ESBD_357591_1714160939593_2024 TPC EHR RFP P1.pdf

Request for Proposal

RFP ID: 06072402

Electronic Health Record System

Issue Date: 4/26/2024 Due Date: 6/7/2024

901 Wallace Blvd.

Amarillo, TX 79106

Invitation

Texas Panhandle Centers Behavioral and Developmental Health (Center) is accepting proposals from vendors experienced in providing and implementing electronic health record (EHR) systems.

The Center invites all qualified vendors to submit a proposal. If you are interested in submitting a proposal, please carefully adhere to the instructions and requirements that follow.

www.texaspanhandlecenters.org on the Visitors tab or by contacting Roger Speight, Director of Professional Services, at Roger.Speight@txpan.org .

Vendors wishing to submit proposals are requested to submit an email indicating your intent to bid by 5/17/2024 - 4:00 p.m. CST. Please send your email to Roger Speight, Director of Professional Services at Roger.Speight@txpan.org. Please state in the subject of your email:

RFP ID: 06072402 .

Vendors who submit intent to bid will receive notification of all questions received and the questions in addition to any addenda that are issued. If intent to bid is submitted questions and for any addenda issued for the RFP.

In accepting proposals, the Center reserves the right to reject any and all proposals, to waive formalities and reasonable irregularities in submitted documents, and to waive any requirements in order to take the action, which it deems to be in the best interest of the Center and is not obligated to accept the lowest cost proposal. The Center will not pay for any costs incurred by respondents in the preparation and/or submission of a proposal. Furthermore, the RFP does not obligate the Center to accept or contract for any expressed or implied services.

The Center will only release names of the vendors who have responded to this solicitation after the Center evaluation team has evaluated the proposals and an award has been made and approved by the Center Board of Trustees.

This Request for Proposal and the procurement process thereof is intended to comply fully with the provisions of procurement for Local Authorities:

25 TAC Part 1, §412.55(a)(1) Procuring goods and non-community services that provide the Best Value to the Local Authority

We greatly appreciate your consideration and look forward to reviewing your submission.

Table of Contents

Introduction

Statement of Work

Schedule

Proposal Submission Instructions

Required Documentation and Procedures for Submitting Proposal

General Requirements and Notices

Pricing Guidelines

RFP Scoring Criteria

User Requirements

Administrative

Form Requirements

Scheduler

Clinical

Treatment Plan

Service Data Collection

Billing

Reporting

Technical

Form Samples

Consent for Treatment with Psychoactive Medications

Patient Consent for Telemedicine and Telehealth Services

Client Infection Reporting Form

Authorization for Treatment/Application for Services - Revised

Financial Assessment - Revised

Abnormal Involuntary Movement Scale

Client Agreement - Revised

Medical Information Survey

Crisis Intake Assessment and Recovery Plan Progress Note Template - Revised

Peer Support Progress Note

Patient Health Questionnaire (PHQ-9)

BMI Adult Screening and Follow-up Progress Note Template - Revised

Child/Adolescent Weight Assessment and Counseling Progress Note Template - Revised .. 105

Colombia Suicide Severity Rating Scale Screening with Triage Points

Tobacco Use: Screening and Cessation - Revised

Physician Progress Note

Physician New Patient Diagnostic Interview Progress Note

Physician Diagnostic Interview Progress Note

Safety Plan

Brief Bipolar Disorder Symptom Scale

Brief Negative Symptom Assessment

Quick Inventory of Depressive Symptomatology

Initial Plan of Care Child/Adolescent Services

Wraparound Recovery Plan Child/Adolescent Services - Revised

Youth Recovery Plan - Revised

Adult Recovery Plan Revised

Discharge Summary

Nursing Tasks Screening Tool

Comprehensive Nursing Assessment - Revised

IDD Person-Directed Plan

IDD Implementation Plan

Initial Plan of Care (IPC) for HCS/CFC - Revised

Initial Plan of Care (IPC) for TxHmL/CFC - Revised

User Requirements Supplement

Form Requirements Supplement

Miscellaneous Supplements

Reports Supplement

Technical - Supplement

Form Samples Supplement

Authorization for Treatment-Application for Services - Revised

Financial Assessment - Revised

Client Agreement - Revised

Crisis Intake Assessment and Recovery Plan Progress Note Template - Revised

BMI Adult Screening and Follow-up Progress Note - Revised

Child-Adolescent Weight Assessment and Counseling Progress Note Revised

Tobacco Use Screening and Cessation - Revised

Wraparound Recovery Plan Child-Adolescent Services - Revised

Youth Recovery Plan - Revised

Adult Recovery Plan Revised & Renamed Uniform Assessment

Comprehensive Nursing Assessment - Revised

Initial Plan of Care for HCS-CFC - Revised

Initial Plan of Care for TxHmL-CFC - Revised

Social Determinants of Health

Community Living Options

Habilitation Assessment

Habilitation Service Plan

Referral for Probation and Substance Use Disorder

Adult BH Recovery Plan

CLAS Standards Demographics

Follow-up from State Facility Discharge

PTSD Checklist

Adult BH Intake and Interview

Additional Questions

Implementation, Training, and Support

Business Associate Agreement

Assurances and Certifications

Vendor Profile

Signature Page

Assurances

Conflict of Interest Questionnaire

Lobbying Certification

Request for Taxpayer Identification Number and Certification (Form W-9)

Financial Information

Insurance

Employer Information Report

Introduction

Texas Panhandle Centers Behavioral and Developmental Health, formerly known as Texas Panhandle Mental Health Mental Retardation, is part of the Texas Community Center system and is governed by a local board of trustees representing the citizens of the upper twenty-one (21) counties of the Texas Panhandle. We serve individuals with behavioral health needs (mental illness), intellectual and developmental disabilities and children with developmental delays.

