HEC Final questionsandanswers_7192011.doc

PFP HEC Questions and Answers The following are the responses to the questions received and deemed relevant to submission of a proposal on the HEC solicitation. Please note since only limited questions received followed the format required in Section L, the Government cannot provide answers by Section for ease of reading.

Q 63 Can you please clarify section L4, Phase 1, Organizational Requirements. We believe that our organization fits into bullet point two, "Organizations that functions as national affinity organization that represent hospitals which address specific patient and/or regional health issues." The association I work for is a scientific and educational association of medical doctors that was founded in the early 20th Century to improve the quality of care for patients. We currently own & operate a nation-wide surgical quality/improvement program. Within this program we have contractual relationships with a wide variety of hospitals everything from multi-institutional systems to small/rural hospitals. We clearly believe that our organization fits into the organization described in bullet point two. Please confirm.

A63 Eligibility criteria were defined in Section L of the solicitation. The government will not confirm any individual eligibility requests, but will only reiterate where the specifics on such can be found in the RFP. While phrases “association of hospitals,” “represents hospitals,” and “represents affiliated members” are used to consider the greatest number of patient and/or regional health issues, organizations will still be evaluated upon their ability to meet the criteria described in Part II of Section L.

Q64 Can a hospital system that has 14 acute care hospitals on the East coast be eligible for participation as the prime contractor or is this intended for systems bigger than that only? If the system needs to be larger, how many hospitals need to be part of the system and can the two systems come together?

A64 Any entity that can meet the terms and conditions of the solicitation may be eligible to submit a proposal. The organizational requirements in section L.4 clearly state, “Organizations that hold corporate ownership and operational control of a hospital chain of at least 25 hospitals.” If your organization has corporate ownership and operational control over 14 hospitals, then it does not currently meet the criteria. It is not the responsibility of the government to advise on how to meet the requirement. However, subcontractors need not meet these eligibility requirements and systems can combine efforts.

Q65 There are multiple organizations in our state that could be considered “association[s] of hospitals as identified through an organizational charter or agreement and a governing body that represents affiliated members.” Can we submit separate applications?

A65 Please note that this is not a grant and the application process is not applicable. This is a contract that requires submission of a proposal. An interested party may submit one proposal addressing all of its subcontractor relationships to meet the eligibility criteria defines in Section L of the solicitation may apply. We also note that some organizations seem unclear on whether a collaborative group that is “identified through an organizational charter or agreement and a governing body that represents affiliated members” and works with hospitals qualifies as an association. It does.

Q66 Can a subcontractor participate as a subcontractor in more than one (multiple) Partnership for Patients solicitations that may arise in the future, such as the National Content Developer?

A66 Yes, subcontractors can participate as subcontractors in more than one Partnership for Patients solicitation but may be required to submit information addressing conflicts of interest. Please note that the NCD procurement effort is already underway with a selected set of vendors already solicited for prime contractor.

Q67 I understand that the HEC must address at least 7 (and up to 10) of the focus areas, but do the hospital participants have to participate in the trainings for all of the 7-10 focus areas that are chosen by the HEC? Or can the hospital choose, say 4, of the focus areas to participate in based on the individual institution’s needs?

A67 Under this performance based statement of work, the manner in which the HEC engages hospitals in focus areas and training is specific to each vendor’s proposed solution to the HEC requirement. Though it cannot be mandated, participating hospitals are expected to participate in all improvement activities offered by the HEC, and are encouraged to participate in opportunities offered by other HECs that may not be offered by their primary HEC.

Q68 Section J – Attachments, J-2, Partnership for Patients Contract SOWs, J-2 Partnership for Patient Various Support Contract Statements of Work presents the SOW, Background and Requirements for the National Content Development (NCD) contract, with Task 1 identified.

Question 1(a) Is it the government’s intent to procure the NCD through Solicitation APP111513, or is this information provided as reference to the HEC?

A68 The information was provided as reference only and not a procurement under APP 111513.

Q69 Question 1 (b) If the government is not soliciting a proposal for the NCD through Solicitation APP11513, when will the government issue the NCD Request for Proposal, and will the solicitation be posted on fbo.gov?

A69 This question is not relevant to APP 111513; however, for your information, the NCD solicitation (and other solicitations) have been issued and no FBO postings were required.

Q70 During the government Webinar conducted on July 6, 2011 it was stated by one of the presenters that other contracting vehicles may be utilized for the other components of the Partnership for Patients program. Please identify which contracting vehicles will be utilized for each of the following:

a) National Content Developer

b) Advanced Participant Network

c) Beneficiary and Medical Professional Engagement

d) Safety Data Measurement Contractor A70 The methodology in which the government solicited activities a-d is not relevant to the HEC proposal submission. The vendors solicited for activity C and D above were provided under Q15 response as posted in an earlier amendment to the HEC.

