DOH25-011 ITB Addendum 2 Q&A FINAL.pdf

Mission:

To protect, promote and improve the health of all people in Florida through integrated state, county and community efforts.

Ron DeSantis Governor

Joseph A. Ladapo, MD, PhD

State Surgeon General

Vision: To be the Healthiest State in the Nation

Florida Department of Health Division of Administration • Bureau of General Services 4052 Bald Cypress Way, Bin B-07 • Tallahassee, FL 32399

PHONE: 850-245-4199

FloridaHealth.gov

Accredited Health Department Public Health Accreditation Board

Addendum 2 Questions and Answers

ITB DOH25-011

Electronic Oral Health Record

DATE: 10/16/2025

TO: Prospective Vendors

FROM: Yasemin Sulker, Procurement Officer

Florida Department of Health Central Purchasing Office

SUBJECT: Addendum 2

The purpose of this addendum is to modify Attachment A, Scope of Work, and to answer questions received in accordance with Section 2.7, Questions, of the Invitation to Bid (ITB). This addendum serves as notice of the following change(s):

Deletions are indicated by “strikethrough” or reference. Additions, updates or replacements are indicated by highlighting.

A. Modifications: The following modifications are made to the ITB:

1. Attachmment A, Scope of Work of the ITB, is hereby deleted in its entirety and replaced with the Revised Attachment A, Scope of Work attached herein.

B. Responses to Questions received pursuant to Section 2.7, Questions: Please see the Department’s response to questions received by the due date outlined in Section 2.5. Timeline, of the ITB, below:

Revised Scope of Work (Attachment A)

DOH25-011

1. PURPOSE:

This scope of work is for a Cloud-based Electronic Oral Health Record (EOHR) for the Dental Locations identified on Exhibit A that will integrate with the Department’s Health Management System (HMS), development and launch of a Patient Upload Application Programming Interface (API), and development and launch of API messaging. Contractor will provide these services to the Florida Department of Health (Department).

2. TERM:

This scope of work will begin on 10/30/2025 or the date on with the purchase order is issued, whichever is later. It will end at midnight, Eastern Time on 9/15/2028. The State of Florida’s performance and obligation to pay under this purchase order and any subsequent renewal is contingent upon annual appropriation by the Legislature and satisfactory performance of the Contractor.

3. LOCATION OF WORK: The worksite for this scope of work is the following location(s):

3.1. Public Health Dental Program (PHDP), 2585 Merchants Row Blvd., Tallahassee, Florida 32399

3.2. The Dental Locations identified on Exhibit A, which are subject to change.

4. CRIMINAL BACKGROUND SCREENING:

In the Department’s sole and exclusive discretion, it may determine that background screening of some or all of Contractor’s officers, agents, employees, subcontractors, or assignees is necessary (collectively individuals). In the event background screenings are required under the resulting purchase order, Contractor agrees to the following:

4.1. Conduct background screenings in accordance with Chapter 435, Florida Statutes, using level 2 screening standards.

4.2. Provide the Department with a written attestation confirming that the individual has completed and cleared the level 2 background screening.

4.3. Not allow the individual to begin work under this purchase order until that individual has been cleared by the Department.

4.4. Be responsible for any costs associated with meeting this screening requirement.

5. CONTRACTOR QUALIFICATIONS AND EXPERIENCE:

CONTRACTOR/STAFF The Contractor must possess the following minimum qualifications and experience:

5.1. Contractor has a minimum of five years of verifiable experience maintaining electronic oral health record solutions as specified in Section 4.4 of Attachment A, Scope of Work

5.2. Contractor’s employees/contractors have at least six years’ cumulative experience in Healthcare data standards such as Health Level Seven (HL7), Fast Healthcare Interoperability Resources (FHIR), or Clinical Document Architecture (CDA)

5.3. Contractor’s employees/contractors have at least six years’ cumulative experience in Health information privacy laws such as the Health Insurance Portability and Accountability Act (HIPAA)

5.4. Contractor’s employees/contractors have at least six years’ cumulative experience in Application Programming Interfaces (APIs)

6. CONTRACTOR RESPONSIBILITIES:

6.1 SERVICE TASKS: Contractor will perform the following tasks in the time and manner specified:

6.1.1 Provide a Cloud-based EOHR that provides, at a minimum, the following:

6.1.1.1 Patient demographics, insurance information, medical history, dental charting, periodontal charting, x-rays, intraoral photos, documentation, progress notes, current conditions, services to be provided, treatment plan creation with patient signature, and services completed.