Our scope of business is comprised of 4 divisions:

Behavioral Health (BH) (including adult, child & adolescent, and substance use) Intellectual and Developmental Disabilities (IDD) Early Childhood Intervention (ECI)* Administration (Admin)

The Center is one of thirty-nine (39) Centers providing similar services throughout Texas, under contract with the Texas Health and Human Services Commission as well as other federal, state and local entities.

The Center is a provider of services as well as the state designated Local Authority (LA) for behavioral health and individuals with intellectual and developmental disabilities. The role of the Local Authority is to plan, coordinate, develop policy, develop and allocate resources, supervise and ensure the provision of community based behavioral health and intellectual and developmental disability services for residents of the twenty-one (21) counties we serve.

*ECI will not be included in the statement of work for this RFP.

Statement of Work

Our Center is seeking proposals for the implementation and on-going maintenance of a new electronic health record system (EHR). In 2020, the Center utilized a prior version of this Request for Proposal (RFP) to select and contract with a vendor to provide EHR services. We have mutually agreed with this vendor to pause our implementation to survey the market for other EHR options. alternative EHR, our plan is to continue our implementation with our current vendor.

The Center is seeking to develop a long-term relationship with a technology vendor that provides the critical services in the areas of clinical documentation, patient scheduling, revenue cycle management, and person centered recovery and care coordination.

Center seeks a product that facilitates effective, thorough and efficient care delivery and coordination. Additionally, we are seeking a relationship with a vendor that will support our needs today, and that will be capable of supporting the growth and developmen programs. Center desires a relationship with a vendor that is able to meet the challenges of continual changes to health care and health IT in Texas and the United States. We want to ensure that the EHR can dynamically support changing needs, and that the partner company will similarly be able to support our growth through strong customer service and support.

Center is expecting a comprehensive proposal from proposers that meets all requirements detailed in this Request for Proposal (RFP). Due to the complexity of the enclosed requirements, the RFP is structured so that it matches the 2020 version but includes supplements to meet current requirements. If you submitted a response to the 2020 version of this RFP, please consider reviewing and adding to your prior submission because of the significant similarities between this current RFP version and our 2020 version.

Center understands that a comprehensive solution that meets all the technical and business needs stipulated in the RFP may require collaboration between a few vendors and will accept proposals that demonstrate a successful relationship between vendors. It must be noted, however, that irrespective of the sub-contracting or arrangement, Center requires one lead vendor to present the proposal and to bear all responsibility for the outcomes described in this initiative.

Center must maintain current levels of functionality throughout the transition, with no disruption to key systems, data collection, billing or other functions. Therefore, our Center requires a migration plan that will allow individual parts of the current system to be functional simultaneously until fully replaced in the new product.

Our current system/hardware platform is Windows Client/Server based utilizing Microsoft FoxPro database for data collection.

It is our expectation that our new electronic health record system will be cloud based. However, it is NOT a requirement of this RFP. If more technical information regarding our current environment is needed, please follow the RFP question submission guidelines in this RFP.

Schedule

Task Date

RFP Distribution 4/26/2024

Email of Intent to Bid Due 5/17/2024

Vendor Questions Due Every effort will be made to answer questions within three business days of receipt

5/24/2024

Final Response to All Questions Available All answers to questions received will be available online and sent to all vendors who responded with an Intent to Bid

5/31/2024

Vendor Proposal Due 6/7/2024

Proposed Vendor Demonstration Schedule 7/8/2024 7/12/2024

Initiate Best and Final Negotiations, Make Recommendation to Center Board of Trustees

7/24/2024

Proposal Submission Instructions

1. All proposals must be submitted by email.

2. Content, exhibits and attachments must be in Microsoft Word, Microsoft Excel, or Adobe

PDF.

3. Proposals and all questions should be directed to:

Roger Speight, Director of Professional Services Roger.Speight@txpan.org

Important Note:

Vendors may not contact other members of the

Roger Speight, Director of Professional Services

4. In the subject line of your proposal submission email include:

RFP ID: 06072402

5. Proposals must be signed electronically by an individual legally authorized to commit to the terms of this RFP and your responses therein.

6. Proposals will not be opened until after the submission deadline of June 7, 2024, at 4:00 p.m. CST. A private proposal opening will be conducted on June 7, 2024, at 4:30 p.m.

CST.

7. Proposals must remain valid for acceptance for one hundred and twenty (120) days from the

Vendor Proposal Due Date.

8. Proposals or modifications received after the time set for submission may not be considered.

9. All statements made in the proposal will be considered final, and, if the proposal is accepted will be used as the basis of the purchase contract.

