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CA26-0572 • 2025

Proposed Contract with Carahsoft Technology Corporation to Contract No. CW122785

Proposed Contract with Carahsoft Technology Corporation to Contract No. CW122785

Technology
Active

The official status still shows this bill as active or still awaiting another formal step.

Sponsor
at the request of the Mayor
Last action
2026-01-20
Official status
Deemed Approved
Effective date
Not listed

Plain English Breakdown

The official source material does not provide specific details about the impact on patient care or treatment plans beyond mentioning that it is for a Clinical Case Management System (CCMS).

Proposed Contract with Carahsoft Technology Corporation

The bill proposes a contract between the District of Columbia and Carahsoft Technology Corporation to design, develop, deploy, host, and maintain a new Clinical Case Management System (CCMS) using commercial off-the-shelf software products.

What This Bill Does

  • Creates a one-year contract for $7,917,104 with Carahsoft Technology Corporation.
  • Requires Carahsoft to design, develop, deploy, host, and maintain a new Clinical Case Management System (CCMS) using commercial off-the-shelf software products.
  • Ensures compliance with procurement laws and regulations.

Who It Names or Affects

  • The District of Columbia government, specifically the Department of Health Care Finance.
  • Carahsoft Technology Corporation.

Terms To Know

Clinical Case Management System (CCMS)
A system used to manage patient care and treatment plans in a clinical setting.
Commercial Off-The-Shelf (COTS) software
Pre-made software that is ready for use without customization.

Limits and Unknowns

  • The contract does not include any option periods beyond the initial one-year term.
  • There are no subcontracting plans required for this contract.
  • No bid protests were filed related to this contract award.

Bill History

  1. 2026-01-20 Council of the District of Columbia LIMS

    CA26-0572 Introduced by Chairman Mendelson at Office of the Secretary

  2. 2026-01-20 Council of the District of Columbia LIMS

    Retained by the Council with comments from the Committee on Health

Official Summary Text

Proposed Contract with Carahsoft Technology Corporation to Contract No. CW122785

Current Bill Text

Read the full stored bill text 
MURIEL BOWSER
MAYOR

January 20, 2026

The Honorable Phil Mendelson
Chairman
Council of the District of Columbia
John A. Wilson Building
1350 Pennsylvania Avenue, NW, Suite 504
Washington, DC 20004

Dear Chairman Mendelson:

Pursuant to section 451 of the District of Columbia Home Rule Act (D.C. Official Code § 1 -
204.51) and section 202 of the Procurement Practices Reform Act of 2010 (D.C. Official Code §
2-352.02), enclosed for consideration and approval by the Council of the District of Columbia is
proposed Contract No. CW122785 with Carahsoft Technology Corporation (Carahsoft) in the
amount of $7,917,104. The period of performance is one year from the date of the award.

Under the proposed contract, Carahsoft will design, develop and deploy a commercial, off -the-
shelf (COTS) software product, or combination of COTS products, for a new clinical case
management system as well as deploy, host, and maintain the technical envir onment upon which
that system will be developed.

My administration is available to discuss any questions you may have regarding the proposed
contract. In order to facilitate a response to any questions you may have, please have your staff
contact Marc Scott, Chief Operating Officer, Office of Contracting and Procurement, at (202) 724-
8759.

I look forward to the Council’s favorable consideration of this contract.

Sincerely,

Muriel Bowser

1

GOVERNMENT OF THE DISTRICT OF COLUMBIA
Office of Contracting and Procurement

Pursuant to section 202(c) of the Procurement Practices Reform Act of 2010, as amended, D.C.
Official Code § 2-352.02(c), the following contract summary is provided:

COUNCIL CONTRACT SUMMARY
(Base Year Contract)

(A) Contract Number: CW122785

Proposed Contractor: Carahsoft Technology Corporation (Carahsoft)

Proposed Contractor’s Principals: Craig P Abod, Chief Executive Officer

Contract Amount (Base Period): $7,917,104

Unit and Method of Compensation: Fixed Unit Price

Term of Contract: Twelve months from the date of award

Type of Contract: Firm Fixed Price Contract

Source Selection Method: Cooperative Agreement

(B) For a contract containing option periods, the contract amount for the base period and for
each option period. If the contract amount for one or more of the option periods differs from
the amount for the base period, provide an explanation of the reason for the difference:

There are no option periods.

(C) The goods or services to be provided, the methods of delivering goods or services, and any
significant program changes reflected in the proposed contract:

The District of Columbia Office of Contracting and Procurement, on behalf of the Department of
Health Care Finance (DHCF), is seeking a Contractor to design, develop and deploy a Commercial,
Off-The-Shelf (COTS) software product, or combination of COTS products, for a new Clinical
Case Management System (CCMS) as well as deploy, host, and maintain the technical environment
upon which that system will be developed.

2

(D) The selection process, including the number of offerors, the evaluation criteria, and the
evaluation results, including price, technical or quality, and past performance components:

The contracting officer determined it to be in the best interest of the District to use the cooperative
agreement procurement method to satisfy to procure a CCMS.

The State of Utah competitively procured these services through the National Association of State
Procurement Officials cooperative agreement bidding and selection process, Contract No. AR2472.

D.C. Official Code §2-354.11 authorizes the Chief Procurement Officer (CPO) to participate in,
sponsor, conduct, or administer cooperative purchasing agreements in any state, county or
municipal jurisdiction for the purpose of procuring supplies and services. On August 6, 2025, the
contracting officer received approval from the CPO to utilize a cooperative purchasing agreement to
procure a CCMS from Carahsoft.

(E) A description of any bid protest related to the award of the contract, including whether the
protest was resolved through litigation, withdrawal of the protest by the protestor, or
voluntary corrective action by the District. Include the identity of the protestor, the grounds
alleged in the protest, and any deficiencies identified by the District as a result of the protest:

None

(F) A description of any other contracts the proposed contractor is currently seeking or holds
with the District:

Carahsoft currently holds approximately 22 contracts with the District.

(G) The background and qualifications of the proposed contractor, including its organization,
financial stability, personnel, and performance on past or current government or private
sector contracts with requirements similar to those of the proposed contract:

Carahsoft has demonstrated through past performance reports that their organization has the history,
organizational and technical experience, including the key personnel required to successfully meet
the requirements of the contract. Likewise, it has been determined that the contractor maintains the
financial resources, accounting, and operational controls to successfully fulfill the District’s
requirement. The contractor has been determined to be responsible in accordance with the District’s
standards for responsibility.

(H) A summary of the subcontracting plan required under section 2346 of the Small, Local, and
Disadvantaged Business Enterprise Development and Assistance Act of 2005, as amended,
D.C. Official Code § 2-218.01 et seq. (“Act”), including a certification that the subcontracting
plan meets the minimum requirements of the Act and the dollar volume of the portion of the
contract to be subcontracted, expressed both in total dollars and as a percentage of the total
contract amount:

There is no subcontracting plan required for the proposed contract.
3

(I) Performance standards and the expected outcome of the proposed contract:

The performance standards are governed by the specified requirements of the contract. The
expected outcome of the proposed contract is to design, develop and deploy a COTS software
product, or combination of COTS products, for a new CCMS as well as deploy, host, and maintain
the technical environment upon which that system will be developed.

(J) The amount and date of any expenditure of funds by the District pursuant to the contract
prior to its submission to the Council for approval:

None

(K) A certification that the proposed contract is within the appropriated budget authority for the
agency for the fiscal year and is consistent with the financial plan and budget adopted in
accordance with D.C. Official Code §§ 47-392.01 and 47-392.02:

The Office of the Chief Financial Officer certified that funding for the contract is consistent with
the financial plan and budget.

(L) A certification that the contract is legally sufficient, including whether the proposed
contractor has any pending legal claims against the District:

The contract has been reviewed by the Office of the Attorney General and found to be legally
sufficient. The contractor has no pending legal claim against the District.

(M) A certification that the Citywide Clean Hands database indicates that the proposed contractor
is current with its District taxes. If the Citywide Clean Hands Database indicates that the
proposed contractor is not current with its District taxes, either: (1) a certification that the
contractor has worked out and is current with a payment schedule approved by the District;
or (2) a certification that the contractor will be current with its District taxes after the District
recovers any outstanding debt as provided under D.C. Official Code § 2-353.01(b):

The Citywide Clean Hands database indicates that Carahsoft is current with its District taxes.

