HomeMy WebLinkAbout32062AGREEMENT NO. 08-042-4
1 FOURTH AMENDMENT TO AGREEMENT
2 THIS FOURTH AMENDMENT TO AGREEMENT (hereinafter "Amendment IV"), is
3 made and entered into this 24th day of March , 2015, by and between the
4 COUNTY OF FRESNO, a political subdivision of the State of California, Fresno, California
5 (hereinafter "COUNTY"), and Netsmart Technologies, a Delaware Corporation, whose
6 address is 4950 College Boulevard, Overland Park, KS 66211, successor in interest to
7 Netsmart New York, Inc. (hereinafter "CONTRACTOR" or "Netsmart").
8 WHEREAS, COUNTY and CONTRACTOR entered into Agreement number A-08-142,
9 dated March 25, 2008 (hereinafter "Agreement"), pursuant to which CONTRACTOR agreed to
10 provide, support, and maintain an electronic integrated mental health information system for
11 the automated support of all Mental Health programs and related financial activities of
12 COUNTY's Department of Behavioral Health (DBH)-(hereinafter "Avatar"); and
13 WHEREAS, COUNTY and CONTRACTOR entered into a First Amendment to the
14 Agreement, effective August 9, 2011 (hereinafter "Amendment I") to allow for the provision of
15 continuous maintenance and support for Avatar pursuant to the terms of the Agreement, and
16 to install, and maintain a Substance Abuse Information System (hereinafter "SAIS"), to allow
17 COUNTY to maintain client, financial, and contract provider (hereinafter "Provider")
18 information; and
19 WHEREAS, COUNTY and CONTRACTOR entered into a Second amendment to the
20 Agreement, effective November 6, 2012 (hereinafter "Amendment II") to have the
21 CONTRACTOR; provide Software Hosting Services and permit COUNTY to load data on the
22 hosted system via Secure Socket Layer (SSL); terminate maintenance related products not
23 being used by COUNTY and to extend the Term of this Agreement; and
24 WHEREAS, COUNTY and CONTRACTOR entered in a Third amendment to the
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1 Agreement, October 8, 2013 (hereinafter "Amendment Ill) to have the CONTRACTOR;
2 implement MyAvatar, a certified electronic health record and practice management solution
3 which included an upgrade of the current application foundation RADplus 2006 to RADplus
4 2011; implement Perceptive Point of Service Scanning to provide staff the ability to quickly
5 and easily scan, capture and organize low volume scanned images; implement
6 MyHealthPoint, a web portal that allows clients access to information related to their health
7 care; and to add additional consulting hours dedicated toward the implementation of MyAvatar
8 and Perceptive Point of Service Scanning; and
9 WHEREAS, COUNTY and CONTRACTOR now desire to amend the Agreement to 1)
10 have the CONTRACTOR implement CareConnect, a software service that enables clinical
11 data to be shared between DBH and laboratory organizations to allow DBH to submit lab
12 orders to laboratory organizations and allow laboratory organizations to submit lab results to
13 DBH, 2) have the CONTRACTOR implement ICD-10 and DSM-5 Upgrade to provide cross-
14 mappings, updates and clinician friendly terms to manage the transition across the different
15 diagnosis vocabularies, 3) have the CONTRACTOR implement OrderConnect™, Netsmart's
16 Surescripts Certified secure Web-based electronic prescribing, order tracking management
17 system, 4) have the CONTRACTOR implement the OrderConnect™ Inventory Module (IMM)
18 which allows an organization to input information related to medication samples that they
19 receive which they then give to patients as well as Prescription Assistance Program (PAP)
20 medications that COUNTY receives and needs to assign to a specific patient, 5) have the
21 CONTRACTOR provide Scriptlink hosting services, 6) have the CONTRACTOR implement
22 MyHealthPointe™ Kiosks which will provide client stations within waiting areas to allow clients
23 to access, and be allowed to, utilize information related to their demographic, administrative,
24 and clinical information to allow the client to be more engaged in their own care, and 7) have
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1 the CONTRACTOR implement the Reaching Recovery System which will provide a
2 measurement-based clinical content tool, and 8) have the CONTRACTOR implement the
3 Recovery Needs Level Assessment within Avatar, which assesses consumers' needs and
4 level of care.
5 NOW, THEREFORE, for good and valuable consideration, the receipt and adequacy
6 of which is hereby acknowledged, COUNTY and CONTRACTOR agree as follows:
7 1. The following definitions shall be added to Section II. DEFINITIONS as set forth
8 in the existing Agreement:
9 CareConnect:
10 A software service that enables clinical data to be shared between providers and other
11 entities, to be used under this Agreement both for the exchange of lab orders and lab
12 results and for the exchange of Clinical Care Documents (CCD) with other Provider
13 Agencies, in support of national standards related to continuity of care.
14 International Statistical Classification of Diseases (lCD}:
15 The international standard diagnostic tool for epidemiology, health management and
16 clinical purposes designed as a health care classification system, providing a system of
17 diagnostic codes for classifying diseases including nuanced classifications of a wide
18 variety of signs, symptoms, abnormal findings, complaints, social circumstances, and
19 external causes of injury or disease. The lCD is revised periodically.
20 Diagnostic and Statistical Manual of Mental Disorders (DSM):
21 Published by the American Psychiatric Association, offers a common language and
22 standard criteria for the classification of mental disorders. The DSM is revised
23 periodically.
24 ICD-10 & DSM-5 Upgrade:
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The industry will be moving from ICD-9 codes to ICD-10 codes for diagnosis and
inpatient procedures. In addition, the American Psychiatric Association has recently
released DSM-5 as a replacement to the current industry standard DSM-IV. The ICD-
1 0 & DSM-5 upgrade will provide the necessary cross-mappings, updates and clinician
friendly terms to manage the transition across the different diagnosis vocabularies
OrderConnect™:
Netsmart's Surescripts Certified secure Web-based electronic prescribing, order
tracking management system.
OrderConnect™ Inventory Management Module (IMM):
A module that allows organizations to input information related to medication samples
that they receive which they then give to patients as well as Prescription Assistance
Program (PAP) medications that they receive and need to assign to a specific patient.
Scriptlink Hosting Services:
Scriptlink is an interface that allows Netsmart customers to create their own web
services, to either perform an external task based on the form data, or update the
current form a user is editing with their own events. Since web services can be written
in any language, customers have greater flexibility to integrate the Avatar product into
their own programs. Scriptlink simply sends the current data in an option to a script. It
is then up to the script writers to decide what to do with that data.
MyHealthPointeTM Kiosk:
MyHealthPointe™ Kiosk provides hardware and application that will be located in
COUNTY waiting areas to foster client engagement at the point of care. Functions of
the application will allow clients the ability to; authenticate their identify, review and
update demographics, verify insurance information, electronically sign administrative
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1 forms, provide information related to medication adherence and management,
2 complete clinical intake screenings and assessments, and other point of care clinical
3 messaging."
4 2. That the existing COUNTY Agreement No. 08-142-3 (Amendment Ill), Page
5 Three (3), beginning with section four (4), line fifteen (15), with the number "4" and ending on
6 page three (3), line twenty three (23), with the word "session." be deleted and the following
7 inserted in its place:
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"4. New Section Ill-Q. shall be inserted following Section 111-P.:
Q. MYHEAL THPOINTE™
CONTRACTOR shall implement MyHealthPointe™ by providing
MyHealthPointe™ web server configuration services and MyHealthPointe™ implementation
services. The parties agree that MyHealthPointe™ will allow COUNTY clients access to a host
13 of information related to their care 24 hours a day via a secure, web-based portal. The parties
14 further agree that MyHealthPointe™ shall allow COUNTY clients the ability to schedule and
15 modify appointments, review and comment on their treatment plans, view current medications
16 and track their usage, communicate with their care team, check billing information and
17 account balances, and record information in an online journal prior to a scheduled session."
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3. New Section 111-R shall be inserted following Section 111-Q.:
"R. CARECONNECT
CONTRACTOR shall implement CareConnect, a software service that
enables clinical data to be shared between providers and other entities, in accordance with
the Scope of Work shown in Revised Attachment G, attached hereto and incorporated herein
by reference. The parties agree that the implementation of CareConnect will allow the
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1 COUNTY to submit electronic lab orders two (2) laboratories of the COUNTY's designation
2 and will allow for electronic lab results to be submitted to COUNTY by each lab provider
3 stated herein. Additionally, the CARECONNECT solution will facilitate the exchange of
4 Clinical Care Documents (CCD) between the COUNTY and other care providers."
5 4. New Section Ill-S shall be inserted following Section 111-R.:
6 "S. ICD-1 0 and DSM-5 Upgrade:
7 CONTRACTOR shall implement the ICD-1 0 and DSM-5 Upgrade to allow
8 the necessary cross-mappings, updates and clinician friendly terms to manage the transition
9 across the different diagnosis vocabularies related to the behavioral health industry migrating
10 from ICD-9 codes to ICD-1 0 codes, in accordance with the Scope of Work shown in Revised
11 Attachment G.".
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5. New Section 111-T shall be inserted following Section 111-S.:
"T. OrderConnect™:
14 CONTRACTOR shall implement OrderConnect™, CONTRACTOR'S
15 Surescripts Certified secure web-based electronic prescribing, order tracking management
16 system, in accordance with the Scope of Work shown in Revised Attachment G. The parties
17 agree that the OrderConnect™ suite is an e-prescribing and medication management product
18 that has the ability to exchange web-based prescription information with community
19 pharmacies via the Surescripts national network and has the ability to exchange web-based
20 laboratory orders and radiology/imaging orders and their results and diagnostic information
21 with specific laboratories. The parties agree that COUNTY currently uses lnfoscriber, another
22 of Netmart's e-prescribing solutions, and that OrderConnect™ will replace the existing
23 lnfoscriber module with the new fees for OrderConnect™ beginning 60 days after the
24 execution of this Agreement as further described in Section VIII. Each OrderConnect™
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facility will be allowed to fax one hundred (1 00) fax pages directly from the application per
month per each prescriber license purchased as further described in Section VIII. The parties
agree that OrderConnect™ will assist the COUNTY with improving quality of care, reducing
medication errors and meeting criteria to receive Medi-Cal and Medicare funds for meaningful
use of an electronic health record (EHR)."
6. New Section 111-U shall be inserted following Section 111-T.:
7 "U. OrderConnect™ Inventory Management Module (IMM):
8 CONTRACTOR shall implement the OrderConnect™ IMM to allow
9 COUNTY to input information related to medication samples that it receives which are then
10 given to COUNTY patients as well as Prescription Assistance Program (PAP) medications
11 that COUNTY receives and needs to assign to specific patients. The parties agree that only
12 COUNTY users with appropriate permission levels can enter inventory. It is further
13 understood between the parties that the OrderConnect™ IMM will allow COUNTY authorized
14 users to assign inventory to prescriptions that are written but are to be filled from the sample
15 supply or from a patient's PAP medications, and that after assignments of sample supply or a
16 patient's PAP medications, the OrderConnect™ IMM will decrement from the total amount
17 that was input."
18 7. New Section 111-V shall be inserted following Section 111-U.:
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"V. Scriptlink Hosting Services:
Scriptlink is a tool that allows COUNTY to create its own programmable
21 functionality when addressing quality control items such as creating warnings to prevent
22 certain types of entries at time of entry to mitigate these types of errors from occurring. The
23 parties now agree that CONTRACTOR shall host the Scriptlink solution via a dedicated and
24 hosted server environment for scripts."
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8. New Section 111-W shall be inserted following Section 111-V: 1
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"W. Subscription Rights:
1. The new subscriptions added as per Amendment IV ("Subscription
4 Products and Services") are specifically included within the grant of license and term of
5 license as "Licensed Programs" under the Agreement.
6 2. COUNTY grants to CONTRACTOR a non-exclusive, non-transferable
7 license (the "Usage License") to use all patient data for the sole purpose of operating the
8 Subscription Products and Services for the benefit of COUNTY and its clients and for
9 maintaining the Subscription Products and Services (for example, creating backups of the
10 Patient Data or moving it between servers) so long as CONTRACTOR has a bona fide need
11 to do so subject to and for the sole purpose required by this Amendment IV and the Master
12 Agreement. The Usage License does not confer on CONTRACTOR any right to share patient
13 data with third parties other than CONTRACTOR employees or consultants who are bound by
14 agreements that contain confidentiality provisions equivalent to those contained in the
15 Agreement. The foregoing restriction on CONTRACTOR's use of Patient Data does not
16 prohibit CONTRACTOR from making use of De-identified Data as described and permitted
17 under HIPAA.
