q As716.xls

XLS spreadsheet 540 KB Posted Jul 16, 2012

Attached to: End Stage Renal Disease Network 18 Federal contract opportunity
Solicitation number: CMS-2012-ESRD-FFPCOMP
Issued by: Department of Health and Human Services Centers for Medicare and Medicaid Services

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Other files attached to End Stage Renal Disease Network 18, newest first.
File	Type	Posted
07-26-12 Signed SF30 Amendment 6.pdf	PDF	Jul 26, 2012
07-20-12 SF30 Amendment 5.pdf	PDF	Jul 20, 2012
QAs revised 72012.xlsx	XLSX spreadsheet	Jul 20, 2012
07-20-12 Amended ESRD BP Forms J-7 A - ESRD Redesign.xlsx	XLSX spreadsheet	Jul 20, 2012
J-18 subcontractplan_101911.doc	DOC document	Jul 16, 2012
J-20b Compliance Attestation.docx	DOCX document	Jul 16, 2012
Bidders Conference_Final 062112.pptx	PPTX presentation	Jul 16, 2012
signed SF30 Amendment 4 07-16.pdf	PDF	Jul 16, 2012
J-2 ESRD Manual reference.docx	DOCX document	Jul 16, 2012
07-16-12_ESRD_FFP_Competitive_RFP_with_TOC1.docx	DOCX document	Jul 16, 2012
ESRD J-20a Information Security Attestation.docx	DOCX document	Jul 16, 2012
ESRD BP Instructions_ REDESIGN.docx	DOCX document	Jun 22, 2012
SF 30 Amendment 3.pdf	PDF	Jun 22, 2012
SF 30.pdf	PDF	Jun 20, 2012
06-19-2012_ESRD_FFP_Competitive_RFP_with_TOC1.docx	DOCX document	Jun 19, 2012
A.4 manual reference matrix.docx	DOCX document	Jun 19, 2012
Attachment J-13.pdf	PDF	Jun 15, 2012
Attachment J-18 Small Business Subcontracting Plan Form .docx	DOCX document	Jun 15, 2012
5-31-2012 ESRD FFP Competitive RFP with TOC.docx	DOCX document	Jun 15, 2012
06-08-12 SF 33.pdf	PDF	Jun 15, 2012
Attachment J-1 Consent to Subcontract.docx	DOCX document	Jun 15, 2012
Attachment J-10.docx	DOCX document	Jun 15, 2012
ESRD BP Forms J-7 A - ESRD Redesign.xlsx	XLSX spreadsheet	Jun 15, 2012
Attachment J-8 Estimated Level of Effort.docx	DOCX document	Jun 15, 2012
Attachment J-7b.xlsx	XLSX spreadsheet	Jun 15, 2012
Attachment J-14 Government Furnished Property.docx	DOCX document	Jun 15, 2012
Attachment J-11.xlsx	XLSX spreadsheet	Jun 15, 2012
ESRD ffp comp RFP Cover Letter.docx	DOCX document	Jun 15, 2012
Attachment J-5 Instructions for Travel Detail.docx	DOCX document	Jun 15, 2012
Attachment J-9.docx	DOCX document	Jun 15, 2012
06-08-12 NW Geographic Areas Map.pdf	PDF	Jun 15, 2012
Attachment J-7.docx	DOCX document	Jun 15, 2012

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RFP Questions

Section #	Page #	Question	Answer
Cover letter & L.15 Proposal Delivery	Cover letter and p. 181	The cover letter states that the proposal is due 8.2.12 at 2 p.m. local prevailing time (Baltimore), and the instructions state it is due 8.2.12 at 11 a.m. local prevailing time. Could CMS please clarify the time the proposal is due on 8.2.12?	2:00 pm EST.
General		May offerors include an appendix with the technical proposal? If yes, is there a page limit to the appendix?	An Appendix can be included with in within the page limitations.
General	N/A	Please clarify eligibility. That is, are QIOs eligible applicants/ESRDs?	This is a Full and Open Competition. All contractors are eligilble to submit proposals if they meet the statutory eligibility requirements to become a Network.
General	N/A	Can an ESRD Network be a division of a QIO?	QIOs and ESRD Networks are eligilble to submit proposals if they meet the statutory eligibility requirements to become a Network.
General	N/A	Are there requirements/expectations regarding the composition of the corporate governing body?	Requiremernts regarding the composition of the corporate governing body could be found in the ESRD manual reference matrix document.
General	General	Will the ESRD Network Manual be provided to bidders before we are to submit our proposals? If so, when can we expect to receive it?	The ESRD Manual reference matrix document has been provided for the purposes of responding to and bidding on this RFP. The ESRD Manual provides technical guidance for the performance of the work associated with the SOW and does not provide information necessary for applicants to develop proposals for this RFP.
General	General	In order to appreciate economies of scale, will CMS accept a single proposal for multiple ESRD Networks?	No
General	General	Can a Bidder submit more than one proposal for a given ESRD Network?	No
General		1. Will the transcript from the bidders conference be available for those who were not able to attend, if so when can it be expected?	no
		2. Please confirm the number and location of networks being competitively bid.	9 Network areas identifed in the RFP.
	42	Page 42 reporting requirements: In one place it states 90% of providers by end of base year must have at least 6 months of consecutive dialysis event data entered into NHSN. In another place on the same page it state 80%. The measurement table on page 44 has 90%. Please clarify.	Page 42 will be corrected to state: "80% of providers by end of base year must have at least 6 months of consecutive dialysis event data entered into NHSN. In another place on the same page it state 80%. This will also be reflceted in the measurement table on page 44.