(N) A certification from the proposed contractor that it is current with its federal taxes, or has
worked out and is current with a payment schedule approved by the federal government:

The contractor has self-certified, via the Bidder Offeror Certification form, that it is current with its
federal taxes.

4

(O) A certification that the proposed contractor has been determined not to violate section 334a of
the Board of Ethics and Government Accountability Establishment and Comprehensive
Ethics Reform Amendment Act of 2011, D.C. Official Code § 1-1163.34a; and (2) A
certification from the proposed contractor that it currently is not and will not be in violation
of section 334a of the Board of Ethics and Government Accountability Establishment and
Comprehensive Ethics Reform Amendment Act of 2011, D.C. Official Code § 1-1163.34a:

The contractor has certified, via the Bidder/Offeror Certification form, that it is (1) not in violation
of section 334a of the Board of Ethics and Government Accountability Establishment and
Comprehensive Ethics Reform Amendment Act of 2011, D.C. Official Code § 1-1163.34a; and (2)
currently is not and will not be in violation of section 334a of the Board of Ethics and Government
Accountability Establishment and Comprehensive Ethics Reform Amendment Act of 2011, D.C.
Official Code § 1-1163.34a.

(P) The status of the proposed contractor as a certified local, small, or disadvantaged business
enterprise as defined in the Small, Local, and Disadvantaged Business Enterprise
Development and Assistance Act of 2005, as amended; D.C. Official Code § 2-218.01 et seq.:

The contractor is not a certified local, small or disadvantaged business enterprise.

(Q) Other aspects of the proposed contract that the Chief Procurement Officer considers
significant:

None

(R) A statement indicating whether the proposed contractor is currently debarred from providing
services or goods to the District or federal government, the dates of the debarment, and the
reasons for debarment:

As of July 11, 2025, the contractor does not appear on the Office of Inspector General Exclusions
Database, the Federal Excluded Parties List or the District’s list of Debarred and Suspended
Contractors.

(S) Any determination and findings issues relating to the contract’s formation, including any
determination and findings made under D.C. Official Code § 2-352.05 (privatization
contracts):

Determination and Findings for Cooperative Agreement
Determination and Findings for Contractor’s Responsibility
Determination and Findings for Price Reasonableness

(T) Where the contract, and any amendments or modifications, if executed, will be made
available online:

http://ocp.dc.gov

5

(U) Where the original solicitation, and any amendments or modifications, will be made available
online:

http://ocp.dc.gov
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441 4th Street, N.W., Suite 960N, Washington, D.C. 20001 (202) 442-5988 FAX (202) 478-1373
Moore
GOVERNMENT OF THE DISTRICT OF COLUMBIA
Department of Health Care Finance

Office of the Chief Financial Officer

MEMORANDUM

TO: Nancy Hapeman
Chief Procurement Officer
Office of Contracting and Procurement
THRU: Delicia V. Moore Delicia V.
Associate Chief Financial Officer
Human Support Services Cluster

Digitally signed by
Delicia V. Moore
Date: 2025.12.01
11:47:37 -05'00'

FROM: Darrin Shaffer
Agency Fiscal Officer
Digitally signed by Darrin A Shaffer
Date: 2025.12.01 08:43:53 -05'00'
Department of Health Care Finance

DATE: December 1, 2025

SUBJECT: Certification of Funding for the Clinical Case Management System (CCMS) Contract

The Office of the Chief Financial Officer hereby certifies that the sum of $7,917,104.00 is included in the District’s
Local Budget and Financial Plan for Fiscal Year 2026 to fund the costs associated with the Department of Health
Care Finance’s (DHCF) Clinical Case Management System (CCMS) contract. This certification supports the
Carahsoft Technology Corpo ration contract cost from January 1, 2026 through December 31, 2026. This fund
allocation is as follows:

Vendor: Carahsoft Technology Corporation Contract Number: CW122785
Fiscal Year 2026 Funding: 1/1/2026 - 9/30/2026

Agency Fund Account Program Cost
Center Project Sub Task Award Split Amount
HT0 3030304 7132001 100063 70280 100465 6.01 3000101 10% 400,000.00
HT0 3035350 7132001 100063 70280 100465 6.01 2500011 90% 3,600,000.00
HT0 3030304 7132001 700079 70280 100464 4.01 3000101 10% 97,639.53
HT0 3035350 7132001 700079 70280 100464 1.03 2500011 90% 878,755.77
HT0 1010001 7132001 100193 70272 000000 Blank 0000000 10% 24,074.07
HT0 4025002 7132001 100193 70272 200881 25.06 2002472 90% 216,666.63
HT0 4020002 7132001 100193 70272 200870 16.02 2000712 100% 720,692.00
FY26 Contract Total 5,937,828.00
Darrin A Shaffer
441 4th Street, N.W., Suite 960N, Washington, D.C. 20001 (202) 442-5988 FAX (202) 478-1373
Fiscal Year 2027 Funding: 10/01/2026 - 12/31/2026

Agency Fund Account Program Cost
Center Project Sub Task Award Split Amount
HT0 3030304 7132001 100063 70280 100465 6.01 3000101 10% 197,927.60
HT0 3035350 7132001 100063 70280 100465 6.01 2500011 90% 1,781,348.40
FY27 Contract Total 1,979,276.00

Upon approval of the District’s Local Budget and Financial Plan by the Council and the Mayor and completion of
the thirty-day Congressional layover, funds will be sufficient to pay for fees and costs associated with the contract.
There is no fiscal impact associated with the contract.

Should you have any questions, please contact me at (202) 442-9079.
400 6th Street NW, Suite 9100, Washington, DC 20001 (202) 727-3400

GOVERNMENT OF THE DISTRICT OF COLUMBIA
Office of the Attorney General

ATTORNEY GENERAL
BRIAN L. SCHWALB

Commercial Division

MEMORANDUM

TO: Tomás Talamante
Director
Office of Policy and Legislative Affairs

FROM: Robert Schildkraut
Section Chief
Government Contracts Section

DATE: December 4, 2025

SUBJECT: Approval of Contract for Clinical Case Management System for the
Department of Health Care Finance
Contractor: Carahsoft Technology Corporation
Contract Number: CW122785
Contract Amount: $ 7,917,104.00

This is to Certify that this Office has reviewed the above- referenced Contract and that we have
found it to be legally sufficient.

If you have any questions in this regard, please do not hesitate to call me at (202) 724-4018.

______________________________
Robert Schildkraut

-GOVERNMENT OF THE DISTRICT OF COLUMBIA
TASK ORDER/DELIVERY ORDER FOR SERVICES
OFFEROR TO COMPLETE BLOCKS 18 & 29
1.REQUISITION NUMBER PAGE
1 of 94
2. TASK ORDER AGREEMENT NO. 3. Award/Effective Date 4. CONTRACT NUMBER 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE
CW122785 See Box 30C State of Utah
Cooperative Agreement
Contract No.: AR2472
7. FOR SOLICITATION INFORMATION
CONTACT:
Email: suma.legesse@dc.gov
A. NAME
Suma T. Legesse
B. TELEPHONE (No Collect Calls)
202-442-9106
8.OFFER DUE DATE:
9. ISSUED BY
Office of Contracting and Procurement
441 4th Street, NW, Suite 330 South
Washington, DC 20001
10. THIS ACQUISITION IS
UNRESTRICTED
SET ASIDE %FOR
SMALL BUSINESS
SMALL DISADV. BUS.
D.C. Supply Schedule
Cooperative Agreement
11. DELIVERY FOR FOB
DESTINATION UNLESS
BLOCK IS MARKED
N/A
12. PAYMENT DISCOUNT TERMS
13. RESERVED
14. METHOD OF SOLICITATION
SIC:
SIZE STANDARD:
RFTOP RFQ IFB RFP 2-STEP
5. CONTRACTOR / OFFEROR
Carahsoft Technology Corporation
11493 Sunset Hills Road Suite 100,
Reston VA 20190
16. PAYMENT WILL BE MADE BY CODE
DHCF.Invoices@DC.GOV
15A DUNS NO. 15B TAX ID NO.
17. DELIVER TO
Department of Health Care Finance
441 4th Street, NW, Suite 900S
Washington, DC 20001
18. ADMINISTERED BY
Department of Health Care Finance
441 4th Street, NW, Suite 900S
Washington, D.C. 20001
18A. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER 18B. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 16 UNLESS BLOCK
BELOW IS CHECKED
SEE ADDENDUM
19
IEM
NO.
20
SCHEDULE OF SUPPLIES/SERVICES
21
QUANTITY
22
UNIT
23
UNIT PRICE
24
AMOUNT
0001 Clinical Case Management System $7,917,104.00
25. ACCOUNTING AND APPROPRIATION DATA
PURCHASE ORDER NO.
26. TOTAL AWARD (FOR GOVT. USE ONLY)
$7,917,104.00
27. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN ONE COPY
TO THE ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER ALL
ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL
PAGES SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED HEREIN. THIS ORDER
IS ISSUED SUBJECT TO THE TERMS AND CONDITIONS OF THE DC SUPPLY
SCHEDULE CONTRACTIDENTIFIED IN BLOCK 4. And the District’s Standard Contract
Provisions, dated July 2010
28. THE FOLLOWING DOCUMENTS ARE INCORPORATED BY REFERENCE INTO
THIS TASK ORDER IN THE FOLLOWING PRIORITY: (1) CONTRACTOR’S PRICE
PROPOSAL. THIS TASK ORDER IS SUBJECT TO THE TERMS AND CONDITIONS OF
THE DC SUPPLY SCHEDULE CONTRACT IDENTIFIED IN BLOCK 4.
29A. SIGNATURE OF OFFEROR /CONTRACTOR 30A. DISTRICT OF COLUMBIA (SIGNATURE OF CONTRACTING OFFICER)
29B. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 29C. DATE S
IGNED
30B. NAME OF CONTRACTING OFFICER (TYPE OR PRINT)
Jarad Dorsey
Contracting Officer
30C DATE
SIGNED
11/24/2025
Natalie LeMay
State and Local Contracts Manager