10. The initial contract term for this system will be negotiated at the time of the contract award.

11. Each proposal must follow the format for document submission presented in the next section.

Required Documentation and Procedures for Submitting Proposal

1. Each proposal response must include the following items:

a. Title Page - Title page must show the RFP subject; the name; the name, address, and telephone number of a contact person; and the date of the proposal.

b. Company Background: The vendor will provide a brief one-page company description, history, number of employees, summary of financial status and number of customer implementations vendor currently supports.

c. Executive Background: The vendor will describe in non-technical terms its electronic health record system, identifying any unique or distinctive features of the system in which the vendor wishes to bring particular attention. Do NOT include pricing in this section. Responses are limited to one page.

d. Transmittal Letter - Submit a signed letter briefly addressing your understanding of the work to be done, the commitment to do the work detailed within this RFP and a statement explaining why the vendor believes it is best qualified to do the required work.

e. Vendor Representative - Include the name and title of the designated individual(s), along with respective telephone number(s) and email addresses, who will be responsible for answering technical and contractual questions regarding the proposal.

f. Pricing Include pricing information as described in the Pricing Guidelines section of this RFP.

g. Vendor Responses Please include responses to the following sections of this RFP:

User Requirements User Requirements Supplement Additional Questions Implementation, Training, and Support Vendor Profile Signature Page Assurances Conflict of Interest Questionnaire Lobbying Certification Request for Taxpayer Identification Number and Certification Financial Information Insurance Employer Information Report (if applicable).

2. Vendor Service Contracts - Vendor must submit a copy of standard contract/master service contract(s), service level agreement(s), and third party source code escrow agreement.

General Requirements and Notices

1. EHR Customer Base in Texas:

The Electronic Health Record, as proposed in the vendor response to this RFP, has, within the prior five years, been fully implemented by vendor in at least one Texas Community Mental Health and Intellectual and Developmental Disability Center created under Chapter 534 of the Texas Health and Safety Code. Such Texas Community Mental Health and Intellectual and Development Disability Center is contracted with the Texas Health and Human Services Commission (HHSC) to serve as the Local Mental Health Authority (LMHA) and Local Intellectual and Developmental Disability Authority (LIDDA) for its catchment area.

2. Requirements Rating Scales

The User Requirements and User Requirements Supplement sections of this RFP utilize the following rating scale:

For each requirement, respond using the following scale:

1 = System meets this requirement fully without additional programming required by Center and the functionality described by this requirement will be provided

2 = System can meet this requirement, but with modifications at an increased cost.

3 = System cannot meet this requirement.

4 = Requirement is not applicable based on the design of the system.

In the above rating scale, the Center expectation is that a vendor rating of 1 means that the requirement is met and will be provided to the Center at "go live" without an investment a vendor rating of 1 was provided for requirements yet the notes for the requirements indicate that the Center must use some sort of vendor-provided tool (ex. form builder or report-writer) to address the requirements. Expecting the Center to use such vendor-provided tools to address requirements doesn't meet the definition of the rating of 1. Vendor should only provide a rating of 1 for those requirements that Vendor plans to develop or provide at its own cost as part of the EHR implementation effort.

3. Background:

All entities are expected to carefully examine the RFP documents. Any ambiguities or inconsistencies should be brought to the attention of Roger Speight, Director of Professional Services.

this RFP. It is the responsibility of an interested entity to obtain clarification of any information contained herein that is not fully understood. Any entity, by and through the submission of a proposal, agrees to be held responsible for:

1. Examining the RFP (including attachments and amendments) and all referenced material;

2. Becoming familiar with the nature and scope of the services required; and

3. Identifying any local conditions, administrative rules, or other factors that may impact completion of the services.

The Center is responsible for interpretation of the wording of this RFP. Its staff will not give verbal answers to inquiries regarding the RFP contents. Any verbal statement regarding the RFP prior to the award shall be considered non-binding. The only formal interpretation of the RFP will be made via responses to formal questions submitted via email by May 24, 2024. Responses to questions will be available to all vendors by May 31, 2024.

The Center will make a good faith effort to contract with Historically Underutilized Businesses.

2. Conflict of Interest:

No public official shall have an interest in any contract, in accordance with Codes Annotated, Local Government Code Title 5, Subtitle C, Chapters 171 and 176.

3. Assignment:

No right, interest, or obligation under this contract shall be assigned or transferred by the vendor without the express written consent of the Executive Director of the Center, or designee. Any attempted assignment or transfer by the vendor without such written consent shall be considered failure of contractual obligations and the Center will reserve the right for immediate cancellation.

4. Applicable Law and Venue:

The contract issued by way of this RFP shall be governed, construed and interpreted under the laws of the State of Texas. Venue for any litigation arising under the contract shall lie in Potter County, Texas.

5. Advertising:

Center has entered into a contract, except to the extent necessary to comply with proper requests of information from an authorized representative of the federal, state or local government. Vendor is prohibited from using contract award information, sales/values/volumes in sales brochures or other promotions, including press releases, unless prior written consent is obtained from the Executive Director of the Center.

6. Business Associate:

The selected vendor agrees that they are a Business Associate as that term is defined under 45 CFR 164.502(e), 164.504(e), 164.532(d) and (e), and as such, will execute a Business Associate Agreement (see Business Associate Agreement section) with Center concurrent with the execution of any contract or agreement for services.

7. Discrimination:

Vendor will ensure that no person on the basis of race, color, national origin, religion, sex, age, sexual orientation, genetic characteristics, veteran status, disability or political affiliation, will be excluded from participation in, be denied the benefits of, or be subject to discrimination with respect to any contract, under any of the policies of the Texas Health

8. Acceptance/rejection of Proposals:

The Center reserves the right to accept or reject any and/or all proposals, to waive informalities or defects in proposals, or to accept such proposal(s) as it shall deem to be of the best value to the Center.