	46	Page 46 describes the general requirement for Innovation projects. The 85% target population and desired outcomes criterion is not clear as to how it should be applied. Some of these projects do not have established benchmark levels to determine an acceptable baseline for comparative analysis. What standard should be applied for KDQOL or Home dialysis? Please clarify.	The Network will need to investigate the ESRD population and determine a baseline of facilities shoud that the >85 percent is not violated.
	32	Page 32 has term “established patient” what does that mean? Language not in manual.	An 'established patient' is one that is not a new patient.
	32	Page 32 refers to “ Beneficiary Satisfaction Survey”. Is it available to see content? If not will Networks have to develop their own? This would not allow for comparative assessment across Networks.	A standardized survey will be created by CMS and be available prior to the start of the contract.
	37	Page 37 the table 4 has reduce IVD/IVT each quarter from baseline. If the baseline is very low in the first quarter. It will be impossible to reduce it. How will that matter be handled? Also some of the IVDs are based on lack of payment or provider unable to meet medical need. These are allowable IVDs that the network cannot reduce… how will these types of IVDs be handled in measurement formula?	The requirement to reduce IVD/IVT each quarter, for low number quarters, is to reduce by at least 1. If a NW has at least 1 IVD/IVT then the Network would reduce that number by at least 1 the following quarter.
		Aim 2 innovative project language only addresses year one work effort. Can we assume that CMS expects each year a innovative selection process will take place within each Network for a new or ongoing Innovative project.	CMS expects each year a innovative selection process will take place within each Network for a new or ongoing Innovative project.
	56	Page 56 contains very brief about supporting CROWN Web. This lack of detail for the ongoing support and coordination required by Network staff is of concern. Given the current amount of work that is taking place now in just helping provider staff to register and define scope and role. Some additional acknowledgement is needed to address tasks related to generation of reports and interventions conducted by Network staff to get providers to complete they reporting functions which now includes all the clinical elements	The ESRD Network will comply with the requirements stated in Section C.4.3.A.1.
		Does CMS require a letter of intent from prospective offerors?	No
General		Being that out-for-bid Networks were randomly selected and were not bid out for performance issues, we assume that they may bid on their current Network as well as other out-for-bid Networks. Is this correct?	Yes.
General		There are several references in the SOW to patient/family participation in LANs and other Network activities that will require a time commitment and potential travel. Will the patients/family members be eligible to receive compensation for time and expenses?	No
General		ESRD Manual is referenced throughout the SOW. It is difficult to respond to this SOW without the clarification, expectations, and direction that will be in the manual. When can contractors expect to see this document?	The ESRD Manual reference matrix document has been provided for the purposes of responding to and bidding on this RFP. The ESRD Manual provides technical guidance for the performance of the work associated with the SOW and does not provide information necessary for applicants to develop proposals for this RFP.
SF33	Field 3.	The Solicitation Number reads CMS-2012-ESRD-DQC, while the RFP reads CMS-2012-ESRD-FFPCOMP. For the purposes of proposal preparation, which is correct?	CMS-2012-ESRD-FFPCOMP
SF-33; SF-30; K.4, Eligibility, Certification of Proposal Preparation	Page 169 -#2	Is it necessary to provide the technical approach in the table format on pages 169 and 170?	The template does not have to be used. However the information from the Tables must be submitted with your technical proposal.
B.6, Transition Services; Attachment J-7 Business Proposal Format- IV. Forms and Instructions, Network Transition Column	8 & Att. J-7	Please clarify the directions regarding submission requirements related to Transition Plan. B.6 states, “… CMS will request a separate technical and business proposal for these services.”	No. See revised Section L and M.
		Attachment J-7, IV. Forms and Instructions, Network Transition Column states, “This column should only be used for offerors that are bidding on a contract that they do not currently hold. … These columns should not be completed by incumbent ESRD Networks – only new bidders.”	The language has been changed. All offerors should propose their transition costs using these forms.
		Should new bidders complete a Transition Plan as part of the proposal submission? Does the new bidder submit both a Technical and a Business transition proposal? In what part of the Technical proposal should the transition plan be included? Is there a page limit for the Transition Plan, if required?	See changes to Section L and M.
C3.14. Emergency Preparedness	20	Throughout the RFP documents, there are instructions to work with the NCC on coordinating emergency preparedness, and other references instruct Networks to work with KCER. Will Networks work with both NCC and KCER on emergency preparedness?	The Networks will be required to work with only one entity in coordinating emergency preparedness.
C.2.2 Role of the Network	12	Will CMS equipment be allowed to fully utilize technology for outreach (i.e., Facebook, YouTube, Skype)? If not, will CMS support the use of non-CMS equipment to leverage technology and engage patients/families/ beneficiaries?	CMS supports the use of technology to engage patients/families/ beneficiaries as long as the ESRD Network adheres to CMS guidelines.
C.3.1 Internal Quality Control Program	13	Why was the name changed from IQI to IQC? QC is a term that is being phased out in the quality industry.	This term is standard for the Quality Improvement Contractors working with CMS.
C.3.4.,Corporate Structure	14	Is the “Patient Action Committee” the same as the “Patient Advisory Committee”?	The language in section C.3.4 should be Patient Advisory Committee.
C.3.4, Corporate Structure; G.7, Key Personnel	14 & 96	It appears that the Patient Services Coordinator has been added as a key position in some portions of the SOW, but not in the key personnel section. Please clarify discrepancy.	Patient Services Director is a key personnel position.
C.3.14, Emergency Preparedness	20	“The Network shall provide an Emergency Preparedness Plan to CMS...” Is this as part of the BCCP or in addition to the BCCP?	The Network shall provide an Emergency Preparedness Plan to CMS in addition to the BCCP.