2
SECTION B: CONTRACT TYPE, SUPPLIES OR SERVICES AND
PRICE/COST
B.1 The District of Columbia Office of Contracting and Procurement, on behalf of the Department
of Health Care Finance (DHCF), is seeking a Contractor to design, develop and deploy a
Commercial, Off-The-Shelf (COTS) software product, or combination of COTS products, for
a new Clinical Case Management System (CCMS) as well as deploy, host, and maintain the
technical environment upon which that system will be developed.
B.1.1 The District requires the Contractor to Design, Develop, and Implement (DDI) the new CCMS
in one (1) release using a hybrid waterfall and Agile methodology. The Contractor shall
demonstrate how it would use this methodology by submitting its proposed process,
deliverables, and other relevant artifacts for the release. The Contractor shall also show how it
would leverage user stories, and product backlogs, and manage release sprints. The Contractor
shall demonstrate their overall ability to deliver quality product documentation and release
management processes.

B.1. The expected duration of the implementation of the core functionality is twelve (12) months
from contract award with full implementation completed within this twelve (12) month period.
The base year will consist of the DDI implementation.

B.2 The District contemplates the award of a firm fixed price contract in accordance with 27
District of Columbia Municipal Regulations (DCMR) Chapter 24.

B.2.1 All indirect and direct costs are the responsibility of the Contractor and should be included in
the pricing structure within the functional area to which they pertain.

B.3 PRICE SCHEDULE – FIXED UNIT PRICE

B.3.1 BASE YEAR

Contract Line
Item Number
(CLIN)
Item Description Total Amount
0001 Project Management Plan
Deliverables (C.5.1.1 – C.5.1.10) $1,344,807.36
0002 Requirements Validation /
Specification Document (C.5.2.1 – C.5.2.5) $1,120,672.80
0003 Design Specification Document (C.5.3.1 – C.5.3.3) $1,307,451.60
0004 Data Conversion (C.5.4.1 – C.5.4.2) $1,307,451.60
0005 System Testing (C.5.2.6 – C.5.2.7.2) & (C.5.5.1 –
C.5.5.5) $896,538.24
0006 Training (C.5.6.1 – C.5.6.3) $373,557.60

3

Contract Line
Item Number
(CLIN)

Item Description

Total Amount
0008 System Go-Live (C.5.7.1 – C.5.8.1) $1,120,672.80
0009 System Certification (C.5.10) $445,952.00
Grand Total for B.3.1 $7,917,104.00

B.5 NONPROFIT FAIR COMPENSATION ACT OF 2020, D.C. Code § 2-222.01 et seq.
B.5.1 Nonprofit organizations, as defined in the Act, shall include in their rates the indirect costs
incurred in provision of goods or performance of services under this contract pursuant to the
nonprofit organization's unexpired Negotiated Indirect Cost Rate Agreement (NICRA). If a
nonprofit organization does not have an unexpired NICRA, the nonprofit organization may
elect to instead include in its rates its indirect costs:
(1) As calculated using a de minimis rate of 10% of all direct costs under this
contract;
(2) By negotiating a new percentage indirect cost rate with the awarding agency;
(3) As calculated with the same percentage indirect cost rate as the nonprofit
organization negotiated with any District agency within the past 2 years;
however, a nonprofit organization may request to renegotiate indirect costs rates
in accordance with B.6.2; or
(4) As calculated with a percentage rate and base amount, determined by a certified
public accountant, as defined in the Act, using the nonprofit organization's
audited financial statements from the immediately preceding fiscal year, pursuant
to the OMB Uniform Guidance, and certified in writing by the certified public
accountant.
4
B.5.2 If this contract is funded by a federal agency, indirect costs shall be consistent with the
requirements for pass-through entities in 2 C.F.R. § 200.331, or any successor regulations.

B.5.3 The Contractor shall pay its sub-contractors which are nonprofit organizations the same
indirect cost rates as the nonprofit organization Sub-Contractors would have received as a
Prime Contractor.

5
SECTION C: SPECIFICATIONS/WORK STATEMENT
C.1 SCOPE:

The District of Columbia Office of Contracting and Procurement, on behalf of DHCF, is
seeking a Contractor for a state-of-the-art, COTS CCMS software product, or combination of
COTS products, as well as deploy, host, and maintain the technical environment upon which
that system will be developed and managed.

DHCF requires the new CCMS to support a holistic care management model that facilitates
improved communication, care coordination, and various core Long Term Support and
Services (LTSS) functions. The Contractor shall develop automated interfaces between the
CCMS and several other information systems; provide ongoing operational licenses (if
applicable); and administer system operations and maintenance services and needed
enhancements as described in C.5.

The Contractor shall manage the interoperability between the CCMS and several other
information systems, including but not limited to, the District’s Medicaid Management
Information System (MMIS), the District of Columbia Access System (DCAS), the District’s
Health Information Exchange (HIE) System, and the District’s Medicaid Data Warehouse
(MDW). The Contractor will also provide ongoing operational licenses (if applicable) and
administer system maintenance services.

C.2 APPLICABLE DOCUMENTS

The following documents are applicable to this procurement and are hereby incorporated by
this reference:

Item
No.
Document
Type Title Date

01

Federal Law
42 USC Title XIX Social Security Act
Grants to States for Medical Assistance Programs and
Section 1903(a), (b), (d) – Federal Financial Participation
Requirements Mechanized Claims Payment and Information
Retrieval Systems
http://www.socialsecurity.gov/OP_Home/ssact/title19/1903.h
tm

Most Recent
02 Federal
Regulation
45 CFR Part 95 – General Administration – Grant Programs
(Public Assistance and Medical Assistance)
http://law.justia.com/cfr/title45/45cfr95_main_02.html Most Recent

03

Federal
Regulation
45 CFR Part 160 and 164
Health Insurance Portability and Accountability Act
(HIPAA) Regulations
http://www.hhs.gov/ocr/privacy/hipaa/administrative/privacy
rule/i ndex.html

Most Recent
04 DC Law District of Columbia Language Access Act
http://ohr.dc.gov/languageaccess/2012report Most Recent

05

Federal
Standard
Guide for Developing Security Plans for Federal Information
Systems NIST SP 800-18
HTTP://CSRC.NIST.GOV/PUBLICATIONS/NISTPUBS/80
0-18REV1/SP800-18-REV1-FINAL.PDF

Most Recent
6

Item
No.
Document
Type Title Date
06 Federal
Standard
Guide for Performing Risk Assessments NIST SP 800-30
HTTP://CSRC.NIST.GOV/PUBLICATIONS/NISTPUBS/80
0-30REV1/SP800_30_R1.PDF Most Recent
07
DC
Regulation
Elderly and Individuals with Physical Disabilities Waiver
regulations.
29 DCMR §§ 4200-4299 (2003). Most Recent
08
DC
Regulation
Individuals with Intellectual and Developmental Disabilities
Waiver regulation
29 DCMR §§ 1900-1999 (2015) Most Recent
09
DC
Regulation
Adult Day Health regulation
29 DCMR §§ 9700-9799, (2015) Most Recent
10
DC
Regulations
PCA regulation
29 DCMR §§5000-5099 (2015) Most Recent
11 Federal
Standard
Executive Order 13166
http://www.lep.gov/13166/eolep.htm Most Recent

