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Agency of Human ServicesHealth & Human Services Enterprise (HSE)Portfolio Management Office208 Hurricane Lane, Suite 103Williston, VT 05495http://ahs.vermont.gov/SEALED BIDREQUEST FOR PROPOSALFOR Enterprise Architecture Consulting Services forHealth & Human Services Enterprise (HSE)Procurement ScheduleRFP Release DateOctober 28, 2015Letter of Intent DueNovember 6, 2015Bidders’ Questions DueNovember 13, 2015 4:30PMResponses to Bidders’ Questions are PostedNovember 20, 2015Bidders’ ConferenceDecember 4, 2015Proposals Due/Closing DateDecember 18,2015 3:00PMBid OpeningDecember 18,2015 3:00PMAnticipated Contract Start DateApril 1, 2016LOCATION OF BID OPENING: 10 Baldwin Street Montpelier, VT 05633PLEASE BE ADVISED THAT ALL NOTIFICATIONS, RELEASES, AND AMENDMENTS ASSOCIATEDWITH THIS RFP WILL BE POSTED nt.gov/purchasing/bidsTHE STATE WILL MAKE NO ATTEMPT TO CONTACT VENDORS WITH UPDATED INFORMATION. CK http://www.vermontbidsystem.com and http://bgs.vermont.gov/purchasing/bids.FOR ANY AND ALL NOTIFICATIONS, RELEASES AND AMENDMENTS ASSOCIATED WITH THE RFP.PURCHASING AGENT:TELEPHONE:E-MAIL:Stephen Fazekas(802) 828-2210Stephen.fazekas@vermont.gov

Enterprise Architecture Consulting ServicesRequest for ProposalsTable of Contents1.0General Information .71.1Introduction .71.2Sole point of contact.71.3Procurement Schedule .81.4Health and Human Services Enterprise (HSE) Portfolio Overview . 81.4.1HSE Platform. 121.4.2HSE Governance . 141.5Agency of Human Services (AHS) Overview . 151.5.11.62.0Mission and Structure . 16Contract Information . 18General Instruction and Proposal Requirements . 182.1Questions and Comments . 182.2Letter of Intent to Bid – Preferred not Mandatory . 182.3Modification or Withdrawal of Proposal . 182.4News Releases . 192.5Multiple Responses . 192.6Amendments and Announcements . 192.7Use of Subcontractors. 202.8Interpretive Conventions. 202.9Instructions for Submitting Proposals . 212.9.1Number of Copies. 21Page 2

Enterprise Architecture Consulting ServicesRequest for Proposals2.9.2Submission . 212.9.2.1Delivery Methods . 222.9.2.2Proposal Submission Requirements . 222.9.32.10Additional Information or Clarification . 23Proposal Instructions . 242.10.1 Package 1 - Technical Proposal . 25 Package 2 - Cost Proposal . 262.10.22.113.0Proposal Format . 24Proposal Crosswalk — Mandatory Templates . 27Order of Precedence. 28Overview and Scope of Work . 283.1Overview .283.2Major Services & Tasks . 293.2.1Enterprise Architecture Consulting Services . 293.2.2Research Support Services . 343.2.3Ad Hoc Consulting Services . 363.2.4Service Warranty . 393.3Professional Service Requirements . 393.4Required Project Policies, Guidelines and Adherence to Best Practice Standards . 404.0Proposal Evaluation . 404.1Evaluation Criteria . 404.2Initial Compliance Screening . 414.3Competitive Field Determinations . 414.4Oral Presentations . 414.5Best and Final Offers. 42Page 3

Enterprise Architecture Consulting ServicesRequest for Proposals4.6Discussions with Vendors . 424.7Award Determination . 424.8Notification of Award. 435.0Glossary of Acronyms and Terms . 44Remainder of this page intentionally left blankPage 4

Enterprise Architecture Consulting ServicesRequest for ProposalsList of FiguresFigure 1.HSE Vision and Mission Statement .8Figure 2.HSE Portfolio: Scope .9Figure 3.HSE Core Values . 10Figure 4.HSE Governance Structure . 15Figure 5.AHS Vision Statement . 16Remainder of this page intentionally left blankPage 5

Enterprise Architecture Consulting ServicesRequest for ProposalsList of TablesTable 1.Procurement Schedule .8Table 2.HSE (HSE) Initiatives . 11Table 3.HSE Platform Services and Capabilities . 12Table 4.Mandatory Response Templates . 27Table 5.QA Deliverables & Services . 34Table 6.Research Support Deliverable . 35Table 7.DII Independent Assessment Reports Deliverable . 36Table 8.Procurement Technical Assistance Deliverables . 39Remainder of this page intentionally left blankPage 6