Q71 Section L of the RFP says that the only organizations that can apply are:

· Organizations that are national, regional, or state association of hospitals as identified through an organizational charter or agreement and a governing body that represents affiliated members.

· Organizations that functions as national affinity organization that represent hospitals which address specific patient and/or regional health issues identified through an organizational charter or agreement and a governing body that represents affiliated members.

· Organizations that hold corporate ownership and operational control of a hospital chain of at least 25 hospitals The members of the Network for Regional Healthcare Improvement are multi-stakeholder regional/state organizations that focus on quality improvement in their communities (see www.nrhi.org) , and several specifically focus on working with hospitals to improve quality of care, address patient safety issues, etc. For example, the Iowa Healthcare Collaborative (www.ihconline.org) and the Pittsburgh Regional Health Initiative (www.prhi.org) both have been widely recognized for the work they have done to help hospitals improve the quality of care. PRHI was the first place in the country to demonstrate that CLABs could be eliminated and sustained.

However, none of our member collaboratives are “associations of hospitals” per se. Most of our member collaborative have hospitals as members or supporters, but hospitals are not their only members. So the way the RFP is written, it appears that they would not be eligible to participate in this program.

On the 7/8 call with Secretary Sebelius, Administrator Berwick, and Joe McCannon, Joe McCannon said that CMS wanted to have broad participation in the program.

Will organizations that do not meet the above criteria be eligible to apply?

A71 Eligibility criteria were defined in Section L of the solicitation. The government will not confirm any individual eligibility requests, but will only reiterate where the specifics on such can be found in the RFP. While CMS intends to broadly interpret the phrases “association of hospitals,” “represents hospitals,” and “represents affiliated members” so as to consider the greatest number of patient and/or regional health issues, organizations will still be evaluated upon their ability to meet the criteria described in Part II of Section L.4.

Q72 What are the anticipated methods and technology-based communications expected for high-volume, rapid-cycle process improvement activities that the HEC would be promoting? Do you expect HECs to use IHI, Lean, Six Sigma, or other methods?

A72 Under this performance based statement of work, the methodology is individual to each interested parties’ technical solution to the requirements. The HEC should determine the best methods to achieve the aims of the initiative.

Q73 In data collection, will the numerators and denominators of the metrics for the 10 conditions be the same? Will they be NQF metrics?

A73 All hospitals participating in the same improvement project (for example, hospitals in the same state or system working under a particular HEC on a particular adverse event) are strongly encouraged to use the same measures. These measures will be identified by the HEC, as described in the SOW, section C of the solicitation. However, measures (and data collection systems) may differ across different HEC constituencies (for example, from one state to another) to best accommodate the local context and constraints.

Q74 What will be the mechanism for Adverse drug events measurement?

A74 In a performance based requirement such as this, this point is at the discretion of the HEC.

Q75 What is the timeline of the NCD RFP? When will educational/training materials begin to be provided to the HECs?

A75 The NCD contract is slated for award by the end of this fiscal year. Information on timing of materials for the HECs will be addressed at the HEC post award meeting with all HEC vendors immediately upon award.

Q76 How much opportunity is there for an HEC to adapt the NCD material for Medicaid, Dual Eligible, Uninsured and for race, ethnicity, and language?

A76 While all Partnership for Patients contractors shall support improving patient safety for all Medicare and Medicaid beneficiaries, tools and supports germane to the Medicaid, Dual Eligible, Uninsured, and minority populations (and other regional or patient health issues) are welcomed. Specialized content developed by an individual HEC may be provided to the National Content Developer and/or provided to all HEC for use by participating hospitals. As stated in Section C of the solicitation, “The HEC may produce additional training support materials to augment or enhance NCD materials,” including the creation of new materials, or the re-use or re-distribution of materials developed by other contractors, to assist the hospital in improving quality and safety for Medicaid, Dual Eligible, uninsured, or minority beneficiaries.

Q77 The NCD also has the task of collecting data from HECs trainings – how will that be different than the data HEC collects?

A77 The data collection requirements of the NCD, as described in Section J of the solicitation, appear below:

The contractor shall monitor and collect training data generated by HEC and APN activities and provide technical assistance in the production of organization specific training materials to meet the needs of their target population. Specific data to be collected in this task will be:

1. Operational Metrics – number of training sessions conducted, attendance of training sessions, number of organizations participating in projects, etc.

2. Improvement measures – identifying quantifiable improvements to care delivered in participating organizations through the use of the organizational evaluation tool and training evaluation methods

3. Training Materials and Implementation Model documentation produced by HEC and APN participants Q78 If the data standards are already established by the NCD and the Data Measurement Contractor, how can the HEC make sure that sufficient standards for race, ethnicity and language are incorporated into its HEC data collection?

A78 The HEC will use what is provided by the NCD and Data Measurement Contractor.

Q79 Can two organizations submit a bid as co-primes? Or even three organizations as tri-primes? Or, if two organizations are jointly submitting a proposal, must the submission come from one organization and the other is considered a subcontractor?