12

Federal
Standard
Executive Order 13164: Establishing Procedures to Facilitate
The Provision Of Reasonable Accommodation
http://www.eeoc.gov/policy/docs/accommodation_procedure
s.html

Most Recent
13 Federal
Standard
Americans with Disabilities Act Amendments Act of 2008
http://www.eeoc.gov/laws/statutes/adaaa_info.cfm Most Recent

14

Federal
Standard
Medicaid Information Technology Architecture Framework
https://www.medicaid.gov/medicaid/data-systems/medicaid-
information-technology-architecture/medicaid-information-
technology-architecture-framework/index.html

Most Recent

15

Federal
Standard
Health Information Technology for Economic and Clinical
Health (HITECH) Act
http://www.hhs.gov/ocr/privacy/hipaa/administrative/enforce
mentrule/hitechenforcementifr.html

Most Recent
16 Federal
Standard
Older Americans Act
http://www.aoa.gov/AoA_programs/OAA/Introduction.aspx, Most Recent
17 Federal
Standard
Rehabilitation Act Section 508 Subpart B Section 1194.21
http://www.accessboard. gov/sec508/guide/act.htm. Most Recent

C.3 DEFINITIONS/ACRONYMS

These terms when used in this contract have the following meanings:
C.3.1 ADA – Americans with Disabilities Act.
C.3.2 Agency – Any department, commission, council, board, office, bureau, committee,
institution, agency, government, corporation, or another establishment of the executive
branch of this state.
C.3.3 Automated Regression Testing – Software testing that is performed to ensure that
changes or enhancements made to a software application or system do not have an adverse
effect on the existing design or functionality.
7
C.3.4 APD – Advance Planning Document. This document was prepared by a state Medicaid
agency in advance of a Medicaid fiscal intermediary procurement and submitted to the
Centers for Medicare and Medicaid for review. It documents the planned approach to the
procurement and any modifications to the Medicaid Management Information System.
C.3.5 Benefits – A schedule of coverages that an eligible participant in the program receives for
specific health care services for the treatment of illness, injury, or other conditions.
C.3.6 Business Day – A normal workday beginning Monday through Friday at 8:15 a.m. and
ending at 4:45 p.m. Eastern Standard Time, except for District and Federal holidays.
C.3.7 Calendar Day – All days of the week including District and Federal holidays.
C.3.8 Case Manager/Case Worker/Service Coordinator – A person designated as the
coordinator of resources for assigned recipients to coordinate care efficiently and
effectively.
C.3.9 Clinical Case Management System (CCMS) – Clinical Case Management System is a
collection of software that facilitate the collaborative process of assessment, planning,
facilitation, care coordination, evaluation, and advocacy for options and services to meet
the needs of Medicaid enrollees or applicants.
C.3.10 Certification – A review by the Center for Medicare and Medicaid Services of an
operational CCMS in response to a state’s request for seventy-five (75%) Federal Financial
Participation to ensure that all legal and operational requirements are met by the system.
C.3.11 CFR – Code of Federal Regulations. The Federal rules that direct a state in its
administration of a Medicaid program and the implementation and operation of a Medicaid
Enterprise IT system (or Medicaid Management Information System).
C.3.12 Claim – A bill rendered by a single provider to the Medical Assistance Program for a
specific service(s) rendered to a single recipient for a given diagnosis or set of related
diagnoses. A claim can be submitted for payment in hard copy form, Electronic Media
Claim (EMC), or directly through online transmission.
C.3.13 CMS – The Centers for Medicare and Medicaid Services (CMS) is a federal agency within
the United States Department of Health and Human Services (HHS) that administers the
Medicare program, Medicaid program, the Children's Health Insurance Program (CHIP),
and the Health Insurance Marketplace. The CMS is responsible for ensuring that the
programs it administers provide access to high-quality, affordable healthcare for eligible
individuals and families.
C.3.14 Conference Room Pilot – A process that validates new systems and allows end-users to
have hands-on experience before implementing the new system. CRP enables the business
to test new systems before fully committing to them.
C.3.15 Confidentiality – All reports, files, information, data, tapes, and other documents provided
to and prepared, developed, or assembled by the Contractor shall be kept confidential.
C.3.16 Configuration – Using native developer tools to modify, activate or “turn on” existing
behaviors and/or features of the baseline product to meet customer requirements.
C.3.17 Contract – The written, signed agreement for the operation of the CCMS.
8
C.3.18 Conversion Data Testing – Software testing that is performed to ensure the accuracy and
completeness of data that is being converted from an old system to a new system.
C.3.19 Corrective Action Plan (CAP) – Corrective actions for an issuer for removing or
reducing deficiencies or risks identified by the Assessor during the assessment of issuer
operations. The plan identifies actions that need to be performed to obtain or sustain
authorization.
C.3.20 Commercial, Off-The-Shelf (COTS) – Software that is commercial off the shelf adapted
aftermarket to the needs of the purchasing organization.
C.3.21 CRP – Conference room pilot.
C.3.22 Customization – Programming new code to add new behaviors and/or features to the
baseline product requirements.
C.3.23 Cutover – The date on which the successful Contractor begins the complete operation of
the CCMS.
C.3.24 Data Element – A specific unit of information has a unique meaning.
C.3.25 DCOA – District of Columbia Office on Aging. is an agency of the government of the
District of Columbia that is responsible for planning, coordinating, and providing a
comprehensive range of services and programs to meet the needs of the District's elderly
population.
C.3.26 DCHFP – District of Columbia Healthy Families Program provides health insurance to
DC residents who meet certain Medicaid Program requirements.
C.3.27 DC WAN – District of Columbia Wide Area Network.
C.3.28 DDA – The Developmental Disabilities Administration within the District of Columbia
Department of Disability Services
C.3.29 DDI – Design, Development, and Implementation.
C.3.30 DDS – District of Columbia Department of Disability Services.
C.3.31 DHCF – District of Columbia Department of Health Care Finance.
C.3.32 Diagnosis Code – The coding structure for all diagnosed medical conditions covered by
Medicaid for claims payment.
C.3.33 Disaster Recovery Plan – Plan developed and maintained by the Contractor for an orderly
shutdown of operations along with detailed plans for resumption of operation.
C.3.34 DSNP – Dual Eligible Special Needs Plans (D-SNPs) enroll individuals who are entitled to
both Medicare (title XVIII) and medical assistance from a state plan under Medicaid (Title
XIX).
C.3.35 DSS – Decision Support System. Used interchangeably with DW – Data Warehouse,
through a DSS is software that runs against a DW.
C.3.36 DW – Data Warehouse. Used interchangeably with DSS – Decision Support System,
though a DW is the collection of data that DSS software utilizes.
9
C.3.37 Enhancements – An augmentation and/or a change to CCMS typically initiated via a
change request by a stakeholder. This includes improvement to the basic system that either
increases the functionality or makes the system run more efficiently.
C.3.38 FFP – Federal Financial Participation. The Federal Government’s share of a State’s
expenditures under the Medicaid program.
C.3.39 Fiscal Intermediary – An organization under contract to perform functions such as claim
processing for the Medicaid Program.
C.3.40 HCBS – Home and Community Bases Services
C.3.41 HCPCS – The CMS Healthcare Common Procedure Coding System
C.3.42 HIE – District of Columbia Health Information Exchange
C.3.43 HIPAA – Health Insurance Portability and Accountability Act
C.3.44 Implementation Testing – Software testing performed to verify whether a software
application or system has been successfully installed, configured, and assimilated in its
intended production environment.
C.3.45 InterRAI – International Resident Assessment Instrument is an organization that develops
and promotes standardized assessment tools and systems for evaluating the needs,
functioning, and outcomes of individuals receiving healthcare services in various settings.
C.3.46 Load or Performance Testing – Software testing that is used to evaluate the performance
of a software application or system under a particular workload or stress.
C.3.47 LTCA – Long-Term Care Administration
C.3.48 LTSS – Long-Term Services and Supports
C.3.49 Medicaid – The Title XIX Medical Assistance Program is intended to provide Federal and
State financial assistance for the health and medical care of eligible persons.
C.3.50 MDS – Minimum Data Set is a standardized assessment instrument tool used in long-term
care facilities to gather information about residents’ health, functioning, and care needs.
C.3.51 MDW – Medicaid Data Warehouse
C.3.52 MITA – Medicaid Information Technology Architecture (MITA) 3.0 is a CMS initiative
that fosters an integrated business and information technology (IT) transformation across
the Medicaid enterprise to improve the administration and operation of the Medicaid
program.