Enterprise Architecture Consulting ServicesRequest for Proposals1.0 General Information1.1IntroductionThe Agency of Human Services (hereinafter AHS) is seeking to establish a service agreementwith a vendor to provide enterprise architecture consulting, and ad hoc research specific to thedesign, development and implementation of the Health and Human Services Enterprise Platform(HSEP) and related programs.The selected vendor will provide analysis, technical and management guidance related to crossprogram issues encountered in the design, development and implementation (DDI) period ofthe key HSE program. These are the Medicaid Management Information Systems (MMIS)Program, Integrated Eligibility (IE) Program, and Health Information Exchange (HIE) / HealthInformation Technology (HIT) Program, as well as enhancements to the Vermont Health Connect(VHC) Program. All of these program have interdependencies and further rely upon a set ofshared services and functionality which collectively comprise the HSE “Platform” (HSEP).Through this procurement, AHS will benefit from improved decision making related to thesequencing and timing of HSE Platform buildout and migration, as well as from improvedtechnology selection and configuration decision making. Augmenting the HSE EnterpriseArchitecture capability in this regard will improve the overall effectiveness of spending of Stateand Federal funds by eliminating potential duplication of development efforts by the several DDIvendors involved and by minimizing implementation delays and associated costs which may beotherwise encountered by incorrect sequencing of shared service development anddeployment.This RFP details Proposal submission requirements, Proposal evaluation process andmethodology, and the required Scope of Work (“SOW”).If a suitable Proposal is selected in response to this RFP, the AHS may enter into a contract(“Contract”) to have the selected Vendor (“Bidder” or “Vendor”) perform all or part of the SOW.1.2Sole point of contactAll communications concerning this RFP will contain the Name and RFP Number in the subjectline and must be addressed in writing to the attention of:Stephen Fazekas, Technology Procurement AdministratorOffice of Purchasing & ContractingStephen.Fazekas@vermont.govPage 7

Enterprise Architecture Consulting ServicesRequest for ProposalsStephen Fazekas is the sole contact for this RFP. Contact with any other State personnel orattempts by Vendors to contact any other State personnel may result in the rejection of theirProposal.1.3Procurement ScheduleThe following Table 1 documents the critical pre-award events for the procurement andanticipated Contract start date. All dates are subject to change at the discretion of AHS.Table 1.Procurement ScheduleProcurement ScheduleRFP Release DateOctober 28, 2015Letter of Intent DueNovember 6, 2015Bidders’ Questions DueNovember 13, 2015 4:30PMResponses to Bidders’ Questions are PostedNovember 20, 2015Bidders’ ConferenceDecember 4, 2015Proposals Due/Closing DateDecember 18,2015 3:00PMBid OpeningDecember 18,2015 3:00PMAnticipated Contract Start DateApril 1, 20161.4Health and Human Services Enterprise (HSE) PortfolioOverviewThe Health and Human Services Enterprise (HSE) is a multi-year, multi-phased portfolio ofPrograms that reshapes and enhances business processes, improves public/private sectorpartnerships, optimizes utilization of information, modernizes the Information Technology (IT)environment, and results in an end-to-end transformation of the person-centric experience (i.e.,model of practice). Impacted stakeholders are: Vermonters, health and human serviceproviders; employees, specifically those employed by the Agency of Human Services (AHS); andother parties such as contractors, advocates, etc.Figure 1.HSE Vision and Mission StatementOur vision is that,Vermont is at the forefront of health and human service delivery to ensure the well-being of allVermonters.Our mission is to,Holistically address Vermonters’ needs by creating a person-centric system that streamlines managementand access to health and human services.Page 8

