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Attachment B – Requirements TableFit Rating Response Codes:5 = Requirement Fully Met (No System Customization Needed) 2 = Alternative Approach to Requirement (describe Approach in Response)4 = Requirement Partially Met (Describe System Customization Needed) 1 = No Solution Proposed (Describe Why in Response)3 = Requirement Not Met (Describe Capability to Develop)Reference # Requirement Description

Requirements listed in this Table are intended for Vendor consideration in their SOW Response. Vendors should use this Table to score the degree to which the Proposed System functionality and supporting Vendor capabilities meet each requirement. Any narrative descriptions should be compiled in an attachment and cross-referenced to this Table.

Fit Rating Response (must provide comment to support response)

Comments Supporting Response Vendor Document Reference

B Basic Requirements

B1 A data system that can be used throughout the state in various Satellite office locations.

B2 Ability for multiple users to enter data at the same time.

B3 Ability to create notification templates with pre-determined contact lists and pre-defined messages.

B4 Capability to send and receive data from other systems including vital, Auris, HIE Etc.

B5 Search or filter contacts on any attribute or combination of attributes within a contact’s profile.

B6 Ability to generate all SHCN letters and envelopes allowing program staff the ability to be able to add, delete and modify letters internally. There will need to be different letter for each region in both English and Spanish. The system will need to be able to auto populate care coordinator or Satellite office staff information into letters, authorization and Action Plans.

All forms and letters must be able to be printed.

Fit Rating Response Codes:5 = Requirement Fully Met (No System Customization Needed) 2 = Alternative Approach to Requirement (describe Approach in Response)4 = Requirement Partially Met (Describe System Customization Needed) 1 = No Solution Proposed (Describe Why in Response)3 = Requirement Not Met (Describe Capability to Develop)Reference # Requirement Description




B7 Some areas will need to be in a read only format for certain staff - manager and director will be able to assign access to staff according to need.

B8 Everything will need to be in alphabetical order. Such as providers, medical conditions, client list and service authorization list. Action Plans, authorizations, financials and applications will need to be in date order, with the most current date first.

B9 Internal e-mail system

B10 Staff need to be able to generate a notification to themselves and other staff for client follow up

B11 All application, letters and medical records can be scanned and saved in client file

B12 Wrap text for all notes and care coordination forms (Action Plan, authorizations, assessment, client notes/follow-up





reminders etc.) 500 word limit

B13 Pre-populated application that can be printed off and mailed to families for yearly renewal corrections.

B14 Dash board that contains the following:

o Each KS-SHCN staff will see the list of client’s they are assigned to work with – when client name is clicked on, it will pull up demographics and follow up notes

o Weekly Follow up tasks (populates according to date on AP, DOB, notes, date provider app. sent)

o Five priorities for the dayo Help button at top of page that contains user

system instruction manual

B15 Side bar box for:

Client search (can be done by first, last name or date of birth, parent’s last or first name, city and county (only need to enter





3 letter to have options pop up)

o only need to enter 3 letters for each name to pop upo SHCN Providerso Clinicso Statues/Regulation/Policieso reports

B16 SHCN Providers: (Tab at the top)

o List providers (alphabetical order)o Check box for provider application on fileo Name- last, first, prefixo Company/practiceo Medical Specialtyo Type of service providedo Address – when zip code (+4) is entered, it will auto

populate City, State and Countyo Phone numbero Fax number





o E-mailo Office contact persono Office billing persono Scan and save signed provider application – if one is not

on file system will auto generate one to be mailed with follow up (6 weeks) appearing in dashboard of service authorizing staff – request a newly completed provider application every five years

Secure direct messaging to providers to be able to share authorization and Action Plan with providers

B17 Statues/ Regulations and Policies

o Index – that hyperlinks to statue, regulation or policy selected – this will need to be something that we can change internally by assigned staff only - read only access allowed for other staff

B18 Tabs above Client Demographics

o Financials





o care coordinationo Release of Informationo Provider Information

B19 Case types

o SHCNo Newborn Screeningo Newborn Hearing screeningo one time diagnostico SSIo clinic onlyo formula only

B20 Status

Open, closed and pending for above case types – drop down box for choices

B21 Demographic window (have all this information flow with the application) – this all must be able to be printed off for client





file

All completed applications will be scanned into client file

Pre-populated applications can be printed off and sent to families for yearly renewal corrections.