C.3.14, Emergency Preparedness	20	“The Network shall participate in an annual emergency preparedness drill in conjunction with the NCC.” Is this a national drill similar to the one currently conducted by the KCER Coalition? Or, is this drill to be initiated by and developed by the Network?	The annual emergency preparedness drill is simiar to those previously conducted by the KCER coalition. The Network Coordinating Council will faciliate the annual emergency preparedness drill.
C.3.14, Emergency Preparedness	20	Are “local stakeholders” (state disaster agencies, SSAs, CMS regional office, etc.) expected to participate in the drill, or are they expected to serve only as advisors in the planning of the drill?	The Networks should seek participation of the local stakeholders in the drill.
C.3.14, Emergency Preparedness	20	Is the focus on the Network’s operations or dialysis facilities’ operations, and if the latter, are facilities to be included in the drill?	The focus is on both the operations and dialysis facilities. A small sample of facilties are to be included in the drill.
C.3.11 Collaboration with State Survey Agency	19	The requirement of every other month for a conference call is not objectionable to the Network; however, the Network has experienced difficulty in getting the SSAs to participate in quarterly calls. We are anticipating a similar problem with the bimonthly calls and the LAN. Is this language included in the SSA scope of work to ensure successful collaborations with these partners?	CMS does not have the authority to mandate participation in these calls. CMS expects the Network to make every effort to encourage SSA participation in these calls.
C.3.18.B Administer Security Program	22	The Network shall comply with the CMS Policy for Information Security Program (PISP). The PISP.pdf document on the CMS website cannot be opened, copied or viewed. Please supply a working copy of the PISP.pdf so that we can assess the level of effort on the technical proposal.	A working copy of the PISP.pdf coould be found by accessing,

http://www.cms.gov/Research-Statistics-Data-and-Systems/CMS-Information-Technology/InformationSecurity/Downloads/PISP.pdf

C.3.18.B Administer Security Program	22	Network System Security Plan (SSP). The only SSP template available was last updated 5/7/2009 and appears to be more geared towards data centers and/or organizations that develop software/hardware for CMS. It specifically asks whether a “system” i.e. hardware or software meets the ARS guidelines. Since Networks are expressly forbidden to develop software, and use only CMS approved hardware and equipment, it seems this document is not applicable to the work listed in the RFP.	The CMS SSP template is written generically so that it can be used to document security controls for any entity or system.
		• Is their a separate “Network” SSP in development?

• If so can we have a copy so that we can determine the level of effort for the technical proposal?

• The structure of the current SSP limits it to one system per SSP. If we are to use the current SSP Template, it seems that we would do one for each business process that has a security impact. Is that correct?	Currently there is only one CMS SSP template and there should only be one SSP document per Network.
	C.3.18.B Administer Security Program	23	The Network shall comply with the CMS Security Assessment and Authorization (SA&A) methodology, policies, procedures, etc., and adhere to the prescribed template. The CMS website referenced says that C&A (Certification & Accreditation) is the old name for SA&A. Further there is no SA&A document or template, only the C&A document version 2.1 8/25/09.	CMS updates security documents in the security library on a regular basis and the most recent versions should be used.
	C.3.18.D Security Review and Verification		• Are we to use C&A version 2.1 dated 8/25/2009 as the SA&A document?	CMS updates security documents in the security library on a regular basis and the most recent version should be used.
			• If so, C&A page 6 section 1.2 Scope says that if we are using a “system” already in production, i.e. CROWNWeb or the various server and workstation systems, we only need concern ourselves with the sixth and final phase of the C&A, which is disposition of such systems as they are retired or replaced. Is that assumption correct particularly in light of the fact that Networks do not develop “systems”?	Business Owners of systems that are already in production and are currently accredited, may only need to address the final phase of the C&A Program (IT Investment Evaluation Phase), which defines activities performed during maintenance of the system and for periodic re-accreditation.
		22	Please clarify the CMS Security Best Practices audio conference. Is this a new call, or does this refer to the now defunct ISSO/SPOC forum call?	The Network shall participate in CMS Security Best Practices conferences and audio conferences as directed by CMS.
	C.3.18.B, Administer Security Program	11	Will a subdomain be provided for the second domain in Aim 3?	The contract performance objective-Domain table provided is the correct table. No additonal subdomains will be added for Aim 3.
	C.3.18.D, Security Review and Verification	22	Network shall document compliance with CMS security requirements and maintain documentation in the Information Security (IS) Risk Assessment (RA). A significant portion of the IS/RA Procedure and Template documents apply towards systems development (SDLC – Systems Development Lifecycle) i.e. software/hardware development. Networks are expressly forbidden to develop software. Are we to assume that we only apply this methodology of risk assessment to Business Functions and not CMS authorized, mandated and supported software and systems?	The CMS IS/RA template is written generically so that it can be used to document security and risks for any entity or system.
	C.2.1 Contract Performance Objectives-Domains	Pages 64 and 65 – Item 11	Shouldn’t this be May 31, 2014 after the first year of the contract?	No, this refers to the Final report being due 5/31 each year and the report being published by 6/25 each year.
	C.3.4 Corporate Structure, including the PAC Section of the ESRD Network Manual Reference Matrix	14	Can the PAC composition also include family members and/or other types of stakeholders after meeting the minimum of 10 patient members, or is it to be patients only?	The Patient Advisory Committee composition should only include patients.
	C.3.8 Network Reporting	17	Re: Network Committee minutes, Section F, Schedule of Deliverables, #7, p. 63, indicates Network committee minutes (NC, BOD, MRB, PAC) to be submitted within 3 business days after the meeting. May we assume draft minutes are acceptable as distribution, and formal approval of minutes by each of the committees may require more time?	3 days is the time allotted to submit minutes.