18 3. In addition to the obligations under the Agreement COUNTY agrees:
19 a. That it has no ownership rights in data or information in the Drug
20 Information Data (DID) services or content.
21 b. To restrict use of DID to licensed healthcare professional directly
22 connected with the COUNTY, either as an employee or an authorized affiliate. Such use shall
23 be made only under the supervision of, and reliance upon, the clinical discretion and judgment
24 of a licensed physician. As between the COUNTY and the publisher of the DID, COUNTY
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1 assumes full responsibility for ensuring the appropriateness of using and relying upon the
2 information supplied by the DID publisher, in view of all attendant circumstances, indications
3 and contraindications. Except as provided above, it will not otherwise make the DID content
4 available to any person, or entity including the government, whether affiliated or not, except as
5 required by subpoena or other legal process and after notice to the owner of the content.
6 c. To maintain accurate and up to date Patient Data in all systems
7 covered by the Master Agreement. COUNTY hereby represents and warrants that is has
8 obtained from its patients all authorizations and consents required under all applicable laws in
9 order for COUNTY to provide data to CONTRACTOR (and its third party vendors If
10 applicable) and for CONTRACTOR and its vendors to use data to provide the services in
11 accordance with this Agreement.
12 d. To provide support to its Users and Consumers related to their use
13 of the Subscription Products and Services.
14 e. To notify CONTRACTOR in the event COUNTY becomes aware of
15 or suspects misuse, unauthorized access, data corruption or any other threat to the security of
16 the Subscription Products system and related data or if COUNTY receives a subpoena or
17 other legal process requiring disclosure of CONTRACTOR confidential information or DID
18 content.
19 f. In connection with the use of Red Book information in DID,
20 COUNTY acknowledges and agrees that the prices contained in Red Book are based on data
21 reported by manufacturers. The DID publishers have not preformed any independent analysis
22 of the actual prices paid by wholesalers and providers in the marketplace. Thus, actual prices
23 paid by wholesalers and providers may well vary from the prices contained in the database
24 and all prices are subject to change without notice."
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9. New Section III-X shall be inserted following Section 111-W:
"X. MyHealthPointe Kiosks:
CONTRACTOR shall implement MyHealthPointe™ by providing
MyHealthPointe™ kiosk services. The parties agree that MyHealthPointe™ kiosks provide
hardware and an application that will be located in COUNTY waiting areas to foster
continuous client engagement at the point of care. Functions of the application will allow
clients the ability to; authenticate their identity, review and update demographics, verify
insurance information, electronically sign administrative forms, provide information related to
9 medication adherence and management, complete clinical intake screenings and
10 assessments, and other point of care clinical messaging."
11 10. New Section Ill-Y shall be inserted following Section III-X:
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"Y. Reaching Recovery System:
CONTRACTOR shall implement the Reaching Recovery System which is
14 a measurement-based clinical content tool. With the purchase of the Reaching Recovery
15 System the COUNTY users receive access to four (4) mental health recovery instruments and
16 longitudinal display of client's progress data. This tool will be accessed from Avatar."
17 11. New Section 111-Z shall be inserted following Section 111-Y:
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"Z. Recovery Needs Level Assessment:
CONTRACTOR shall implement Reaching Recovery Needs Level
20 Assessment tools to assess clients' needs/level of care. The assessment is self-scored and
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provides a recommendation of level of care ranging from most intensive to least intensive.
These tools will be provided as screens in Avatar as a stand-alone assessment that provides
unlimited use with clients but does not interact with/share data with the full Reaching
Recovery System."
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1 12. New Section 111-AA shall be inserted following Section 111-Z:
2 "The applications must run on a client operating system that is consistently and
3 currently supported by the operating system vendor. Applications under maintenance are
4 expected to always be current, or no more than one version behind, in regards to the required
5 client 0/S. No outdated or unsupported client 0/S will be implemented on the production
6 network. COUNTY will apply patches to both the client 0/S and security subsystems on
7 COUNTY PCs as releases are available from 0/S vendors following coordination with
8 CONTRACTOR to ensure continued operations following such updates.
9 In order to support a secure environment, the application must run on the latest
10 supported security release of any required third-party software, such as JAVA, Flash,
11 etc. COUNTY will notify CONTRACTOR when a critical security patch is released for such
12 products. CONTRACTOR will have 30 days to ensure application can perform in the updated
13 environment or such time that may be reasonably required based on the requirement.
14 COUNTY will actively run anti-virus management on all PCs. The application is expected to
15 perform adequately while anti-virus management is active."
16 13. Attachment E-1 to the Agreement shall be replaced by Revised Attachment E-1,
17 attached hereto and incorporated herein by reference.
18 14. Attachment G to the Agreement shall be replaced by Revised Attachment G,
19 attached hereto and incorporated herein by reference.
20 15. Section VIII. COMPENSATION/INVOICING, as previously modified by
21 Amendment Ill, shall be deleted in its entirety and replaced with the following:
22 "VIII. COMPENSATION/INVOICING:
23 A FEES/CHARGES
24 Refer to Revised Attachment E-1 for a schedule of all compensation payable
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1 under this Agreement. All fees, including annual maintenance fees for Avatar, will be paid as set
2 forth in Revised Attachment E-1. In no event shall the maximum expenditure under this
3 Agreement for the entire term exceed $5,441 ,386.
4 The fees for SAIS Maintenance and Support for 28 Providers will be $47,401 for
5 the period of July 1, 2011 through June 30, 2012. The fees will be $48,823 for the period of July
6 1, 2012 through June 30,2013. The fees will be $50,287 for the period of July 1, 2013 through
7 June 30, 2014. The fees will be $51,796 for the period of July 1, 2014 through June 30, 2015.
8 The fees will be $53,350 for the period of July 1, 2015 through June 30, 2016. The fees will be
9 $54,951 for the period of July 1, 2016 through June 30, 2017.
10 Fees for Software Hosting Services shall be as follows:
11 1) Services related to migrating to a Hosted system shall be $6,400.
12 2) Set-up Services
13 Set-up services shall consist of building the live and test databases, the reporting
14 systems, and the web server system in the Netsmart Data Center. Installation of all licensed
15 programs together with any patches for optimal performance. Configuration and testing of
16 software programs. Establishing security infrastructure, establishing backup/disaster recovery
17 environments and setting up SSL connectivity. Total charges for Set-Up services shall be
18 $7,500.
19 3) Hosting Charges
20 Licensed Programs will be hosted at the Netsmart Data Center. Monthly price is
21 based upon a rate of $37 per named user per month for 615 named users per month, until
22 January 1, 2016 when the purchase will increase to 800 named users per month. Monthly fee
23 will begin on the first day of the first month following the date of execution of Amendment II.
24 Total monthly recurring charges for615 names users shall be $22,755; however, beginning on
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1 January 1, 2016 the total monthly recurring charges for 800 names users shall be $29,600.
2 4) Consulting Services
3 For consulting services that do not fall under the scope of Additional Avatar Support
4 as indicated in Section III-E(6) of this Agreement, CONTRACTOR shall provide consulting
5 services at the rate of $225 per hour for a maximum of 100 hours per year, beginning in Fiscal
6 Year 2012-13 (July 1, 2012 to June 30, 2013). In no event shall consulting service fees paid
7 under this Agreement exceed $22,500.00 annually. Any consulting services must be requested
8 by COUNTY in writing. CONTRACTOR shall invoice COUNTY for consulting service fees as
9 used.
10 5) The following Products will be discontinued effective upon execution of
11 Amendment II:
12 i. Avatar MSO, Annual Maintenance
13 ii. HL-7 Interfaces (2), Annual Maintenance
14 iii. PeopleSoft Interface, Annual Maintenance
15 iv. Avatar Mobile (25), Annual Maintenance
16 6) In the event that Software Hosting Services are terminated pursuant to Section Ill
17 J. Software Hosting Services, Subsection 7, the monthly charges for software hosting services
18 shall cease effective upon a mutually agreed upon date with any remaining charges prorated
19 based upon the last day of provision of software hosting services by CONTRACTOR.
20 Fees for implementation of the My Avatar Upgrade will be as follows:
21 Professional fees associated with implementation of the My Avatar upgrade as
22 described in Revised Exhibit G shall be $19,800.
23 Fees for implementation of Perceptive Point of Service Scanning shall be as follows:
24 1) Avatar Perceptive Point of Service Scanning Third Party Software shall be $9,500.
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1 2) Netsmart Monthly Subscription Fee for Avatar Perceptive Hosting for up to 50
2 named users shall be $237.41 per month. Monthly subscription fee will begin on the first day of
3 the first month after the Perceptive Point of Service Scanning go live date.
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3) Netsmart Professional Services for Avatar Perceptive implementation as described
in Revised Exhibit G shall be $7,500.
4) Netsmart Professional Services for Avatar Perceptive Hosting Set up services
shall be $7,500.
5) Third Party monthly support fees for Avatar Perceptive Point of Service scanning
maintenance shall be $158.33 per month. Third party monthly support fees for Avatar Perceptive
Point of Service scanning maintenance will begin on the first day of the first month after the
Perceptive Point of Service Scanning is made available to the COUNTY.
Fees for implementation of MyHealthPointe™ fees shall be as follows:
1) MyHealthPointe™ subscription fees shall be $4,166.66 per month. The first
monthly subscription fee shall begin the first day of the following month after the
MyHealthPointe™ is made available to the COUNTY.
2) MyHealthPointe™ web server configuration services shall be $3,000.
3) MyHealthPointe™ implementation services shall be $9,000.
4) MyHealthPointe™ kiosks monthly subscription fees shall be $750 per month. The
fees associated with the subscription shall begin 60 days after execution of Amendment IV.
5) MyHealthPointe™ kiosks monthly screening content fee shall be $500 per month.
The fees associated with the subscription shall begin 60 days after execution of Amendment IV.
6) MyHealthPointe™ kiosks implementation services shall be $33,700. Fees for
implementation services shall be invoiced at 50% due upon initiation of project implementation
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1 and 50% upon project completion.
2 Consulting Fees for Implementation of the My Avatar Upgrade and Perceptive Point of
3 Service Scanning:
4 CONTRACTOR shall provide consulting and training services for the
5 implementation of the My Avatar Upgrade and the Perceptive Point of Service Scanning
6 consistent with an agreed upon project plan ("Project Plan") at the rate of $225 per hour for a
7 maximum of 448 hours for the period of July 1, 2013 through June 30, 2014. In no event shall
8 MyAvatar Upgrade and the Perceptive Point of Service Scanning consulting service fees paid
9 under this Agreement exceed $100,800 for the period of July 1, 2013 through June 30, 2014.
10 Any My Avatar Upgrade and the Perceptive Point of Service Scanning consulting services must
11 be included in the Project Plan agreed to in writing by COUNTY's Contract Administrator and
12 CONTRACTOR. CONTRACTOR shall invoice COUNTY for consulting service fees as used.
13 Fees for implementation of CareConnect shall be as follows:
14 1) Annual fees for CareConnect base subscription for up to 1,000 named users on
15 the enterprise Avatar solution shall be $15,300. The fees associated with the subscription shall
16 begin 60 days after execution of Amendment IV.
17 2) CareConnect base set up and implementation services shall be $6,000. Fees for
18 implementation services shall be invoiced at 50% due upon initiation of project implementation
19 and 50% upon project completion.
20 3) CareConnect Lab Order Outbound Interface -annual subscription fee shall be
21 $6,000. The fees associated with the subscription shall begin 60 days after execution of
22 Amendment IV.
23 4) CareConnect Lab Order implementation services shall be $6,000. Fees for
24 implementation services shall be invoiced at 50% due upon initiation of project implementation
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1 and 50% upon project completion.
2 5) CareConnect Lab Results Inbound Interface annual subscription fee shall be
3 $6,000. The fees associated with the subscription shall begin 60 days after execution of
4 Amendment IV.
5 6) CareConnect Lab Results implementation services shall be $6,000. Fees for
6 implementation services shall be invoiced at 50% due upon initiation of project implementation
7 and 50% upon project completion.
8 7) CareConnect Referral Connector Interface annual subscription fee shall be
9 $3,000. The fees associated with the subscription shall begin 60 days after execution of
1 0 Amendment IV.
11 8) CareConnect Referral Connector implementation services shall be $5,000. Fees
12 for implementation services shall be invoiced at 50% due upon initiation of project
13 implementation and 50% upon project completion.
14 Fees for the ICD-10 and DSM-5 Upgrade shall be as follows:
15 1) Third party annual subscription for Diagnosis Content on Demand shall be
16 $8,769.12. The fees associated with the subscription shall begin 60 days after execution of
17 Amendment IV. Under this subscription, 160 named users will access DSM content for
18 recording diagnosis. In the event that more than 160 names users access DSM content for
19 recording diagnosis, a surcharge of $0.50 per month shall apply for each additional named user.
20 2) For Netsmart professional services, the Plexus Foundation Implementation-Avatar
21 product shall be $12,000. Fees for implementation services shall be invoiced at 50% due upon
22 initiation of project implementation and 50% upon project completion.