C.3.53 MMIS – Medicaid Management Information System. A mainframe system that processes
Medicaid claims. Also referred to as “Omnicaid,” or the “Medicaid enterprise system.”
C.3.54 OAA – Older Americans Act
C.3.55 OCP – District of Columbia Office of Contracting and Procurement
C.3.56 Offshore Sub-contracting Personnel – is the hiring of individuals or companies incorporated
and located outside of the United States of America (USA) to perform specific tasks or projects.
C.3.57 PACE –The Programs of All-Inclusive Care for the Elderly provides comprehensive
10
medical and social services to certain frail, community-dwelling elderly individuals, most
of whom are dually eligible for Medicare and Medicaid benefits.
C.3.58 Parallel Testing – Testing based upon a comparison of old and new system results.
Requires a period of parallel operation where both systems operate and use the same data.
C.3.59 PDPM – The PDPM is a reimbursement model implemented by CMS to replace the
previous Resource Utilization Group (RUG) system.
C.3.60 Person-Centered Service Plan – Care Plan that addresses the beneficiary’s long-term care
needs.
C.3.61 POA&M – Plan of Action and Milestone. A corrective action plan for resolving
information security vulnerabilities.
C.3.62 Prior Authorization (PA) – Approval given in advance by the Medicaid program to a
provider for a service to a recipient.
C.3.63 Program – A distinct set of services for a distinct population with specific operational
requirements.
C.3.64 Provider – A person, organization, or institution certified to provide health or medical care
services.
C.3.65 Recipient – Medicare term for an eligible participant or beneficiary.
C.3.66 SDLC – Software Development Life Cycle is a structured process that enables the
production of high-quality, low-cost software, in the shortest possible production time.
C.3.67 Service Authorization – Approval given in advance by DDS to a provider for a service to
a recipient. A service authorization triggers the generation of a PA.
C.3.68 System Test – The process integrates testing of all components of the system.
C.3.69 Service Level Agreement (SLA) – Contractual agreement between a service provider and
a customer that outlines the level of service that will be provided and define the metrics
that will be used to measure service performance, such as availability, response time, and
uptime.
C.3.70 System Integration Test (SIT) – Software testing that focuses on verifying the interfaces
and interactions between different subsystems or components of a larger system.
C.3.71 Transition – The system conversion from the Contractor to the State or successor
Contractor.
C.3.72 Turnover – The transfer of the MMIS/CCMS to the State and/or a successor Contractor.
C.3.73 User Acceptance Testing (UAT) – Software testing performed by end-users or customers
to verify whether a software application or system meets their requirements and is ready
for deployment.
C.3.74 Utilization Review – The process of monitoring and controlling the quantity and quality of
health care services delivered under the Medicaid program.
C.3.75 Waiver – An exception requested from or granted by CMS in response to a request from a
State usually regarding some required aspect of Medicaid regulations in order to
implement a new program or system.
11
C.4 BACKGROUND

C.4.1 Current Clinical Case Management System (CCMS)

The District’s current CCMS has been in operations since 2018. The District's ongoing
Medicaid reform requires that the CCMS evolves to meet both short-term and long-term
programmatic goals. There is an increased need for LTSS providers (including Long Term
Care (LTC) facilities), District Government Agencies in the health and human services
cluster, and Medicaid health management organizations to communicate and coordinate
with one another regarding LTSS for Medicaid applicants and enrolled Medicaid
beneficiaries. The CCMS uniquely serves this purpose, functioning as a hub for care
coordination, quality management, and healthcare information sharing among all the
District’s Medicaid LTSS stakeholders.

C.4.1.1 Provision of LTSS: DHCF administers the District’s Medicaid program, which provides
health care coverage to over 300,000 residents with low incomes. Under DHCF’s state
Medicaid plan, eligible beneficiaries can receive a traditional package of institutional and
Home and Community-Based Services (HCBS), such as nursing home coverage and
personal care services. They may also qualify for and enroll in one of the three waiver
programs—one for persons who are Elderly and/or Physically Disabled (EPD), which
DHCF administers, or a second and third waiver for people with Intellectual and
Developmental Disabilities (IDD), which Department of Disability Services (DDS)
administers with DHCF oversight. Under these waiver programs, beneficiaries can receive
enhanced packages of HCBS, such as extended coverage for Personal Care Services
(PCA). Beneficiaries can also have their LTSS services coordinated by health plans, case
management providers (in the case of EPD), or Agency Service Coordinators (in the case
of IDD). LTSS is a major cost driver for the District’s Medicaid program. Approximately
12,000 of the 300,000 Medicaid beneficiaries received LTSS.

C.4.1.2 The current CCMS supports business processes related to the EPD Waiver, State Plan,
Programs of All-Inclusive Care for the Elderly (PACE), and Dual Eligible Special Needs
Plans (DSNP) programs. Intake, clinical assessment, eligibility determination, ongoing
follow-up, etc. occur using electronic forms, and documents get routed, reviewed, and
approved manually and automatically. The current CCMS enables the routing of
electronic forms and workflow between various program participants, including DHCF,
providers, Contractors, and case managers. DHCF uses the current CCMS for the EPD
Waiver, State Plan, PACE, and D-SNP programs.

C.4.2 Federal Financial Participation

C.4.2.1 Title XIX of the Social Security Act Section 1903(a), (b), (d) allows States to receive 90
percent Federal Financial Participation (FFP) for all expenditures attributable to the design,
development, and installation of mechanized claims processing and information retrieval
systems for their Medicaid programs. The legislation also allows States to claim 75 percent
FFP for the operation of such systems.

C.4.2.2 FFP is largely determined by if the system has been certified by the Centers for Medicare
and Medicare Services (CMS) under the Department of Health and Human Services
12
(HHS). The system must meet the CMS Certification requirements for Care Management
as defined in the CMS LTSS CMS-Required Outcomes. The Contractor must participate in
CMS Certification Life Cycle reviews. DHCF requires a COTS solution that is comprised
of modules that can be integrated into the District’s Medicaid Enterprise System. The
solution shall have the potential to utilize DHCF’s MMIS, DCAS, HIE, and MDW
components where desired. Dynamic data exchange with external systems is desirable. The
System must support standards-based inbound and outbound transactions whenever
appropriate. The District expects the new CCMS COTS system to be certified within one
(1) year after system go-live as required by CMS.

C.4.3 MMIS Environment

C.4.3.1 Successful deployment of a new CCMS can only be accomplished with an understanding
of the current MMIS. MMIS includes several modules: claims processing, recipient
eligibility, provider enrollment, prior authorization, third-party liability, reference data,
electronic visit verification, and financial management are included. The MMIS also
supports the coordination of benefits, surveillance and utilization review, federal and
management reporting, and case management. Currently, the District is in the DDI phase
of a new MMIS implementation with a tentative go-live date of December 2025. The
CCMS system will interface with the current MMIS, and once the new MMIS is in
production, CCMS will interface with the new MMIS.

C.5 REQUIREMENTS

The Contractor shall have the ability to:

1. Design, develop and deploy a COTS software product, or combination of COTS
products, for a new CCMS as well as deploy, host, and maintain all hardware,
software, network connectivity and data storage for production, test, and any of all
the disaster recovery sites for the CCMS; and

2. Develop all interfaces for the CCMS to all internal and external (e.g., MMIS,
DCAS, HIE) systems, and all reports, plans, and documents to support related
Medicaid programs and services.
C.5.1 Project Initiation

C.5.1.1 The Contractor shall conduct a Kick-Off Meeting for the District Staff. A date for this
meeting must be set and approved by the District within one (1) week of contract
award. This meeting must, at a minimum, include:

1. Introduction of the Contractor’s project staff (project manager and technical
lead);
2. An in-person meeting with District staff with a walk-through and explanation of
preliminary project schedule, product roadmap, and preliminary release
schedule (if applicable);
13
3. Contact information for all Contractor staff (email addresses, office phone
numbers, cell phone numbers);
4. Plan and process to be used to interact with District staff for release planning
and sprint planning; and
5. Create the Kick-Off Meeting presentation deck and submit to the District
including meeting notes and all hand out materials covered during the meeting.

