REQ-DASOBO-00085573_REALD-SOGI_OHA_Approved.pdf

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REQUEST FOR SPECIAL PROCUREMENT No. REQ-DASOBO-00085573

PART A. Requesting Agency must complete Items 1 through 13.

1. Requesting Agency Name: The Department of Administrative Services, State Procurement Services (DAS SPS) on behalf of the Oregon Health Authority (OHA)

2. Date of Request: October 7, 2024 3. Agency Number: 107090

4. Agency Contact Name: Julie Curry 5. Phone: (503) 446-8169

6. Type of Request: ___Class Special Procurement _X_Contract-specific Special Procurement

7. Time Period Requested: From: October 7, 2024 To: April 1, 2029

8. Total Estimated Cost: $14,000,000

9. Title: Supplies and/or Services to be Acquired: Stand-Alone Cloud-based Data Warehouse Solution for Phase 2 of the project summarized below:

OHA’s Equity & Inclusion Division (E&I) plans to build a stand-alone cloud-based data warehouse solution that will collect and consolidate Race, Ethnicity, Language and Disability (REALD) and Sexual Orientation and Gender Identity (SOGI) data from multiple sources, interface with internal State and external data systems, and support multi-functional reporting for E&I, treatment providers, and State and federal partners. When the data warehouse environment is created, functionality and data from the existing on-premises SQL server Repository will be migrated into the cloud-based data warehouse and enhanced.

10. Request, Background, Current Need, and Proposed Contracting Procedure:

a. Request:

In effort to fully comply with House Bill (HB 3159), DAS SPS, on behalf of OHA, is requesting approval of this Special Procurement (SP) No. REQ-DASOBO-00085573 to direct award a contract to Deloitte Consulting, LLP (Deloitte) for the additional development of the REALD & SOGI Repository for a discrete segment of the project summarized above. This period of performance (Phase 2, described below) will allow sufficient time to produce a competitive solicitation for future services (Phase 3).

b. Background:

The Oregon Legislature passed House Bill 3159 (HB 3159) in 2021, mandating how OHA must collect and store Race, Ethnicity, Language, and Disability (REALD) & Sexual Orientation and Gender Identity (SOGI) data from Coordinated Care Organizations (CCOs), health providers and insurers. This collection of demographic data, and how it is processed and prepared for analytics and reporting, helps OHA improve Medicaid data, and helps OHA understand who is impacted by health inequities across 30+ surveillance data systems in OHA. Accurate, complete, and timely collection of demographic data, supported by automated processes for data validation, processing, and consolidation, is essential for identifying populations disproportionately

SP No. REQ-DASOBO-00085573_REALD-SOGI_OHA Page 2 of 8 affected by health inequities and determining effective strategies to reduce these disparities. The REALD & SOGI Repository and Registry will enhance the quality and timeliness of demographic data, enabling OHA to leverage this data to improve care and services, identify inequities, and address them more effectively to better serve communities.

OHA’s pandemic response over the last three years has been supported by federal funds from the Federal Emergency Management Agency (FEMA). Funds have allowed OHA to expand or build repositories with data collected during the pandemic and other hazards to: support equitable access to vaccines and treatments;

provide epidemiologic and other interventions to reduce the spread of disease; produce robust data and data visualization to support transparency for leaders and the public; provide supports to Oregon community partners and the healthcare system to ensure healthcare access; and provide new tools to support Oregonians in making safety and risk evaluations.

The work to meet these Legislative mandates has been split into three phases, one of which (Phase 1) was previously completed:

Phase 1: Patient Facing Survey Tool (PFST) Phase 1 work is described for context. The PFST is a secure, web-based form that allows individuals to enter their REALD & SOGI information to facilitate easy automatic reporting to the OHA. This was created during the pandemic to offer providers the option to use a customized REALD & SOGI survey link or a QR code (with their information embedded in the QR code). PFST allows patients to use the link or QR code to complete the REALD questions. Initially developed by an external vendor, PFST is now operational and part of the REALD & SOGI Registry, which is supported by the Office of Information Services (OIS)

Phase 2: Repository The REALD & SOGI Repository (Repository) was implemented following a detailed assessment of REALD data quality in Medicaid Management & Information System (MMIS) / Decision Support & Surveillance Utilization Review System (DSSURS) conducted in 2018 that found the MMIS system inadequate to fully maximize the data quality of REALD & SOGI data.