23 Fees for OrderConnect™ shall be as follows:
24 1) Annual fees for OrderConnect base subscription shall be $1,500. The fees
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1 associated with the subscription shall begin 60 days after execution of Amendment IV. Each
2 OrderConnect facility will be allowed to fax 100 pages directly from the application per month per
3 each prescriber license purchased by COUNTY. Any fax pages in excess of the 100 page
4 allowance in any calendar month will be billed at $0.20 per page for the balance of that month.
5 2) OrderConnect base set up and implementation services shall be $6,750. Fees for
6 implementation services shall be invoiced at 50% due upon initiation of project implementation
7 and 50% upon project completion.
8 3) OrderConnect Inventory Management annual subscription fee shall be $3,000.
9 The fees associated with the subscription shall begin 60 days after execution of Amendment IV.
10 4) OrderConnect Inventory Management implementation services shall be $675.
11 Fees for implementation services shall be invoiced at 50% due upon initiation of project
12 implementation and 50% upon project completion.
13 5) OrderConnect Non-Prescriber User annual subscription fees for 33 users shall be
14 $5,148. The fees associated with the subscription shall begin 60 days after execution of
15 Amendment IV.
16 6) OrderConnect Full Suite Prescriber annual subscription fees for 51 users shall be
17 $63,648. The fees associated with the subscription shall begin 60 days after execution of
18 Amendment IV.
19 Fees for Scriptlink Hosting services shall be as follows:
20 1) Scriptlink Hosting Services annual subscription fee shall be $15,000. The fees
21 associated with the subscription shall begin 60 days after execution of Amendment IV.
22 Fees for Reaching Recovery System shall be as follows:
23 1) Netsmart subscription fees for the Reaching Recovery System to support 2,500
24 clients shall be $25,000. The fees associated with the subscription shall begin July 1, 2015.
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1 2) Reaching Recovery System Clinical Content Implementation fee is $2,000. Fees
2 for implementation services shall be invoiced at 50% due upon initiation of project
3 implementation and 50% upon project completion.
4 Fees for the Recovery Needs Level Assessment services shall be as follows:
5 1) Recovery Needs Level Assessment Term License annual fee shall be $2,500. The
6 fees associated with the subscription shall begin July 1, 2015.
7 2) Recovery Needs Level Assessment Term Maintenance annual fee shall be $525.
8 The fees associated with the subscription shall begin July 1, 2015.
9 3) Netsmart fees for the Recovery Needs Level Assessment implementation services
10 shall be $600. Fees for implementation services shall be invoiced at 50% due upon initiation of
11 project implementation and 50% upon project completion.
12 It is understood that all expenses incidental to CONTRACTOR'S performance of services
13 under this Agreement shall be borne by CONTRACTOR.
14 B. INVOICE SCHEDULE-AVATAR AND SAIS INSTALLATION, TRAINING AND
15 LICENSE FEES AND SOFTWARE HOSTING SERVICES AND IMPLEMENTATION OF
16 MY AVATAR UPDGRADE AND PERCEPTIVE POINT OF SERVICE SCANNING,
17 CARECONNECT™,ICD-10 & DSM-5 UPGRADE, ORDERCONNECT™, ORDERCONNECT
18 INVENTORY MANAGEMENT MODULE, AND SCRIPTLINK HOSTING SERVICES:
19 CONTRACTOR shall invoice COUNTY for the products and services according to
20 the following plan and as shown in Revised Attachment E-1:
21 1) 50% of Total SAIS Software upon execution of Amendment I to this Agreement.
22 2) 50% of Total SAIS Software Installation upon First Production Use as defined in
23 the Project Plan.
24 3) CONTRACTOR shall invoice COUNTY for Software Hosting Services according
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1 to the following plan:
2 a) Professional set-up services shall be $7,500 and data migration from
3 client server to Netsmart data center shall be $6,400 with both amounts to be invoiced by
4 CONTRACTOR upon execution of Amendment II.
5 b) The total amount payable to CONTRACTOR by COUNTY for
6 Professional set-up services and data migration shall be $13,900.
7 c) For Software Hosting Services, the monthly recurring charges shall be
8 $22,755 for 615 names users and will begin on the first day of the first month following the
9 date Amendment II is executed. Thereafter, beginning on January 1, 2016 the monthly
10 recurring charges shall be $29,600 for 800 names users and will begin on the first day of the
11 first month of January 2016.
12 4) For Implementation of the MyAvatar Upgrade, professional services shall be
13 $19,800 with 50% of this amount to be invoiced by CONTRACTOR upon execution of
14 Amendment Ill. The balance (50%) will be invoiced by CONTRACTOR upon successful
15 implementation.
16 5) For implementation of the Perceptive Point of Service Scanning, professional
17 services for Avatar Perceptive Implementation shall be $7,500 with 50% of this amount to be
18 invoiced by CONTRACTOR upon execution of Amendment Ill. The balance (50%) will be
19 invoiced by CONTRACTOR upon completion of the Perceptive Point of Service Scanning
20 professional services tasks listed in the Project Plan.
21 6) For implementation of the Perceptive Point of Service Scanning, professional
22 services for Avatar Perceptive Hosting set up shall be $7,500 with 50% of this amount to be
23 invoiced by CONTRACTOR upon execution of Amendment Ill. The balance (50%) will be
24 invoiced by CONTRACTOR upon completion of the Hosting set-up professional services
19
1 tasks listed in the Project Plan.
2 7) For implementation of Avatar Perceptive Point of Service Scanning, Third Party
3 Software shall be $9,500 to be invoiced by CONTRACTOR upon execution of Amendment Ill.
4 8) For implementation of Avatar Perceptive Point of Service Scanning, the
5 Netsmart monthly subscription fee for Avatar Perceptive Hosting for up to 50 named users
6 shall be $237.41 per month. The monthly subscription fee for Avatar Perceptive Hosting will
7 begin on the first day of the first month after the Perceptive Point of Service Scanning is made
8 available to COUNTY.
9 9) For implementation of Avatar Perceptive Point of Service Scanning, Third Party
10 Monthly Support Fees of $158.33 per month for Avatar Perceptive Point of Service Scanning
11 Maintenance shall begin on the first day of the first month after the Perceptive Point of Service
12 Scanning is made available to COUNTY.
13 10) For implementation of MyHealthPointe™, the MyHealthPointe™ monthly
14 subscription fee shall be $4,166.66 per month. The monthly subscription fee shall begin on
15 the first day of the first month after the MyHealthPointe™ is made available to COUNTY.
16 11) For implementation of MyHealthPointe™, MyHealthPointe™ web server
17 configuration services shall be $3,000 with 50% of this amount to be invoiced by
18
19
20
21
22
23
24
CONTRACTOR upon execution of Amendment Ill. The balance (50%) will be invoiced by
CONTRACTOR after completion of the web server configuration.
12) For implementation of MyHealthPointe™, professional services for
MyHealthPointe™.implementation services shall be $9,000 with 50% of this amount to be
invoiced by CONTRACTOR upon execution of Amendment Ill. The balance (50%) will be
invoiced by CONTRACTOR after completion of the MyHealthPointe™ professional services
20
1 tasks listed in the Project Plan.
2 13) Annual fees for CareConnect base subscription shall begin 60 days after
3 execution of Amendment IV.
4 14) CareConnect base set up and implementation services shall be invoiced at 50%
5 due upon initiation of project implementation and 50% upon project completion.
6 15)1nterface-Lab Order Outbound Interface-annual subscription fee shall begin
7 60 days after execution of Amendment IV.
8 16) CareConnect Lab Order implementation services shall be invoiced at 50% due
9 upon initiation of project implementation and 50% upon project completion.
10 17) Interface-Lab Results Inbound Interface annual subscription fee shall begin 60
11 days after execution of Amendment IV.
12 18) CareConnect Lab Results implementation services shall be invoiced at 50%
13 due upon initiation of project implementation and 50% upon project completion.
14 19) CareConnect Referral Connector Interface annual subscription fee shall begin
15 60 days after execution of Amendment IV.
16 20) CareConnect Referral Connector implementation services shall be invoiced at
17 50% due upon initiation of project implementation and 50% upon project completion.
18 21) Third party annual subscription for Diagnosis Content on Demand shall begin
19 60 days after execution of Amendment IV.
20 22) For Netsmart professional services, the Plexus Foundation lmplementation-
21 Avatar product fees for implementation services shall be invoiced at 50% due upon initiation
22 of project implementation and 50% upon project completion.
23 23) Annual fees for OrderConnect base subscription shall begin 60 days after
24 execution of Amendment IV.
21
1 24) OrderConnect base set up and implementation services shall be invoiced at
2 50% due upon initiation of project implementation and 50% upon project completion.
3 25) OrderConnect Inventory Management annual subscription fee shall begin 60
4 days after execution of Amendment IV.
5 26) OrderConnect Inventory Management implementation services shall be
6 invoiced at 50% due upon initiation of project implementation and 50% upon project
7 completion.
8 27) OrderConnect Non-Prescriber User annual subscription fees shall begin 60
9 days after execution of Amendment IV.
10 28) OrderConnect Full Suite Prescriber annual subscription fees shall begin 60
11 days after execution of Amendment IV.
12 29) Scriptlink Hosting Services annual subscription fee shall shall begin 60 days
13 after execution of Amendment IV.
14 30) For implementation of MyHealthPointe ™ kiosks, the implementation fee shall
15 be $33,700 with 50% of this amount to be invoiced by CONTRACTOR upon execution of
16 Amendment IV. The balance (50%) will be invoiced by CONTRACTOR after completion of
17 the MyHealthPointe TM kiosks go live date.
18 31) For implementation of the MyHealthPointe TM kiosks, the Netsmart monthly fee
19 shall be $750 per month. The monthly fee will begin on the first day of the first month
20 following the MyHealthPointe TM kiosks go live date.
21 32) For implementation of the MyHealthPointe TM kiosks, the screening content
22 monthly fee shall be $500 per month. The monthly fee will begin on the first day of the first
23 month following the MyHealthPointe ™ kiosks go live date.
24 33) Netsmart subscription fees for the Reaching Recovery System shall begin July
22
1 1, 2015.
2 34) Reaching Recovery System Clinical Content Implementation fee is shall be
3 invoiced at 50% due upon initiation of project implementation and 50% upon project
4 completion.
5 35) Recovery Needs Level Assessment Term License annual fee shall begin July 1,
6 2015.
7 36) Recovery Needs Level Assessment Term Maintenance annual fee shall begin
8 July 1, 2015.
9 37) Netsmart fees for the Recovery Needs Level Assessment implementation
10 services shall be invoiced at 50% due upon initiation of project implementation and 50% upon
11 project completion.
12
13
c. SYSTEM MAINTENANCE AND SUPPORT FEES:
COUNTY shall pay CONTRACTOR for Avatar System Maintenance and
14 Support for 615 named users and 200 concurrent users, up to January 1, 2016, at that point
15 support will be provided for 800 named users and 200 concurrent users through the end of
16 this Agreement. COUNTY shall pay CONTRACTOR for SAIS System Maintenance and
17 Support for 28 Providers, and COUNTY shall pay CONTRACTOR for Software Hosting
18 Services, and COUNTY shall pay CONTRACTOR for Avatar Perceptive Hosting for up to 50
19 users, and COUNTY shall pay CONTRACTOR for Third Party Monthly Support fees for
20 Avatar Perceptive Point of Services Scanning Maintenance and COUNTY shall pay
21 CONTRACTOR for MyHealthPointe™ Subscription fees, and MyHealthPointe™ Kiosks
22 Subscription fees, and MyHealthPointe™ subscription screening fees, and COUNTY shall pay
23 CONTRACTOR for CareConnect base subscription fees, and COUNTY shall pay
24 CONTRACTOR for fees associated with CareConnect Lab Order Outbound Interface to two
23
1 laboratories, and for fees associated with CareConnect Lab Results Inbound interface from
2 two laboratories, and for fees associated with CareConnect Referral Connector, and COUNTY
3 shall pay CONTRACTOR for Third Party subscription fees for Diagnosis Content on Demand
4 for 160 named users, and COUNTY shall pay CONTRACTOR for OrderConnect™ Full Suite-
S Prescriber subscription fees for 51 prescribers, and COUNTY shall pay CONTRACTOR for
6 OrderConnect™ Non-Prescribing User subscription fees for 33 non-prescribers, and
7 COUNTY shall pay CONTRACTOR for OrderConnect™ base fees, and COUNTY shall pay
8 CONTRACTOR for OrderConnect™ Inventory Management Module subscription fees, and
9 COUNTY shall pay CONTRACTOR for Scriptlink hosting subscription fees, and Netsmart
10 subscription fees for the Reaching Recovery System, and Recovery Needs Level Assessment
11 Term License, and Recovery Needs Level Assessment Term Maintenance as set forth
12 hereinabove and in Revised Attachment E-1.
