings shall be performed primarily at Contractor’s facilities. Occasional travel to an ICE Health Clinic at a detention center or ICE Headquarters located at 801 I Street NW, or 500 12th St. SW Washington D.C. may be required for meetings and briefings.

period of performance The period of performance is one (1) 12-month base period with four (4) 12-month option periods.

progress meeting During the period of performance, the contractor, at a minimum, shall attend weekly status meetings to be held in-person or via teleconference.

deliverables and delivery schedule The Contractor shall submit all items, except as noted below, to the COR and ICE Program Manager via electronic mail. Unless otherwise noted, all days are calendar days.

Table 3 – Deliverables and Delivery Schedule

Transition-in and Transition-out Plans The Contractor shall be responsible for the transition of all technical activities identified in this Contract. The Contractor shall submit a final Transition-in Plan within fifteen (15) calendar days after contract award it shall reflect all necessary activities to facilitate the transition of services to the Contractor and expected completion dates of those activities. All activities must be completed within thirty (30) calendar days after the kickoff meeting. The following technical activities must be included as part of the Transition-in Plan:

· Inventory and orderly transfer of all Government Furnished Equipment and Property (GFE/GFP), software and licenses

· Transfer of up-to-date documentation currently in process

· Favorable Entry of Duty (EOD) for all Contractor staff from the ICE Personnel Security Unit The Transition-in Plan shall be approved by the COR and describe the Contractor’s process for transitioning from the incumbent with no disruption in operational services.

The Contractor shall be responsible for the transition-out of all technical activities identified in this Contract during the final, awarded period of performance. The Contractor shall submit the Transition-out Plan one hundred and forty (140) days prior to the completion of the period of performance. The Transition-out Plan shall be approved by the COR. The Contractor shall complete the transition by the end of the period of performance of this Contract. The following technical activities must be included as part of the Transition-out Plan:

· Inventory and orderly transfer of all GFE, software and licenses

· Submittal of all contract deliverables to date, including designs, document, briefings, reports, spreadsheets, detainee database and source code, as applicable

· Detailed document providing detailed instructions for extraction of ICE’s eHR detainee data from the database used by the Contractor’s eHR COTS using HL7 format.

Weekly and Monthly Status Report The Contractor shall prepare a weekly and monthly status report. Weekly status reports are due by 12:00 PM ET on Friday. The weekly status report will include:

· Description of work accomplished (Accomplishments)

· Work planned for the following week (Planned Activities)

· Updated project schedule (of next planned release)

· Open risks and issues The initial monthly reports are due the 5th day of the month or the next following business day. The monthly status report will include:

· Service Desk Incident Summary Report

· Financial burn rate report detailing the funding expenditures (to include Labor category, labor rate and hours by CLIN) against the overall funds and estimated monthly expenditures.

Delivery Instructions The Contractor shall provide electronic copies of each deliverable. Electronic copies shall be delivered via email. Email deliverables should be clearly marked in the subject line as a deliverable (requiring review and/or action by the Government). The electronic copies shall be compatible with MS Office 2010 or other applications as appropriate and mutually agreed to by the parties. Once created, deliverables and work products are considered the property of the Federal Government. Any work that deviates from this contract and the approved deliverables listed herein shall not be accepted without prior approval from the COR.

Written Acceptance / Rejection by the Government The Government shall provide written notification of acceptance or rejection of all final deliverables within fifteen (15) calendar days of receipt. All notifications of rejection will be accompanied with an explanation of the specific deficiencies causing the rejection.

Items must be approved by the COR and/or the appropriate Government authority to be considered “accepted”. The Government will provide written acceptance, comments, or change requests within fifteen (15) calendar days from receipt by the Government, of all required deliverables.

Notice Regarding Late Delivery The contractor shall notify the COR as soon as it becomes apparent to the Contractor that a scheduled delivery will be late. The Contractor shall include in the notification the rationale for late delivery, the expected date for the delivery, and the impact of the late delivery on the project. The COR will review the new schedule with the PM and provide guidance to the Contractor.