A79 The government will award to one prime contractor based upon that vendor’s Taxpayer ID number; the prime may engage as many subcontractors as it deems necessary to perform the HEC work.

Q80 Can a bidding organization be prime contractor on one contract as well as a sub-contractor on another contract?

A80 The government will evaluate all proposals and prime/subcontracting arrangements that meet the eligibility criteria; in addition, conflicts and other related factors such as risk in performance and management will also be evaluated.

Q81 Can an organization participate as a sub-contractor on two different HEC contracts?

A81 See response provided to Q25 under Amendment 0002, which states:

Hospitals that choose to participate in the Partnership for Patients may be able to engage and work with more than one prime contractor or subcontractor if there is a compelling reason to do so but we seek to avoid duplication of effort. After the contracts are awarded, we will conduct a post-award reconciliation with all awardees in order to better coordinate which hospitals will participate with which Hospital Engagement Contractors. Potential subcontractors are allowed to team with multiple prime contractors. However, the government will consider the risk of successful performance in its evaluation of an offeror’s submission based upon the availability of its subcontracts (i.e., are they spread too thin across multiple contracts?)

Yes, it is possible to serve as a subcontractor to the prime contractor if one is focused on only certain focus areas. It is the business decision of an offeror the number of subcontracts it finds necessary to meet the requirements of the SOW.

Note that no contracting directly with hospitals will occur. Rather, the offeror (and any subcontractors contracted with that offeror) will be engaging hospitals in the work described in Section C of the solicitation.

Q82 If an organization submits a proposal with a sub-contractor that is subsequently awarded a primary contract, will there be an opportunity for the organization to replace the subcontractor within the same fixed price?

A82 The government does not grant consent on subcontracts in this firm fixed price arena; however, prime contractors are advised that subcontracts are intended to meet both performance and subcontract goals (i.e., small businesses…etc) as identified in Section G.14 of the solicitation.

Q83 Is it required to have letters of support/commitment from most or all hospitals that will be potential participants in the trainings/improvement projects?

A83 See response provided to Q61 under Amendment 0002.

Q84 Intentionally left blank A84 Intentionally left blank Q85 If letters of support are not required, would they strengthen a proposal?

A85 The government will evaluate all proposals from eligible entities in accordance with the information provided in Section M of the solicitation.

Q86 Is there a preferred or required format for the labor and budget portion of the proposal?

A86 Section L.4 Business Submission identifies the information required; the solicitation is amended to require any spreadsheet submissions to be provided in Excel 7 for compatibility and readability since only electronic versions of proposals will be received.

Q87 Certain parts of the RFP reference the “State” (e.g. Section L.4 in description of Budgetary Information and Past Performance) – does this mean “Contractor”?

A87 The term was used in error and the correction (which replaces the word “State” with the word “Contractor”) is addressed in Amendment 0003.

Q88 Under which part of the proposal is the best opportunity to address the Board governance issue for HECs, similar to the request that APN participants seek commitment of the Board to achieve goals?

A88 The individual interested party submitting a proposal may select to address any technical issues or business issues in the section of the submission the party finds appropriate.

Q89 If multiple proposals claim to have a hospital in their program/jurisdiction, how will it be decided which contractor is responsible for that hospital, once both projects get funded and started?

A89 Hospitals that choose to participate in the Partnership for Patients may be able to engage and work with more than one prime contractor or subcontractor if there is a compelling reason to do so but we seek to avoid duplication of effort. After the contracts are awarded, we will conduct a post-award meeting with all awardees in order to better coordinate which hospitals will participate with which Hospital Engagement Contractors.

Q90 What is the expected reach? For example, what is the expected number of hospitals for a given contractor? Can the recruitment and enrollment be limited to the members of a hospital association or to meeting the criteria such as for as a safety net hospital? What are the kinds of criteria expected for hospitals to participate?

A90 Under this performance based statement of work, the methodology is individual to each interested parties’ technical solution to the requirements.

Q91 How should a HEC approach hospitals that are already participating in CCTP, contrasted with those that are not?

A91 There is no prohibition on hospitals that are already participating in the Community Based Care Transitions Project from participating in the Partnership for Patients. The work being conducted by the two programs is different.

Q92 The NCD seems to have the responsibility to provide the content of the national program for direct training to hospitals as well – will that overlap with the HECs work?

A92 No, they are intended to collaborate, not duplicate. As stated in the Section C of the solicitation, “The HEC may produce additional training support materials to augment or enhance NCD materials.”

Q93 Will the “patient engagement council” established by the Beneficiary and Medical Professional Engagement Contractor have special activities around Medicaid populations and minority populations? What special considerations should be taken into account in the HEC’s work for Medicaid, Dual Eligible or the Uninsured?

A93 See response to Q76 Q94 What special considerations should be taken into account in the HEC’s work for Medicaid, Dual Eligible or the Uninsured?