13 CONTRACTOR shall invoice COUNTY for Avatar and SAIS System
14 Maintenance and Support and Software Hosting Services and Avatar Perceptive Hosting
15 services and Avatar Perceptive Point of Service Scanning Maintenance and MyHealthPointe™
16 subscription fees, MyHealthPointe™ Kiosks Subscription fees, MyHealthPointe™ subscription
17 screening fees, CareConnect base subscription fees, for fees associated with CareConnect
18
19
Lab Order Outbound Interface to two laboratories, and for fees associated with CareConnect
Lab Results Inbound interface from two laboratories, and for fees associated with
20 CareConnect Referral Connector, Diagnosis Content on Demand subscription fees,
21
22
23
OrderConnect™ Full Suite-Prescriber subscription fees, OrderConnect™ Non-Prescribing
user subscription fees, OrderConnect™ base subscription fees, OrderConnect™ Inventory
Management Module subscription fees, and Scriptlink hosting subscription fees, Netsmart
24 subscription fees for the Reaching Recovery System, and Recovery Needs Level Assessment
24
1 Term License, and Recovery Needs Level Assessment Term Maintenance annually and
2 separately in advance. COUNTY represents that Avatar and SAIS Systems Maintenance
3 and Support and Software Hosting Services, Avatar Perceptive Hosting services and Avatar
4 Perceptive Point of Service Scanning Maintenance, MyHealthPointe™ subscription fees,
5 CareConnect base subscription fees, CareConnect Optional Interface-Lab order Outbound
6 and Inbound subscription fees, Diagnosis Content on Demand subscription fees,
7 OrderConnect™ Full Suite-Prescriber subscription fees, OrderConnect™ Non-Prescribing
8 user subscription fees, OrderConnect™ base subscription fees, OrderConnect™ Inventory
9 Management Module subscription fees, and Scriptlink hosting subscription fees, Netsmart
10 subscription fees for the Reaching Recovery System, and Recovery Needs Level Assessment
11 Term License, and Recovery Needs Level Assessment Term Maintenance are not subject to
12 the State sales tax or similar taxes due to Avatar System Software and Maintenance
13 Releases being transmitted by remote telecommunications from CONTRACTOR to COUNTY.
14 Any sales or similar tax which may be assessed shall be paid by COUNTY.
15 D. ADDITIONAL USER LICENSE FEES AND MAINTENANCE
16 For the Term of this Agreement COUNTY may opt to purchase and shall pay
17 CONTRACTOR for Avatar additional licenses above the initia1615 named user licenses
18 purchased by COUNTY and Avatar System Maintenance and Support fees for these additional
19 licenses as follows:
20
21
1)
2)
22 per named license.
Additional Avatar User License (taxable)$ 800 per user per year.
Additional Avatar Annual Maintenance I License (non-taxable) at $168
23 COUNTY shall pay CONTRACTOR $2,000 per year for each additional SAIS
24 Provider for SAIS Annual Maintenance and Support fees, beginning in Fiscal Year 2012-13.
25
1 For Software Hosting Services, COUNTY shall pay CONTRACTOR $37 per
2 month per additional named user.
3 For Avatar Perceptive Hosting services, COUNTY shall pay CONTRACTOR
4 $4.75 per month per additional named user.
5 For Diagnosis Content on Demand, COUNTY shall pay CONTRACTOR $0.50
6 per month per additional named user.
7 E. FEE CHANGES
8 CONTRACTOR may increase maintenance and support fees upon thirty (30) days
9 advance written notice to COUNTY, provided that CONTRACTOR shall not increase such fees
10 more than once in any one-year period, and provided further that each increase will not exceed
11 the previous year's fees by the lesser of three percent (3%) per year or the cumulative
12 percentage increase in the Consumer Price Index, All Urban Consumers for the United States-
13 Medical Care, during the previous calendar year. Notwithstanding the foregoing, there shall be
14 no charge for Additional Avatar Support, beyond the amounts listed in Revised Attachment E-1.
15
16
17
F. REGULATORY CHANGES
State and Federal regulatory changes are to be included as part of the Avatar and
SAIS Systems Maintenance and Support and Software Hosting Services and implementation of
18 the MyAvatar Upgrade, the Perceptive Point of Service Scanning, MyHealthPointe™,
19 MyHealthPointe™ Kiosks, CareConnect, ICD-10 and DSM-5 Upgrade, OrderConnect™,
20 OrderConnect™ Inventory Management Module, Reaching Recovery System, Recovery Needs
21 Level Assessment and Scriptlink hosting as long as the change is a change to a current function
22 of the System. Also included are changes required by the discovery of current regulatory
23 requirements that have not been applied in the Avatar and/or SAIS and/or MyAvatar Upgrade
24 and/or Perceptive Point of Service Scanning and/or MyHealthPointe™ Systems and/or
26
1
2
3
4
5
6
7
8
9
MyHealthPointe™Kiosks and/or Software Hosting Services and/or CareConnect and/or ICD-10 &
DSM-5 Upgrade and/or OrderConnect™ and/or OrderConnect™ Inventory Management Module
and/or Reaching Recovery System and/or Recovery Needs Level Assessment and/or Scriptlink
Hosting services. Any change mandated by California or federal regulatory requirements
resulting in new Avatar and/or SAIS and/or MyAvatar Upgrade and/or Perceptive Point of
Service Scanning and/or MyHealthPointe™ Systems functionality and/or MyHealthPointe™
Kiosks and/or Software Hosting Services and/or CareConnect and/or ICD-10 & DSM-5 Upgrade
and/or OrderConnect™ and/or OrderConnect™ Inventory Management Module and/or
Reaching Recovery System and/or Recovery Needs Level Assessment and/or Scriptlink Hosting
10 services, where that function does not exist as a current function of the System, will be an
11
12
13
14
15
enhancement to the Avatar and/or SAIS and/or My Avatar Upgrade and/or Perceptive Point of
Service Scanning and/or MyHealthPointe™ and/or Software Hosting Services Systems and/or
CareConnect and/or ICD-1 0 & DSM-5 Upgrade and/or OrderConnect™ and/or OrderConnect™
Inventory Management Module and/or Reaching Recovery System and/or Recovery Needs
Level Assessment and/or Scriptlink Hosting services at an additional cost to COUNTY as
16 Additional Maintenance Services, at the cost identified in Section VIII-G.
17
18
19
G. ADDITIONAL AVATAR SUPPORT (ALSO KNOWN AS ADDITIONAL
MAINTENANCE SERVICES):
COUNTY shall pay CONTRACTOR's current prevailing rate ($1 ,600 currently) per
20
day for Additional Maintenance Services provided by CONTRACTOR pursuant to Section III.E.6
21
of this Agreement. This rate shall not increase by more than 3% per year during the term of this
22 Agreement. In no event shall Additional Maintenance Service Fees paid under this Agreement
23 exceed $105,000.00 annually. Any Additional Maintenance Services must be requested by
24 COUNTY in writing. CONTRACTOR shall invoice COUNTY for Additional Maintenance Service
27
1 Fees as used. However, beginning with Fiscal Year 2012-13 (July 1, 2012-June 30, 2013) and
2 through the remainder of the contract term, such Additional Avatar Support funding is not part of
3 this Agreement.
4 H. INVOICING/PAYMENT
5 CONTRACTOR shall submit all invoices to COUNTY of Fresno, Department of
6 Behavioral Health, Accounts Receivable, P.O Box 4500., Fresno, CA 93718, Attention: Business
7 Office. COUNTY shall mail payment within 45 days of receipt of a proper invoice. Payment
8 shall be mailed to Netsmart Technologies, Inc., 4950 College Boulevard, Overland Park, KS
9 66211.
10 I. TRAVEL AND TEMPORARY LIVING EXPENSES
11 Travel and temporary living expenses incurred by CONTRACTOR as requested by
12 the County of Fresno and will be compensated according to the COUNTY rules listed below as
13 Items 1-5.
14 1) Any subsequent travel and temporary living expenses incurred by
15 CONTRACTOR for the purpose of problem resolutions or for the provision of additional services
16 in regards to the Avatar System require COUNTY approval and shall not exceed the following:
17 2) Air travel, not to exceed the coach or tourist class rate, to COUNTY's
18 location, and shall be purchased using procedures, which result in the lowest available net
19 COUNTY cost.
20 3) Auto rentals while at COUNTY's location, not to exceed one medium-size
21 rental auto for every two (2) CONTRACTOR employees.
22 4) The standard COUNTY per diem rate will be paid for meals, cost of lodging,
23 mileage and miscellaneous expenses, such as taxi fares (where no rental car is involved),
24 parking and tips, etc., directly related to a business trip to COUNTY's location.
28
1
2
3
4
5) CONTRACTOR will retain on file and available upon request by COUNTY,
receipts, invoices or other documents to verify such expenses.
J. TAXES
Federal, California and local taxes are included in the fees set forth in this
5 Agreement as they are specifically identified. COUNTY shall pay all taxes, however designated,
6 which are levied on this Agreement, or the products or services, excluding taxes based upon
7 CONTRACTOR's income. COUNTY will provide CONTRACTOR with a copy of any tax
8 exemption certificates, which are applicable."
9 16. Section L. entitled Health Insurance Portability and Accountability Act, beginning at
10 line 23 of page IX of Attachment A to the Agreement shall be deleted in its entirety and replaced
11 with the following:
12 L. "HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT
13 A. The parties to this Agreement shall be in strict conformance with all applicable
14 Federal and State of California laws and regulations, including but not limited to Sections
15 5328, 10850, and 14100.2 etseq. of the Welfare and Institutions Code, Sections 2.1 and
16 431.300 et seq. of Title 42, Code of Federal Regulations (CFR), Section 56 et seq. of the
17 California Civil Code and the Health Insurance Portability and Accountability Act (HIPAA),
18 including but not limited to Section 1320 D et seq. of Title 42, United States Code (USC) and
19 its implementing regulations, including, but not limited to Title 45, CFR, Sections 142, 160,
20 162, and 164, The Health Information Technology for Economic and Clinical Health Act
21 (HITECH) regarding the confidentiality and security of patient information, and the Genetic
22 Information Nondiscrimination Act (GINA) of 2008 regarding the confidentiality of genetic
23 information.
24 Except as otherwise provided in this Agreement, CONTRACTOR, as a Business
29
1 Associate of COUNTY, may use or disclose Protected Health Information (PHI) to perform
2 functions, activities or services for or on behalf of COUNTY, as specified in this Agreement,
3 provided that such use or disclosure shall not violate the Health Insurance Portability and
4 Accountability Act (HIPAA), USC 1320d et seq. The uses and disclosures of PHI may not be
5 more expansive than those applicable to COUNTY, as the "Covered Entity" under the HIPAA
6 Privacy Rule (45 CFR 164.500 et seq.), except as authorized for management, administrative
7 or legal responsibilities of the Business Associate.
8 B. CONTRACTOR, including its subcontractors and employees, shall protect, from
9 unauthorized access, use, or disclosure of names and other identifying information, including
10 genetic information, concerning persons receiving services pursuant to this Agreement,
11 except where permitted in order to carry out data aggregation purposes for health care
12 operations [45 CFR Sections 164.504 (e)(2)(i), 164.504 (3)(2)(ii)(A), and 164.504 (e)(4)(i)]
13 This pertains to any and all persons receiving services pursuant to a COUNTY funded
14 program. This requirement applies to electronic PHI. CONTRACTOR shall not use such
15 identifying information or genetic information for any purpose other than carrying out
16 CONTRACTOR's obligations under this Agreement.
17 C. CONTRACTOR, including its subcontractors and employees, shall not disclose
18 any such identifying information or genetic information to any person or entity, except as
19 otherwise specifically permitted by this Agreement, authorized by Subpart E of 45 CFR Part
20 164 or other law, required by the Secretary, or authorized by the client/patient in writing. In
21 using or disclosing PHI that is permitted by this Agreement or authorized by law,
22 CONTRACTOR shall make reasonable efforts to limit PHI to the minimum necessary to
23 accomplish intended purpose of use, disclosure or request.
24 D. For purposes of the above sections, identifying information shall include, but not
30
1 be limited to name, identifying number, symbol, or other identifying particular assigned to the
2 individual, such as finger or voice print, or photograph.
3 E. For purposes of the above sections, genetic information shall include genetic
4 tests of family members of an individual or individual, manifestation of disease or disorder of
5 family members of an individual, or any request for or receipt of, genetic services by individual
6 or family members. Family member means a dependent or any person who is first, second,
7 third, or fourth degree relative.
8 F. CONTRACTOR shall provide access, at the request of COUNTY, and in the
9 time and manner designated by COUNTY, to PHI in a designated record set (as defined in 45
10 CFR Section 164.501), to an individual or to COUNTY in order to meet the requirements of 45
11 CFR Section 164.524 regarding access by individuals to their PHI. With respect to individual
12 requests, access shall be provided within thirty (30) days from request. Access may be
13 extended if CONTRACTOR cannot provide access and provides individual with the reasons
14 for the delay and the date when access may be granted. PHI shall be provided in the form
15 and format requested by the individual or COUNTY.