Client’s picture will be displayed along with the following:

o Name: last, first, middleo Date of Birth – auto populate current ageo Case status – Open, Pending or Closedo Care Coordinatoro Sex – check box male/femaleo Social Security numbero Check box for interpreter with drop down

options for what type of interpreter is needed – sign language, Spanish, French, German, etc.

o Mother maiden nameo Alias of applicant and/or parentso E-mail address





o Applicant or Parent phone numbero Applicant’s diagnosis and code or reason for

applyingo Home addresso Apartment numbero Cityo Stateo Zip code – when this is entered it will auto

populate the city, state county and Satellite office location (ex. 66612 would populate Topeka, Kansas, Shawnee County and Topeka Satellite office) – we will need the ability to add other Satellite offices in the future

o Mailing address (if different)o School or Early Intervention Services – drop

down boxo School district – drop down box with district

name and numbero Special Services – drop down box (OT, PT,





Speech, Counseling, Other)o Phone numbers: home, cell and worko Current medications – need to be able to list

numerous medications, medication name, dose, prescribing doctor, name and address and phone number of pharmacy

o Is applicant a legal US resident – yes/no drop down box

o Is applicant a legal US citizen – yes/no drop down box

o Do you speak English? Yes/noo If no, language spoken – drop down box with

different language options – we will need to be able to add languages

o Contact person who speaks English – name - phone number

o Applicant’s race – drop down box (American Indian or Native Alaskan, Asian, Black/African American, Native Hawaiian or Other Pacific





Islander, White, othero Ethnicity – check box for Hispanic or Latinoo Parent/Applicants Marital status – drop down

box – Single, married, widowed, divorced, and separated

o Parents name (custodial) - Last, First, Middle – with a check box for step parent

o Phone numbers: Home, work and Cello Parent name (non-custodial) – Last, First, Middleo Phone numbers: Home, work and cello Name of legal Guardian if different from Parents

– Last, First, Middle – check box for guardianship papers on file with SHCN - relationship

o Phone numbers: Home, work and cello Addresso City – this will self-populate when zip code is

enteredo State - this will self-populate when zip code is

entered





o Zip code (+4)o Check box for frontier, rural and urban

B22 Client Insurance information:

Name of primary insurance carrier – Last, First, Middle, relationship to applicant

Ability to scan and save image of insurance card (front and back) and insurance summary page

name of insurance company, start date, Policy and group number, deductible per family/individual, dental/Orthodontic coverage (check box – yes/no)

Secondary insurance – same information as above

Secure direct messaging to insurance providers (KanCare) to be able to share authorization, HCP and Action Plan

B23 Financials (tab – under client)





Check box for foster child

Check box for birth certificate on file with SHCN

Check box for custody or divorce papers on file with SHCN

o List of all persons living in the household – Last, First names, relationship to applicant, date of birth, applied for Medicaid, Name of insurance company, start date, Policy and group number, Deductible per family/individual, Dental/ orthodontic coverage (drop down box - yes/no), Receiving SSI (drop down box - yes/no) – this area will need to allow for multiple persons living in the household

Auto calculates financials:

Check stubs – ability to input gross wages from six check stubs and frequency of pay– system will auto generate average per pay period and calculate yearly total – this will need to be able to record and calculate multiple





persons in the household income

Other calculations needed

Income tax

Self-employment

Unemployment

Assets – Type of resources, primary account holder, value– several lines that can be filled in and will then self-populate total – self calculate assessments allowed by number of members in household according to the demographics – if this amount is greater than allowed amount it will self-populate to final financial calculation sheet

(KAECES) food stamps

SSI

SSDI





Medical condition – this will self-populate from demographics and self-identify if it is a genetic/metabolic condition (NBS) or non-genetic