A94 See response to Q76 Q95 Section L notes that “no funds are available at this time”. When will funding be confirmed? Will it be confirmed before the proposal due date of August 5th? Is the expectation that groups will commit resources to respond to the RFP without confirmation of available funds?

A95 The government will not make awards to HECs without funding availability confirmed. No work shall commence and no preaward costs may be expended prior to obligation on the part of the Government as noted by the contract being signed by the Contracting Officer.

Q96 What is the process that will be used to select “winning” proposals? There doesn’t appear to be a process defined for HAC. The Clinical Care Transitions program has a selection process that includes an Experts Technical Panel that will review and evaluate all proposals. This review process will take several months.

A96 Section M of the solicitation defines the methodology and factors to be considered prior to awarding an HEC.

Q97 Why is it necessary that the proposed educational activities need to address at least 7 of the 10 healthcare associated complications?

A97 The statement of work defines the government’s requirement; they remain unchanged. In order to meet the aims of the Partnership for Patients to reduce preventable inpatient harm by 40% and readmissions by 20% over a 3 year period, the PFP has identified ten adverse events for focus as starting points in the larger, needed effort to reduce harm. Although the PFP will not limit its work to these areas and will pursue the reduction of all-cause harm, these focus areas are those for which content will be initially developed and learning activities broadly conducted and made available to hospitals participating in the partnership Q98 Since “changing healthcare clinician behavior” is the crux of this initiative, it would appear that each activity should include continuing education for appropriate health care professional depending upon the topic (physicians, pharmacists, nurses, nurse practitioners, respiratory therapists, etx.). What is CMS’ opinion of this?

A98 This is not a question that requires a response in order to submit a proposal.

Q99 There is no mention in the solicitation as to an “upper limit” of the contract amount. Is there a limit as to the contract dollar amount?

A99 See response to Q13 under Amendment 0002.

Q100 We are a national professional society that represents pharmacists practicing in hospitals and components of health systems. How will this impact our eligibility?

A100 Any entity that can meet the terms and conditions of the solicitation may be eligible to submit a proposal.

Q101 You identify a “National Content Developer” – it sounds as if this organization will provide the core content and activities for this endeavor. What will be their specific role, and how will this group be determined?

A101 The NCD is being solicited and awarded under a different solicitation than the HEC. The Statement of work for that activity is provided, for your information, under Section J of the HEC.

Q102 On the conference call you said that up to 100 contracts would be let for this initiative. Yet Section J identifies only 4 distinct “contractors.” Beyond these 4 contractors – what will determine the awarding of these other 96 contracts?

A102 The government is interested in awarding as many as 100 contracts for HEC work under APP 111513. The other contract activities addressed in the webinar are a part of the PfP activity but are not a part of the HEC awards. The SOWs for those other activities are provided in Section J for informational purposes.

Q103 Can you please provide additional information as to the specific responsibilities of the APN contractor?

A103 The SOW for this activity is provided as a J Attachment, see Amendment 0002.

Q104 Contracts will be let for up to 24 months – with an option for an additional 12 months. How should budgets be submitted regarding this “option year”?

A104 Offerors should provide the same information for the possible option year as provided for the base period of performance. Option year pricing will be locked in at the award of the base year with the option to fund and exercise the option at the discretion of the government. This information is now provided in Section L, as revised through this Amendment 0003.

Q105 “The Government reserves the right to request other than certified current cost and pricing data in order to evaluate price proposals submitted in response to this competitive solicitation” – what specifically does this mean?

A105 You are referred to FAR 15.403-3 for information applicable the government’s ability to require information other than certified current cost and pricing data prior to making a determination of a fair and reasonable price in a competitive environment.

Q106 What specifically constitutes a “conflict of interest” regarding work already contracted for?

A106 Since conflicts are specific to a particular vendor and the body of work in question, they cannot be addressed in a global manner. However, your attention is called to Q51 under Amendment 0002 for additional information.

Q107 We have never done work in the past for the Federal government – to demonstrate “past performance” what should we submit?

A107 Past performance information as defined in Section L should be relevant to the content, size and scope of this HEC activity; Federal government work is not mandated by the solicitation.

Q108 Is there a limit to the number of subcontractors that a prime contractor can hire?

A108 No.

Q109 What constitutes a “go-no-go” capability review?

A109 Section L.4 of the RFP defines the eligibility criteria; these are the go-no-go criteria referenced in Section M. This language has been added under Amendment 0003 to Section L.4 for clarity purposes. The requirements are unchanged.

Q110 Which CMS personnel will be reviewing the proposals and who will be making the final approval decision?

A110 That information is internal to the government and is not subject to release through this process, debriefings or FOIA.

Q111 What will be the proposed timeframe for project updates?

A111 Project updates are not a part of the initial proposal submission; you are referred to Section F for the due dates on any contractual deliverables.