16 CONTRACTOR shall make any amendment(s) to PHI in a designated record set
17 at the request of COUNTY or individual, and in the time and manner designated by COUNTY
18 in accordance with 45 CFR Section 164.526.
19 CONTRACTOR shall provide to COUNTY or to an individual, in a time and
20 manner designated by COUNTY, information collected in accordance with 45 CFR Section
21 164.528, to permit COUNTY to respond to a request by the individual for an accounting of
22 disclosures of PHI in accordance with 45 CFR Section 164.528.
23 G. CONTRACTOR shall report to COUNTY, in writing, any knowledge or
24 reasonable belief that there has been unauthorized access, viewing, use, disclosure, security
31
1 incident, or breach of unsecured PHI not permitted by this Agreement of which it becomes
2 aware, immediately and without reasonable delay and in no case later than two (2) business
3 days of discovery. For the purposes of this Agreement, "Security incident" does not include
4 trivial incidents that occur on a daily basis, such as scans, "pings", or unsuccessful attempts to
5 penetrate computer networks or servers maintained by CONTRACTOR. Immediate
6 notification shall be made to COUNTY's Information Security Officer and Privacy Officer and
7 COUNTY's DPH HIPAA Representative, within two (2) business days of discovery. The
8 notification shall include, to the extent possible, the identification of each individual whose
9 unsecured PHI has been, or is reasonably believed to have been, accessed, acquired, used,
10 disclosed, or breached. CONTRACTOR shall take prompt corrective action to cure any
11 deficiencies and any action pertaining to such unauthorized disclosure required by applicable
12 Federal and State Laws and regulations. CONTRACTOR shall investigate such breach and is
13 responsible for all notifications required by law and regulation or deemed necessary by
14 COUNTY and shall provide a written report of the investigation and reporting required to
15 COUNTY's Information Security Officer and Privacy Officer and COUNTY's DPH HIPAA
16 Representative. This written investigation and description of any reporting necessary shall be
17 postmarked within the thirty (30) working days of the discovery of the breach to the addresses
18 below:
19 County of Fresno
Dept. of Behavioral Health
20 HIPAA Representative
(559) 600-9180
21 4441 E. Kings Canyon Road
Fresno, CA 93702
22
County of Fresno
Dept. of Public Health
Privacy Officer
(559) 600-6405
P.O. Box 11867
Fresno, CA 93775
County of Fresno
Information Technology Services
Information Security Officer
(559) 600-5800
2048 N. Fine Street
Fresno, CA 93727
H. CONTRACTOR shall make its internal practices, books, and records relating to
23
24
the use and disclosure of PHI received from COUNTY, or created or received by the
32
1 CONTRACTOR on behalf of COUNTY, in compliance with HIPAA's Privacy Rule, including,
2 but not limited to the requirements set forth in Title 45, CFR, Sections 160 and 164.
3 CONTRACTOR shall make its internal practices, books, and records relating to the use and
4 disclosure of PHI received from COUNTY, or created or received by the CONTRACTOR on
5 behalf of COUNTY, available to the United States Department of Health and Human Services
6 (Secretary) upon demand.
7 CONTRACTOR shall cooperate with the compliance and investigation reviews
8 conducted by the Secretary. PHI access to the Secretary must be provided during the
9 CONTRACTOR's normal business hours, however, upon exigent circumstances access at
10 any time must be granted. Upon the Secretary's compliance or investigation review, if PHI is
11 unavailable to CONTRACTOR and in possession of a Subcontractor, it must certify efforts to
12 obtain the information to the Secretary.
13 I. Safeguards
14 CONTRACTOR shall implement administrative, physical, and technical
15 safeguards as required by the HIPAA Security Rule, Subpart C of 45 CFR 164, that
16 reasonably and appropriately protect the confidentiality, integrity, and availability of PHI,
17 including electronic PHI, that it creates, receives, maintains or transmits on behalf of COUNTY
18 and to prevent unauthorized access, viewing, use, disclosure, or breach of PHI other than as
19 provided for by this Agreement. CONTRACTOR shall conduct an accurate and thorough
20 assessment of the potential risks and vulnerabilities to the confidential, integrity and
21 availability of electronic PHI. CONTRACTOR shall develop and maintain a written information
22 privacy and security program that includes administrative, technical and physical safeguards
23 appropriate to the size and complexity of CONTRACTOR's operations and the nature and
24 scope of its activities. Upon COUNTY's request, CONTRACTOR shall provide COUNTY with
33
1 information concerning such safeguards.
2 CONTRACTOR shall implement strong access controls and other security
3 safeguards and precautions in order to restrict logical and physical access to confidential,
4 personal (e.g., PHI) or sensitive data to authorized users only. Said safeguards and
5 precautions shall include the following administrative and technical password controls for all
6 systems used to process or store confidential, personal, or sensitive data:
7 1. Passwords must not be:
8 a. Shared or written down where they are accessible or
9 recognizable by anyone else; such as taped to computer screens, stored under keyboards, or
10 visible in a work area;
11
12
13
14
15
16
17
2.
b. A dictionary word; or
c. Stored in clear text
Passwords must be:
a.
b.
c.
d.
Eight (8) characters or more in length;
Changed every ninety (90) days;
Changed immediately if revealed or compromised; and
Composed of characters from at least three (3) of the
18 following four (4) groups from the standard keyboard:
19 1) Upper case letters (A-Z);
20
21
22
23
2)
3)
4)
Lowercase letters (a-z);
Arabic numerals (0 through 9); and
Non-alphanumeric characters (punctuation symbols).
CONTRACTOR shall implement the following security controls on each
24 workstation or portable computing device (e.g., laptop computer) containing confidential,
34
1 personal, or sensitive data:
2 1. Network-based firewall and/or personal firewall;
3 2. Continuously updated anti-virus software; and
4 3. Patch management process including installation of all operating
5 system/software vendor security patches.
6 CONTRACTOR shall utilize a commercial encryption solution that has received
7 FIPS 140-2 validation to encrypt all confidential, personal, or sensitive data stored on portable
8 electronic media (including, but not limited to, compact disks and thumb drives) and on
9 portable computing devices (including, but not limited to, laptop and notebook computers).
10 CONTRACTOR shall not transmit confidential, personal, or sensitive data via e-
11 mail or other internet transport protocol unless the data is encrypted by a solution that has
12 been validated by the National Institute of Standards and Technology (NIST) as conforming to
13 the Advanced Encryption Standard (AES) Algorithm. CONTRACTOR must apply appropriate
14 sanctions against its employees who fail to comply with these safeguards. CONTRACTOR
15 must adopt procedures for terminating access to PHI when employment of employee ends.
16 J. Mitigation of Harmful Effects
17 CONTRACTOR shall mitigate, to the extent practicable, any harmful effect that
18 is suspected or known to CONTRACTOR of an unauthorized access, viewing, use,
19 disclosure, or breach of PHI by CONTRACTOR or its subcontractors in violation of the
20 requirements of these provisions. CONTRACTOR must document suspected or known
21 harmful effects and the outcome.
22
23
K. CONTRACTOR's Subcontractors
CONTRACTOR shall ensure that any of its contractors, including
24 subcontractors, if applicable, to whom CONTRACTOR provides PHI received from or created
35
1 or received by CONTRACTOR on behalf of COUNTY, agree to the same restrictions,
2 safeguards, and conditions that apply to CONTRACTOR with respect to such PHI and to
3 incorporate, when applicable, the relevant provisions of these provisions into each
4 subcontract or sub-award to such agents or subcontractors.
5 L. Employee Training and Discipline
6 CONTRACTOR shall train and use reasonable measures to ensure compliance
7 with the requirements of these provisions by employees who assist in the performance of
8 functions or activities on behalf of COUNTY under this Agreement and use or disclose PHI
9 and discipline such employees who intentionally violate any provisions of these provisions,
10 including termination of employment.
11 M. Termination for Cause
12 Upon COUNTY's knowledge of a material breach of these provisions by
13 CONTRACTOR, COUNTY shall either:
14 1. Provide an opportunity for CONTRACTOR to cure the breach or end the
15 violation and terminate this Agreement if CONTRACTOR does not cure the breach or end the
16 violation within the time specified by COUNTY; or
17 2. Immediately terminate this Agreement if CONTRACTOR has breached a
18 material term of these provisions and cure is not possible.
19 3. If neither cure nor termination is feasible, the COUNTY's Privacy Officer
20 shall report the violation to the Secretary of the U.S. Department of Health and Human
21 Services.
22 N. Judicial or Administrative Proceedings
23 COUNTY may terminate this Agreement in accordance with the terms and
24 conditions of this Agreement as written hereinabove, if: (1) CONTRACTOR is found guilty in
36
1 a criminal proceeding for a violation of the HIPAA Privacy or Security Laws or the HITECH
2 Act; or (2) there is a finding or stipulation that the CONTRACTOR has violated a privacy or
3 security standard or requirement of the HITECH Act, HIPAA or other security or privacy laws
4 in an administrative or civil proceeding in which the CONTRACTOR is a party.
5 0. Effect of Termination
6 Upon termination or expiration of this Agreement for any reason,
7 CONTRACTOR shall return or destroy all PHI received from COUNTY (or created or received
8 by CONTRACTOR on behalf of COUNTY) that CONTRACTOR still maintains in any form,
9 and shall retain no copies of such PHI. If return or destruction of PHI is not feasible, it shall
10 continue to extend the protections of these provisions to such information, and limit further
11 use of such PHI to those purposes that make the return or destruction of such PHI infeasible.
12 This provision shall apply to PHI that is in the possession of subcontractors or agents, if
13 applicable, of CONTRACTOR. If CONTRACTOR destroys the PHI data, a certification of date
14 and time of destruction shall be provided to the COUNTY by CONTRACTOR.
15 P. Disclaimer
16 COUNTY makes no warranty or representation that compliance by
17 CONTRACTOR with these provisions, the HITECH Act, HIPAA or the HIPAA regulations will
18 be adequate or satisfactory for CONTRACTOR's own purposes or that any information in
19 CONTRACTOR's possession or control, or transmitted or received by CONTRACTOR, is or
20 will be secure from unauthorized access, viewing, use, disclosure, or breach. CONTRACTOR
21 is solely responsible for all decisions made by CONTRACTOR regarding the safeguarding of
22 PHI.
23 Q. Amendment
24 The parties acknowledge that Federal and State laws relating to electronic data
37
1 security and privacy are rapidly evolving and that amendment of these provisions may be
2 required to provide for procedures to ensure compliance with such developments. The parties
3 specifically agree to take such action as is necessary to amend this agreement in order to
4 implement the standards and requirements of HIPAA, the HIPAA regulations, the HITECH Act
5 and other applicable laws relating to the security or privacy of PHI. COUNTY may terminate
6 this Agreement upon thirty (30) days written notice in the event that CONTRACTOR does not
7 enter into an amendment providing assurances regarding the safeguarding of PHI that
8 COUNTY in its sole discretion, deems sufficient to satisfy the standards and requirements of
9 HIPAA, the HIPAA regulations and the HITECH Act.
10 R. No Third-Party Beneficiaries
11 Nothing expressed or implied in the terms and conditions of these provisions is
12 intended to confer, nor shall anything herein confer, upon any person other than COUNTY or
13 CONTRACTOR and their respective successors or assignees, any rights, remedies,
14 obligations or liabilities whatsoever.
15 S. Interpretation
16 The terms and conditions in these provisions shall be interpreted as broadly as
17 necessary to implement and comply with HIPAA, the HIPAA regulations and applicable State
18 laws. The parties agree that any ambiguity in the terms and conditions of these provisions
19 shall be resolved in favor of a meaning that complies and is consistent with HIPAA and the
20 HIPAA regulations.
21 T. Regulatory References
22 A reference in the terms and conditions of these provisions to a section in the
23 HIPAA regulations means the section as in effect or as amended.
24 U. Survival
38
1 The respective rights and obligations of CONTRACTOR as stated in this Section
2 shall survive the termination or expiration of this Agreement.
3 V. No Waiver of Obligations
4 No change, waiver or discharge of any liability or obligation hereunder on any
5 one or more occasions shall be deemed a waiver of performance of any continuing or other
6 obligation, or shall prohibit enforcement of any obligation on any other occasion."