C.5.1.2 The Contractor shall develop and deliver to the District, for approval, a Project
Management Plan that defines the project management methods that shall be utilized
and leveraged for the duration of the project. A draft Project Management plan is due
thirty (30) days from the project kick-off date. The final Project Management Plan is
due in accordance with the dates set forth in the approved Project Work Plan and
Schedule. The Project Management Plan shall at a minimum:

1. Define the organizational structure of the development team and what is
expected from District Stakeholders;
2. Describe how and when development progress and status will be shared with
District leadership/executives. This includes the necessary web-based for which
all necessary District stakeholders will have access;
3. Describe the project work plan update process;
4. Define procedures and tools for retaining and updating project artifacts; and
5. Describe sign-off and approval procedures.

C.5.1.3 The Contractor shall develop and deliver to the District, for approval, a
Communication Plan that describes the means of communication between all parties
involved and affected by the project. A draft Communication plan is due thirty (30)
days from the project kick-off date. The final Communications Plan is due in
accordance with the dates set forth in the approved Project Work Plan and Schedule.
The Communication Plan must be at a minimum:
1. Describe communication procedures for project team members and stakeholder
analysis;
2. Describe status reporting frequency and distribution;
3. Contain project participant contact lists; and
4. Describe project meeting frequency and participants.

C.5.1.4 The Contractor shall develop and deliver to the District, for approval, a Risk
Management Plan that describes how risks associated with the project will be
identified, analyzed, and managed. A draft Risk Management plan is due thirty (30)
days from the project kick-off date. The final Risk Management Plan is due in
accordance with the dates set forth in the approved Project Work Plan and Schedule.
The Risk Management Plan must at a minimum:

1. Describe the process for identification and quantification of potential issues and
risks;
2. Describe the process for tracking and resolving issues and risks;
3. Describe the process for mitigating risks;
4. Describe the process for reporting risks and periodically reviewing them for
change in impact or likelihood; and
14
5. Include contingency plans for critical risks.

C.5.1.5 The Contractor shall develop and deliver to the District, for approval, a Staffing Plan
that describes the personnel resources required for the project. A draft Staffing plan is
due thirty (30) days from the project kick-off date. The final Staffing Plan is due in
accordance with the dates set forth in the approved Project Work Plan and Schedule.
The Staffing Plan must, at a minimum:

1. Identify the Contractor’s staff, including sub- contractor’s staff, to be assigned
(e.g., the total number of persons, skill sets, and percentage of time to be spent
on the project);

2. Identify District staff assignment needs (e.g., total number of persons, skill sets,
and percentage of time needed on the project); and

3. Identify roles and responsibilities of all staff during all phases of the project.

C.5.1.6 The Contractor shall develop and deliver to the District, for approval a Project Work
Plan and Schedule that defines the work breakdown of all tasks and activities
throughout the entire project. The Project Work Plan will be a working document that
will be reviewed and updated on a weekly basis. The first version of the Project Work
Plan and Schedule is due for delivery to and review by the District within two weeks of
the Kick-Off meeting. The Project Work Plan must have, at a minimum:
1. Work Breakdown Structure that includes the timeframe for completing
activities;
2. Include a GANTT chart of the project schedule;
3. Identify the completion dates for each activity and dependencies between
activities;
4. Contain milestones that meet the anticipated outcome for each activity;
5. Milestones that indicate checkpoints at which time the contractor will deliver
documented proof of successful completion of the activity to the District
Contract Administrator (CA) for review and acceptance. The CA’s acceptance
of the Contractor’s documented proof is required in order for the Contractor to
continue with the next phase and/or for the District to release any payment for
activity to-date to the Contractor;
6. A weekly project status meeting for review to be scheduled by the contractor
(subject to District approval). The contractor shall conduct the meeting and
update the project work plan on a weekly basis prior to that meeting; and
7. Support a 12-month DDI contract phase resulting in the CCMS
System going live within twelve (12) months of the Kick- Off
meeting.

C.5.1.7 The Contractor shall maintain and deliver a weekly Project Status Report that include:
15
1. Overall schedule status (i.e., on-schedule or behind schedule);
2. A Percentage of all current activities completed as per the project schedule;
3. Accomplishments since last report;
4. A summary of any "yellow" issues not resolved within two (2) weeks of
identification;
5. A summary of any "red" issues; and
6. A list of all open action items and the responsible party.

C.5.1.8 The Contractor shall maintain a Deliverables Status Summary throughout DDI that
reports, in a concise, tabled format, the status of all milestones from the Project Work
Plan and all deliverables in section F.3 as they occur during DDI. The Deliverables
Status Summary will have two columns: Milestone / Deliverable and Status. The status
shall be reported as one of the following: Not Started, Started, Completed, and
Approved. Additionally, the status shall be followed by a date. The Deliverable Status
Summary shall be included with the Weekly Status report.
C.5.1.9 The Contractor shall develop and deliver to the District, for approval, a draft Change
Control Plan thirty (30) days from the project kick-off date, covering both system and
operational (including configuration) changes. The final Change Control Plan is due in
accordance with the dates set forth in the approved Project Work Plan and Schedule.
The Change Control Plan at a minimum shall:

1. Specify the procedures for requesting, obtaining internal and District approvals,
scheduling, testing, implementing, verifying and documenting all changes;
2. Contain specifics on how the contractor shall assure:
a. Quality control (refer to Quality Management Plan); and
b. That final acceptance of systems changes by the CA is obtained as
necessary.
3. Identify those attributes of the CCMS system that are controlled through system
configuration:
a. The contractor shall reconcile this list to the Requirements
Traceability Matrix; and
b. Attributes of the CCMS system that are controlled through
system configuration are assumed to provide an agile response
needs of 24-48 hour turnaround between District request for
change and contractor’s delivery of test results to the District.
4. Define a change request procedure for adding, modifying, and deleting
any system edits. The procedure shall include:

a. The duration from the date a change request is submitted to the
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Contractor to the date when the test results are available for District’s
review;
b. The duration from the date the test results are approved to
implementation; and
c. Detailed testing guidelines.

C.5.1.10 The Contractor shall develop and deliver to the District, for approval, a draft Quality
Management Plan due (30) days from the project kick-off date, describing the
methodology, tools and metrics that will be used to monitor the quality of processes
and products for the entire life cycle of the project in the areas of planning, control,
assurance and improvement. The final Quality Management Plan is due in accordance
with the dates set forth in the approved Project Work Plan and Schedule. The Quality
Management Plan, at minimum, shall:

1. Describe the process for sampling and auditing, as well as strategies
for ensuring the quality of data and reports from such data and
information;
2. Identify and describe the criteria for evaluating quality of each deliverable;
3. Identify personnel responsible for management and their roles and
responsibilities;
4. Describe the strategies for communicating quality metrics, improvement
initiatives and outcomes to both internal and external stakeholders; and
5. The Quality Management plan shall also include quality control and
assurance. This plan shall define the content and format of the
respective quality control and assurance reports that shall be produced
during the Operational Phase.

C.5.2 Requirements Elaboration/Validation

C.5.2.1 The Contractor shall hold the necessary number of requirements validation sessions to
elaborate and verify all District's requirements specified in the Statement of Work and
identify the gaps between DHCF requirements and the vendor’s COTS product.
Requirements validation and elaboration sessions shall include at a minimum:
1. The list of requirements about the functional area for which the session is
scheduled;
2. A demonstration of how the product meets the current requirements, or an
explanation of how the product will meet the requirement, or if the requirement
will be met in a later release;
3. A list any known/discovered gaps between the existing product functionality
and the requirement;
4. The documentation process by which the outcome of each analyzed
requirement is recorded and shared with District stakeholders; and
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5. Ensure the contractor has a thorough, detailed understanding of pertinent
District Medicaid program and business requirements.

C.5.2.2 The Contractor shall develop and deliver to the District, for approval, a Functional
Requirements Document (FRD), based on the Project Work Plan and Schedule,
describing in detail the requirements for the CCMS solution which have been
determined through the requirements gathering sessions conducted with District staff.
The CCMS solution FRD must, at a minimum, contain:

1. A Requirements Traceability Matrix (RTM) to be used for requirements
traceability during all design and testing processes as a checklist to confirm that
every requirement is met. The RTM must include at minimum:

a. Requirement Id;
b. Requirement description;
c. Business need justification;
d. Requested by/Department;
e. Module functionality within the system;
f. DDI status;
g. Associated Test case; and
h. Testing status.