	C.3.8 Network Reporting	17	Re: Draft Annual Report of Network Activities, in Section F, Schedule of Deliverables, #10, p. 64, the due date of April 30, 2013, appears to be a typographical error. Was this intended to be the year 2014, to follow the close of the first annual period of performance?	No, the due date for the draft annual report is 4/30/2013.
	C.3.8 Network Reporting	17	Re: Final Annual Report of Network Activities, in Section F, Schedule of Deliverables, #11, p. 63, the due date of June 25, 2013, appears to be a typographical error. Was this intended to be the year 2014, to follow the close of the first annual period of performance?	No, the due date for the Final report posting is 6/25/2013.
	C.3.9 Meetings	18	Re: contract post-award meeting, will this meeting be held telephonically or in-person?	Telephonically.
	C.3.9 Meetings	18	Re: QualityNet conference, may we assume four key personnel positions will attend this meeting (Executive Director; Quality Improvement Director, Patient Services Director, and Data Manager)?	CMS will provide guidance prior to any requirements related to this event.
	C.3.9 Meetings	18	Re: national meetings as directed by CMS, will these meetings be telephonic or in-person? If in-person, what is the anticipated frequency and number of required staff in each period of performance?	CMS guidance will be provided for meeting attendance after the contract award.
	C.3.9 Meetings	18	Re: LAN meetings/conferences, may we assume the QIO collaborative meetings will include at least one in-person meeting?	CMS cannot make any assumptions about the QIO collaborative meetings.
	C.3.10 Collaboration with the Network Coordinating Center	18	Please clarify what aggregate data sets will be analyzed by the NCC.	The aggregate data that is referred to here are trends and identified best practices of LAN related activities and metrics used in each of the AIMs LAN projects of the NWs.
	C.3.11 Collaboration with State Survey Agency	19	May we assume that the every-other-month formal communications entail telephonic meetings coordinated and funded by the ESRD Network contract?	The assumption that the every-other-month formal communications entail telephonic meetings coordinated and funded by the ESRD Network contract is correct.
	C.3.5 Provision of educational information	15	If the best method of reaching patients is through direct mailing, the Network will need significant resources for printing and shipping costs. The Network has conducted patient environmental scans to determine the best method of communication. In our Network >70% of respondents requested information by mail only. This does not align with the Paperwork Reduction Act. Will CMS support direct mailing?	The Paperwork Reduction Act does not impact direct mailings, only information collection activities. CMS expects the Network to utilize the most cost-effective and efficient processes capable within the available resources .
	C.3.5 Investigate and resolve NEPOP undeliverable	15	Are we to interpret that the Network’s role is now only monitoring/oversight for the NEPOP process? All quality issues reside at NCC and facilities, not the Networks.	The Network responsiblities are listed on pages 15 and 16 of the RFP, and involve more than just monitoring/oversight.
	C.3.5 Communication Requirements	15	What languages will be required for translation? All? Will there be funds available for translation services? Will there be a preferred vendor for Networks to use to reduce duplication of efforts and resources?	CMS expects all Network contractors to be able to provide necessary translantions to the prevalent populations under your jurisdiction within the resources that are available.
	C.3.8 Network Reporting	17/18	The Quarterly Progress and Status Reports are listed as a deliverable but are not in the Schedule F. Is the QPR still required now that we are providing a monthly report? If it is required will there be a template supplied?	The QPR is being replaced by the Monthly Report. Some material will only be reported quartery. A template for the Monthly report will be provided prior to the start of the contract.
	C.3.14, Emergency Preparedness, Emergency Plan	20	Will CMS provide a template for the emergency plan?	Yes, a template for the emergency plan will be provided.
	C.3.8 General Requirement: Network Reporting	Page 65 – Item 13	Is this deliverable describing meetings that Network staff will be attending or is it describing meetings that are developed by the Network staff?	This deliverable is describing meetings that Network staff will attend.
	C.3.9 General Requirements: Network Meetings	23	Should the offeror budget for a security audit or will this be a cost paid for by CMS should they decide to require an independent evaluation?	If CMS would decide to audit an ESRD facility, CMS will fund these audits.
	C.4.1.A.1, Foster Patient and Family Engagement at the Facility Level	25	Please clarify the social marketing tools that are approved for use.	The ESRD Network will submit proposed social marketing tools by the end of quarter 4 of the base contract year for COR approval.
	C.4.1.A.3, Convene/Support Patient LAN	26	Which CMS staff will participate in our Patient Engagement LAN and how do we identify these individuals?	The ESRD Network CORs, GTLs and any other additional staff identified by CMS will particapte in the Patient Engagement LAN activities.
	C.4.1.A.3, Convene/Support Patient LAN	28	Can CMS provide clarification on how Networks obtain baseline data for the LAN campaigns which must be designed to demonstrate at least a 10% relative improvement? Will CMS provide datasets?	The Network will propose a tool to obatin the baseline data and a tool to measure 10% relative improvement.
	C.4.1.B.1, Evaluate and Resolve Grievances	31	The SOW states that the Network shall document grievances directly reported to the Network by patients and/or grievances reported to facilities by patients. Are we required to develop a mechanism to track grievances that are resolved at the facility level so that these can be reported?	The ESRD Networks will utilize the NCU to track grievances that are reported to the Network or grievances reported to facilities by the patients.