7 17. The subsection NOTICES, as set forth in Section IX on page 33 of the original
8 Agreement, shall be deleted in its entirety and replaced with the following:
9 "NOTICES: The persons and their addresses having authority to give and receive
10 notices under this Agreement are as follows:
11
12
13
14
COUNTY
COUNTY OF FRESNO
Mr. Robert W. Bash
Director, Internal
Services Department
2048 N. Fine Street
Fresno, CA 93727
CONTRACTOR
Netsmart Technologies, a Delaware Corporation
Mr. Joseph McGovern
Executive Vice President
3500 Sunrise Highway, Suite D122
Great River, NY 11739
15 Any and all notices between COUNTY and the CONTRACTOR provided for or
16 permitted under this Agreement or by law shall be in writing and shall be deemed duly served
17 when personally delivered to one of the parties, or in lieu of such personal services, when
18 deposited in the United States Mail, postage prepaid, Certified Mail, addressed to such party."
19 18. COUNTY and CONTRACTOR agree that this Fourth Amendment is sufficient to
20 amend the Agreement and, that upon execution of this Fourth Amendment, the Agreement,
21 the First Amendment, the Second Amendment, the Third Amendment, and this Fourth
22 Amendment together shall be considered the Agreement. The Agreement, as hereby
23 amended, is ratified and continued. All provisions, terms, covenants, conditions and promises
24 contained in the Agreement and not amended herein shall remain in full force and effect.
39
...
I :i~ I .
1 IN WITNESS WHEREOF, the parties have executed this Third Amendment to
3
4
5
3500 Sunrise Highway., Suite D122
6
Great River, N.Y. 11739
7
8
9
10
11
15
DATE: 2-Z)-ZOIS
REVIEWED & RECOMMENDED FOR
APPROVAL
16 APPROVEDASTOLEGALFORM
Daniel C. CederborQ, County Counsel
17
18
19
20
21 FOR ACCOUNTING USE ONLY:
ORG No.:
22 Account No.:
56309055
7309
23
0404 dbh \_
24
40
Deborah A. Poochigian, C
Board of Supervisors
ATTEST:
~SD)u~~~-~
Bernice E. Seidel, Cieri< to Boar of
Supervisors
REVIEWED & RECOMMENDED FOR
APPROVAL
APPROVED AS TO ACCOUNTING FORM
Vicki Crow, C.P.A. Controller/Treasurer-
Auditor-Controller/Treasurer-Tax Collector.
By:
Revised Attachment E-1 Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal Year Year Year Year Year Year Year Year Year Year Description 2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 2013-14 2014-15 2015-16 2016-17 Total Licenses ($207 ,450) Due at contract siQninQ $41,490 $41,490 Due upon installation $62,235 $62,235 Due on 1/23/09 Phase 1 Implementation $20,745 $20,745 Due upon Phase 1 Go-Live $20,745 $20,745 Due on 8/1/2009 Phase 2 Implementation $20,745 $20,745 Due when all Deliverables Certified as delivered $41,490 $41,490 Total Licenses $103,725 $41,490 $62,235 $207,450 Professional Services ($530,228) Due at contract siqninq $53,023 $53,023 14 Equal Monthly Payments of$30,298.74 $60,598 $363,584 $424,182 Due when all Deliverables Certified as delivered $53,023 $53,023 Totals Professional Services $113,621 $363,584 $53,023 $530,228 Maintenance ($2,546, 115) LeQacy Maintenance (HSIS) (Currently paid by County) $183,647 $94,578 $278,225 Avatar-New Svstem $83,732 $172,488 $177,663 $182,993 $188,483 $194,137 $199,961 $205,960 $1,405,417 Additional Avatar Support (includes change orders) $105,000 $105,000 $105,000 $0 $0 $0 $0 $0 $315,000 lnfoscriber $11,160 $11,495 $11,840 $12,195 $12,561 $12,938 $0 $0 $72,189 SAIS $47,401 $48,823 $50,287 $51,796 $53,350 $54,951 $306,608 Escrow*** $2,500 $2,575 $2,652 $2,732 $2,814 $2,898 $2,985 $3,075 $22,231 Total Maintenance $183,647 $296,970 $291,558 $344,556 $246,743 $254,145 $261,769 $256,296 $263,986 $2,399,670 I Hosting Set Up Services (due upon execution of amend II) $7,500 $7,500 Data Migration (due upon execution of amend II) $6,400 $6,400 Recurring Monthly Charges $0 Hosting Services ($22,755/mo.) ($29,600/mo. starting 1/1/16) $159,285 $273,060 $273,060 $314,130 $355,200 $1,374,735 Total Hosting Services $173,185 $273,060 $273,060 $314,130 $355,200 $1,388,635 Consulting Services 100 hours per year @ $225/hr $22,500 $22,500 $22,500 $22,500 $22,500 $112,500 Total Consulting Services $22,500 $22,500 $22,500 $22,500 $22,500 $112,500 My Avatar Upgrade ($19,800) $9,900 (50%) invoiced upon execution of amend Ill $9,900 $9,900 $9,900 (50%) invoiced upon go live date $9,900 $9,900 Total MyAvatar Upgrade $19,800 $19,800 Page 1 of 7
Revised Attachment E-1 Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal Year Year Year Year Year Year Year Year Year Year Description 2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 2013-14 2014-15 2015-16 2016-17 Total Perceptive Point of Service Scanning Netmart hosted Third Party Software-Avatar Perceptive POS Scanning-invoiced upon execution of Amendment Ill $9,500 $9,500 Avatar Perceptive Hosting Monthly Subscription fee ($237.41/month for up to 50 named users)-starts the first day of the following month of the go live date $2,612 $2,849 $2,849 $2,849 $11 '159 Professional Services-Avatar Perceptive Implementation-$7,500-50% ($3,750) invoiced upon execution of amend Ill with balance ($3, 750i invoiced after the go live date $7,500 $7,500 Professional Services-Avatar Perceptive Hosting Set up fee ($7,500)-invoiced upon execution of amend Ill $7,500 $7,500 Third Party Monthly Support Fees ($158.33/mo)-Avatar Perceptive POS Scanning Maintenance-starts the first day of the following month of the qo live date $1,742 $1,900 $1,900 $1,900 $7,442 Total Perceptive Point of Service Scanning Netsmart hosted $28,854 $4,749 $4,749 $4,749 $43,101 Consulting Services-My Avatar & Perceptive 448 hours for FY 2013-14 only@ $225/hr $100,800 $100,800 Total Consulting Services-My Avatar & Perceptive $100,800 $100,800 MyHealthPointe Subscription (annual) MyHealthPointe Subscription-begins on the first day of following month after MyHealthPointe go live date. $45,833 $50,000 $50,000 $50,000 $195,833 Total MyHealthPointe Subscription $45,833 $50,000 $50,000 $50,000 $195,833 MyHealthPointe Web Server Configuration Services MyHealthPointe Web Server Configuration Services-50% I ($1 ,500) invoiced upon execution of Amendment Ill, with balance ($1 ,500) invoiced after the go live date $3,000 $3,000 Total MyHealthPointe Web Server Configuration $3,000 $3,000 MyHealthPointe Implementation MyHealthPointe Implementation-50% ($4,500) invoiced upon execution of Amendment Ill, with balance ($4,500) invoiced after the go live date $9,000 $9,000 Total MyHealthPointe Implementation $9,000 $9,000 Page 2 of 7
Revised Attachment E-1 Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal Year Year Year Year Year Year Year Year Year Year Description 2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 2013-14 2014-15 2015-16 2016-17 Total MyHealthPointe Kiosks Subscription (Monthly) MyHealthPointe Subscription · $750 per month for 5 units with the fee beginning 60 days after execution of Amendment IV. $750 $9,000 $9,000 $18,750 Total MyHealthPointe Kiosks Subscription $750 $9,000 $9,000 $18,750 MyHealthPointe Kiosks Screening Content Subscription (Monthly) MyHealthPointe Kiosks Screening Content Subscription -$500 per month for 5 units with the fee beginning 60 days after execution of Amendment IV. $500 $6,000 $6,000 $12,500 Total MyHealthPointe Kiosks Screening Content Subscription $500 $6,000 $6,000 $12,500 MyHealthPointe Kiosks Implementation Services (One-Time) MyHealthPointe Kiosks Implementation Services · 50% ($16,850) invoiced upon initiation of project implementation and 50% ($16,850) upon project completion. $33,700 $33,700 Total MyHealthPointe Kiosks Implementation Services $33,700 $33,700 CareConnect Base Subscription (Annual) CareConnect Base Subscription-$15,300 for up to 1,000 named users with the fee beginning 60 days after execution of Amendment IV. $1,275 $15,300 $15,300 $31,875 Total CareConnect Base Subscription $1,275 $15,300 $15,300 $31,875 CareConnect Base Set Up and Implementation Services (One-Time) CareConnect Base Set Up and Implementation Services -50% ($3,000) due upon initiation of project implementation and 50% ($3,000) upon project completion. $6,000 $6,000 Total CareConnect Base Set Up and Implementation Services $6,000 $6,000 CareConnect Lab Order Outbound Interface Subscription (Annual) CareConnect-Two (2) Lab Order Outbound Interface Subscriptions • Fees beginning 60 days after execution of Amendment IV. $500 $6,000 $6,000 $12,500 Total CareConnect Lab Order Outbound Interface Subscription $500 $6,000 $6,000 $12,500 Page 3 of 7
Revised Attachment E-1 Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal Year Year Year Year Year Year Year Year Year Year Description 2007-08 2008-09 2009·10 2010-11 2011·12 2012-13 2013·14 2014-15 2015·16 2016-17 Total CareConnect Lab Order Implementation Services (One· Time)_ CareConnect Lab Order Implementation Services -50% ($1 ,500) due upon initiation of project implementation and 50% ($1 ,500)_ upon project completion. $6,000 $6,000 Total CareConnect Lab Order Implementation Services $6,000 $6,000 CareConnect Lab Results Inbound Interface Subscription JAnnual) CareConnect-Two (2) Lab Order Inbound Interface Subscriptions -Fees beginning 60 days after execution of Amendment IV. $500 $6,000 $6,000 $12,500 Total CareConnect Lab Results Inbound Interface Subscription $500 $6,000 $6,000 $12,500 CareConnect Lab Results Implementation Services (One· Time) CareConnect Lab Results Implementation Services -50% ($1 ,500) due upon initiation of project implementation and 50%($1 ,500) upon project completion. $6,000 $6,000 Total Care Connect Lab Results Implementation Services $6,000 $6,000 CareConnect Referral Connector Interface Subscription (Annual) CareConnect Referral Connector Interface Subscription Fees b~nning 60 days after execution of Amendment IV. $250 $3,000 $3,000 $6,250 Total CareConnect Referral Connector Interface Subscription $250 $3,000 $3,000 $6,250 CareConnect Referral Connector Implementation Services (One-Time) CareConnect Referral Implementation Services -50% ($2,500) due upon initiation of project implementation and 50% ($2,500) upon project completion. $5,000 $5,000 Total CareConnect Referral Connector Implementation Services $5,000 $5,000 ICD-10 and DSM-5 Upgrade Diagnosis Content on Demand Third Party Subscription (Annual) Diagnosis Content on Demand Third Party Subscription -Fees for 160 named users beginning 60 days after execution of Amendment IV. $730.76 $8,769.12 $8,769.12 $18,269 I 1 TotaiiCD-10 and DSM-5 Upgrade Diagnosis Content on I Demand Thif'd earty Subscriptiol'l ___ -$730.76 $8,769.12 $8,769.12 $18,269 I Page 4 of 7
Revised Attachment E-1 Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal Year Year Year Year Year Year Year Year Year Year Description 2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 2013-14 2014-15 2015-16 2016-17 Total ICD-10 and DSM-5 Upgrade Netsmart Professional services for Plexus Foundation Implementation-Avatar product (One-Time) ICD-1 0 and DSM-5 Upgrade Netsmart Professional services for Plexus Foundation Implementation-Avatar product-50% ($6,000) due upon initiation of project implementation and 50% {$6,000) upon completion. $12,000 $12,000 TotaiiCD-10 and DSM-5 Upgrade Netsmart Professional services for Plexus Foundation Implementation-Avatar product $12,000 $12,000 OrderConnect Base Subscription (Annual) OrderConnect Base Subscription -Fees beginning 60 days after execution of Amendment IV. $125 $1,500 $1,500 $3,125 Total OrderConnect Base Subscription $125 $1,500 $1,500 $3,125 OrderConnect Base Set Up and Implementation Services {One-Time) OrderConnect Base Set Up and Implementation Services-50% ($3,375) due upon initiation of project implementation and 50% ($3,375) upon project completion. $6,750 $6,750 Total OrderConnect Base Set Up and Implementation Services $6,750 $6,750 OrderConnect Inventory Management Module Subscription (Annual) OrderConnect Inventory Management Module Subscription -Fees beginning 60 days after execution of Amendment IV. $250 $3,000 $3,000 $6,250 Total OrderConnect Inventory Management Module Subscription $250 $3,000 $3,000 $6,250 OrderConnect Inventory Management Module Set Up and Implementation Services {One-Time) OrderConnect Inventory Management Module Set Up and I Implementation Services-50% {$337.50) due upon initiation I of project implementation and 50% ($337.50) upon project I completion. $675 $675 Total OrderConnect Inventory Management Module Set Up and Implementation Services $675 $675 OrderConnect Non-Prescriber User Subscription (Annual) 1 OrderConnect Non-Prescriber User Subscription-Fees for 33 users beginning 60 days after execution of Amendment IV. $429 $5,148 $5,148 $10,725 Total OrderConnect Non-Prescriber User Subscription -----------$429 $5,148 $5,148 $10,725 Page 5 of 7
Revised Attachment E-1 Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal Year Year Year Year Year Year Year Year Year Year Description 2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 2013-14 2014-15 2015-16 2016-17 Total OrderConnect Full Suite Prescriber User Subscription (Annual) OrderConnect Full Suite Prescriber User Subscription -Fees for 51 users beginning 60 days after execution of Amendment IV. $5,304 $63,648 $63,648 $132,600 Total OrderConnect Full Suite Prescriber User Subscription $5,304 $63,648 $63,648 $132,600 Scriptlink Hosting Services Monthly subscription fee for the Plexus Cloud Hosting-Avatar Scriptlink product shall be $1,250 per month with the monthly subscription fee beginning on the first day of the first month following the date that the subscription software is made available to COUNTY. $1,250 $15,000 $15,000 $31,250 Total Scriptlink Hosting Services $1,250 $15,000 $15,000 $31,250 Reaching Recovery System Subscription (Annual) Reaching Recovery System Subscription · $25,000 fee for 2,500 users beginning July 1, 2015. $25,000 $25,000 $50,000 Total Reaching Recovery System Subscription $25,000 $25,000 $50,000 Reaching Recovery System Clinical Content Implementation Services lOne-Timel Reaching Recovery System Clinical Content Implementation Services · 50% ($1 ,000) due upon initiation of project implementation and 50% ($1 ,000) upon project completion. $2,000 $2,000 Total Reaching Recovery System Clinical Content Implementation Services $2,000 $2,000 Recovery Needs Level Assessment Term License Subscription (Annual) Recovery Needs Level Assessment Term License Subscription · $2,500 fee beginning July 1, 2015. $2,500 $2,500 $5,000 Total Recovery Needs Level Assessment Term License Subscription $2,500 $2,500 $5,000 Recovery Needs Level Assessment Term Maintenance Subscription (Annual) Recovery Needs Level Assessment Term Maintenance Subscription · $525 fee beginning July 1, 2015. $525 $525 $1,050 Total Recovery Needs Level Assessment Term Maintenance Subscription $525 $525 $1,050 --- ---Page 6 of 7
Revised Attachment E-1 Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal Fiscal I Year Year Year Year Year Year Year Year Year Year Description 2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 2013-14 2014-15 2015-16 2016-17 Total Recovery Needs Level Assessment Implementation Services (One-Time) Recovery Needs Level Assessment Implementation Services -50% ($300) due upon initiation of project implementation and 50% l$300) upon project completion. $600 $600 Total Recovery Needs Level Assessment Implementation Services $600 $600 TOTAL $217,346 $588,721 $412,228 $291,558 $344,556 $442,428 $756,992 $624,617 $896,115 $866,825 $5,441,386 Page 7 of 7
SCOPE OF WORK
1. Purpose
Revised Attachment G
Page 1 of 16
The purpose for this statement of work is to outline the requirements and deliverables for the
implementation and project management of the Client's Implementation. The scope is based on
the latest generally available software release, project timeline, and use of Plexus Foundations
implementation methodology, Plexus Home content and recommendations. The details ofthe
scope of services are included below.