2. The RTM shall be continuously updated throughout the DDI phase, and the
latest updated version must be posted to SharePoint;

3. Each RTM requirement will require District approval of the Contractor’s
proposed means of addressing it;

4. Identification of all interfaces to all systems, both internal and external to the
District;

5. Descriptions of the system environments (e.g., development, testing,
production), their intended use, intended user(s), and which environment(s) the
District will use for testing, reviewing Contractor’s testing, and production;

6. Identification of application security requirements and identification of users
and their system access needs; and

7. List the activities that will be recorded in the application’s audit trail. For each
activity, list the data to be recorded.

C.5.2.3 The Contractor shall deliver Business Process Maps and Workflow Diagrams, based on
the Project Work Plan and Schedule, detailing the major business processes and ensure
that the Business Process maps, and Workflow diagrams capture all roles, inputs,
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outputs, conditions, dependencies, tasks, system interfaces and data involved in the
District's operations. The Business Process maps, and Workflow may be produced by
the Contractor's product or tool of choice. The Business Process and Workflow catalog,
at a minimum, must include the following:
1. A unique identifier and description;
2. Rule type;
3. State;
4. Related business process;
5. Related business requirement;
6. Related rules; and
7. Source and references or explanatory documentation (e.g., policy, organizational
goal or external constraint).

C.5.2.4 The Contractor shall hold Conference Room Pilot (CRP) sessions and deliver a
presentation to validate the COTS software application against DHCF business
processes and to identify the gaps between all requirements and the vendor COTS
product. CRP sessions shall at a minimum:

1. Be led and conducted by a business or functional-skilled
individual from the Contractor’s CCMS project staff;
2. Leverage Contractor-created scripts to ensure the best presentation;
3. Include District process nomenclature and terminology, and
operational roles nomenclature, and as such will be present
on/within all textual content such as titles, menus, tabs, tables,
navigation panes, and headers/footers;
4. Leverage pre-loaded legacy, test data of a volume sufficient for a
consistent and complete CRP;
5. Include key out-of-the-box reports to be specified during requirements
gathering; and
6. Conference Room Pilot presentation deck.

C.5.2.5 The Contractor shall deliver to the District, for approval based on the Project Work
Plan and Schedule, the proposed outline content, format for reports and manuals
required for the Operational Contract phase. These will include, but not be limited to:
1. Operations Manual;
2. Web Portal User Manual;
3. Call Center Manual; and
4. Call Center Summary report template including number of calls received by
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type of inquiry, average hold time, number of calls answered by a live operator,
average speed of answer, average time on hold, average call transfer time, call
resolution statistics for the previous month’s call, and number of calls
abandoned.

C.5.2.6 The Contractor shall develop and deliver to the District, for approval, a System
Security Plan (SSP), based on the Project Work Plan and Schedule, using the guidance
from NIST Risk Management Framework (RMF) (NIST SP 800-18) before
implementation to establish an information security program in accordance with the
Federal Information Security Management Act (FISMA) and demonstrate compliance
before transitioning the CCMS to operations.

The Contractor shall ensure the SSP includes but is not limited to the following:

1. Description of how the CCMS is to be compliant with all the federal and state laws
regarding the security and privacy of medical data and records, and all protected
health information, including:

a. The Code of Federal Regulations (at 45 CFR 95.621) provides that state
agencies are responsible for the security of all automated data
processing systems involved in the administration of HHS programs,
and includes the establishment of a security plan that outlines how
software and data security shall be maintained. This section further
requires that State agencies conduct a review and evaluation of physical
and data security operating procedures and personnel practices on a
biennial basis;

b. The security and privacy standards contained in Pub. L. 104–191, the
HIPAA, and adopted in 45 CFR Part 164, Subparts C and E, as follows:
The security standards require that measures be taken to secure
protected health information that is transmitted or stored in electronic
format. The privacy standards apply to protected health information
that may be in electronic, oral, and paper form; and

c. The requirements in section 1902(a)(7) of the Social Security Act (the
Act), as further interpreted in federal regulations at 42 CFR 431.300 to
307.

2. Description of how the Contractor ensures compliance with CMS requirements and
guidelines regarding activities such as identifying and reporting:

a. Any functions that the Contractor performs that involve PHI;
b. All type(s) of PHI provided to the Contractor, if applicable;
c. The contracting arrangement’s safeguards to protect PHI, and provisions
for audits of the Contractor’s compliance with those safeguards
d. DHCF does not allow the Contractor the use of offshore sub-
contracting personnel.
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3. Specify the audit standards and/or contractual measures in place to ensure:

a. Policies and procedures exist to assure PHI and other personal
information remain secure; and
b. Annually conducted audits.

4. Description of the process and procedures that the Contractor shall use to report
security breach incidents (regardless of severity or loss of actual data) to the
District within four (4) hours of discovery or awareness of a breach;
5. Description of measures to secure data and software;
6. Description of if/how data is encrypted in transit and storage;
7. Description of physical and equipment security measures;
8. Description of personnel security;
9. Description of software used for security;
10. Description of the user roles and the access capabilities of each role;
11. Description of how users are assigned certain roles;
12. Identification of the staff responsible for controlling the system’s security;
13. Description of contingency security procedures during a disaster recovery event;
14. Description of how the Contractor works with the District to conduct an annual
security review;

15. Password security control; and
16. Audit trails for all data access.

C.5.2.7 The Contractor shall deliver the External Vulnerability Assessment Certification
Report conducted by an independent entity that performed a Security Risk Assessment
of the CCMS during development in accordance with the CMS certification guidance
on CMS.gov (https://www.cms.gov/files/document/sspisrapdf).
C.5.2.7.1 The Contractor shall develop and deliver to the District, for approval, a Security Risk
Assessment Response based on the applicable security controls. Conducting and
documenting the Security Risk Assessment shall use the standards in NIST SP 800-30.

C.5.2.7.2 After the District reviews and accepts the Security Risk Assessment Response, the
Contractor shall develop and deliver to the District, for approval, a Security Plan of
Action and Milestones (POA&M) document. The Security POA&M shall be a living
document that is based on the findings and recommendations of the security
assessment report. The Security POA&M shall describe the deficiencies in the security
controls and address the residual risk.
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C.5.3 Design and Development

C.5.3.1 The Contractor shall develop and deliver to the District, for approval, a system Design
Specification Document (DSD), based on the Project Work Plan and Schedule, that depicts
and describes all solution components, system processes, user interfaces,
system/application interfaces, and database design. The DSD document must, at a
minimum contain:

1. A general narrative of CCMS System and Supporting Services solution;
2. A detailed description and diagram of the CCMS System and Supporting
Services solution architecture identifying how components are integrated to
meet the requirements;

3. The RTM from the FRD and SSP extended to include:
a. Indication of whether the system solution involves a configurable
system attribute, “base” program code, District-specific program code,
or a combination of these attributes;
b. Description of any District-specific program code implemented
(pseudo-code or the actual program code will be acceptable in place of a
narrative); and
c. Instructions on how any configuration attributes are accessed (screen
prints are acceptable), the valid values and their definitions.
4. An identification of major interface (internal as well as external) files and
processing architecture;

5. An identification of all third-party software or applications and an explanation
of licensing methods (e.g., number of licenses by user or number of concurrent
users). The CCMS System and Supporting Services solution schema - a listing
and brief description of each table including its structure - column names, field
lengths and types (numeric, alpha, varchar);

6. A listing and brief description (purpose, frequency) of reports to be produced;

7. Detailed screen information:

a. Mapping of all data presented to the user (via U/I) to that data’s source
table and column; and

b. Mapping of CCMS data fields to all inquiry, display, and input screens.
8. Detailed documentation of all rules to be controlled by the rules-based solution;
9. Identification of all COTS software products used in the solution;

10. Identification of all requirements met by COTS software; and
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11. Descriptions of the system environments (e.g., development, testing,
production), their intended use, intended user(s), and which environment(s) the
District will use for testing, reviewing Contractor’s testing, and production

C.5.3.2 The Contractor shall develop and deliver to the District, for approval, an Interface
Control Document (ICD) based on the Project Work Plan and Schedule, prior to
implementation. The ICD shall include:

1. The definition of the message structure and protocol that govern the exchange
of data between systems;
2. The identification of the communication path along which the data between the
systems is expected to flow; and

3. Detail on process steps, processing time requirements, message/file format,
communication method, and security requirements shall also be provided.