6.1.1.2 Provide and generate operational, financial, compliance, and customizable reports as required by the Department.

6.1.1.3 Automated text messaging and email reminders to clients based on scheduled appointments in compliance with HIPAA requirements and requirements as specified by the Department. Ensure the automated text messages and email reminders provide clients the ability to opt in and opt out. Ensure the clinic or appointment type is not disclosed.

6.1.1.4 Provide messaging report of responses for the automated text messaging and email reminders.

6.1.1.5 Provide user interface that enables the electronic ordering, renewal, and cancellation of medications, including controlled substances, 24 hours a day, 365 days a year.

6.1.1.5.1 Maintain an active certification for the electronic prescribing of controlled substances as detailed in the Final Rule ‘Electronic Prescribing for Controlled Substances’ [Docket No. DEA-218, RIN 1117-AA61] as published in the Federal Register.

6.1.1.6 Integrates with existing CHD sensors, phosphoretic plate processors, and intraoral cameras as specified by the Department.

6.1.2 Within 60 calendar days of issuance of the purchase order with a Dental Location (as identified on Exhibit A), install the Cloud-based EOHR solution at that Dental Location.

Ensure each Dental Location’s sensors, phosphoretic plate scanners, and intraoral cameras are connected to the Cloud-based EOHR solution upon installation of the Cloud-based EOHR solution. Maintain the Cloud-based EOHR at that Dental Location throughout the Purchase Order term.

6.1.3 Within 30 calendar days of written request by the county health department’s program manager of the Dental Location (as identified in Exhibit A) perform a migration of all existing patient records within CHD dental software applications to the Cloud-based EOHR as requested by the Department.

6.1.4. Conduct an online training for each Dental Location within ten business days of the installation of the Cloud-based EOHR. Online training may be provided to more than one Dental Location at a time.

6.1.5. Within ten business days of installation of the Cloud-based EOHR, provide a recorded training to that Dental Location. Ensure the recorded training covers all aspects, including troubleshooting of the Cloud-based EOHR.

6.1.6. Within ten business days of installation of the Cloud-based EOHR, provide written instructions to that Dental Location. Ensure the written instructions covers all aspects, including troubleshooting of the Cloud-based EOHR.

6.1.7. Provide the Dental Location access to the Cloud-based EOHR system within 10 business of installation of the Cloud-based EOHR.

6.1.8. Maintain an application uptime of 99.9% per month.

6.1.8.1. Response to system outage of business-critical impact within one hour of notification.

6.1.8.2. Response to system malfunction impacting users within four business hours of notification.

6.1.8.3. Response to non-urgent technical issues within 24 business hours of notification.

6.1.8.4. Response to general informational inquiries within 48 business hours of notification.

6.1.8.5. Resolution of system outage of business-critical impact within four hours of notification.

6.1.8.6. Resolution of system malfunction impacting users within one business day of notification.

6.1.8.7. Resolution of non-urgent technical issues within three business days of notification.

6.1.8.8. Resolution of general inquiries within seven business days of notification.

6.1.9. Provide customer support for the cloud-based EORH upon request via phone and online from 8:00 a.m. to 6:00 p.m. Eastern Standard Time, Monday-Friday, except state of Florida holidays. Ensure all customer support is provided from the continental United States. If the problem is unable to be resolved via phone or online, provide in person, onsite technical assistance as directed by the Department.

6.1.10. Develop and launch a Patient Upload Application Programming Interface (API) as follows:

6.1.10.1. As part of the Cloud-based EOHR, develop standard messaging using

RESTful API (HL7 v2.5.1 payload) to support the transfer of inbound client demographic data from the Department’s HMS to the EOHR client chart.

6.1.10.2. Ensure the API has the ability to receive all demographic fields from the Department. Demographic fields include but are not limited to the following: first, middle and last name, preferred name, date of birth, HMS medical record number, addresses (residence and mailing), telephone number, communication preference, billing consent, direct messaging email, HIPAA on file, date HIPAA was signed.