2. Project Duration
Project Duration
The following project start and end dates are estimates, and are subject to adjustment based upon
the Effective Date of the Amendment IV and both parties overall cooperation of such
implementation. Netsmart requires a minimum of sixty (60) days following the Effective Date
of this Amendment IV to accommodate pre-project activities such as planning, staffing and
technology activities. Additional services will be applicable for any project where the duration
from project kick-off to go-live is in excess of 12 months.
Notice of Changes or Delays
In the event Netsmart determines, in good faith, at any time during the course of the project
implementation, that failure, delay, inadequacy of performance by Client in performance of its
obligations, or Client requested changes to the scope of work, as specified in the statement of
work, may prevent Netsmart from completing any ofNetsmart's obligations in the agreed upon
time frame or cause Netsmart to incur additional or unanticipated costs or expenses, Netsmart
will promptly notify Client's Project Manager in writing, which notice shall specify in
reasonable detail: (1) any alleged failure, delay or inadequacy of performance by Client and (2)
the estimated impact including the resulting costs or expenses of such alleged failure, delay or
inadequacy of performance on Netsmart's obligations. Client will respond to the notice,
specifying any grounds for disagreement, within ten (1 0) working days from receipt of the
notice. Absent any disagreement, the date for Netsmart's completion of such obligation may be
appropriately extended and Client agrees to pay the corresponding additional costs or expenses
as determined by Netsmart. In the event of a disagreement, Netsmart retains the option to either
stop or continue with the work, and will begin the dispute resolution steps included in the
contract between the parties. In the event action or inaction by Client delays the project,
Netsmart may, at its option, terminate the Contract if any delay continues beyond 180 days. In
that event, Netsmart will be entitled to payment for work performed and materials provided prior
to the termination date and recover any damages permitted under the relevant agreement between
the parties. Client will also be responsible for payment of the cost of reengaging on a project that
has been placed on hold by Client for longer than 180 days.
Cancellation of events associated with travel must be given 2 weeks prior to scheduled onsite or
Client will still be charged for travel that has been booked.
3. Scope of Services
3.1 Scope of ICD-1 0 Capabilities
Revised Attachment G
Page 2 of 16
In order to support the changes that this federal mandate requires, the following
updates have been made to the myAvatar platform to support the transition.
• Incorporation of standard web service that provides access to externally hosted content
for cross-mapped diagnosis search
o Requires additional licensing
o Requires network connection at each end user work station
• System wide registry setting to indicate ICD-10 cutover date
o Ability to flex at the payor (PM) or provider (MSO) level as required
• Pull appropriate diagnosis based on date of service for all claims
o 83 7 Institutional
o 83 7 Professional
o 837 Dental
o UB-04
o HCFA-1500
• Provide ability to cross-map between ICD-9 and ICD-1 0 for procedures
o Does not replace CPT codes -only applies to inpatient procedure billing
o Allows clients to input cross mapped content for simultaneous capture of both ICD-9
and ICD-1 0 procedure codes
• DRG Capture
o Allows clients to input cross mapped content for ICD-10-CM to DRG Codes
• Advanced Billing Rules
Revised Attachment G
Page 3 of 16
o Allows clients to input smaller subset of I CD-I 0 codes used for Advanced Billing
Rules
o Ability to create both ICD-9 and I CD-I 0 Billing Rules
Registry Settings
Configuration Training
End-User Training
ICD-10
Netsmart resources will assist in applying required
registry settings to enable I CD-I 0 functionality.
Project team training focuses on the following areas:
I. Setting of the ICD-1 0 registry setting
2. Connection to external web service
3. Review individual payor and provider ICD-
1 0 over-ride capabilities
4. Validation of successful data conversion
5.
6.
7.
from existing diagnosis tables to new
diagnosis tables
Training on ICD-1 0 Procedure input and
configuration
Training on Advanced Billing Rules input
and configuration
Training on DRG input and configuration
During this event, Client will deliver training to all
end users in preparation for go-live.
Objectives
• Train end-users on ICD-1 0 functionality
Client responsibilities:
• Distribute training materials provided by
N etsmart (or create custom training materials)
• Conduct end-user training, ensunng that all
necessary staff are trained prior to go-live.
Netsmart responsibilities:
• Provide client with Netsmart training materials
Revised Attachment G
Page 4 of 16
3.2 Scope of OrderConnect Capabilities
OrderConnect Scope of Services
OrderConnect is a secure, Web-based prescribing and medication management system. The
system can be utilized anywhere using a Window-based system via there is access to the
Internet Explorer browser.
Access clinical resources at the point of prescribing,
reordering and discontinuations.
Confirm and submit the prescription by fax or electronically
to the pharmacy of choice or print locally.
Utilize OrderConnect inbox capability to post messages to
staff.
Prescriber's Desktop & Be alerted to potential drug-to-drug/food interactions, drug
Virtual Pharmacist allergy alerts and pregnancy/lactation alerts.
Access and review your own as well as peer-medication
dosing patterns using the libraries built automatically during
the prescribing process.
Access online clinical resources.
Enter and track medication interactions for non-agency
prescribed medications.
Access and review crucial patient diagnostic, medical and
prescription information.
Medication Profile Provides valuable information on medication alerts, known
allergies, patient care suggestions & overdose alerts.
Supports compliance with accreditation standards and
regulatory requirements.
Included in full suite implementations. (Not in scope for
Orders & Results eRx only)
Order and review lab orders.
Order and review radiology orders.
Included in full suite implementations. (Not in scope for
Patient Care Suggestions eRx only)
Create customized patient care suggestions based on your
unique client demographics.
Utilize Surescript network to confirm prescription coverage
eligibility.
Utilize Surescript network to access medication history
Eligibility and Formulary information from participating payors and pharmacies.
Netsmart will register 20 prescribers with Surescripts. Checking Additional prescriber registrations will be considered out of
scope may require additional professional services.
Confirm medication formulary status in real-time during
prescribing event.
Non-Prescriber Registration N etsmart will train OrderConnect project team to register
non-prescribers.
OrderConnect Live
Configurtion
Reporting
Revised Attachment G
Page 5 of 16
OrderConnect live configuration requires the care record
environment to be available and fully functional.
Generate real-time reports from a suite of 37 available
standard reports.
Daily operations reports
Quality assurance reports
Security reports
Administration reports
Track prescription from order submission to pharmacy
received.
3.3 Scope of CareConnect Capabilities
CareConnect Scope of Services
CareConnect enables the sharing of clinical information between and among providers
involved in the care of a consumer and with other entities such as Regional Health Information
Organizations (RHIOs). CareConnect works with the Netsmart enterprise system to provide a
secure way to exchange clinical and administrative information. It is the vehicle for Clinical
Information Exchange.
Satisfy Meaningful Use requirements to provide the
capability to exchange key clinical information among
providers of care and patient authorized entities
electronically.
CareConnect will satisfy the following Stage II Meaningful
Use requirements:
• Exchange Clinical Information (Other Providers)
Key Features • Immunization Reporting
• Public Health Surveillance Reporting
• Meaningful Use Measures
The following services are available for interfacing through
CareConnect:
• Lab Orders Out
OrderConnect • For lab orders and results OrderConnect is considered
a prerequisite solution.
3rd Party Vendors • Non-preferred vendor selection may require time to
develop the connection.
• Engagement from 3rd party vendors/connections is
required.
4. Assumptions
Revised Attachment G
Page 6 of 16
~ Netsmart will devote sufficient resources and timely communication to the project in
order to assure its reasonable success.
~ New hardware will be delivered by the date required in the Project Schedule.
~ Client will use Crystal v.9 Professional or later for all report development
~ Client will provide resources as identified in the work breakdown structure of the project
plan.
~ A training room will be available for the training sessions with working equipment and
appropriate software loaded if it is part of the planning and expectations for the project.
~ Individuals scheduled to attend training will attend.
~ Netsmart will provide recommended practices during the implementation.
~ The project will be executed according to the event-based Netsmart Plexus Foundation
Methodology as outlined below.
~ Client resources will travel to the designated event location for identified events in the
Netsmart Plexus Foundation Methodology.
~ Any usage of diagnosis and/or procedure code content that is utilized within the Netsmart
solutions must be fully licensed by the client. Additionally, the client must provide proof
of this licensing. This includes Micromedex content, CPT or DSM codes.
5. Location of Work & Client Responsibilities
Revised Attachment G
Page 7 of 16
The location of work by Netsmart and Client staff identified in the detailed project schedule
and Plexus event descriptions is work performed eitiher on-site at Client location(s), at a
Netsmart regional office or conducted remotely. A high-level outline for work location and
Client responsibilities is provided below.
Client
Responsibilities
Attend Knowledge Transfer Sess·
( Provide Data Collection J
, I I I I . .1 J I J .I It Jil II I . I I
( Conduct System Testing: )
( Maintain System Post Go-Uve J
, 111 . . C I I .. I . I I ' . I . I .. I 1
6. Plexus Events, Expectations & Deliverables
Revised Attachment G
Page 8 of 16
The following section of this document details the mam deliverables of the Client
Implementation.
6.1 Sales to Operations Transition
Our implementation services begin with a formal transition from our Sales Team to our
Project Management Team. This thorough transition process ensures that the
expectations set and project management scoped during the sales process is reviewed
including all contract components, and operational flows gathered during the sales cycle.