As stated in Section 5.3, the list of enhancements requested by IHSC shall be approved by the vendor for inclusion in a release. If the vendor cannot complete the enhancements within the next scheduled semi-yearly release or annual release (as originally estimated by the vendor) renegotiation of the enhancements will be made as specified in Section 5.3.

performance standards

The following table defines the performance standards by severity for eCW product support. The Contractor shall not be held accountable for delays due to Government responsiveness. The Government anticipates an average of five (5) Standard / Non-emergency Software Maintenance Requests per month, and one (1) Emergency software Maintenance request per month.

Table 5 – Production Support Performance Standards

CONTRACTOR PERSONNEL SECURITY Requirements

GENERAL

The United States Immigration and Customs Enforcement determined that performance of the tasks as described requires that the Contractor, subcontractor(s), vendor(s), etc. (herein known as Contractor) have access to sensitive DHS information, and that the Contractor will adhere to the following.

PRELIMINARY DETERMINATION

ICE will exercise full control over granting; denying, withholding or terminating unescorted government facility and/or sensitive Government information access for Contractor employees, based upon the results of a background investigation. ICE may, as it deems appropriate, authorize and make a favorable expedited pre-employment determination based on preliminary security checks. The expedited pre-employment determination will allow the employees to commence work temporarily prior to the completion of the full investigation. The granting of a favorable pre-employment determination shall not be considered as assurance that a favorable full employment determination will follow as a result thereof. The granting of a favorable pre-employment determination or a full employment determination shall in no way prevent, preclude, or bar the withdrawal or termination of any such access by ICE, at any time during the term of the contract. No employee of the Contractor shall be allowed to enter on duty and/or access sensitive information or systems without a favorable preliminary fitness determination or final fitness determination by the Office of Professional Responsibility, Personnel Security Unit (OPR-PSU). No employee of the Contractor shall be allowed unescorted access to a Government facility without a favorable pre-employment determination or full employment determination by the OPR-PSU. Contract employees are processed under the ICE Management Directive 6-8.0. The contractor shall comply with the pre-screening requirements specified in the DHS Special Security Requirement – Contractor Pre-Screening paragraph located in this contract, if HSAR clauses 3052.204-70, Security Requirements for Unclassified Information Technology (IT) Resources; and/or 3052.204-71, Contractor Employee Access are included in the Clause section of this contract.

BACKGROUND INVESTIGATIONS

Contract employees (to include applicants, temporaries, part-time and replacement employees) under the contract, needing access to sensitive information, shall undergo a position sensitivity analysis based on the duties everyone will perform on the contract. The results of the position sensitivity analysis shall identify the appropriate background investigation to be conducted. Background investigations will be processed through the Personnel Security Unit. Prospective Contractor employees shall submit the following completed forms to the Personnel Security Unit through the Contracting Offices Representative (COR), no less than 35 days before the starting date of the contract or 5 days prior to the expected entry on duty of any employees, whether a replacement, addition, subcontractor employee, or vendor:

1. Standard Form 85P “Questionnaire for Public Trust Positions” Form will be submitted via e-QIP (electronic Questionnaires for Investigation Processing) (Original and One Copy)

2. Three signed eQip Signature forms: Signature Page, Release of Information and Release of Medical Information (Originals and One Copy)

3. Two FD Form 258, “Fingerprint Card”

4. Foreign National Relatives or Associates Statement (Original and One Copy)

5. DHS 11000-9, “Disclosure and Authorization Pertaining to Consumer Reports Pursuant to the Fair Credit Reporting Act” (Original and One Copy)

6. Optional Form 306 Declaration for Federal Employment (applies to contractors as well) (Original and One Copy)

Prospective Contractor employees who currently have an adequate current investigation and security clearance issued by the Department of Defense Central Adjudications Facility (DoD CAF) or by another Federal Agency may not be required to submit complete security packages, and the investigation will be accepted for adjudication under reciprocity.