	C.4.1.B.1, Evaluate and Resolve Grievances	31	Can we receive more information on the process for obtaining responses to patient satisfaction surveys? It appears that the Network will not have a role in sending these surveys (a task for the NCC), but it is a performance measure for the Networks.	The Networks will no longer will be responsible for ensuring at least 50% of all beneficiaries who file a grievance during the contract period prior to evaluation, complete the Beneficiary Satisfaction Survey, with 80% of the respondents indicating they are satisfied or very satisfied with the Network’s activities. It corrrected on page 32. It should read: Networks will ensure that 100% of all beneficiary data for filed grievances be submitted to the NCC.
	C.4.1.B.1, Evaluate and Resolve Grievances, Table 3; Deliverable #49	33, 76	The table indicates that beneficiary data should be provided to the contractor monthly; deliverable #49 states the information should be provided quarterly. Please correct discrepancy.	CMS will correct the discrepancy to reflect deliverable # 49 to be reported monthly.
	C.4.1.C.1, Decrease IVDs and IVTs	35	CROWNWeb has different categories for IVD which are not consistent with current regulations or NCU. It gives: Lack of Payment, Non-Adherence, Physical Harm, Physical Threat, Property Damage/Theft, Verbal/Written Abuse, Verbal/Written Threat. NCU gives: Non-Payment, Facility Ceases to Operate, Unable to Meet Medical Needs, On-going Disruptive Abusive Behavior, Immediate Severe Threat, Termination by Physician. Will CMS harmonize these two data collection efforts?	CMS recognizes CROWNWeb and the NCU are two stand alone systems.
	C.4.1.C.2, Address Patients at Risk for IVD/IVT and Failure to Place	36	Can CMS provide additional clarification on the exclusions that are defined in the ESRD Network manual?	Additional information could be found in Amendment 1 of the ESRD manual reference matrix document, see number 19.
	C.4.1.D.5 Provide Technical Support in the Area of Vascular Access; C.4.1.D.7 Contract Monitoring & Evaluation: C.4.1.D Vascular Access Management; C.4.1.D Vascular	Pages 39, 41, and 80 (Item 68)	Is the ≥90 day catheter improvement rate a Network rate, a participating facility group rate, or an individual facility rate?	The >90 day catheter rate is for those facilities with LTC rates greater than 10%.
	C.4.1.E.1, Support NHSN; Deliverable # 74	42 & 81	The SOW states 80% of facilities shall be successfully reporting at least six consecutive months to NHSN. The deliverable schedule states > 90% of facilities should be reporting. Please clarify discrepancy.	These are two separate things. 90% of facilites must be reporting , but 80% must be reporting at least 6 months of data.
	Table 6: Minimum Performance Criteria for C.4.1.E Patient Safety: HAIs	Page 44	Is the expectation that a 5% relative improvement on the Dialysis Facility Event primary measure will occur every quarter with a final relative improvement of 15%?	No, the 5% relative improvement is for the contract period up to the point of evaluation.
	C.4.1 AIM 1, Better Care for the Individual through Beneficiary and Family Centered Care	24, 1st full paragraph	“The two tiers are: (1) engagement at the dialysis facility level to foster patient and family involvement; (2) development and implementation of a beneficiary and family centered care focused LAN to promote patient and family involvement at the Network level.” Is the beneficiary and family centered care focused LAN the same as the Patient Engagement LAN referred to in Table 1, page 10?	Yes, the beneficiary and family centered care focused LAN is the same as the Patient Engagement LAN referred in Table 1.
	C.4.1.A.2 Involve Patients/Families in CMS Meetings.	26	Re: attendance at COR monthly monitoring meetings and annual evaluation site visit by patient SME, family member, and/or caregiver, could CMS please specify when patient/family attendance is expected to be telephonic versus in-person?	CMS requires attendance. The format is up to what is worked out between the Patient/Family member and the Network, although in-person is perferred for the annual evaluation.
	C.4.1.A.3 Convene/Support Patient LAN	27	“During the base contract year, the Network shall establish the LAN with 10 or more patients. The Network shall maintain 100% membership with 60% attending required meetings and activities throughout the course of the project.” Given that ESRD patients may experience unexpected serious medical complications that may lead to their inability to participate on the LAN for the duration of the activities, may we assume that under such circumstances it would be acceptable to replace an individual in the membership group with another to maintain 100% membership?	It would be acceptable to replace an individual in the membership group with another to maintain 100% membership.
	C.4.1.A.4 Contract Monitoring and Evaluation: C.4.1.A Patient and Family Engagement, Table 2 Minimum Performance Criteria	29	If the Network has more than the minimum Patient SMEs, is the 100% membership and 60% attending based on the 10 minimum or the increased number?	Yes, the 100% membership and 60% attending is based on the 10 minimum of Patient SMEs.
	C.4.1.B.1 Evaluate and Resolve Grievances	31	In what manner is it anticipated that Networks will receive information regarding grievances reported to facilities by patients?	CMS expects Networks to use the same methods currently in place to track grievances filed by patients directly to the NW or grievances filed at the facility.
	C.4.1.B.1. Evaluate and Resolve Grievances	32	Regarding maintaining review timeliness for all cases at or greater than 90%, please clarify the timeline for review (e.g., within how many days of the case being opened)?	CMS expects Networks to use methods similar to those in place to review grievances. Additional guidelines will be provided prior to the beginning of the 2013 SOW.
	C.4.1.B.1 Evaluate and Resolve Grievances	32	Re: “Adhere to the required investigatory and documentation elements in 100% of grievance cases,” what are the required investigatory and documentation elements of grievance cases?	CMS expects Networks to use methods similar to those in place to review grievances. Additional guidelines will be provided prior to the beginning of the 2013 SOW.