6.1.10.3. Ensure the API has the ability to accept a standard HL7 merge message from HMS.

6.1.10.4 Coordinate with the Department’s Office of Information Technology to conduct testing of the API as directed by the Department.

6.1.10.5. Coordinate with the Department’s Office of Information Technology to conduct trouble shooting to the API as directed by the Department.

6.1.10.6. Launch the patient demographic API no later than May 31, 2027.

6.1.11. Provide a statewide training for the API as directed by the Department.

6.1.12. Provide external (online or by telephone) technical assistance for the API as requested by the Department. Ensure all technical assistance is provided from the continental United States. If the problem is unable to be resolved externally, provide technical assistance onsite and in person as directed by the Department.

6.1.13. Develop and launch standard messaging using RESTful API (HL7 v2.5.1 payload) that will support outbound client service information from the EOHR to the Department’s HMS as follows:

6.1.13.1. Develop messaging to involve the Department’s API to transmit service information from EOHR into the HMS with fields identified in Task 6.1.10.2 and including but not limited to program component, CDT codes, tooth numbers (including primary teeth, permanent teeth and supernumerary teeth), service description and details (arch, quadrant, surface) service date, service site per service, service provider, billing provider, billing provider NPI, client oral health status, maternity status, special health care needs, appointment types, and referral information.

6.1.13.2. Coordinate with the Department’s Office of Information Technology to conduct testing of the API messaging as directed by the Department.

6.1.13.3. Coordinate with the Department’s Office of Information Technology to conduct trouble shooting to the messaging as directed by the Department.

6.1.13.4. Launch the API messaging in 6.1.13.1 no later than August 31, 2027.

6.1.14. Provide a statewide training for the API messaging as directed by the Department.

6.1.15. Provide external (online or by telephone) technical assistance for the API outbound messaging from the EOHR to HMS as requested by the Department. Ensure all technical assistance is provided from the continental United States. If the problem is unable to be resolved externally, provide technical assistance onsite and in person as directed by the Department.

6.1.16 Within 30 calendar days of contract termination, as directed by the Department provide all EOHR record data to the Department in importable formats, such as CVS, JSON, or FHIR.

6.1.17. DATA SECURITY AND CONFIDENTIALITY TASK:

The Contractor, its employees, subcontractors, and agents must comply at all times with all Department data security procedures and policies in the performance of this scope of work as specified in the Data Security and Confidentially document attached to the purchase order.

6.2. DELIVERABLES:

Contractor will complete and submit the following deliverables to the Department in the time and manner specified:

6.2.1. Upon Completion: Provide and install of a Cloud-based EOHR at each Dental

Location in the time and manner specified in Tasks 6.1.1. through 6.1.9 and Task 6.1.16.

6.2.2. Upon Completion: Develop and launch the API in the time and manner specified in Tasks 6.1.10. through 6.1.12.

6.2.3. Upon Completion: Develop and launch the API messaging in the time and manner specified in Tasks 6.1.13. through 6.1.15.

7. METHOD OF PAYMENT:

7.1 Purchase orders will be issued to the Contractor.

7.2 The method of payment for this purchase order is unit rate.

7.3 The Contractor will receive payment in advance for goods or services described in this scope of work.

7.4 The Contractor must submit an invoice to the Department Contract Manager upon completion of each deliverable that provides a detailed accounting of the deliverables performed during the invoice period for which payment is being requested.

7.5 The Contractor is responsible for the performance of all tasks and deliverables contained in this scope of work.

8. PERFORMANCE MEASURES AND FINANCIAL CONSEQUENCES:

All deliverables and related tasks must be completed 100% as specified. Failure to satisfactorily complete or submit a deliverable in the time and manner specified will result in a financial consequence as indicated below:

8.1 Failure to complete and submit Deliverable 6.2.1. in the time and manner specified will result in a payment reduction equal to 40 percent of the total invoiced amount.

8.2 Failure to complete and submit Deliverable 6.2.2. in the time and manner specified will result in a payment reduction equal to 25 percent of the total invoiced amount.