9. Negotiation:

The Center reserves the right to negotiate with vendors determined to have a reasonable chance of being selected. All such vendors shall be afforded fair and equal treatment with respect to such negotiations, and no such vendor shall be given information that would give that vendor a competitive advantage over any other vendor.

10. Cancellation:

The Center may choose to cancel the RFP without award.

11. Validation:

The Center may validate any information in a proposal by using outside sources or materials. If validation discloses that information provided by a proposer is deliberately false, the proposal will be ineligible for consideration.

12. Purchase Contract:

Vendor response from this RFP will be an attachment to any EHR purchase contract with Vendor that results from this RFP.

13. Standing:

Vendor is in good standing with all state and federal funding and regulatory agencies; is not currently debarred, suspended, or otherwise excluded from participation in federal, state, county or city contract or grant programs; is not delinquent on any repayment contracts; has not had a required license or certification revoked; has not had a contract terminated by the HHSC, DSHS, or DADS; and has not voluntarily surrendered an obligation issued by HHSC or any other entity within the past three (3) years.

14. Conflict of Interest:

The Center reserves the right to retain all performance by any successful vendor, and to recover all consideration paid to any vendor pursuant to a contract thus permitting forfeiture of such contract, in the event that vendor:

1. Was doing business at the time of submitting the proposal or had done business during the 365 day period immediately prior to the date on which the proposal was due with an undisclosed key person;

2. does business with a key person after the date on which the proposal is due and prior to full performance of the contract and fails to disclose the name of any such key person in writing to Center prior to commencing business with such key person; or

3. fails to submit a completed Form CIQ (see Conflict of Interest Questionnaire section) if required by Chapter 176 of the Texas Local Government Code.

14. Termination and Funding:

This contract is made contingent upon the continuation of federally funded programs, or the continued availability of state or local funds to cover the full term and cost. This contract is subject to termination, without penalty, either in whole or in part, if funds are not appropriated or are discontinued. In this instance, Center may cancel this contract by giving thirty (30) days written notice to the vendor.

15. Limitation of Liability:

The Center will not enter into any Contract that purports to in any way limit the amount of damages recoverable under the Contract.

Pricing Guidelines

For the purpose of developing a pricing proposal, the following indicates the number of planned users for the system:

Individual License Pricing User Type Number of

Users Administrative Users 5 All Other Users (Super Users, Data Entry Only Users, Read-only Users)

Concurrent User Pricing

Number of Concurrent Users 110 the system. Please identify all potential costs for purchasing and implementing the System using the guidelines below:

1. Proposed fees must clearly differentiate set-up and implementation fees from ongoing monthly subscription fees.

2. Proposed fees must separately identify all potential third party fees.

3. The proposal must include the cost and frequency of system updates.

4. The proposal must identify all expected hardware costs.

5. The proposal must identify the time period for which all fees are guaranteed at the rate specified in the proposal.

6. The proposal must describe the circumstances and process by which the vendor may increase fees.

7. Pricing should include all potential costs related to the system, including but not limited to the following:

a. Hardware

b. Extract, Transform, and Load Processes

c. Costs to convert existing scanned documents into scanned documents integrated and accessible through system

d. Installation

e. Training f.

g. Periodic costs that are charged to the Center for updates to SNOWMED, ICD-10, DSM-5 or other external table values that are incorporated into system

h. Document scanning costs

i. Text message sending/receiving costs

j. Costs for sending electronic lab orders, receiving electronic lab order results, and lab interface creation costs

k. Third party licensing or support costs

l. Costs for maintaining separate Test, Train, and Live versions of the system

m. Vendor hosting versus Center hosting costs

n. Ongoing monthly subscription

o. Custom programming fee structure

p. Support fee structure for requested support that exceeds what is included in the monthly subscription fee

q. Training fee structure for requested training that exceeds what is included in the monthly subscription fee

r. Any third party products such as a recommended tool for report-writing

8. Pricing should include potential costs, pricing guidelines, and services that would be include the pricing guidelines and any types of limitations for extracting data out of the successor system.

9. Please list the cost of adding additional users should we need to increase our count above 260.

RFP Scoring Criteria

Vendor proposals will be evaluated according to the following criteria:

1. Requirement that Vendor must have implemented the EHR, as proposed in this RFP response, at a Texas Community MH/IDD Center within the prior five years (see General Requirements and Notices section).

2. Results of demonstrations and presentations

3. Comprehensiveness of response to this RFP

4. Ability to meet specifications and requirements described in this RFP 5.

6.

7.

8. Reporting capabilities

9. Dashboards provided with system 10.

11. Quality of implementation approach 12.

13. Approach to state and federal compliance

14. Pricing criteria.

User Requirements

Please complete this section in its entirety and include responses as part of the response to this RFP. A separate version of this section was provided that allows you to record responses along with each requirement.

For each requirement, respond using the following scale:

1 = System meets this requirement fully without additional programming required by Center and the functionality described by this requirement will be provided

2 = System can meet this requirement, but with modifications at an increased cost.

3 = System cannot meet this requirement.

4 = Requirement is not applicable based on the design of the system.

There is a notes field for each requirement that allows for clarifications to responses.

Administrative

Reference Administrative Rating

AD-010 Ability to extract patient insurance and billing data to load into

Notes:

AD-020 Same data never keyed twice in system. Single entry of data is shared wherever needed throughout system.