	C.4.1.B.1 Evaluate and Resolve Grievances, Focused Audit	32	Re: “At the end of the 1st and 3rd Quarters, conduct a focused audit of all grievances received to identify systemic issues and trends,” Section F, Schedule of Deliverables, #52, p.76, states the date to perform the focused audit is by March 1, 2013, while page 32 states to use 1st quarter findings. Could CMS please clarify?	1st and 3rd Qtr are the appropriate time periods. CMS will adjust the SOW and SOD as necessary.
	C.4.1.B.3 Promote Use of ICH CAHPS and /or Any Similar Survey Identified by CMS	34	Could CMS please clarify the mechanism by which the Network shall obtain data to track the number of facilities that are using the ICH CAHPS?	The Network will arrange for this information following and adhere to the regulations on data collection that are applicable.
	C.4.1.B.3 Promote Use of ICH CAHPS and /or Any Similar Survey Identified by CMS	35	Could CMS please clarify the mechanism by which ICH CAHPS patient results data will be provided to the Network?	Additional funding for the administration of the ICH CAHPS survey is not provided to dialysis facilities. Dialysis facilities are required by the Conditions for Coverage, published on April 15, 2008 (73 FR 20481) to measure, analyze, and track quality indicators that pertain to patient satisfaction (42 CFR 494.110). The ICH-CAHPS survey satisfies this requirement as discussed in the preamble of the rule (73 FR 20415). Guidance regarding the current methodology for administering this survey for purposes of the Quality Incentive Program may be found at:

https://www.cahps.ahrq.gov/CAHPSkit/files/53_Fielding_the_ICH_Survey.pdf or http://www.ahrq.gov/cahps/hemodialysis/ .

C.4.1.B.4. Address Issues Identified through Data Analysis	35	Could CMS please clarify the source and timeline of availability of information for the Network to track provider participation in administering the ICH CAHPS?	CMS will make this information available upon completion of the QIP rulemaking.
C.4.1.B.4. Address Issues Identified through Data Analysis	35	Could CMS please clarify if the Network assistance to facilities with the interpretation of results and development of action plans to improve patients’ experience of care is specifically referring to the QIA that is to impact 10% of the Network population and at least 20 facilities?	The Network assistance to facilities with the interpretation of results and development of action plans to improve patients’ experience of care is specifically refers to the QIA, which is to impact 10% of the Network population and at least 20 facilities.
C.4.1.C.2 Decrease IVDs and IVTs, Address Patients At Risk for IVD/IVT and Failure to Place	36	“Based on interactions with patients and/or facilities, investigate and document any patients perceived by the Network to be at risk for IVD/IVT and/or failure to place as a new patient in the NCU database, or other CMS-designated system, within 24 hours of receiving the information.” Will the next business day meet the intent of “within 24 hours” investigation and documentation in NCU, if the contact comes in on a Friday?	Yes, the next business day will meet the intent of “within 24 hours” investigation and documentation in the NCU.
C.4.1.C.3, Contract Monitoring and Evaluation: C.4.1.C.1: Decrease IVDs/IVTs and C.4.1.C.2: Address Patients at Risk for IVD/IVT and Failure to Place, Table 4 Minimum Performance Criteria	37	Will CMS exclude from the “Number of IVDs/IVTs” the discharge reasons that are permitted in the ESRD Conditions for Coverage (facility closure, non-payment)?	CMS will continue montior all IVDs and IVTs.
C.4.1.C.4 Generate Monthly Access to Dialysis Care Reports	37	Will CMS provide a template for this report?	CMS will provide a Dialysis Care Report template.
C.4.1.D.1 Improve AV Fistula Rates for Prevalent Patients	38	Could CMS please clarify who establishes the monthly goal upon which 75% achievement is assessed?	CMS established the monthly improvement goal for AV Fistula Rates for Prevalent Patients.
C.4.1.D.2 Reduce Catheter rates for Prevalent Patients	38	Could CMS please clarify who establishes the monthly goal upon which 75% achievement is assessed?	CMS established the monthlyreduction of Catheter rates for Prevalent Patients
C.4.1.D.3 Support Facility Vascular Access Reporting	39	This section references using the Fistula First data collection tool or another method(s). May we assume this means the data collection from CROWNWeb and that VA facilities and DME Suppliers will be exempted because their participation in CROWNWeb is voluntary?	At this time, the VA facilities are not required to submit data into CROWNWeb.
C.4.1.E Reduction of Healthcare Acquired Infections; C.4.2.A Aim 2 Innovation Projects	Pages 81 and 82 – Items 75, 76, and 78	The deliverable relating to the NHSN project and the innovation projects states data source is a dashboard. Where will the dashboard be housed? Who is populating the dashboard? When will Networks have access to the dashboard?	CMS will provide information whhen the CMS Dashboard is complete.
C .4.1.B.1 Evaluate & Resolve Grievances	Page 31	What is the Grievance procedure for investigation and resolution? Are all handled with process of past serious grievance and how are complaints, now grievances, that are less serious handled?	There is no category known as complaints. Refer to amendment 1 in the ESRD manual reference matrix document.
C .4.1.B.1 Evaluate & Resolve Grievances	Page 32	How will the NW get the information to document grievances reported to facilities by patients?	The NW will get the information to document grievances reported at the facility level using current processes. The patient may either file a grievance by calling the Network directly, or they are able to file their grievance at the facility. The facility is to inform the Network that a patient has filed a grievance; the Network is expected to followup on all grivances filed.
C .4.1.B.1 Evaluate & Resolve Grievances	Page 31	What will the process be for the NCC in conducting patient satisfaction surveys relative to the grievance process	CMS is in the process of determining the process on how the NCC will be conducting patient satisfaction surveys relative to the grievance process.
C .4.1.B.1 Evaluate & Resolve Grievances	Page 32	What are the definitions of grievances and the specific process described in Manual ?	There is no category known as complaints. Refer to Amendment 1 in the manual reference matrix document. Additional guidance will be provided prior to the beginning on the 2013 SOW.