All financial information will auto calculate on a final financial calculation sheet (see example sheet) to determine eligibility – archive and edit for updates -printable

All financial submitted and application can be scanned in to client file and saved there

Application tracking sheet needs to be included in this area

Once application is approved or denied an auto notification can be sent to the Satellite office in the clients location

B24 Care Coordination (tab - under client)

Client name – will self-populate from Demographic page





Age - will self-populate from Demographic page

Medical condition - will self-populate from Demographic page

Direct Assistance Program (DAP) Chosen – List client specific DAP’s, year to date amount used and remaining balance – need to be able to track client DAP usage and have link to main DAP budget

Drop down box for:

genetic/metabolic

Non genetic/metabolic

Names, ages and relationship of others in the household - will self-populate from Demographic page

Address and phone numbers will self-populate for Demographic page

Check box if client has care coordination with another agency – agency information, care coordinator contact





information – list of gap filling services if necessary that SHCN can assist with – this will need to hold multiple providers

Client care level – I, II, III (drop down) – this will need to be able to be pulled for a report

List of client’s doctors (check box by each doctor’s name to see if they are a current SHCN provider and have a signed provider agreement on file)

o Provider’s nameoo Addresso Phoneo Faxo What was requested by SHCN (200 word limit)o This will need to accommodate multiple

providersCare coordinator assigned – drop down box with staff names – we will need to be able to add to this





Medical records ordered – date - by who – what was requested - when received – date received, what and from who or a follow up generated (two weeks) to dash board tasks

Client notes: have one-liner (subject) that states note topic – click on line to pull up all details – this will help staff scan to find what they are looking for faster without having to read all notes – will need to be able to do key word searches in this area

Staff can send follow-up notifications self and to each other

Service authorization needs to have date (to and from) – service – and by who

Internal and external referral can be sent through the system

B25 Service Authorization TAB – this will need to link to client profile page

Basic client demographics will pre-populate for demographic





page (Clients name, DOB, address, phone)

Wrap text with character limit of 500 words

Pre-populated authorization wording that can be modified or deleted by care coordinator – One for each Direct Assistance Program

A service amount check box that if clicked the authorization amount can be entered and will show on the authorization as maximum amount authorized

Pre-populate care coordinators name, contact information and date.

B26 Intake Form TAB:

Name: last, first, middle

Date of Birth – auto populate current age

Sex – check box male/female





Social Security number

Mother maiden name

E-mail address

Applicant or Parent phone number

Applicant’s reason for requesting diagnostic evaluation

Home address

Apartment number

City

State

Zip code – when this is entered it will auto populate the city, state county and regional office location (ex. 66612 would populate Topeka, Kansas, Shawnee County and Topeka Satellite office) – we will need the ability to add other Satellite offices in the future





Drop down box:

Does the client have insurance?

Yes/no

Name of insurance company and policy number

Deductible/Co-Pay/Co-Insurance information

Insurance coverage period – calendar box for selection

B27 Action Plan TAB - (our form in an electronic version that can be changed updated as needed while still saving the originals) – must be able to be printed – This will need to link with client profile page

Date plan was developed and by who (SHCN care coordinator and caregiver/client)

Client’s name, age and contact information

Goals: Goals should be specific, obtainable and measurable with projected completion dates,





actual completion dates and who is responsible for the action to be taken.

Care coordinators name and contact information

Referrals – KDHE /other – list who referred to, contact information and why

DAP(s) client has chosen – when the Action Plan (AP) is printed it should be auto linked to the correct DAP(s) forms as an option to print with AP.