6.2 Hardware Network OS/Installation
If Client-Hosted:
The Client is responsible for providing the hardware, operating system software, and the
network upon which the licensed programs operate. In the event hardware is purchased
through Netsmart Technologies, its installation is coordinated and managed by Netsmart.
Netsmart's engineers require the completion of a hardware/network survey prior to
installation of any solutions. This ensures that all equipment meets application and
performance requirements before Netsmart Technologies installs the programs.
IfNetsmart Hosted:
The client is responsible for providing the desktop hardware, operating system software,
LAN/WAN network, and Internet connectivity upon which the licensed programs
·operate.
Netsmart's engineers require the completion of a desktop hardware, network, and
bandwidth survey prior to installation of any solutions. This ensures that all equipment
and connectivity methods meet minimum application and performance requirements
before Netsmart Technologies installs the programs.
6.3 Software Delivery and Installation
If Client-Hosted:
Licensed software solutions and keys are delivered via FTP with User Documentation
that describes the application and database organization.
Netsmart's system engineers install the solution on the system hardware/server and a
subset of Client workstations. This software installation is performed remotely via VPN
connection and includes the following:
• Loading the InterSystems Cache database products needed by the application
• Loading purchased Netsmart's Licensed Programs that make up the solution
Revised Attachment G
Page 9 of 16
• Testing the software to ensure access from the Client workstations
• Training the customer on installing workstation software
• Training the customer on basic operation tasks related to system start-up, shut-
down, back-up and recovery procedures
Netsmart engineers will create and install Plexus Home, BUILD, TEST and LIVE
environments for all applications purchased.
IfNetsmart Hosted:
User documentation is delivered via FTP which describes the application and database
organization.
Netsmart's system engineers install the solution on server system hardware within
Netsmart's Plexus Cloud hosting environment. Netsmart will also assist the client in
connecting to the hosting environment and connecting a subset of client
workstations. Netsmart's Plexus Cloud installation will include:
• Loading the InterSystems Cache (for Avatar) or SQL (for TIER) database
products needed by the application on all applicable servers
• Loading purchased Netsmart's Licensed Programs that make up the solution
• Testing the software to ensure access from the client workstations
• Training the customer on installing workstation software
Netsmart engineers will create and install Plexus Home, BUILD, TEST and LIVE
environments for all applications purchased.
6.4 Project Planning
The Project Planning Event is an opportunity to begin preparing your project team. The
Client project team will be introduced and the team's responsibilities will be discussed.
The Plexus Foundations implementation methodology is introduced and the different
events within the methodology presented, outlining the objectives of each event and the
roles and responsibilities of each member of the team. Additionally project tools that will
be used will be shown through demonstration and hands-on experience.
If purchased, Super User Solution web-based training courses are provided to up to 25
named Project Team users via the myLeamingPointe (www.myleamingpointe.com)
online platform. Individual user training access is distributed and available to Project
Team users starting at the Project Kick Off Plexus Methodology event and concludes at
initial Go Live event. Users will have unlimited access to the provided solution training
courses during the implementation.
Objectives:
• Review project management principles
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• Review event-based Netsmart Plexus Foundations methodology
• Provide hands on experience with solutions
• Introduction to tools to be used during the project
• Introduction to Starter Kit questions
• Introduce Plexus Home & scripts
• Introduce myLeamingPointe training classes (where applicable)
• Conduct project Planning Assessment (Gate 1)
• Plan for next event
Client Responsibilities:
• Identify Client project team and develop Client Staffing Plan
• Ensure correct Client personnel attends the Project Planning event
• Provide necessary facilities and equipment to support session if applicable
• Complete Starter Kit questions
• Complete myLeamingPointe training classes (where applicable)
• Review and sign Communication Management, Change Management & Risk
Management Plans
6.5 General Project Management
Active throughout the project lifecycle and fundamental to it is a monitoring and
measurement process that consists of numerous cost and scope control, testing, quality
assurance and acceptance activities. These ongoing activities are supplemented by
critical control points, progress checkpoints, called Plexus Gates are included to ensure
that the project cannot advance to the next phase until the required activities and
acceptance factors are successfully met. The monitoring and measurement process
employed by Netsmart Technologies ensures that projects are properly stewarded to both
a time and cost budget. This critical process transcends across the entire project
implementation process to help ensure on-time project completion within estimated cost
parameters along with properly managed and approved schedule and scope changes.
• Status meetings & Project Status Reports
• Client signoff and acceptance letters
• Project plan change requests
• Product Change Requests
• Product Improvement Forms
• Plexus Gates
6.6 Project Kickoff
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The Project Kickoff consists of three discreet activities: Project Kickoff presentation,
Workflow Assessment and Scope Review.
The project kickoff presentation gives the Client Executives, project sponsors and project
leadership an opportunity to create excitement for the organization and the project as well
as pass down key messages and expectations.
The scope review session includes breakout sessions led by SA's to review in detail the
contract scope.
During the Workflow Assessment the Netsmart Solution Architect (SA) and Client
departmental/solution representatives, which could include a combination of IT analysts,
departmental heads and/or key stakeholders from that department, will walk through the
departments to get an understanding of the Client's unique workflow and processes and
how it aligns with Netsmart's recommended practices. The walkthrough will be
facilitated using both the Starter Kit questions, having already been completed, as well as
the Workflow Assessment which will serve as a framework for questions and
documentation of the discussions that occurred during the assessment. During the
Workflow Assessment portion of the event, the discussions are a continuation of the data
collection started during Project Planning. The Solution Architect will provide a
demonstration of basic departmental workflow, if applicable, providing context for
additional design decisions to be made. This event will represent the culmination of data
collection and design decisions leading to the building of a complete and functional
system.
Client leaves the Project Kickoff event with assignments to be performed over the next
several weeks. The assignments will be documented along with expected due dates and
can be reviewed as a part of the Event Summary Document. The Netsmart project team
will work with the Client to establish these deadlines and schedule conference calls to
provide guidance and ensure the Client is on track.
Objectives:
• Conduct official project kickoff meeting
• Introduce Netsmart Solution Architects
• Review Starter Kit outstanding items
• Conduct Workflow Assessment
• Identify improvement opportunities
• Conduct scope review
• Identify project risks & scope concerns
• Present data collection materials
• Conduct Plexus Project Kickoff Assessment (Gate 2)
• Conduct integration discussions
• Discuss data collection materials
• Identify Policies & Procedures requiring change
• Review the event summary and sign-off
• Plan for next event
Client responsibilities:
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• Deliver Project Kickoff presentation (with Netsmart leadership support)
• Complete Starter Kit questions prior to the event
• Complete any required data collection, following the event, by deliverable due
dates
• Participate and provide feedback during departmental walkthroughs
• Participate in scope review discussions
• Provide knowledge of requested data and current departmental processes and
workflow
• Identify Standard Operating Policies & Procedures for organization that will
require change
• Make design decisions for future state processes
• Complete data collection assignments by defined due dates
• Identify process improvement opportunities
• Provide necessary facilities and equipment to support the event if applicable
6. 7 Final Review & Validation
This event consists of three discrete parts: Final Review & Application Training, System
Testing & Learning Plan discussions.
The Final Review discussion is intended to present the design decisions and data
collection as it is now represented in the Clients completed system and confirm their
accuracy. Additionally, as a part of Final Review, application training relevant to testing
and training is delivered to the Client personnel.
The System Testing Session will be include a starter set of test scripts, examples upon
which they can customize their own scripts, as well as instruction on testing principles,
policies and procedures. During this session, there will also be discussion regarding the
development of a Client testing strategy/plan for which the Client will be given a sample
on which to build their own.
The Learning Plan session is included to help Clients develop a solid plan to ensure end-
users will be effectively trained prior to go-live. This will be critical to the success of the
project as well as adoption of the solutions. The plan will include training strategies,
resource requirements, any required technologies and/or logistics, timelines, goals and
objectives.
The same group of Clients that attended Solution Review should attend the Final Review
& Validation event. Additionally, while it may be the same individuals, depending on
your staffing plan, the event should also include any individuals who will be expected to
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conduct system testing and/or end-user training. It is recommended that trainers
participate in testing. It affords them an opportunity to practice and become familiar with
the system.
Objectives (Final Review)
• Provide in-depth demonstration of the solutions and build using the Client's
domain
• Review and confirm design decisions and build
• Confirm the solution workflow
• Complete design process
• Provide hands-on solution training
• Conduct Plexus Final Design Assessment (Gate 3)
• Plan for next event
Objectives (System Validation)
• Provide training on test script development and testing concepts
• Begin development of Client-specific system test scripts
• Plan for next event
Objectives (Learning Plan Development)
• Conduct Learning Plan session
• Begin development on Learning Plan
• Plan for next event
Client responsibilities:
• Participate in Final Review & Validation event
• Provide appropriate resources to attend sessions
• Complete data collection assignments
• Validate design and build
• Signoff design decisions
• Customize sample test scripts to use during system and integration testing
• Customize sample training materials in preparation for end-user training
• Develop Learning Plan & execute against plan for end-user training
6.8 Go-Live Preparation
The Go-Live Preparation event is the official milestone to transition project ownership
from the Netsmart project team to the Client. Solution and project management
discussion are delivered during this week and focus, in preparation for go-live, on
assessing the Client's knowledge of the system as well as preparing the Client for their
training events and go-live. In the solution discussions, the Client trainers are expected to
provide. a \\~e uemonstration of the system back to the Netsmart project team to confirm
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their understanding of the system and to confirm they are prepared to effectively train the
end-user population.
System Testing, while not complete, should be well underway. Netsmart Project
Management will facilitate the event at the Client site, while the rest of the Netsmart
project team participates via a conference call.
In addition to the above, during this event, the Client will receive training on how to
maintain the system using Netsmart maintenance tools. The event includes training on
commonly used maintenance activities, not design and build activities. After
maintenance training, the Client is equipped to make changes, modifications and updates
to their implemented system.
Client representatives who will maintain and support the production system should attend
this event, although not always, this is commonly IT personnel.
Those attending the event should be the same as the Final Review and Validation
attendees. Department heads and/or key departmental representatives should attend the
solution activities along with the Client representative responsible for testing
coordination.
Solution-Specific Activities & Objectives
• Client to demo system using the Client demo script exhibiting a clear
understanding of the solution functionality and departmental processes
• Understand open issues, escalate, and plan as appropriate
• Review completed training materials
• Review Go-Live Readiness Assessment
• Prepare Client representatives to make common data base updates
• Train Client to locate supporting documentation and to use the appropriate tools
to manage system maintenance
• Educate Client on troubleshooting tools and techniques
Project Management Activities & Objectives
• Initiate ownership transition process
• Confirm system testing is in process, on track and scheduled for completion prior
to Integration Testing
• Confirm and Finalize Integration Testing Plan if applicable
• Confirm Client policies and procedures have been updated
• Initiate Go-Live Planning
• Conduct Plexus Go-Live Preparation Assessment (Gate 4)
• Plan for next event
Client Responsibilities:
• Demonstrate understanding of system and departmental processes by leading a
demonstration of the application
• Fi\\ahze Training Strategy/Plan
• Provide adequate training facilities
• Provide completed testing materials
• Schedule and perform end-user training
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• Finalize Integration Testing scripts and Integration Testing Plan
• Confirm users will be trained and available for Integration Testing
• Confirm facilities and hardware is in place to support Integration Testing
• Develop and own the Go-Live Plan
• Attend database maintenance training
• Learn the application tools needed to maintain the production system
6.9 Integration Testing
One round of Integration Testing will be conducted according to the Client's Integration
Testing Plan. Integration Testing will be executed at the Client's site and will be led by
the Client project management team with assistance from the Netsmart project team.
IT will allow the system testers to flow a complete patient experience, "a day in the life"
of a patient, using the system including all involved, major workflow processes. This
event also allows the Client to validate SOPs and end-user training prior to conversion.
Objectives
• Complete Integration Testing according to plan
• Confirm Go-Live preparedness
• Ensure all critical path issues have an action plan
• Conduct Plexus Go-Live Assessment (Gate 5)
• Plan for next event
Client responsibilities:
• Lead and direct integration testing activities
• Conduct application integrated testing
• Conduct operational testing
• Document integrated test results
• Troubleshoot and resolve testing issues
• Update issues list with any unresolved integration test findings
6.1 0 Go-Live:
Go-Live is the event when solutions are moved into productive use by the end-user
population. It will take place at the Client site, supported by both project teams.
Netsmart support will include remote support from the Netsmart Delivery
Consultants/ Analysts.
Objectives:
• Begin functional use ofNetsmart solutions
..
• Transition support from Netsmart project team to the Client
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• Gather and document feedback regarding project experience, including
methodology & project team resources
Client responsibilities:
• Develop and complete go-live plan
• Confirm all systems, resources and 3rd parties are scheduled and prepared for go-
live
• Conduct go-live plan meetings to outline plan for all solutions and users
• Execute go-live plan
• Document go-live issues