Development of the Repository by Deloitte began in 2022 under a contract resulting from an emergency procurement to maximize the use of REALD data that has been in the ONE eligibility system since 2017, as well as high quality REALD data from other internal sources (Birth Certificate and Acute and Communicable Disease data (e.g., COVID)). Deloitte continues to support activities around the Repository’s continued development.

The Repository collects and consolidates REALD and SOGI data from multiple sources, will interface with internal State and external data systems, and supports multi-functional reporting for OHA, CCOs, and community partners. Future enhancements, including cloud migration, are planned to improve data processing speed, scalability, and disaster recovery. Additionally, new data portals are being developed to streamline data requests and reporting, ensuring timely and efficient access for business users.

Data from the REALD & SOGI Repository is being used across OHA by analysts working with Medicaid members such as the CCO Metrics Dashboard. The Repository also provides bimonthly data files to the Coordinated Care Organizations (CCOs). The Repository was established to enhance the quality

SP No. REQ-DASOBO-00085573_REALD-SOGI_OHA Page 3 of 8 and completeness of demographic data collected across multiple sources, including Medicaid, birth certificates, and disease data. The Repository has significantly reduced data gaps and non-responses, enabling more informed policy and program decisions.

Phase 3: Registry & Integrations The REALD & SOGI Registry will be enhanced to serve as the primary hub for data intake from various sources, including electronic health record systems (EHRs) and online surveys. The registry will need to meet the evolving needs of providers, insurers, and other invested parties, ultimately enhancing data collection and utilization across the organization.

Registry development & integration work is anticipated to utilize a vendor procured through the competitive Request for Proposal (RFP) or Master Price and Services Agreement (MPSA) based Request for Quote (RFQ) process. OHA intends for the vendor selected to not only complete Registry development, but also to take over Repository maintenance and enhancements after a transition period with the current vendor.

Phase 3 will include development of the REALD & SOGI Registry and development of Application Programming Interfaces (APIs) to facilitate adoption and easy transmission of data from submitting organizations, and integration of all system components to form the complete REALD & SOGI system.

The Registry will be the primary hub for data intake and will provide varied mechanisms for inputs including inputs from EHR systems, data from individuals taking an online survey with a QR code shared by the provider or insurers, and directly from individuals via an online portal/mobile application.

Phase 2 work is the subject of this Special Procurement.

Deloitte developed the REALD & SOGI Repository during the pandemic period, under OHA emergency contracts in 2021 and 2022. E&I accessed Deloitte’s services under OHA Contract No. 178181 in 2023, to ensure strategic short-term planning for the Repository as part of the HB 3159 solution that would include receipt and storage of REALD & SOGI data.

This Repository is critical to continuing OHA’s post-pandemic cleanup activities and supports and complements new Medicaid programming from the 1115 waiver and data collection by OHA grantees, and to address new emergencies like the State’s behavioral health system crisis and the escalating houselessness crisis. Additionally, COVID-19 and resulting conditions are still emergent health issues that OHA responds to without FEMA assistance. The human metapneumovirus (HMPV) and respiratory syncytial virus (RSV) pandemics both emerged after COVID-19, and global public health experts are preparing for others in the future. OHA has an ongoing commitment and to improve health equity and bring parity to conditions known to cause gaps and inequitable health outcomes. OHA will need a robust and efficient REALD & SOGI Registry for public data management and Repository for warehousing the data collected for these future epidemics.

OHA recognizes that reliable and valid demographic data is a cornerstone of health equity improvement.

Accurate, complete, and timely demographic data collection, with automated processes for cleaning, processing, and consolidating the data for analytics, is necessary to identify populations most impacted by health inequities and understand what specific health services and supports needed.

OHA also recognizes:

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• The State of Oregon is required to have an operational vital records repository and statistics system under Oregon Revised Statutes (ORS) 432 and HB 3159.