B28 Clinic - side bar

All clinic forms should be able to be scanned and linked to client information

Client’s name, date of birth, address, phone, e-mail, SHCN condition and if they are a SHCN client – patient information should self-populate from demographics

Clinic attended, providers seen, date of clinic





If cancelation occurred – who canceled, when and why

Clinic notes

B29 Client Portal

Current status – active, clinic only, pending (only for those who have an application that has been sent or is going through the medical &/or financial eligibility process

Can enter or update SHCN application electronically

Can fill out Special Bequest forms

Request services – this information would send a message to the care coordinator – including Special Bequest

Complete family and client needs assessment - this information would send a message to the care coordinator





Access their personal information – demographics, Authorizations, action plan(read only format)

Order formula – this information would send a message to care coordinator who orders formula

B30 Special Bequest TAB - this will need to be able to be printed and secure e-mailed to commissioners

Request received by (drop down with care coordinators names)

Client’s first, middle and last name

Client’s address

phone

Client’s date of birth – auto calculates age

Parent name

Request – this will need to be a wrap text (500 word limit)

Requested by





Item name and description

Amount of item

Vender options for item

Matching funds – by who and amount

Special Bequest meeting date

Drop down box with approved, not approved, additional information requested, approved at a different amount than requested (if this is the option chosen than a blank needs to appear so amount approved can be imputed)

Completion date

B31 Ability to customize what data is collected for client profiles.

B32 Ability to conduct surveys via notification system.

B33 Ability to receive acknowledgement of notifications.





B34 Persistent notifications when alerts go unanswered.

B35 Budget tracking TAB (with subtabs of DAP’s and contracts that link to main budget)– will need one budget that tracks all DAP’s authorized, contracts and total budget costs authorized and total cost paid out

Each DAP total allotted amount – this will need to be able to be modified, amounts transferred from one DAP to another, changed, or reset for new year by manager, director or financial staff – when being set for new year all client authorizations not paid will be auto deducted from total

Client name, DAP amount authorized, authorization for, who authorized by and a check box to show when paid

Amounts authorized will need to come off the budget amount allotted for each DAP

When DAP (main budget) expenditure is at 90% an alert would be generated and sent to program manager, director and financial staff

Budget tracking per client per DAP chosen – this would be linked to client data and balance remaining per DAP to appear





on each client profile page – all this will need to pre-populate to main budget

Each client budget will link to the main budget – as amounts are authorized they will auto deduct from main budget

Date, Client name, DAP, amount authorized, authorization for, who authorized by and a check box to show when paid

This should send an auto alert to the care coordinator listed when the authorized amount reaches 80% yearly allocation

This would need to be able to be cleared and reset with application renewal acceptance

R Reporting Requirements

R1 Ability to scan and save provider application

Provider reporting - Date application was last signed – A report can be generated from this date to pop up on a designated staff’s weekly follow-up list so that they can follow-up with





providers every five years to fill out a renewal application

Reports can be pulled based on date of application on file, provider specialty, name linked to client name, county, city

R2 Miscellaneous reports can be pulled from the following fields in Demographics: Age, date of birth, medical condition, medical code, service authorization dates, action plan dates, projected goal dates vs. actual completion dates, care levels, care coordinator client list and their location and client level, care coordinator follow up notes (according to note date to follow-up), intake form date and reason for service, Special Bequests (dates, requests, amounts requested and approved) Early Intervention services, school district (name or number), race, ethnicity, language, resident, citizen, county, city, zip code, sex, foster child, medication, frontier, rural, urban and case types, date of application, referrals made and to who, SSI status, qualified financial eligibility scale (sliding fee), genetic/metabolic, non-genetic/metabolic, non-genetic





youth turning 21 years old, Medicaid status, food stamps and any other data tracking identified through care coordination.

Designated staff should have auto alerts for those non-genetic/metabolic youth turning 21 years old and DOB for all clients, so that renewal application can be sent 6 weeks prior to the child’s DOB.

R3 Financial reports can be pulled on individual Client DAP’s, individual DAP’s, total budget, authorized amounts, paid amounts, pending amounts outstandingInformation should be able to be pulled for a specific period of time - five years to 1 day

R4 Each staff will receive weekly follow-up reminders in their dash board task list – for letters that need to be sent, calls, action plan duties, follow-up note dates etc.