8.3 Failure to complete and submit Deliverable 6.2.3. in the time and manner specified will result in a payment reduction equal to 25 percent of the total invoiced amount.

8.4 Failure to comply with Task 6.1.16., DATA SECURITY AND CONFIDENTIALITY will result in a payment reduction equal to 10 percent of the total invoiced amount for each day the Contractor is not in compliance.

9. CONTRACTOR TRAVEL REIMBURSEMENT:

Reimbursement for travel expenses is authorized only when approved in advance by the Department Contract Manager and conducted in accordance with Section 112.061, Florida Statutes and Department Internal Operating Procedure (IOP) 56-37.

10. DEPARTMENT CONTRACT MANAGER:

The Department Contract Manager for this scope of work is:

TBD TBD

11. CONTROLLING TERMS AND CONDITIONS:

11.1 Data Security and Confidentiality Document;

11.2 Agency Invitation to Bid (DOH23-040)

11.3 Department Purchase Order Terms and Conditions;

11.4 Contractor’s Response to the Department’s Invitation to Bid, and

11.5 Department Scope of Work SOWxx-xx.

Questions and Answers

# Question Answer

Does FL DOH have a dental EHR solution in place today that will be replaced by the new system? If yes, what is the system/what are the systems in use? What are the major bottlenecks or drivers for replacement?

Yes, most county health department dental programs are using Eaglesoft. About five programs are using Dentrix, and some of the school-based sealant programs are using the Department’s Health Management System (HMS). The main drivers for replacement are to increase security, the Windows 10 to 11 migration, centralization of the Department’s electronic medical record (HMS), and the desire to eliminate dual data entry with the EHR and EOHR.

Does/do the system/s in use currently integrate with the system/s used across DOH public health clinics?

The current EOHRs do not integrate with HMS.

HMS is centralized.

Will the new EOHR require integration to new or existing DOH EHRs in use in other public health settings?

The EOHR will be used for DOH locations, school-based sealant programs and mobile units which would be off-campus from the main DOH location. The new EOHR will not require integration to non-DOH other public health settings.

Is there a contract renewal driver for the expedited timeline for installation/implementation? Is the implementation period anticipated to be the 12-18 months before the demographic’s API is delivered in May 2027 or is go-live anticipated after both the demographic and API messaging is delivered Aug. 31, 2027?

See Addendum 2, Revised Scope of Work (Attachment A), sections 6.1.2., 6.1.10.6., and 6.1.13.4 of the solicitation.

Is data migration from existing system/s part of the scope of this project? If so, can you provide information on type, volume, and format of data to be migrated?

Data migration is expected. Primary sources of data are chart records in Eaglesoft or Dentrix; phosphoretic plate x-rays, digital panorex images, sensors, and intraoral cameras. Data volume range is approximately 105GB-630 GB which includes the images folder.

(Approximately 5,000- 650,000 patient records per dental program).

Export format, such as CVS, JSON, FHIR is acceptable. See Addendum 2, Revised Scope of Work (Attachment A), section 6.1.3, of the solicitation.

Can you provide a complete list of systems that will require interface/integration?

Patterson ScanX Schick sensors Dexis sensors MouthWatch cameras Panorex sensors Other intraoral sensors

HMS

Will the new EOHR be required to share data with FL Health Information Exchange (HIE)?

The EOHR will not be required to integrate with the Health Information Exchange.

FL DOH recently released an RFI for Public Health across the state that included dental clinics and dental EHR requirements. Would the State prefer a single vendor comprehensive EHR solution that includes all dental capabilities, including a shared e-prescribing solution, and shared enterprise data model across all public health and dental services, or is dental being carved out as a separate specialty with a preference for multiple vendor solutions?

FL DOH prefers a single statewide dental solution that will integrate with HMS.

Would the State of FL be interested in information about a single data model solution that provides integrated dental capabilities with enterprise EHR data capture and reporting? If yes, should the vendor respond to both this invitation to bid and a future DOH public health bid?

See Section 3.2 of the ITB.

Would the State consider delaying the OEHR project until a vendor is selected for the PH clinics?

No

Would the State consider extending the due date of this invitation to bid so that additional time for review of questions/answers can be given for the most complete response?