• Per House Bill 3159, the State of Oregon is required to provide a REALD and SOGI Registry.

• Phase 2 Registry development will complement Oregon’s advancement of health equity to improve health outcomes per federal law and address Centers of Medicare and Medicaid Services (CMS) priorities for reducing health disparities.

c. Current Need:

The Repository currently lives on an SQL server located in Enterprise Information Services (EIS) Data Center Services. This does not match with the State’s Cloud-Forward policy and presents a less adaptable, less secure environment than is desirable. In addition, most work for the Repository today is manually accomplished, requiring significant investment of staff time, and intake points are limited.

To remedy this, OHA intends to move the Repository into a Cloud environment and automate as much as possible to make the Repository more efficient and prepared to meet future needs. Future needs are inclusive of operations and uses relating to processing of open text responses with more nimble software, automated data quality scripts, as well as decreased processing time. Additionally, the Repository should:

• Accommodate the REALD & SOGI data standards.

• Initiate ingestion or migration of data directly from All Payers All Claims (APAC) insurers who serve more than 5000 Oregon Health Plan (OHP) members in Oregon.

• Facilitate person-matching, clinical quality indicators (CQI) processes, and automation of data request management and data outputs.

• Populate relevant demographic Transformed Medicaid Statistical Information System (T-MSIS) tables from the Repository to improve Oregon’s reported status within the CMS Data Quality (DQ) Atlas.

These functionality improvements will make data more accessible to all Oregonians, facilitating greater opportunities to identify and mitigate emerging data quality inequities in the future. OHA will also be able to prepare for changes in reporting and to provide data in line with new federal gender identity and modality reporting, i.e., accessible dashboarding to provide dynamically calculated metrics. Finally, improvements in person-matching will increase the likelihood of recovering and matching data on Oregonians who may be facing difficulties with reporting or sharing personal information. For example, individuals may face accessibility issues, or legal and family issues leading to name changes for personal health and safety. These changing dynamics in a person's life can cause identification and data integrity issues which would hinder adequate person-matching, whereas process improvements may minimize duplicitous data for a single person.

Long term, OHA’s goal is to make the Repository the sole source of REALD and SOGI information to be utilized by all its systems. This Phase 2 of the project will be focused on creating a location to store that data which OHA REALD & SOGI Data Governance Committee and will then be able to utilize for future approach planning. This work requires immediate continuation support from Deloitte to complete.

Work efforts to be undertaken to remedy the technical issues are being approached in three stages:

Migrate solution to cloud environment (Phase 2A: Lift and Shift):

Deloitte as the contractor will apply an existing On-premises Initial Repository (on-prem IR) design decomposition to develop the REALD & SOGI Repository Solution in Microsoft Azure Cloud (Cloud Migration or Lift and Shift), delivering a solution to build a cloud-based data warehouse that collects

SP No. REQ-DASOBO-00085573_REALD-SOGI_OHA Page 5 of 8 and consolidates Race, Ethnicity, Language and Disability (REALD) and Sexual Orientation and Gender Identity (SOGI) data from multiple sources, interfaces with internal State and external data systems, and supports multi-functional reporting for treatment providers, and State and federal partners.

When the REALD & SOGI Repository data warehouse environment is created, functionality and data from the existing Repository will be transferred into it and tested. Along with migrating the On-premises initial Repository to the cloud, the contractor will implement changes required to ingest the new REALD & SOGI extract from the ONE system into the cloud solution. After the Lift and Shift, the contractor will address new data management improvement capabilities with testing, documentation updates, and knowledge transfer prior to completing close-out reporting.

Enhance Data Management Capabilities and Data Quality (Phase 2B):

Following Phase 2A, Deloitte as the contractor will address new data management capabilities, adding new sources of REALD & SOGI data, developing data dictionaries and data models, developing data quality monitoring dashboards along with testing, documentation updates, and knowledge transfer.

Implement Data Governance, Data Sharing and Reporting Capabilities (Phase 2C):

Deloitte as the contractor will implement a REALD & SOGI data marketplace solution where users can request/access REALD & SOGI data for their data reporting and analytics needs. This marketplace solution will also include implementation of a data governance process, data monitoring, data retention policies and data usage agreements. Phase 2C also includes Project stabilization and Close Out Reporting.