AD-030 Ability to purge records in accordance with retention policies. Please describe the types of retention policies supported.

AD-040 Ability to merge client records when duplicates are identified.

Notes:

AD-050 Ability to archive client records for inactive clients with the ability to re-activate if the client presents for services.

Please describe how inactive clients are determined for the purpose of archiving.

justify archiving the client, but the client is continuing to make be archived?

Please describe what specific data is re-activated if an archived client is re-activated.

AD-060 Ability to exclude specific clients from being accessed by specific staff. The staff are completely blocked from seeing any information regarding excluded clients on screens, reports, and any other system interfaces.

AD-080 Ability to either limit access or provide full access to client records for auditors and other types of external staff. Please describe methods available for limiting access to client records.

AD-090 Ability for staff to view along with effective in one view.

AD-100 View Tracking can be enabled on a module-by-module basis to track whenever a user views data in that module. The client whose data was viewed is recorded with the View Tracking information (i.e., date/time etc.).

AD-110 A history of all changes to data is retained with the ability to view, through a user-friendly system interface, changes including the date, time, and user that made a change.

AD-120 A user-friendly system interface provides the specific data that was changed between two versions of a single record.

AD-130

expired based on retention policy.

AD-140 Modification Reason requirement can be enabled on a module-by-module basis requiring the user to document a reason for changing the data in a record.

AD-150 Forms can be saved as Draft and completed at a later time. If a user is changing an existing record and saves the new version of the record as a draft, please describe if the prior version of the record is treated as

AD-160 Staff receive alerts that they have draft forms to complete.

AD-170 User and technical documentation is available. Please describe documentation and any other resources that are available to users and technical staff to help them understand the system.

AD-175 User and to provide users with short and concise instructions for common functions.

AD-178 User and technical documentation provides Frequently Asked Questions (FAQs) with answers to commonly asked questions about the system.

AD-180 Operating system clipboard can be used to copy information to and from fields within the system. For example, a user may want to copy information from a Word, Excel, or Adobe file into a text field within

AD-190 Center can designate any forms in system to require electronic signature by staff and/or clients.

AD-200 Forms requiring electronic signature can be entered by data entry staff and later signed by appropriate staff. Please describe if the unsigned forms are treated as drafts until they are signed.

AD-210 Staff receive alerts when forms have been entered that require and are lacking electronic signature.

AD-220 Ability to enforce that electronically signed forms are converted to drafts and must be re-signed in the event that they are changed.

AD-230 Signature image capture for all applicable forms requiring client and/or family signatures.

AD-240 Ability to present or print any documents that require client signature in English and Spanish.

AD-250 To assist the user in multi-tasking in the system, ability to view or modify multiple different client records at the same. Please describe how this is accomplished.

AD-260 To assist the user in multi-tasking in the system, ability to view or modify multiple types of information for the same client at the same time. Please describe how this is accomplished.

AD-270 System contains scanning functionality that allows scanned documents to be part of client record without the use of a third party application.

AD-280 Scanning functionality works with well-require specific manufacturers or models of scanners.

AD-290 Scanned documents have indexes that contain the type of document and key identifying information about the document.

AD-300 System provides intelligent routing of scanned documents to appropriate client medical records.

AD-310 System is able to perform bulk scanning of documents that can be routed to different medical records.

AD-320 Pictures can be scanned, identified with indexes, and attached to a

AD-330 Live help desk support is available Monday through Friday from 8 5 CST. Please describe how this type of support would be accessed by the Center.

AD-340 Off hours support is available 24 hours per day, 7 days per week, 365 days per year for designated users. Please describe how this type of support would be accessed by the Center.

Form Requirements

Reference Form Requirements Rating

FR-010 Please indicate whether the following forms are pre-defined in the system. If the system contains an alternate form that closely resembles the following form, please include a copy of this form.

See the Form Samples section for copies of the following forms.

N/A

FR-010.010 Consent for Treatment with Psychoactive Medications

Notes:

FR-010.020 Spanish version of Consent for Treatment with Psychoactive Medications (see FR-010.010)

FR-010.030 Patient Consent for Telemedicine and Telehealth Services

Notes:

FR-010.040 Spanish version of Patient Consent for Telemedicine and Telehealth Services (see FR-010.030)

FR-010.050 Client Infection Reporting Form

Notes:

FR-010.060 Authorization for Treatment/Application for Services

Notes:

FR-010.070 Financial Assessment

Notes:

FR-010.080 Abnormal Involuntary Movement Scale

Notes:

FR-010.090 Client Agreement

Notes:

FR-010.100 Medical Information Survey

Notes:

FR-010.110 Crisis Intake Assessment and Recovery Plan Progress Note Template

FR-010.120 Peer Support Progress Note

Notes:

FR-010.130 Patient Health Questionnaire (PHQ-9)

Notes:

FR-010.140 BMI Adult Screening and Follow-up Progress Note Template

Notes:

FR-010.150 Child/Adolescent Weight Assessment and Counseling Progress Note Template

FR-010.160 Colombia Suicide Severity Rating Scale Screening with Triage Points

Notes:

FR-010.170 Tobacco Use: Screening and Cessation

Notes:

FR-010.180 Physician Progress Note

Notes:

FR-010.190 Physician New Patient Diagnostic Interview Progress Note

Notes:

FR-010.200 Physician Diagnostic Interview Progress Note

Notes:

FR-010.210 Safety Plan

Notes:

FR-010.220 Brief Bipolar Disorder Symptom Scale

Notes:

FR-010.230 Brief Negative Symptom Assessment

Notes:

FR-010.240 Quick Inventory of Depressive Symptomatology

Notes:

FR-010.250 Initial Plan of Care Child/Adolescent Services

Notes:

FR-010.260 Wraparound Recovery Plan Child/Adolescent Services

Notes:

FR-010.270 Youth Recovery Plan

Notes:

FR-010.280 Adult Recovery Plan

Notes:

FR-010.290 Discharge Summary

Notes:

FR-010.300 Nursing Tasks Screening Tool

Notes:

FR-010.310 Comprehensive Nursing Assessment

FR-010.320 IDD Person-Directed Plan

Notes:

FR-010.330 IDD Implementation Plan

Notes:

FR-010.340 Initial Plan of Care (IPC) for HCS/CFC

Notes:

FR-010.350 Initial Plan of Care (IPC) for TxHmL/CFC

Scheduler

Reference Scheduler Rating

SC-010 At the time of scheduling an appointment or appointments, ability to limit this scheduling based on the following factors:

N/A

Notes:

SC-010.020 Only schedule covered se

Notes:

SC-010.030 For clients with payers that require authorizations for all services or specific services, ensure that there is a current authorization for the date and type of service.

SC-020 When scheduling appointments for clients, notify staff if there are date:

N/A

Notes:

SC-020.010 Demographic data updates

Notes:

SC-020.020 Financial Assessment (including payer updates)

Notes:

SC-020.030 Insurance authorizations

Notes:

SC-020.040 Treatment Plans

Notes:

SC-020.050 Assessments

SC-020.060 Release of Information

Notes:

SC-020.070 Medication Consents

Notes:

SC-020.080 Consent to Treat

Notes:

SC-020.090 Proof of residency

Notes:

SC-020.100 Guardianship Paperwork

Notes:

SC-020.110

when scheduling appointments.

N/A

Notes:

SC-020.120 Ability to indicate in the scheduled appointment which of the above forms should be completed for the client.

SC-030 When scheduling appointments, provide error messages if the describe recommended approach for allowing and preventing client appointment overlaps.

SC-040 When scheduling appointments, provide warning messages if staff time overlaps other scheduled appointments. Please describe recommended approach for allowing and preventing staff appointment overlaps.

SC-050 Schedules for staff that work in different locations are recognized by the Scheduler so that staff appointments are only scheduled in these locations during the times that staff are present in them.

SC-060 Ability to grant certain staff access to the scheduler and restrict other staff from accessing the scheduler.

SC-070 Ability to create appointment records for: N/A

Notes:

SC-070.010 One or many clients

SC-070.020 One or many staff

Notes:

SC-070.030 A group of clients contained on a Group Roster. The appointment is scheduled for the Group and all of the individual clients on the Group Roster are scheduled.

SC-070.040 One or many types of services

Notes:

SC-070.050 One or many Center-defined resources such as equipment, conference rooms, etc.

SC-080 If a Group Roster is scheduled, individual clients assigned to the Group Roster are tested for appointment overlaps.

SC-090 Ability to schedule multiple staff/resources in one entry across locations when the client will be receiving multiple types of services consecutively.

SC-100 Recurring Appointment functionality allows for multiple appointment records to be created through a single entry based on the type of recurrence entered by the user.

SC-110 Ability to perform .

Notes:

SC-120 appointment scheduling based on the following criteria:

N/A

Notes:

SC-120.010 Target Date Range

Notes:

SC-120.020 Time of Day

Notes:

SC-120.030 Specific staff

Notes:

SC-120.040 Provider Type such as LPC, LPHA, QMRP, etc.

Notes:

SC-120.050 Location of Clinic

SC-120.060 Based on the planned service entered on the appointment screen, staff qualified to provide this service

SC-120.070

Notes:

SC-130 Bulk appointment transfer capability to transfer multiple appointments from one staff to another.

SC-140 Ability for staff with appropriate security privileges to perform centralized scheduling across locations and programs.

SC-150 Scheduler security ensures that users can only see and/or modify

SC-160 Ability to generate appointment reminders for clients based on scheduled appointments.

SC-170 Ability to send text messages as appointment reminders based on include any costs associated with sending text messages to clients in the Pricing section of RFP response.

SC-180

plan to attend an appointment.

SC-190 Ability to send automatic phone messages as appointment reminders

SC-200

plan to attend an appointment.

SC-210 Ability to send email messages as appointment reminders based on

SC-220

attend an appointment.

SC-230 Ability to record external provider appointments in scheduler with the ability to document the activity or results of that appointment in a field or fields in the appointment record.

Clinical

Reference Clinical Rating

CL-010 Ability to create a client record with limited demographic information with the ability to correct and add additional information later. Please list minimum fields necessary to build a client record.

CL-020 In client demographics, ability to record different gender types other than male and female. Please list additional gender types supported.

CL-025 Ability to changes along with the date of the change.

CL-030 Name aliases are collected in case the same client provides different names for him/herself.

CL-040 Name searches in the system search alias records in addition to names recorded on the Client Demographic screen to help prevent duplicate client records.

CL-050 Fuzzy name searches are used to identify potential duplicate clients that may be spelled differently than what the user enters.