Q112 What if 100 contracts are not let, or there is a surplus of grant money after the contracts are funded – how will this budget surplus be spent/allocated?

A112 That information is not relevant to submission of a proposal in response to this solicitation. Please note these are contracts and not grants.

Q113 “It must be noted that the Government considers that efficient competition can be maintained if the number of proposals in the competitive range for the award does not exceed fifteen (15). Therefore, pursuant to the rights afforded to the Contracting Officer per FAR 15.306(c)(2); the Contracting Officer may limit the number of proposals in the competitive range to permit an efficient competition among the most highly rated proposals.” Can you please clarify this paragraph’s information in light of the fact that it is planned for 100 contracts to be awarded?

A113 The reference to the number 15 is incorrect and has been removed under this Amendment 0003. The intent of the overall language allows for the government to limit only those proposals that are evaluated and deemed to be the most highly rated to move into the competitive range in the event that a range must be established and the government must enter into negotiations in order to make awards. In accordance with L.1, FAR 52.215,it is the government’s expectation that awards will be made on initial offers only.

Q114 The“purpose of this contract is to obtain the services of qualified vendors to develop and possibly implement a campaign designed to decrease patient harm as described in J-1 of this contract.” How can a contract be let to “possibly implement” a campaign? If the contract is awarded then doesn’t that mean the vendor WILL implement the contracted activity?

A114 Any vendor receiving an HEC award will be responsible for adhering to all terms and conditions of the contract, in its entirety.

Q115 “The period of performance for the contract is 36 months from the date of award” –yet the teleconference said it was for 24 months, with a 12 month option. Which is correct?

A115 Both are equally correct. The base period is 24 months with an optional 12 month period at the government’s discretion.

Q116 In promoting the availability of those activities selected for funding by the government, is there a means to identify the selected activities as being funded by the government – and thereby enhance participant perception of the program?

A116 This question is not relevant to the submission of a proposal in response to APP 111513.

Q117 Will there be a central website whereby contractors can share their experiences, and provide a forum for addressing issues that might arise in the course of the activities?

A117 Yes, the National Content Developer will host a web-based training portal, which will include, among other features, a collaboration forum wherein participants and contractors can communicate.

Q118 Why is there such little lead time for the development of the proposals? You expect to award a contract for a 2-3 year program based on less than 30 days of lead time – of which half of this time will be devoted to the actual writing of the proposal.

A118 Thank you for your input. However, the solicitation remains unchanged at this time.

Q119 What is the “base date” for the Deliverable due dates noted in Section F.2? Is it September 30th ?

A119 While the question is unclear since term base date does not appear in the solicitation, the deliverable chart indicates that all activities begin from the date of the award of the contract, anticipated to be awarded by the end of this fiscal year.

Q120 In Section G.2 what is meant by the term “Both monthly and cumulative dollars provided”?

A120 While the payment schedule is provided in B3 and it is expected that monthly invoices be in accordance with the B schedule, the vendors are still responsible for providing on each monthly invoice both the monthly amount for payment and the cumulative amount paid to date.

Q121 A tenet of professional medical education is that there is no such thing as “one size fits all.” Will HECs be able to modify/customize the materials provided by the NCD?

A121 Under this performance based statement of work, the manner in which any particular HEC addresses NCD material is specific to interested parties’ technical solution to the requirements. As stated in the Section C of the solicitation, “The HEC may produce additional training support materials to augment or enhance NCD materials.”

Q122 What will be the process by which the NCD develops content? Who will be the experts who identify the content, and how will they be chosen?

A122 The NCD effort is being awarded under a separate procurement; the response to the first question above is dependent upon the individual technical solution of the award winning vendor. That award has not yet been made but the SOW for such is provided in Section J of this RFP.

Q123 Task 1

a. Are hospitals limited to participating with only one HEC?

b. Are any hospital types excluded from participating (e.g., for-profit, govt, county, critical access)

c. Is there a targeted and/or minimum number of hospitals that a HEC should strive to include in the submitted proposal?

d. Will all solutions be provided to the HEC by the NCD?

e. When will various materials from the NCD be available?

f. In bullet 4, what is meant by “Other important entities and/or stakeholders”?

g. In bullet 5 – How are submitting entities to know what events will be better supported by others? (stated requirement that proposal needs to document “where other organizations are addressing those of the ten adverse events they choose not to support”)

h. Do we need to name the hospital partners in the proposal?