Based on the Centers for Medicare and Medicaid Services (CMS) Advanced Planning Document (APD) for potential 90/10 federal funding, approved by CMS on September 12, 2024, OHA anticipates the costs for services under the contract resulting from this SP for Phase 2 will not exceed, for the full potential term authorized under this SP, $14,000,000. Per federal expectations, the terms of the contract resulting from this SP will be deliverables-based payments made for successful work.

If OHA is not able to engage in the desired contract with Deloitte for Phase 2 work, OHA and the State may be unable to promptly and effectively provide services and goods essential to protecting the public’s health, safety, and welfare that are required by current Oregon legislation. OHA does not have staff to continue the Repository work without ongoing external support and pausing the project (and associated services) to transition to another provider, resulting in delay and additional cost for transition and related inefficiencies in service delivery. Without the ongoing support of Deloitte resources for this work:

• OHA will not be able to seamlessly continue to provide the data collection and reporting services that Oregon health care organizations and providers currently receive.

• Oregon will not be able to meet federal reporting requirements.

• OHA will not be able to continue equity-related improvement activities for Oregonians.

d. Proposed Contracting Procedure:

• DAS SPS will issue a public notice (Notice) on OregonBuys for a period of seven calendar days, as required by Oregon Administrative Rule (OAR 125-247-0287), regarding approval of this SP.

• The Notice will include provisions that any affected party may protest the approval of the SP.

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• DAS SPS will respond to and resolve all protests, if any as outlined in Oregon Revised Statutes (ORS) 279B.405-415.

• If no protests to this SP are received or sustained, DAS SPS, on behalf of OHA, will enter into negotiations for a direct award contract with Deloitte.

• DAS SPS and OHA will work with EIS and obtain its endorsement prior to executing the Contract, if required.

11. Justification for use of Special Procurement:

The development and implementation of the REALD & SOGI Repository is mandated by Oregon’s HB 3159 passed in 2021 (also known as the Data Justice Act; ORS 413.163-413.164) and is supportive of ORS. 432, Vital Statistics. OHA also plans to populate the demographic T-MSIS files sent to CMS that will have significantly better data completeness, as well as automation processes to facilitate filling data requests across OHA and Oregon Department of Human Services (ODHS) so that the data can be used in identifying and addressing inequities.

Completing an open market solicitation for additional development support work is not in OHA’s best interests for the following reasons:

• Completing a solicitation for REALD & SOGI Registry development work at this time will lead to an unnecessary delay in planned Phase 2 work. As described above, the current technical limitations and concerns are severe and need to be remediated as quickly as possible to support service delivery, required reporting, and to meet legislative mandates.

• Completing a solicitation for REALD & SOGI Registry development work at this time will lead to delays in seeking federal funding reimbursement from CMS, placing a burden on Oregon General Funds and thus, Oregon taxpayers.

• Open competitive solicitations are planned for future REALD & SOGI Registry development with the intent for the vendor selected to take over not only Registry development, but also support of the existing Repository. Deloitte Consulting, LLP, will need to be retained by OHA until such a time that becomes possible, or the system and its transition will suffer.

12. Findings to Satisfy the Required Standards: This proposed special procurement:

__X___ (a) will be unlikely to encourage favoritism in the awarding of public contracts or to substantially diminish competition for public contracts because:

If OHA is not able to engage in the desired contract with Deloitte for Phase 2 work, OHA and the State may be unable to promptly and effectively provide services and goods essential to protecting the public’s health, safety, and welfare that are required by current Oregon legislation.

