Appendix H_1.docx
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- Attached to
- Adult and Older Adult System of Care Services
- Solicitation number
- RFSQ-BHS-FY23-0210
- Issued by
- Santa Clara County, San Diego City, California
About this file
This is an Electronic Health Record (EHR) Status Questionnaire for the County of Santa Clara's Behavioral Health Services Department in response to RFSQ-BHS-FY23-0210 for Adult and Older Adult System of Care Services. The questionnaire requires offerors to provide detailed information regarding their EHR capabilities and integration with the County's myAvatar system through Netsmart's Fast Healthcare Interoperability Resources (FHIR) Application Programming Interface (API). Offerors must identify their current EHR vendor and platform, confirm whether their systems can be certified with myAvatar through Provider Connect Enterprise (PCE) implementation, and verify their ability to produce 837 billing files or manage contracts with vendors for this functionality. The questionnaire differentiates between existing County-contracted providers already using myAvatar and new offerors, with separate question pathways accordingly.
The questionnaire addresses implementation timelines and resource requirements for various myAvatar deployment types, ranging from approximately four weeks for non-billing data collection setups to three to four months for PCE implementation. Offerors must specify which implementation type best suits their organization based on the RFSQ parameters, confirm adequate resources and staffing to complete implementation prior to contract commencement, and describe their organization's detailed implementation plan with the County's support through weekly go-live preparation meetings. All responses must be complete, accurate, and submitted with the proposal response; any omissions, inaccuracies, or misstatements may result in rejection of the response in whole or in part. Offerors must also provide contact information for EHR-related communications and certify under penalty of perjury that all statements and representations are true and accurate.
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Text version
APPENDIX H
County of Santa Clara – Behavioral Health Services Department RFSQ-BHS-FY23-0210: Adult and Older Adult System of Care Services
OFFEROR’S ELECTRONIC HEALTH RECORD (EHR) STATUS
All EHR information requested in the form shall be furnished by Offeror and shall be submitted with the response. Statements shall be complete, accurate, and in the form requested. Any omissions, inaccuracies, or misstatements may be cause for the rejection of a response in whole or part.
| Question |
| Response |
| 1. Is Offeror an existing County-contracted Provider (CCP)? |
| YES ☐ NO ☐ |
If yes: Answer Question 2 If no: Answer Questions 3-5 & 9-11 (skip questions 2 & 6-8)
| 2. Does Offeror already have a contract(s) with the County of Santa Clara in which myAvatar is already being used? |
| YES ☐ NO ☐ |
If yes: Answer Questions 3-8 & 11 (skip questions 9 & 10) If no: Answer Questions 3-5 & 9-11 (skip questions 6-8)
3. Please provide the name of Offeror’s organizational EHR vendor and platform:
(ex. Netsmart, myAvatar, or N/A)
4. Does Offeror’s EHR have the capability of being certified with Netsmart’s myAvatar system through Fast Healthcare Interoperability Resources (FHIR) Application Programing Interface (API) allowing the implementation type of Provider Connect Enterprise (PCE)? [footnoteRef:1] [1: Offeror Electronic Health Records (EHR) would need to be compatible with FHIR if client data is to be electronically exchanged with the County of Santa Clara. The Offeror’s EHR vendor is responsible to assess the ability of their EHR to be compatible with FHIR and can reference the PCE Companion Guide (on the County’s partner site) that outlines the requirements necessary for integration.]
YES ☐ NO ☐
5. Does Offeror’s EHR have the capability to produce 837[footnoteRef:2] billing files or manages an active contract with an additional vendor to produce 837 billing files on Offeror’s organization’s behalf? [2: 837 billings files are electronic files that contain client and individual claim information. These are standard claim files and are comprised of individual claims that are then submitted electronically to be processed.]
YES ☐ NO ☐
| 6. What implementation of myAvatar is being used? |
| ☐ Provider Connect Enterprise (PCE) |
☐ Provider Connect NX (PCNX) with 837 billing ☐ Provider Connect NX (PCNX) with non-837 billing, using Fast Service Entry ☐ Provider Connect NX (PCNX) without a billing setup, completing forms solely for data collection.
| 7. Based off your understanding of the BHSD’s current myAvatar implementation type, will Offeror’s staff need a different (more enhanced) implementation type if awarded a contract for the services listed in this RFSQ? |
| YES ☐ NO ☐ |
If yes:
· Provide a reason:
Click or tap here to enter text.
· Proceed to question 8
If no: Proceed to question 11
| 8. Given the lengths of time provided below, does Offeror’s organization have enough resources to complete the need for a different (more enhanced) implementation type chosen in question 6 prior to the start of the contract? |
| ☐ PCE: about 3-4 months of prep |
☐ PCNX with 837 billing: about 2 months of prep ☐ PCNX with non-837 billing: about 6 weeks of prep ☐ PCNX without a billing setup: about 4 weeks of prep
YES ☐ NO ☐
| 9. Based off your understanding of the RFSQ parameters and your EHR capabilities, what type of implementation of myAvatar would best suit Offeror’s organization? |
| ☐ Provider Connect Enterprise (PCE) |
☐ Provider Connect NX (PCNX) with 837 billing ☐ Provider Connect NX (PCNX) with non-837 billing, using Fast Service Entry ☐ Provider Connect NX (PCNX) without a billing setup, completing forms solely for data collection.
| 10. Given the lengths of time provided below, would Offeror’s staff have enough resources to complete the selected implementation chosen in question 8 prior to the start of the contract? |
| ☐ PCE: about 3-4 months of prep |
☐ PCNX with 837 billing: about 2 months of prep ☐ PCNX with non-837 billing: about 6 weeks of prep ☐ PCNX without a billing setup: about 4 weeks of prep
YES ☐ NO ☐
| 11. With the County’s support in weekly go-live prep meetings, please describe Offeror’s organization’s plan to implement myAvatar. |
| Click or tap here to enter text. |
12. Please confirm the contact(s) the County shall contact for EHR related communications:
| NAME |
| TITLE |
The undersigned hereby declares under penalty of perjury that all statements, answers and representations made in this questionnaire are true and accurate, including all supplementary statements hereto attached. In the case of a corporate Offeror, the signature of one duly authorized representative is sufficient.
Signature
(Please print or type name)
Title
Signature
(Please print or type name)
Title
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