A123

a. Hospitals that choose to participate in the Partnership for Patients may be able to engage and work with more than one prime contractor or subcontractor if there is a compelling reason to do so but we seek to avoid duplication of effort. After the contracts are awarded, we will conduct a post-award meeting with all awardees in order to better coordinate which hospitals will participate with which Hospital Engagement Contractors. Potential subcontractors are allowed to team with multiple prime contractors.

b. Institutions satisfying the requirements of §1861(e)(1) through (e)(9) of the Social Security Act, including children’s hospitals and psychiatric hospitals satisfying the requirements of §1861(e)(3) through (e)(9) of the Act and inpatient rehabilitation facilities paid under §1866(j) of the Act, or certified by the Secretary as a Critical Access Hospital under §1820(e), are considered a hospital for the purposes of this solicitation, including VA hospitals and Department of Defense military treatment facilities meeting these criteria.

c. Under this performance based statement of work, the methodology is individual to each interested parties’ technical solution to the requirements. Subsection 2 of Part II of Section L.4, states that proposals will be evaluated on their organizational strength and capacity to successfully carry out the requirements of the contract. Therefore, the HEC is expected to ensure the broadest possible participation within the organizational structure documented to satisfy the organizational requirements described in Part I of Section L.4. Associations, collaborative, and affinity organizations should describe their ability to guarantee buy-in and participation from hospitals they represent (or would represent if they hospital meets the eligibility for membership but is not a dues-paying member) as described in their organization charter or agreement, or, if a hospital chain, hospitals for which they hold corporate ownership and control.

d. It is unclear what is meant by “solutions.” The NCD will serve as a resource and will provide training materials. The HEC is responsible for coordinating with the NCD the materials that they will disseminate. The SOW for the NCD is provided in Section J as a reference for your review to obtain a clear understanding of that contractor’s requirements.

e. The NCD contract is slated for award by the end of this fiscal year. Information on timing of materials for the HECs will be addressed at the HEC post award meeting with all HEC vendors.

f. This refers to any and all important stakeholders across the health care system. The Partnership for Patients has sought to include providers (including doctors, nurses, and other clinicians), health care insurance plans, unions, employers, hospital associations, professional societies, government health departments, and other entities, among others.

g. It is the responsibility of offerors to decide how to submit their best plan. The government cannot provide technical advice for proposals.

h. Yes, we ask that you identify the hospitals you plan to engage. This information is useful as we seek to avoid duplication of efforts amongst Hospital Engagement Contractors, subcontractors, and participating hospitals. After the contracts are awarded, we will conduct a post-award meeting with all awardees in order to better coordinate which hospitals will participate with which Hospital Engagement Contractors.

Q124 Task 5 (a)Do all hospitals in a HEC have to participate in activities for ALL adverse events and topics selected by the prime contractor?

A124 Under this performance based statement of work, the methodology is individual to each interested parties’ technical solution to the requirements.

Q125 Related to HEC subcontractors and prime contractors:

a. Can industry be included (e.g., device manufacturers? Pharmaceutical companies?)

b. Can employers or employer groups be included as a subcontractor?

c. Can a prime also be a subcontractor on a different prime’s contract?

d. Can an organization serve as a subcontractor on more than one prime contract?

A125 While the scientific expertise and improvement knowledge from all segments of the public health, health professional, and payer communities and other stakeholders is encouraged in all work of the Partnership for Patients Initiative, only organizations meeting the criteria in L4 of the solicitation may participate as prime contractors. However, subcontractors need not meet these eligibility requirements Q126 Can an applicant build in costs for data collection system enhancement?

A126 This is a firm fixed price effort and interested parties should address only the government’s requirements in building up to a price which meets the technical solution being offered by the vendor.

Q127 How does one account for administrative and other overhead costs?

A127 See response to Q13 as provided in Amendment 0002 .

Q128 What supporting documentation of intent to participate do you need from subcontractors?

A128 No particular documentation is required and it is up to each individual offeror how it shows through prime and or subcontract arrangements that it can meet the government’s requirements.

Q129 Are the obstetrical adverse events of interest the ones from the AQHR patient safety indicators? If not, what are they?

A129 Adverse events applicable to this HEC are addressed in Section C of the RFP.

Q130 Should the proposal be structured as indicated in Section L but weave in Requirements outlined in Section C?

A130 The instructions provided in L allow for vendors to address the requirements of Section C in a uniform manner.

Q131 Section K indicates that the “The State/Contractor shall provide the following FAR certification.

52.225-25

PROHIBITION ON ENGAGING IN SANCTIONED ACTIVITIES

RELATING TO IRAN-CERTIFICATION

Each State shall register all information required at the following website used for representations and certifications necessary for award of Federal contracts. https://www.uscontractorregistration.com/” There is a cost of $599 associated with this registration. Are organizations submitting a proposal required to register on this site or is this something that should happen after the organization has become a contractor?

A131 All submissions of proposals must include the Section K certifications. Please note that the use of the word State is removed from this item under this Amendment 0003. Only the term contractor shall remain. https://orca.bpn.gov/search/publicsearch.aspx is the official site for the certifications.

Q132 Also note that Section L under Business Submission refers the applicant to the above noted website in Section K for submission of all mandated ORCA certifications. I cannot find a list of mandated ORCA certifications on the home page of the website. Where is the list of mandated ORCA certifications located?

A132 The following are the mandatory certifications:

(a) 52.203-2, Certificate of Independent Price Determination.