CL-060 Allow for the following additional search fields when searching for potential duplicate client records:

N/A

Notes:

CL-060.010 Social Security Number

Notes:

CL-060.020 Birth Date

Notes:

CL-060.030 Ethnicity

CL-060.040 Gender

Notes:

CL-070 An interface exists in the system to allow patients to check themselves in for a service and verify that their demographics are current.

CL-080 A roster of one or many staff that are assigned to Team is maintained by the system.

CL-090

including the begin and end date of the assignment, is maintained by

CL-100

staff person to receive alerts regarding the client.

CL-110

CL-120 One person on the Care Team can be identified as the Primary Care Team Member. Validations in the system only allow one person at any given time to serve in this role.

CL-130 Messaging capability between staff includes the ability to send doing messaging.

CL-140 whom the staff person is assigned as a Care Team Member.

CL-150

performed in a single operation.

CL-160

accomplished in a single operation.

CL-170

be accomplished in a single operation.

CL-180 Tracks individuals or organizations that are granted access to the Protected Health Information.

CL-190 Each release of Protected Health Information to an authorized individual or organization is tracked along with the type of Protected Health Information that was released.

CL-200 Lab orders can be electronically sent to labs.

Notes:

CL-210 Lab results can be electronically imported into system. In the Pricing section of the RFP response, please describe costs associated with sending electronic lab orders, acquiring electronic lab order results, and lab interface creation costs.

CL-220 Lab alerts are generated based on no timely results of lab request.

Please describe who would be recipient of these alerts.

CL-230 Lab alerts are generated based on results that are outside of normal limits. Please describe who would be recipient of these alerts.

CL-250

Notes:

CL-260

information.

CL-270 Based on system security, ability for non-prescriber medical support staff to enter and save medications into ePrescribing system for subsequent prescriber signature and electronic transmission to pharmacy.

CL-280 Ability for ePrescribing system to store more than one pharmacy for each client.

CL-290 Ability for ePrescribing system to designate one pharmacy as the

CL-300 Lab and prescription documents received electronically through e-fax or an electronic interface without an identifiable matching client record are queued for follow-up in a dashboard area or some other type of system interface.

CL-310 Ability to access a payer-specific medication formulary based on the

CL-320 Ability to print a prescribed medications for a specified time frame.

CL-330 Ability to maintain a Center inventory of medications. N/A

Notes:

CL-340 N/A

Notes:

CL-350 Ability to track client forms by due date with automatic alerts sent to appropriate staff. Automatic alerts provide Center-defined lead times on a form-by-form basis for staff to complete forms on or before the due date. Please describe who would be recipient of these alerts. Assuming that these alerts exist, please list client data forms that are tracked by date that have this capability.

CL-360 Ability to automatically identify specific types of forms required for different client populations. Please describe method of defining types of forms for these different client populations.

CL-370 Ability for Center to define a hierarchical structure of Programs (organizational/reporting units).

CL-380 Ability to assign clients to multiple concurrent Programs based on services that the clients are receiving.

CL-390 Ability to indicate which of a primary one.

CL-400 System tracks complete history of client assignments to Center-in these Programs.

CL-410 Ability to identify, at a glance, the programs where clients are being served. Please describe the method for doing this.

CL-420 Center-defined follow-up timeframes trigger messages to staff regarding multiple follow-ups for different Center-defined reasons regarding clients Center-defined follow-up messages need to be generated for reasons other than the client being opened and closed in a program.

CL-430 Ability to identify individuals that have not received a specific service in a specified time period.

CL-440 Ability to map diagnosis codes to other diagnosis codes required by payers or funding sources for claims and/or reporting requirements.

CL-450 Maintain a complete history of diagnosis reviews performed by staff. These diagnosis reviews are saved by diagnosis date and diagnosis time.

CL-460 Ability to save diagnoses performed by external staff.

Notes:

CL-470 Allows diagnoses to be recorded using DSM-IV, ICD-9, DSM-5, and ICD-10 code sets.

CL-480 Supports SNOMED code sets.

Notes:

CL-490 On a no-axis DSM-5

Diagnosis transaction. System has a method to determine this the no-axis DSM-5 diagnosis record.

CL-500 Vendor provides annual ICD-10 and DSM-5 updates that can be automatically uploaded into system.

N/A

Notes:

CL-510 Collects details for State Facility Admissions, Absences, Discharges, and State-required follow-ups.

CL-520 Collects data necessary to batch -

CARE system.

CL-530 Ability to record Medication Administration Records.

Notes:

CL-540 Ability to import medication orders into Medication Administration Records.

CL-545 Ability to record Injection Administration Records.

Notes:

CL-560 Ability to track arrival date and time of client in order to meet required assessment and service delivery timeframes for programs such as the Crisis Center.

CL-570

authority (ex. Police).

CL-580 System tracks complete history of client assignments to Center-defined residential locations for bed-day counts. Begin and end

CL-590 Center-defined follow-up timeframes trigger messages to staff regarding follow- discharge from the residential location.

CL-600 For residential clients, documents client bed days and provides a means to suppress billing when these clients have temporary absences from these residential assignments to avoid inappropriate billing for the duration of the absence.