OHA intends to follow the competitive Request for Proposal (RFP), or Master Price and Services Agreement (MPSA) based Request for Quote (RFQ) process for Phase 3, Registry & Integrations.

and

(b)(i) will result in substantial cost savings to the contracting agency or to the public because:

SP No. REQ-DASOBO-00085573_REALD-SOGI_OHA Page 7 of 8 or

___X__ (b)(ii) will otherwise substantially promote the public interest in a manner that could not practicably be realized by complying with the requirements of ORS 279B.055, 279B.060, 279B.065, or 279B.070, or any rules adopted thereunder because:

A special procurement is the applicable sourcing method for DAS SPS, on behalf of OHA, to fully comply with HB 3159 in Phase 2 of this project. This will ensure that legislative mandates are met by OHA providing accurate, complete, and timely collection of demographic data, which is supported by automated processes for data validation, processing, and consolidation. The collection of this data is essential for identifying populations disproportionately affected by health inequities and determining effective strategies to reduce these disparities. The REALD & SOGI Repository and Registry will enhance the quality and timeliness of demographic data, enabling the OHA to leverage this data to improve care and services, identify inequities, and address them more effectively to better serve Oregon communities.

Completing an open market solicitation for additional development support work is not in OHA’s best interests for the following reasons:

• Completing a solicitation for REALD & SOGI Registry development work at this time will lead to an unnecessary delay in planned Phase 2 work. As described above, the current technical limitations and concerns are severe and need to be remediated as quickly as possible to support service delivery, required reporting, and to meet legislative mandates.

• Completing a solicitation for REALD & SOGI Registry development work at this time will lead to delays in seeking federal funding reimbursement from CMS, placing a burden on Oregon General Funds and thus, Oregon taxpayers.

• Open competitive solicitations are planned for future REALD & SOGI Registry development with the intent for the vendor selected to take over not only Registry development, but also support of the existing Repository. Deloitte Consulting, LLP, will need to be retained by OHA until such a time that becomes possible, or the system and its transition will suffer.

13. Signature: The actual signature of the Agency Head or designee (e.g., Designated Procurement Officer) is not required on the Request if it is submitted through OregonBuys. Agency may elect to attach a signed Request.

S ignature: e.g. Electronical ly in OregonBuys

Type Name: Date:

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PART B. The Department of Administrative Services completes Part B.

STATUTORY AND RULE AUTHORITY:

ORS 279B.085(2) states the Director of the Department of Administrative Services may approve a special procurement if the Director finds that a written request submitted under ORS 279B.085(4) demonstrates that the use of a special procurement as described in the request, or an alternative procedure prescribed by the Director will:

(a) Be unlikely to encourage favoritism in the awarding of public contracts or to substantially diminish competition for public contracts; and

(b)(A) Result in substantial cost savings to the contracting agency or to the public; or

(B) Otherwise substantially promote the public interest in a manner that could not practicably be realized by complying with requirements that are applicable under ORS 279B.055, 279B.060, 279B.065 or 279B.070 or under any rules adopted thereunder.

OAR 125-246-0170 delegates the authority of the Director of the Department of Administrative Services to approve special procurements to the State Chief Procurement Officer. OAR 125-247-0285 through 125-247-0288 implement ORS 279B.085.

OAR 125-247-0700(2) Protests and Judicial Review of Special Procurements designates the State Chief Procurement Officer as the Contract Review Authority.

FINDINGS: The findings are accepted, adopted, and incorporated by reference herein.

CONDITIONS OF APPROVAL:

1. Notice Period. The Authorized Agency shall post the Public Notice on OregonBuys. The Special Procurement may not be used until after the completion of the seven (7) day notice period required pursuant to OAR 125-247-0287(4), and either:

a. No Written protests are received by the Contract Review Authority, State Chief Procurement Officer, from an Affected Person in response to the notice, or

b. If any protest is received during the notice period, then not until:

i. the State Chief Procurement Officer or delegate issues a written disposition of the protest in accordance with ORS 279B.400 and OAR 125-247-0700 and OAR 137-047-0700, and

ii. confirms in writing the first possible date of use of the Special Procurement.

2. ORS 279A.165 Requirements. Authorized Agency shall comply with the requirements of ORS 279A.165 and OAR 125-247-0287(12) regarding a report about this Special Procurement. Agency shall use a form and follow the instructions provided by the State Chief Procurement Officer or delegate.

3. Authorized Agency shall comply with all Enterprise Information Services (EIS) conditions and requirements prior to contract execution, if any.

APPROVED

Jay Jackson, Procurement Policy Officer Date:

Department of Administrative Services, State Procurement Services

10/14/2024