(b) 52.203-11, Certification and Disclosure Regarding Payments to Influence Certain Federal Transactions.

(c) 52.204-3, Taxpayer Identification.

(d) 52.204-5, Women-Owned Business (Other Than Small Business).

(e) 52.209-2, Prohibition on Contracting with Inverted Domestic Corporations—Representation.

(f) 52.209-5, Certification Regarding Responsibility Matters.

(g) 52.214-14, Place of Performance—Sealed Bidding.

(h) 52.215-6, Place of Performance.

(i) 52.219-1, Small Business Program Representations (Basic & Alternate I).

(j) 52.219-2, Equal Low Bids.

(k) 52.219-22, Small Disadvantaged Business Status (Basic & Alternate I).

(l) 52.222-18, Certification Regarding Knowledge of Child Labor for Listed End Products.

(m) 52.222-22, Previous Contracts and Compliance Reports.

(n) 52.222-25, Affirmative Action Compliance.

(o) 52.222-38, Compliance with Veterans’ Employment Reporting Requirements.

(p) 52.222-48, Exemption from Application of the Service Contract Act to Contracts for Maintenance, Calibration, or Repair of Certain Equipment Certification.

(q) 52.222-52, Exemption from Application of the Service Contract Act to Contracts for Certain Services—Certification.

(r) 52.223-1, Biobased Product Certification.

(s) 52.223-4, Recovered Material Certification.

(t) 52.223-9, Estimate of Percentage of Recovered Material Content for EPA-Designated Items (Alternate I only).

(u) 52.225-2, Buy American Act Certificate.

(v) 52.225-4, Buy American Act—Free Trade Agreements—Israeli Trade Act Certificate (Basic, Alternate I & II).

(w) 52.225-6, Trade Agreements Certificate.

(x) 52.225-20, Prohibition on Conducting Restricted Business Operations in Sudan—Certification.

(y) 52.225-25, Prohibition on Engaging in Sanctioned Activities Relating to Iran—Certification.

(z) 52.226-2, Historically Black College or University and Minority Institution Representation.

(aa) 52.227-6, Royalty Information (Basic & Alternate I).

(bb) 52.227-15, Representation of Limited Rights Data and Restricted Computer Software.

Q133 Does the application need to include a Subcontracting Plan (Section J-4) or is this something that is completed once the organization is chosen as a contractor?

A133 The proposal submission must include the Subcontract Plan, if applicable as defined in Amendment 0001. This must be submitted prior to award.

Q134 During the Industry Day webinar participants were told that the registration process is complicated and typically takes months to complete, but that CMS staff would be available to ensure that everyone was registered properly given such a brief time frame to register and to develop a proposal. I contacted the listed Contract Specialist who told me that, based upon inherent fairness in Government contracting, he cannot respond to individual questions via email. I appreciate this policy, but am in need of guidance on registration. Is there someone to whom you can refer me to regarding the appropriate registration procedure? Or, is there a document to which you can refer offerors on the registration procedure to allow the organization to submit an application?

A134 If the registration in question is theCentral Contractor Registration, yes, each interested party must register at that www.ccr.gov location. That process is not complex and takes approximately 48 hours. However, submission of a proposal for receipt of a government contract may be considered complex and requires attention to all the details provided in the solicitation. There is no additional information outside of what is provided to all vendors under APP 111513 that can be provided.

Q135 In Section L under Technical approach/design and implementation plan, the offeror is instructed to make a clear and concise presentation of the technical approach chosen for this Contract, including a discussion of elements such as population diversity, demographic variation and settings (e.g., rural, urban…etc).” This must be complete and cover all aspects of the SOW for Phase I and Phase 2.” Please define SOW Phase 1 and Phase 2. Where in the solicitation can one find a discussion of these Phases? I was unable to find such a discussion under Section C Scope of Work.

A135 The use of the term Phase in Section L is inaccurate and was deleted in Amendment 0003. Offerors are directed to the tasks as defined in the SOW.

Q136 I am writing on behalf of a company that manufactures a patient safety technology with some questions related to solicitation # APP111513 Patient Safety Hospital Engagement Contractor. This company’s technology addresses many of the areas of focus listed under the Partnership for Patients.

My questions are:

1. Is a company such as this permitted to submit the proposal?

2. If yes, can the proposal be submitted before the hospitals involved with the project are finalized? The company is currently in negotiations with hospitals about this but this may not be completed by early August.

3. Can 2 small health systems be combined to submit the proposal?

4. Is the vision of this initiative primarily educational or would tools/devices to support patient safety be a reasonable part of this project?

A136 Only organizations meeting the criteria in L4 of the solicitation may participate as prime contractors. A prime and as many subcontractors as necessary (including two systems as noted in the question) can combine to meet these criteria.

Q137 The Scope of Work indicates that we must establish a set of improvement measures (one process and one outcome). Will CMS provide a list of measures and definitions for us to select or do we need to develop our own measures?