Enterprise Architecture Consulting ServicesRequest for ProposalsThe HSE is predicated on providing Vermonters with improved access to their personal data in asecure, timely and effective manner, resulting in solutions that improve life situations andpromote positive outcomes while enhancing access to benefits and services. The HSE strategy isto create the future state of business processes, invest in new and upgraded IT solutions thatserve current needs, while being positioned to continually evolve the Enterprise. As such, theHSE represents a holistic approach to health and human services system innovation.The HSE is managed in the operational planning document known as the Vermont HealthInformation Technology Plan (VHITP) available in the Procurement Library. The HSE consists ofthe: Vermont Health Connect (VHC), Vermont’s state-based marketplace; Eligibility andEnrollment Solution referred to Integrated Eligibility (IE); Medicaid Management InformationSystem (MMIS), and the State Medicaid Health Information Technology Plan (SMHP) - HIE/HIT.These strategic solutions are incrementally deployed using Vermont’s new Service-OrientedArchitecture (SOA) which allows for a modular, flexible, interoperable and learning computingenvironment leveraging shared services, common technology, and detailed information. Thenew environment is designed consistent with the Centers for Medicare and Medicaid Services(CMS) Medicaid Information Technology Architecture (MITA) and Seven Standards & Conditionsto meet the goals of increasing electronic commerce and transitioning to a digital enterprise. Akey concept to the enterprise approach is the optimization of the integration of health andhuman services as allowable under the A-87 Exception pursuant to Federal Policy Guidelines.As depicted in Figure 2, the HSE is a combination of Programs (VHC, IE, MMIS, HIE/HIT) that relyupon a Services Oriented Architecture (SOA), elements of which are implemented as common,shared services and processes. This approach is consistent with best practices and Federalguidance requiring asset reuse where possible in order to improve the value obtained from thefinancial investment made.Figure 2.HSE Portfolio: ScopeVHCIEMMISHIE/HITHSEP - SOA Platform, Process Management & Shared ServicesThe HSE portfolio initiatives, supported across programs by the HSEP functionality, will enablethe Agency of Human Services (AHS) “Agency of One” vision to come to fruition. Whetherhelping a family access health care or child care, protecting a young child from abuse,supporting youth and adults through addiction and recovery, providing essential healthpromotion and disease prevention services, reaching out to elder Vermonters in need of athome or nursing home assistance, enabling individuals with disabilities to have greaterindependence, or supporting victims and rehabilitating offenders, AHS provides support to manyVermonters and seeks to assist all Vermonters in accessing applicable services. The “Agency ofPage 9

Enterprise Architecture Consulting ServicesRequest for ProposalsOne” vision focuses on securely sharing any and all applicable data in a timely and effectivemanner while comporting with all relevant privacy requirements in order to ensure: Vermonters receive the services critical to their success and identify additional supportsthat will help them prosper Cross-departmental referrals and awareness – “no wrong door” for Vermonters Policy and Public Health efforts have necessary data for program analysis and programservice coordinationThe HSE foundation is a person-centric system of practice where the “person” is at the focalpoint in conjunction with the “Triple Aim” - improving the care experience, improving the healthof the population, and reducing the cost of care. The overall cost is offset by overall savings froman improved delivery model; Vermont has already seen some early results, based on theBlueprint experience available at: http://hcr.vermont.gov/blueprint , and the (Medicaid)Vermont Chronic Care Initiative (VCCI) available at: ic-care-initiative-vcci , with data indicating fewer hospital readmissionsand fewer emergency room visits.Figure 3.HSE Core ValuesWe serve Vermonters.We put Vermonters health and well-being at the forefront of all efforts because we are Vermonters too.We are a Team.We collaborate across departments because we know the value of getting health and human servicesright.We are Innovative.We address all challenges, big or small, using our creativity and ingenuity.We say it Loud and Clear.We know that our collective success relies on communication so we do it well and often.We are Enterprise Thinkers.We focus on addressing all facets of Vermonters’ lives that affect health and well-being so we arrive atquality solutions faster.We are an Agency of One.Our success is achieved together, and that’s the bottom line.Integrated investment in functional solutions and a standard computing platform is a keyenabler for the AHS to adopt an enterprise approach, and achieve true innovation in health carefor the general population. Relevant initiatives are listed in the table below.Page 10