No

Does the State have a budget for this project or is this invitation to bid part of budgetary planning purposes?

Yes, the budget is approximately $280,629.00 annually contingent upon annual appropriation.

What State/DOH resources will be available to work with the vendor to meet the timelines of this project?

At the Department’s discretion, the Department will provide staffing resources from the Dental Program office and the HMS team

What is the scoring breakdown for this bid? Is there a scoring benefit if the vendor is a minority owned, small business, or local business?

Please see Section 2.8. Basis of Award; Section 2.9., Identical Outcomes; and Identical Tie Certification, Attachment F of the solicitation.

Can you provide a list of the FL CHD sensors, phosphoretic plate processors, and intraoral cameras that the OERM must interface with?

Please see the Answer to Question 6.

Does FL DOH/CHD have existing imaging/PACS solutions that require integration to the new OERM (if yes, please provide details) or will the new OERM need to provide X- RAY, panoramas, and/or imaging viewers?

The new EOHR will need to provide x-ray, panorex, and imaging viewers or include a third party to provide viewers to be included in the cost. See Addendum 2, Revised Scope of Work (Attachment A), section 6.1.2, of the solicitation.

Can the Department clarify whether the EOHR must support bidirectional integration with the Health Management System (HMS) in real time, or is nightly batch processing acceptable for certain data exchanges?

The Department expects real-time communications.

The solicitation references HL7 v2.5.1 payloads. Will the Department also require compliance with FHIR R4 resources for future interoperability with state or federal health systems?

Yes, the Department requires compliance with FHIR R4 resources for future interoperability with state or federal health systems. See Addendum 2, Revised Scope of Work (Attachment A), section 3.9.3.2, of the solicitation.

For Task 6.1.3, does the Department anticipate requiring automated ETL migration tools for legacy patient records, or will migration be handled via manual export/import processes from the current CHD dental applications?

The vendor will be responsible for data migration. We expect an automated migration tool to be used.

Can the Department provide a list of approved CHD sensors, phosphor plate scanners, and intraoral cameras to confirm compatibility and integration requirements with the EOHR?

See the Answer to Question 6.

Regarding Attachment G (Data Security & Confidentiality), does the Department require contractors to hold a SOC 2 Type II or FedRAMP Moderate certification for hosting environments, or will a third-party security audit be sufficient?

Per Attachment G, the determination on whether Section 1.b and/or 1.c is required will be at the request of the Department upon contract execution.

For the 99.9% uptime requirement, will the Department measure uptime at the application layer (end-user access) or at the infrastructure/service availability layer, and how will SLA compliance be monitored?

The 99.9% uptime applies to only those things that the vendor controls. SLA monitoring process will be coordinated with the selected vendor.

Task 6.1.1.5 requires compliance with DEA’s EPCS Final Rule. Does the Department require integration with a specific state Prescription Drug Monitoring Program (PDMP) vendor, or should the contractor propose a standards-based solution?

Compliance will be satisfied via integration with the Department’s EHR. The EOHR will not be required to provide ePrescribing functionality.

Given the milestone dates (May 31, 2027 for demographic API and Aug 31, 2027 for outbound messaging), would the Department consider phased rollouts (e.g., pilot locations) prior to statewide launch to mitigate risk?

The Department would consider phased rollouts prior to the statewide launch.

For training requirements, will the Department accept a hybrid training model (live + on-demand video + knowledgebase) to satisfy online, recorded, and written training deliverables, or must these be delivered separately?

See Addendum 2, Revised Scope of Work (Attachment A), sections

6.1.4 and 6.1.5 of the solicitation.

Upon contract termination, does the Department require data migration back into HMS or into a Department-designated repository, and should this be included in pricing for final deliverables?

Data must be provided in an importable format, such as CVS, JSON, FHIR. Yes, the data migration back into HMS or into a Department designated repository should be included. See Addendum 2, Revised Scope of Work (Attachment A), section 6.1.16. of the solicitation.

Failure to file a protest within the time prescribed in section 120.57(3), Florida Statutes, or failure to post the bond or other security required by law within the time allowed for filing a bond shall constitute a waiver of proceedings under Chapter 120, Florida Statutes.