R5 Manager will receive and auto notification weekly on any staff persons weekly follow ups that were not competed two weeks after their follow-up task appeared

R6 Be able to pull reports on Newborn Screening and Newborn





Hearing Screening

R7 Insurance reporting - can be pulled by insurance type, authorization date and Action Plan dates

R8 Data tracking indicators on national and state preforming measures, SHCN priorities and care coordination objectives

R9 Customizable reporting and analytics

R10 Ability to create and launch frequently requested reports

R11 Ability to export reports with off-line creation of pivot tables and cross-referencing.

R12 Detailed notification analysis report for quick and easy broadcast review.

R13 Generate EDS report (Medicaid clients) – report needs to be saved in “notepad” format, in order to transfer it to HP, through Core FTP Pro.

o Clients first and last nameo Clients date of birtho Clients ID #





S Security Requirements

S1 Provide Audit logs of changes made within the system.

S2 Ability to store and send Personally Identifiable Information (PII) data locally and securely to comply with Kansas regulatory requirements

S3 Provide Encryption of data at rest.

S4 Role-based access controls for organization administrators, group managers, data managers, dispatchers and notification operators.

S5 Secure user authentication

S6 Provide ability for administrator to reset user password, reinstate a user, and disconnect or logout a user.

H Hosting Functions

H1 Provide 24 hours per day and 7 days per week live support.





H2 Provide 98.9% uptime availability of notification system.

H3 Vendor shall establish and maintain up to three (3) processing environments. These processing environments are:1) Production – Versions of released, fully tested and user

accepted code. Requires stringent change management and monitoring controls and processes.

2) Testing/QA – This environment will be the initial staging area for testing upgrade/update components (scripts, data conversions, etc). Activities in this environment may contain an accumulation of incremental updates as a rollup package accepted in the Development environment. After final acceptance, this environment will serve as the on-going Development Testing/QA environment. Testing should mirror the Development environment plus include the same security infrastructure components as Production to allow technical staff to fully ensure secure application and data access requirements are met.

3) Disaster Recovery - Mirrors the production environment with hardware and software requirements. Will serve as a





backup to the production environment if production environment is deemed unusable. This environment must be located in different city than production system.

H4 Provide Regular Backup and Recovery Services.

H5 Provide administration of all security devices, i.e., firewalls and, secure authentication server.

H6 Availability to a wide variety of care coordinators and families across Kansas

H7 All hosting vendors for KDHE must complete three (3) “Cloud Service Provider” documents to meet KDHE hosting requirements. These documents are located in APPENDIX C.

T Technical Requirements

T1 Browser-based access using Internet Explorer version 9.0 or greater.

T2 Ability to conform to KDHE server operating system standard (MS/Windows Server 2008 or greater) or propose an alternative solution and the rational for using a different server operating system.

T3 Ability to conform to KDHE database engine standard (MS/SQL Server 2012) or propose an alternative solution and the rational for using a different database engine.

T4 Easy refreshing of test and training data, on demand, by system administrator or qualified database administrator.

T5 Accurate/current data and meta-data dictionary available.

T6 Database support data replication and synchronization across multiple physical servers.

T7 Provide recommended hardware configurations based on contact population.

T8 Provide Application Programming Interfaces (API)

T9 Ability to interface with Kansas online training system called KS-Train at https://ks.train.org/

T10 Web-based applications shall NOT: User shared folders or network drives User parental paths Query information or hierarchy paths via the query string.

T11 Web Accessibility shall: Conform to Information Technology Policy 1210 Revision 2,

State of Kansas Web Accessibility Requirements and Section 508 of the Rehabilitation Act (29 U.S.C. 794d) regarding American Disabilities Act compliance guidelines. Developers may research this information at http://www.da.ks.gov/kpat/policy/.

Vendor response will indicate their ability to conform to this requirement or propose an alternate solution and the rationale.

T12 Ability to operate across State’s 100 MB WAN and 10/100/1000 LAN or propose an alternative solution and the rationale for using a different configuration.

T13 Ability to support up to 5000 concurrent users.

web viewincome tax. self-employment. unemployment. ... will need to be able to do key word searches...

Documents