C .4.1.B.1 Evaluate & Resolve Grievances	Page 32	How does CMS want grievance related to ESRD QIP or PPS incentives documented in the NCU and what is the definition or guidelines for determining if it is related to ESRD QIP or PPS incentives?	All grievances shall be entered into the NCU according to the most current CMS approved NCU instructions. The ESRD Networks should utilize their expertize in assessing whether there are patient care issues that might be associated with the prospective payment system and/or the Quality Incentive Program. The Network COR and GTL as well as the Learning and Action Network special project awardee should be used as resources when Networks are considering causes and whether additional investigation related to payment based provider behavior is warranted. Greivances that may have a payment related cause of poor patient care shall be reported to the COR, GTL, and the Learning and Action Network special project awardee.
C .4.1.C.1 Decrease IVDs and IVTs	Page 36	What are the specific definitions to be used for documenting IVDs?	The specific definitions could be found in amendment 1, manual reference task area matrix document--see number 17 .
C .4.1.C.1 Decrease IVDs and IVTs	Page 36	How do NWs determine if facilities are reporting all IVDs to the NW and/or if NW receiving notification of all IVDs? It will be difficult for NWs to work with facilities to avert IVDs if not being notified (p.36) Also definitions are needed for Avert IVD and Avert IVT.	CMS expects the ESRD Network to use the current mechanisms to determine if facilties are reporting and receiving all notifications of IVDs.
C.4.1.C.2 Address Patients at Risk for IVD/IVT and Failure to Place	Page 36	How will NWs have standardization of category “At risk for IVD patients” if at risk status is determined by NW perception of at risk and there are no standardized definitions or approaches/process?	CMS expects the ESRD Network to use the current mechanisms to determine if facilties are reporting and receiving all notification of IVDs.
C.4.1.C.1 Decrease IVDs and IVTs	Page 36	Please explain what and how something would be classified an IVT. Is an IVT supposed to be documented like an IVD? There is currently no process for documentation. More information is needed on the difference between IVD and IVT.	The specific definitions are found in amendment 1, manual reference task area matrix document--see number 17 in matrix document .
C .4.1.B.1 Evaluate & Resolve Grievances; C.4.1.C.1 Decrease IVDs and IVTs	Pages 31, 32, 34, 36,	When will the complete NW Manual be available? It is referenced throughout the RFP and specifically on the noted pages additional information is needed.	The ESRD Manual reference matrix document has been provided for the purposes of responding to and bidding on this RFP. The ESRD Manual provides technical guidance for the performance of the work associated with the SOW and does not provide information necessary for applicants to develop proposals for this RFP.
C.4.1.D.1 AVF Rates	38	When a facility reaches a 68% AVF rate, are they still required to obtain monthly gains?	No, the facility will only need to sustain their rate.
C.4.1.B.3 Promote Use of ICH CAHPS and/or Any Similar Survey Identified by CMS; C.4.1.B.4 Address Issues Identified through Data Analysis	Page 34 & 35	How will the Network be able to track the facilities using the ICH CAHPS and receive the results to develop a QIA?	CMS expects the Networks to describe this process in the RFP.
C.3.5 Communication Requirements	Page 15	What level of 508 compliance will be required for Network websites	For specific guidance on the 508 compliance for website, see Section 508 of the Rehabilitation Act of 1973 as amended by the workforce Investment Act of 1998 (P.L. 105-220) subsection 508(b) 1194.22.
C.4.1.E., Patient Safety: HAIs, Table 6	44	In table 6, row related to “Reduce HAIs,” is it CMS’ intention that ≥5% relative improvement be achieved each quarter or some progress made toward the eventual achievement of ≥5% relative improvement?	5% relative improvement over the contract period up to the time of evaluation.
C.4.1.E.1 Support NHSN	42	Could CMS please clarify who establishes the monthly goal upon which 75% achievement is assessed?	The 75% is based on a linear calculation of the Network-specific rate based on the Network's baseline and the goal to be achieved. This will be incorporated into the CMS Dashboard, but will be Network-specific.
C42. Innovation Pilot Projects and deliverable #78	46-52	We are not aware of trend data on dialysis staff vaccinations, diagnosis-specific hospitalizations, transplant referrals, and KDQOL data. Could CMS provide this data and information on the evidence basis for the evaluation measures?	CMS will not provide any trend data. It is the Networks responsibilities to investigate these areas.
C.4.2.C Population Health Innovation Pilot Projects: Contract Monitoring and Evaluation	48	What are the pre-specified thresholds to be achieved and when will they be provided?	The pre-specified thresholds are listed with each of the five (A-E) projects for each measure. Each measure within a selected project area must be achieved.
C.4.3 AIM 3: Reduce Costs of ESRD Care by Improving Care, Documentation of Network Staff Training	54	Section F, Schedule of Deliverables, #79, p. 82, references training requirements. Could CMS please clarify which Network staff positions are expected to receive and document the training?	All key NW staff and any staff who communicate content directly to providers would be expected to have completed the specified training.
C.4.3 AIM 3: Reduce Costs of ESRD Care by Improving Care, QIP Monthly Activities Report	54	Section F, Schedule of Deliverables #80, p. 83, seventh bullet, refers to “monthly calls with SSAs.” Deliverable #12 indicates the routine SSA calls are to be held bi-monthly. Please clarify frequency of SSA calls.	Call should be at least bi-monthly. CMS will correct this in the SOW.