An adequate and current investigation is one where the investigation is not more than five years old and the subject has not had a break in service of more than two years.

Required forms will be provided by ICE at the time of award of the contract. Only complete packages will be accepted by the OPR-PSU. Specific instructions on submission of packages will be provided upon award of the contract.

Be advised that unless an applicant requiring access to sensitive information has resided in the US for three of the past five years, the Government may not be able to complete a satisfactory background investigation. In such cases, DHS retains the right to deem an applicant as ineligible due to insufficient background information.

The use of Non-U.S. citizens, including Lawful Permanent Residents (LPRs), is not permitted in the performance of this contract for any position that involves access to DHS /ICE IT systems and the information contained therein, to include, the development and / or maintenance of DHS/ICE IT systems; or access to information contained in and / or derived from any DHS/ICE IT system.

TRANSFERS FROM OTHER DHS CONTRACTS

Personnel may transfer from other DHS Contracts provided they have an adequate and current investigation (see above). If the prospective employee does not have an adequate and current investigation an eQip Worksheet will be submitted to the Intake Team to initiate a new investigation.

Transfers will be submitted on the COR Transfer Form which will be provided by the Dallas PSU Office along with other forms and instructions.

CONTINUED ELIGIBILITY

If a prospective employee is found to be ineligible for access to Government facilities or information, the COR will advise the Contractor that the employee shall not continue to work or to be assigned to work under the contract.

The OPR-PSU may require drug screening for probable cause at any time and/ or when the contractor independently identifies, circumstances where probable cause exists.

The OPR-PSU will conduct reinvestigations every 5 years, or when derogatory information is received, to evaluate continued eligibility.

ICE reserves the right and prerogative to deny and/ or restrict the facility and information access of any Contractor employee whose actions conflict with the standards of conduct, 5 CFR 2635 and 5 CFR 3801, or whom ICE determines to present a risk of compromising sensitive Government information to which he or she would have access under this contract.

REQUIRED REPORTS

The Contractor will notify OPR-PSU of all terminations/ resignations within five days of occurrence. The Contractor will return any expired ICE issued identification cards and building passes, or those of terminated employees to the COR. If an identification card or building pass is not available to be returned, a report must be submitted to the COR, referencing the pass or card number, name of individual to whom issued, the last known location and disposition of the pass or card. The COR will return the identification cards and building passes to the responsible ID Unit.

The Contractor will report any adverse information coming to their attention concerning contract employees under the contract to the OPR-PSU through the COR, as soon as possible. Reports based on rumor or innuendo should not be made. The subsequent termination of employment of an employee does not obviate the requirement to submit this report. The report shall include the employees’ name and social security number, along with the adverse information being reported.

The Contractor will provide, through the COR a Quarterly Report containing the names of personnel who are active, pending hire, have departed within the quarter or have had a legal name change (Submitted with documentation). The list shall include the Name, Position and SSN (Last Four) and should be derived from system(s) used for contractor payroll/voucher processing to ensure accuracy.

Submit reports to the email address psu-industrial-security@ice.dhs.gov.

EMPLOYMENT ELIGIBILITY

The contractor will agree that each employee working on this contract will successfully pass the DHS Employment Eligibility Verification (E-Verify) program operated by USCIS to establish work authorization.

The E-Verify system, formerly known as the Basic Pilot/Employment Eligibility Verification Program, is an Internet-based system operated by DHS USCIS, in partnership with the Social Security Administration (SSA) that allows participating employers to electronically verify the employment eligibility of their newly hired employees. E-Verify represents the best means currently available for employers to verify the work authorization of their employees.

The Contractor must agree that each employee working on this contract will have a Social Security Card issued and approved by the Social Security Administration. The Contractor shall be responsible to the Government for acts and omissions of his own employees and for any Subcontractor(s) and their employees.

Subject to existing law, regulations and/ or other provisions of this contract, illegal or undocumented aliens will not be employed by the Contractor, or with this contract.