CL-610 Ability to support the following residential bed day requirements: N/A

Notes:

CL-610.010 Bed board functionality showing clients in beds and status of all beds

CL-610.020 Bed board functionality showing documentation of routine checks

Notes:

CL-610.030 Bed board functionality showing medication orders

Notes:

CL-610.040 Bed board functionality showing medication administration

Notes:

CL-610.045 Bed board functionality showing injection administration

CL-610.050 Specific data field(s) identified for recording an inventory of

CL-620 Ability to create and manage stored phrases that can be used in various system interfaces. These stored phrases can be managed at the Center level and individual staff level.

CL-630 Ability to save and electronically sign the following types of consents:

N/A

Notes:

CL-630.010 Release of Information

Notes:

CL-630.020 Medication Consent

Notes:

CL-630.030 Consent to Treatment

Notes:

CL-630.040 CFR42 Part 2 Substance Abuse Disclosure

Notes:

CL-640 Ability to record Medical Power of Attorney and Guardianship and include on Client Data Overview and Client Demographic interfaces.

CL-650 System support for the following care coordination activities: N/A

Notes:

CL-650.010 Ability to record referrals to and from internal Programs and external entities with time-based follow-ups that automatically generate alerts for staff. Please describe who would be recipient of these alerts.

CL-650.020 Ability to record tasks for internal Programs and external entities with time-based follow-ups that automatically generate alerts for staff. Please describe who would be recipient of these alerts.

CL-650.030 Ability for the Center to define automatic referrals based on events recorded in the system. For example: If a client is identified as having a substance use issue, then a referral could be automatically generated to an internal substance use department.

CL-650.040 Collects the date and time that a Referral is closed to indicate its completion.

CL-670 CANS 3-5, CANS 6-17, and ANSA assessments built in system with the business rules, level of care calculation, and validations defined by the Texas Health and Human Services Commission.

CL-680 Provide alerts when the next section of a CANS 3-5, CANS 6-17, or ANSA is due based on the completion of a prior section.

CL-690 Messaging capabilities that are linked to specific CANS 3-5, CANS 6-17, and ANSA assessments allow for messaging between the provider(s) and the authorizer.

CL-700 For clients receiving Texas Resilience and Recovery (TRR) services, validations in the system ensure that a TRR Discharge Assessment is recorded before these clients are discharged from the Center.

CL-710

descriptions of the criteria that are defined for the answers to these questions.

CL-720 System tracks complete history of client assignments to Center-membership in these Special Populations.

CL-730 System tracks complete history of client assignments to a Waiting List for Center-defined Programs. Begin and end dates track

Notes:

CL-740 In the Waiting List, ability to record a r for the Program which allows for slots in the Program to be filled based on this need.

CL-750 Follow-up messages can be sent to staff based on a Follow-up date recorded on the Waiting List record.

CL-760 System has validations to ensure that all episodic information is ended prior to discharge from the Center. Examples of episodic information are Treatment Plans, Program Assignments, Waiting Lists, etc.

CL-770 Collects and tracks history of

Notes:

CL-780 Vital Signs collected include the following: N/A

Notes:

CL-780.010 First Sitting or Standing blood pressure

Notes:

CL-780.020 Second Sitting or Standing blood pressure

Notes:

CL-780.030 Official Blood Pressure Reading (user indicates whether to use the First or Second Sitting or Standing blood pressure reading as

CL-780.040 Height

Notes:

CL-780.050 Weight

Notes:

CL-780.060 Temperature

Notes:

CL-780.070 Pulse Rate

Notes:

CL-780.080 Respiration

CL-780.090 Glucose Level

Notes:

CL-780.100 Adult BMI

Notes:

CL-780.110 Computes Adult BMI Indicator which describes whether BMI is abnormal.

CL-780.120 Child BMI

Notes:

CL-780.130 Computes Child BMI Indicator which describes whether BMI is abnormal.

CL-790

service delivery process (ex. Intake process, crisis stabilization, ongoing service delivery, etc.). Please provide a brief description of this interface.

CL-800 Incident reporting module exists that allows staff to report incidents such as illness, behaviors, accidents, and medication errors.

CL-810 When viewing a are due:

N/A

Notes:

CL-810.010 Demographic data updates

Notes:

CL-810.020 Financial Assessment (including payer updates)

Notes:

CL-810.030 Insurance authorizations

Notes:

CL-810.040 Treatment Plans

Notes:

CL-810.050 Assessments

Notes:

CL-810.060 Release of Information

CL-810.070 Medication Consents

Notes:

CL-810.080 Consent to Treat

Notes:

CL-810.090 Proof of residency

Notes:

CL-810.100 Guardianship Paperwork

Notes:

CL-810.110 N/A

Notes:

CL-820 Forms Tracker specific data in the system, ability to create Center-defined Form Types with accompanying frequencies. Collects when the Form is completed and generates alerts when a Form becomes due. For each Form Type, lead times can be recorded to provide a Center-defined amount of time for staff to complete the Form.

CL-830 Ability to track and report on Patient Assistance Program efforts in acquiring free or low cost medications from pharmaceutical companies.

N/A

Treatment Plan

Reference Treatment Plan Rating

TP-010 Ability for Center to build custom treatment plan formats utilizing differing terminologies, differing fields, differing review periods, and differing numbers of hierarchical levels for different program areas within the Center.

TP-020 Ability to enter free-form text into treatment plans to allow for client developed (in their own words) content.

TP-030 Behavioral Health Person Centered Recovery Plan pre-defined and provided with system.

TP-040 Ability to record an IDD Person-Directed Plan (PDP) (see Form…