C.4.3.A.1 Assist Facilities in Understanding and Complying with QIP Processes and Requirements	54	Re: “Registering provider Master Account Holders (MAH) to access http://www.dialysisreports.org or another website designated by CMS to provide ESRD QIP Performance Score reports…,” Section F, Schedule of Deliverables, #82, p. 84, refers to the Network registering facility MAHs. Currently, this is a secure process that may only be completed by the facility; the Network may not register facilities on their behalf. Please clarify if the DFR web-based reporting system registration process is going to be revised.	There have not been any new changes to the NW role and processes regarding MAH or facility accounts, nor are changes planned at this time. Each year the NWs send the MAH login information and passwords to the designated MAH at each facility; the facility MAH is responsible for logging in to set-up user accounts. NWs are responsible for providing the MAH instructional information and password to the designated MAH at each facility, and are also for maintaining a current list of MAHs at each facility.
C.4.3.B Support for Facility Data Submission to CROWNWeb, NHSN, and/or Other CMS-Designated Data System(s)	56	Re: “Oversee the timely and accurate submission of data into CROWNWeb using the CROWNWeb Reports,” could CMS please clarify the validation method the Networks will be expected to utilize to oversee the accuracy of data submitted by facility staff in CROWNWeb, NHSN, and/or other CMS-designated data system(s) (e.g., data collection/medical record abstraction)?	The CROWNWeb will provide reports to assist the ESRD Network in oversseing the Facility data submission.
C.4.1.C Patient LAN/SMEs	24	Waitlist justification: Is the person removed from the group once they get a transplant? Our transplant patients were on the waitlist and have valuable knowledge of the waitlist and transplant. It seems we will discriminate against patients wanting to serve but not being able to due to their waitlist status (e.g. one of our PAC was on the waitlist but was recently removed due to another health issue. Would this person then lose their position?) How often should the review of qualifications take place? Monthly? Quarterly? Annually?	Transplantation does not remove a patient from participation in the LAN process
C.4.1.A .2 Involve Patients/Families in CMS Meetings	25/26	How is this to be paid? Are there previsions within the contract for travel of these PPAs and their families? Many patients do not have access to the internet and would not be able to be present via webinar. Will CMS included additional travel or technology funding to ensure patient/families can successful participate?	Networks are to determine this within their proposals. Violation of CMS polices is not permitted.
C.4.1.B.3 Promote use of ICH CAHPS	34	Will the facilities be provided with funds for third party implementation of the survey? Third parties are charging thousands of dollars to perform this service. Will three be an approved third party vendor listing for facilities to refer to in order to conduct this work?	Additional funding for the administration of the ICH CAHPS survey is not provided to dialysis facilities. Dialysis facilities are required by the Conditions for Coverage, published on April 15, 2008 (73 FR 20481) to measure, analyze, and track quality indicators that pertain to patient satisfaction (42 CFR 494.110). The ICH-CAHPS survey satisfies this requirement as discussed in the preamble of the rule (73 FR 20415). Guidance regarding the current methodology for administering this survey for purposes of the Quality Incentive Program may be found at:

https://www.cahps.ahrq.gov/CAHPSkit/files/53_Fielding_the_ICH_Survey.pdf or http://www.ahrq.gov/cahps/hemodialysis/ .

C.4.1.D.2 Reduce Catheter Rates for Prevalent Patients	38	Is the catheter rate >90 days for catheters alone or including catheter with AVF or AVG maturing?	The >90 days catheters are when it is used as the primary vascular access.
C.4.1.A.3 Convene/Support Patient LAN	Page 26	The RFP states that patients may be both SME/PAC and LAN. Is it permissible for patients to be only an SME/PAC member or only a LAN participant?	It is permissible for patients to be an SME/PAC member or a LAN participant or both.
C.4.1.D.1. Improve AV Fistula Rates for Prevalent Patients; F.3 Schedule of Deliverables	Pages 38 and 79	AVF re-measure is stated to be September 30 (end of 3rd quarter on pg. 38) and is stated to be October 15th on pg 79. Is this measure referring to the September 30 data, or to the October 15th dashboard (i.e., August data)?	Evaluation will take place by the end of 3rd quarter and will utilize the available data at that time.
C.4.1.D.5. Provide Technical Support in the Area of Vascular Access	Page 39	Indented paragraph states: “The Network shall evaluate the effectiveness of all implemented interventions.” Can CMS provide a definition/criteria for what it determines to be effectiveness?	The Network is able to demonstrate that the intervention is effective in achieving the desired goal(s).
C.4.1.D.7. Table 5	Page 38 &40	Please clarify the meaning of following statement, found in row 1, column 2: “Meet at least 75% of monthly goal with the possible exception of a flat or decreased value for any one month.”	The C.4.1.D.7. Table 5 will be corrected to state: "Meet at least 75% of monthly goal".
C.4.1.E.1. Support NHSN	Page 42	Paragraph 2 states: “…90% of facilities must be reporting Dialysis Facility Event data for at least six consecutive months.”	These are two separate things. 90% of facilites must be reporting, but 80% must be reporting at least 6 months of data.
		Paragraph 5 states: “At least 80% of all facilities in the Network’s service area shall be successfully reporting at least six consecutive months of Dialysis Facility Event data to NHSN within in the base contract.” Does this mean that the 90% only refers to option year 1 and option year 2?	This is only applicable for the base year of the contract.
C.4.1.E.1 HAI	42	The text appears to state that both 90% (second paragraph) and 80% (fifth paragraph) of facility must report 6 months of Dialysis Facility Event data in NHSN. Which is correct?	These are two separate things. 90% of facilites must be report, but 80% must be reporting at least 6 months of data.
Other		I was looking to see if transportation was a section to submit a response to. Ambulance or chair car transportation to get these clients to and from their treatments.	This question does not apply at this time in this RFP.

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