Enterprise Architecture Consulting ServicesRequest for ProposalsTable 2.HSE (HSE) InitiativesINITIATIVEDESCRIPTIONHealth and Human ServicesEnterprise (HSE) PlatformThe HSE Platform is envisioned as a suite of shared servicesthat are reusable across the MMIS, IE, HIE/HIT and VHCmarketplace solutions.Medicaid ManagementInformation System (MMIS)The MMIS includes a Pharmacy Benefits Manager (PBM)component (contract executed with Goold Health Systems,Inc.), a Care Management component (contract executed withEQHealth Solutions, Inc.), and the Core MMIS (RFP issued),including a Contact Center (RFP issued).Health InformationExchange/Technology (HIE/HIT)HIE/HIT is the successful transmission of accurate, up-to-dateand meaningful clinical data to private and public health careproviders while supporting State and State-funded agencies.HIE includes currently operating systems/solutions, someprojects currently in development, and a set of new projectsthat need to extend and expand HIE services.Integrated Eligibility (IE)The ACCESS System is currently the “system of record” foreligibility for Medicaid, 3SquaresVT, General Assistance, ReachUp and LIHEAP. The AHS is in the procurement process for anew screening, application, eligibility determination, andenrollment system for health and human services programs,referred to as the “Integrated Eligibility - IE” System.Vermont Health Connect (VHC)The State elected to establish a State-run Health InsuranceMarketplace, named Vermont Health Connect (VHC). Theinitiative provides eligibility determination for Medicaid (basedon Modified Adjusted Gross Income MAGI) and the Children’sHealth Insurance Program (CHIP), Qualified Health Plan, andadditional services for non-Medicaid Marketplace activities.VHC passes all Medicaid eligibility determinations to ACCESS(IE) for use by the MMIS. Upon retirement of the ACCESS (IE)legacy system, VHC will pass these determinations to the newintegrated eligibility solution.*Note: Implementation Advanced Planning Documents can be found in the Procurement Library.Page 11

Enterprise Architecture Consulting ServicesRequest for Proposals1.4.1HSE PlatformThe HSE Platform is the foundation for building out all new functionality for programs andservices to support a person/family centered model of practice. Vendors must have anunderstanding of the HSE Platform as this is a key architectural component for all initiativeswithin the HSE Portfolio as shown in Table 2 above. The HSE Platform’s infrastructure iscomprised of shared components and services that offer the capabilities defined in Table 3.Table 3.HSE Platform Services and CapabilitiesIdentity ManagementConsent ManagementEnsure individuals are identified across the range of roles, health andhuman services programs that they interact with, and have access onlyto information and functionality for which they are authorizedEnsure that appropriate information is shared with only individualsthat are authorized and have a need to access to itPage 12

Enterprise Architecture Consulting ServicesRequest for ProposalsPortalEnterprise InformationExchange (EIE)Master Data Management(MDM)Rules EngineEligibility AutomationFoundationContent ManagementAnalytics and BusinessIntelligence (BI) Tools andRepositoriesCollaboration CapabilitiesUniversal CustomerManagement (UCM)Enterprise ContentManagement (ECM) andCustomer CommunicationManagementProvide a consistent user interface and access to information andfunctionalityReferred to as a gateway, or service bus, which provides a standardsbased mechanism for integrating with and sharing information amongthe full range of health and human services and administrativeapplicationsIncludes Master Person Index, and Master Provider Index to ensure acommon view and single version of the “truth” across AHS programsDefine and manage the business rules that will drive eligibilityassessments for AHS programsProvide shared functionality for eligibility screening, application anddeterminations services for AHS programsAllow management of and access to a wide range of informationand mediaCreate reports and dashboards to shed light on and manage currentoperations, and to develop analytical and predictive analyses forfuture planning and policy developmentThese capabilities include: Service Coordination (Secure Messagingand Shared Case Notes), Client and Provider Look-Up and Query,Referral Management (Create Referral and Manage Referral), andAlerts and NotificationsEnsure individual (member) data is managed holistically. This isgenerally serviced by Customer Relationship Management (CRM)applications that touch multiple areas of a customer (member)activity. Services to be used include CRM 2.0 capabilities thusoffering bi-directional communications and exchanges. This is thebackbone of any customer management systemAllow for the management of structured and un-structured dataacross the enterprise. The customer communication managementpart refers to notifications constructed by the business to formallycommunicate with members by way of the enterprisePage 13

Enterprise Architecture Consulting ServicesRequest for ProposalsBusiness ProcessManagement (BPM)1.4.2A SOA supported system that generates, stores, and re-usesbusiness processes required to perform the necessary businessrequirements of the target solutionHSE GovernanceA governance structure has been established to support and administer the HSE. The HSEPortfolio Management Office (HSE PMO): Manages the overall portfolio Manages cross-program dependencies based on an enterprise perspective Establishes consistent processes, tools and artifacts to manage cross-program/projectdependencies, funding, reuse, and processes Facilitates interactions throughout the GovernanceThe HSE Portfolio is administered by the HSE PMO which is part of the AHS Secretary’s Office,with participation from the Governor’s Office including , Agency of Administration (AOA),Department of Information and Innovation (DII). The HSE Portfolio is administered by AHS inpartnership with the AOA including the Director of Health Care Reform, DII and the Departmentof Finance and Management (DFM).The Secretary of the Agency of Human Services (AHS) is responsible for making decisionsaffecting the AHS and the HSE. The Secretary does so with the assistance of a HSE SeniorLeadership Team (SLT) and, as necessary, upon consultation with or the advice of the HSE InterAgency Advisory Team (IAT) and/or the Intra-Agency Operations Team (IOT). Much of the workof HSE is conducted by Program Teams and Process Teams.Vendors are encouraged to review the HSE Governance documented provided in theProcurement Library.Page 14