A137 First, please note that the requirement is: “Unless the contractor can provide a strong argument to do otherwise, each improvement project should include at least one process measure and one outcome measure.” (Emphasis added.) To address the question: the PFP does not plan to provide a list of pre-approved measures for this purpose. It is the responsibility of each offeror to determine their own measurement strategy, including the identification of specific measures for each of the conditions selected. In general, offerors may develop their own measure, or they may rely on existing measures (or may propose variations on existing measures). In any case, the principal purpose of this measurement will be to support the improvement work of hospitals, and the HEC measurement strategy should be justified in these terms. For example, a measure set that takes a full calendar quarter to abstract, clean, and produce may not be suitable for a rapid-cycle improvement environment.

Q138 For the measures, will we be expected to collect patient level data (HIPAA compliant) or can we collect hospital specific aggregate rates?

A138 Either approach is acceptable; it is the responsibility of each offeror to determine their own measurement strategy given the objectives and guidance described in the SoW.

Q139 While our efforts of the FHA initiative will focus on the ten areas plus the two additional areas focused on leadership and culture, are participating hospitals in the FHA HEC required to focus on all 10 of the areas or can hospitals within the group choose to address only a few?

A139 The statement of work defines the government’s requirement; they remain unchanged In order to meet the aims of the Partnership for Patients to reduce preventable inpatient harm by 40% and readmissions by 20% over a 3 year period, the PFP has identified ten areas of focus. Although the PFP will not limit its work to these areas and will pursue the reduction of all-cause harm, these focus areas are those for which content will be initially developed and learning activities broadly conducted and made available to hospitals participating in the partnership.

Q140 How do we integrate this work with our existing initiatives that focus on surgical care (SSI and VTE), readmissions, CAUTI and CLABSI? Some of these hospitals may or may not want to join this new initiative. Can we use our existing collaborative for some of these areas or does this work need to be separate?

A140 The statement of work defines the government’s requirement; they remain unchanged. In order to meet the aims of the Partnership for Patients to reduce preventable inpatient harm by 40% and readmissions by 20% over a 3 year period, the PFP has identified ten areas of focus as starting points for this work. Although the PFP will not limit its work to these areas and will pursue the reduction of all-cause harm, these focus areas are those for which content will be initially developed and learning activities broadly conducted and made available to hospitals participating in the partnership. Proposals are encouraged to be as all encompassing as possible. While local conditions or levels of performance may lead to different priorities of efforts all hospitals are encouraged to be engaged in all areas. Offerors can enhance existing work to meet the criteria of the solicitation. So as to avoid duplication other work for constituent hospitals, they can also select as few as 7 of the listed adverse events.

Q141 What level of background check will those from our organization leading the project need to complete?

A141 The definitions of applicability on each level of background check are provided in H.1.

Q142 What incentive will hospitals and healthcare professionals be provided so as to participate in these initiatives? Will healthcare professionals receive continuing medical education credit for participating in the activities?

A142 The manner in which HECs engage hospitals is specific to the technical approach of an individual offeror in response to this solicitation. As stated in the Background of Section C of the solicitation, “the Hospital Engagement Contractor (HEC) may address additional forms of harm and complications beyond this core set and must also support organizations in developing strategies to deepen leadership investment and organizational culture for quality.” At the discretion of the HEC, continuing education may be a component of these strategies.

Q144 Will there be a national “CMS HAC” website that will provide a centralized location to house all of the activities that occur under this initiative?

A144 Yes, the National Content Developer will host a web-based training portal, which will provide access to information from all ongoing Partnership activities.

Q145 How do the on-going Congressional budget talks impact this endeavor? What will happen if Congress is unable to reach a Federal budget agreement?

A145 At this time, CMS is soliciting proposals under the HEC solicitation with the intent of making awards by the end of this fiscal year. We cannot engage in speculation in relation to this question.

Q146 What roles will American Hospital Association and The Joint Commission play in this initiative?

A146 CMS cannot address this question or any question with regard to specific parties. We refer offerors to the SOW for the requirements and Section L for eligibility information. In a performance based effort such as this, each offeror may submit a proposal with its individualized plans including subcontracting arrangements that will allow it to successfully meet the requirements of the contract.

Q147 Departments in hospitals have varying educational needs – surgeons will have little concern for “obstetrical problems” or “preventable falls.” Nor will pharmacists. Internists/Hospitalists will want to focus on “adverse drug events” and DVT. How do you see the need to customize the programs to meet the needs of the individual specialty audience?

A147 It is the responsibility of the offeror to engage with hospitals and professionals within the HEC’s network and tailor communication and support as needed based on the topic and target audience.

Q148 Have you identified those hospitals/hospital systems that this initiative should be focused on – is it the lowest 25% of institutions? Will hospitals/systems that rank in the upper 25% be excluded?

A148 No hospital will be…