Enterprise Architecture Consulting ServicesRequest for ProposalsFigure 4.HSE Governance StructureGovernance ensures fidelity to the vision, goals and objectives of the HSE Portfolio, and thatprojects are successful in achieving intended results within budget and on schedule, and thatProgram delivery and the resulting products are of the highest quality.1.5Agency of Human Services (AHS) OverviewThe “Agency of One” is the approach within the Agency of Human Services that enables ourstate staff working together with an integration focus to deliver effective client centeredexperiences. This is discussed in AHS’ strategic planat: s-strategic-plan/ahs-strategicplan/view.The goals of this approach include: Decrease the lasting impacts of poverty on individuals, children and families in Vermontand create pathways out of poverty Promote the health, well-being and safety of individuals, families and our communitiesPage 15

Enterprise Architecture Consulting ServicesRequest for Proposals Enhance AHS’s focus on program effectiveness, accountability for outcomes, andworkforce development and engagement Ensure that all Vermonters have access to high quality health careThis: Requires Accountability: Results Based Accountability Emphasizes root causes, prevention & early intervention, not just symptoms Involves multiple organizations: AHS, State Government, Community Partners1.5.1Mission and StructureThe Agency of Human Services (AHS) is responsible for health care and human services supportacross the State and has the statutory responsibility for child welfare and protection, theprotection of vulnerable populations, public safety, public health, public benefits, mental healthand administration of Vermont’s public health insurance system. In addition, the AHS serves asthe single State Medicaid Agency (SMA).Figure 5.AHS Vision Statement The reduction of the impacts of poverty in our state and the creation of pathways outof poverty The promotion of health, well-being and safety in our communities An enhanced focus on accountability and effectiveness in achieving our goals The assurance of high quality health care for all VermontersAHS consists of the following Departments with the following responsibilities: Department for Children and Families (DCF) — DCF provides a wide array of programsand services, including adoption and foster care, child care, child development, childprotection, child support, disability determination, and economic benefits such as:Reach Up, Essential Person, General Assistance/Emergency Assistance, 3SquaresVT,Home Heating Assistance and Health Insurance.http://dcf.vermont.gov/ Vermont Department of Health (VDH) — VDH sets the State’s public health prioritiesand works with the State to help realize public health goals within the population servedPage 16

Enterprise Architecture Consulting ServicesRequest for Proposalsby the State. VDH collaborates with the State on clinical initiatives (i.e. Alcohol and DrugAbuse Programs) to reduce medical costs in the State through the agency’s GC programwaiver. These programs include Early Periodic Screening, Diagnosis, and Treatment(EPSDT) and dental care initiatives to children across the State.http://healthvermont.gov/ Department of Corrections (DOC) — DOC is responsible for managing all adult prisonsand community correctional sites. For incarcerated offenders, the department isrequired and committed to providing basic and humane care that includescomprehensive integrated health and mental health services that are connected withand continue as the individual transitions from or into the community. For offenders inthe community, the department is charged with ensuring compliance with conditions .The State maintains a unified correctional system with 8 correctional (prison/jails/workcamps) facilities spread out over the State. Each facility provides comprehensive healthand mental health services to 8,000 Vermonters over the course of a year. Themajority of offenders entering and leaving corrections are Medicaid eligible.http://www.doc.state.vt.us/ Department of Disabilities, Aging and Independent Living (DAIL) — DAIL administers allcommunity-based long-term care services for older Vermonters, individuals withdevelopmental disabilities, traumatic brain injuries, physical disabilities, personalcare/attendant services, high technology nursing, and the Choices for Care Long TermCare Medicaid Waiver program.http://www.dail.vermont.gov/ Department of Mental Health (DMH) — DMH is responsible for administering mentalhealth services and programs for children and adults across the State. DMH assuresaccess to mental health services and works closely with multiple human servi

Feb 17, 2016 · FOR Enterprise Architecture Consulting Services for . Health & Human Services Enterprise (HSE) . key concept to the enterprise approach is the optimization of the integration of health and . elements of which are implemented as common, shared services and This approach is consistent with best pract

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