C.5.3.3 The Contractor shall be responsible for developing all interfaces required for the
complete and successful operation of the CCMS. The Contractor shall be responsible
for acquiring the information required to design and construct the interfaces (interface
requirements), the District shall provide the necessary information and specifications.

C.5.4 Data Conversion

C.5.4.1 The Contractor shall develop and deliver to the District, for approval, a Data
Conversion / Data Migration Plan, based on the Project Work Plan and Schedule, to
describe how the solution shall convert all data and image files from the current system
to address the requirements determined during the requirements analysis process. The
Data Conversion Plan shall, at a minimum, contain:
1. A description of the data conversion strategy and conversion schedule;

2. Description of any data transformations or deletions planned;

3. Detailed description of how all data shall be physically migrated and / or
initially loaded to the development, testing, model office, and production
environments of the solution system; production data migrations to occur prior
to operational phase shall include all Provider data residing on the Provider file
at the time of conversion Identification of all software tools to be used in data
transformation, migration, and validation;

4. Detailed plan and schedule for conversion of all files and images;

5. Specifications exception handling and for manually converting data and
capturing missing or unreliable data elements that cannot be converted;

6. Specifications for converting imaged documents;

7. Definition of the metrics that shall be generated by the conversion process to
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measure the completeness of the conversion;

8. Detailed description of all files to be converted and whether it shall be a manual
or an automated conversion or a combination of both; and

9. Methods for user validation of converted data and final conversion of files.

C.5.4.2 The Contractor shall develop and deliver to the District, for approval, the Technical
Data Conversion specifications, based on the Project Work Plan and Schedule. The
Technical Data Conversion specifications must include, at minimum:
1. A detailed mapping, transformation, source to target, description of the data,
including image data showing its source location in the current CCMS and its target
location in the new CCMS solution; and

2. A file layout of all files to be converted within the solution.

C.5.5 Testing
C.5.5.1 The Contractor shall develop and deliver to the District, for approval, a Test and
Operational Readiness Plan, based on the Project Work Plan and Schedule. This plan
shall describe how the new CCMS System solution shall be tested, demonstrated to
satisfactorily meet all requirements and prepared for production implementation. The
testing shall adhere to industry best practices for testing, such as those of the PMI
PMBOK and the Institute of Electrical and Electronic Engineers (IEEE) standard for
software verification and validation. The System Test Plan and Testing, Validation,
and Operational Readiness Plan must at a minimum contain:
1. Description of testing tools and defect resolution tracking methods to be
used (Note: Contractor shall provide all testing hardware and software);
2. Description of how the Contractor shall establish a test environment
separate from the production environment (Note: Contractor shall
supply and host all hardware and software to establish the required
separate environments with web-access by District staff;
3. Description of how the system shall be tested to confirm that it enforces
system security standards;
4. Description of how accessibility compliance with federal and state
requirements including, but not limited to the Americans with
Disabilities Act (ADA) shall be tested;
5. Description of which activities shall be conducted by Contractor
staff onsite at the District, if any;
6. Description of the process for notification of all stakeholders, internal
and external to the District, of the timelines for system implementation
and any training or responsibilities of theirs for pilot testing or interface
testing;
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7. A timetable for delivery of draft and final versions of user
documentation, guides, and manuals to include, but not limited to,
Operations Manual, Web portal user manual, and Call center manual;
8. Layouts of the reports to be produced as a result of data conversion;
9. Demonstration of functionality of all interfaces;
10. Inventory of what is populated in the business rules-based solution
repository in order to make the system operable, both standard
configuration attributes and any/all District-specific attributes with:
a. A detailed explanation of the process to be used to demonstrate
through testing that the migrated data processes appropriately in
the new system;
b. A detailed strategy for end-to-end testing of business rules,
including planned usage of any tools leveraged to automatically
identify and fix conflicting rules; and
c. An explanation of the testing approach for testing integration with
other systems (i.e., MMIS).
11. The Contractor shall execute regression testing. The regression
testing shall include at a minimum:
a. The FRD, DSD, RTM requirements and the RTM shall be
extended to include a cross-reference to system test cases used to
confirm that each requirement that has been successfully tested;
b. Each RTM requirement will require District approval of the
Contractor’s test results; and
c. District approval will require that randomly selected test results
are repeatable in an Contractor-supplied testing environment
where the District staff shall either test, and/or observe a
Contractor’s tests.

C.5.5.2 The contractor shall develop and deliver to the District, for approval, a
User Acceptance Test (UAT) Plan based on the Project Work Plan and
Schedule. The UAT plan, at minimum, should include:
1. UAT entrance and exit criteria;
2. UAT Test Schedule;
3. Names of UAT testers and other UAT resources;
4. Description of the functionality to be tested;
5. The preparation required to ensure that the test can be conducted;
6. A cross-reference to each requirement in the RTM that is being
25
tested; and

7. At least two test cases for each requirement and sub-requirements:
one positive test and one negative test.

C.5.5.3 The Contractor shall develop and deliver to the District, for approval based
on the Project Work Plan and Schedule, the User Acceptance Test Cases
and Scripts that will guide DHCF users through UAT testing.
C.5.5.4 The contractor shall develop and deliver a UAT Status Report based on the
Project Work Plan and Schedule. The UAT Status Report must include:
1. Summary and detail of the progress and status of all testing; and
2. Pass/fail statistics, issues encountered, issues resolved, and issues that
lead to configuration/change control procedures.
C.5.5.5 The Contractor, after finalizing UAT, shall develop and deliver to the
District, for approval, the UAT Summary Results Report. The UAT
Summary Results Report must include:
1. An overview of how the UAT was conducted;
2. Test schedule;
3. Test execution status;
4. A list of items organized by type and severity discovered during UAT;
5. Status of each issue; and
6. Sign off.

C.5.5.6 The Contractor shall provide a CCMS test environment for Users to test the System.

C.5.5.7 The Contractor shall ensure that the CCMS test system(s) is populated with the data
necessary to ensure the validity of the testing for all phases of the testing.

C.5.5.8 The Contractor shall provide and use an automated test management tool suite to
manage, assess, track, and perform the required test and supporting activities through
the life of the Contract.

C.5.5.9 The Contractor shall provide a software-based Defect Tracking System for use by the
Contractor and the District.

C.5.5.11 The Contractor shall ensure that District staff has access to the CCMS test cases and
results in the test management tool.

C.5.5.12 The Contractor shall use a Defect Tracking Tool that provides detailed defect reporting
during CCMS testing.

C.5.5.13 The Contractor shall ensure that the CCMS Defect Tracking Tool captures details
about each defect including uploading documents, test case ID, description, symptoms,
sequence of steps used to recreate it, type, and severity.
26
C.5.5.12 The Contractor shall ensure that the CCMS Defect Tracking Tool allows the
Contractor and the District Staff to review all open issues and assign a priority level
and resources responsible for resolution.

C.5.5.14 The Contractor shall ensure that the CCMS Defect Tracking Tool tracks statuses and
maintains a history of each defect.

C.5.5.15 The Contractor shall assist District staff to execute User Acceptance Test (UAT) test
cases and request the execution of all processes to fully test the System.
C.5.5.16 The Contractor shall ensure that a test environment is maintained and updated with the
most recent data throughout the life of the Contract.

C.5.5.17 The Contractor shall ensure that the CCMS Defect Tracking Tool allows those
assigned to resolve the defect the ability to record an explanation upon resolution.

C.5.5.18 The Contractor shall ensure that the CCMS Defect Tracking Tool allows those
assigned to resolve the defect the ability to record an estimated duration and delivery
date.

C.5.6 Training

C.5.6.1 The Contractor shall develop and deliver to the District, for approval based on the Project
Work Plan and Schedule, a Training Plan that describes how all users/workers shall be
trained to operate the CCMS. The Training Plan shall at a minimum contain:
1. Identification of all stakeholders to be trained in the use of the new CCMS to, at
a minimum, include the District Case Workers (the District estimates that
approximately 300 hundred (300) District Case Workers users shall require
training) and Vendor Case Workers (approximately fifty (50) shall require
training);

2. Description of the types of training to be provided for each role of all
stakeholders and how the training shall be provided;

3. The training schedule, topics, and materials to be used for all training;

4. All user-training content and material (e.g., instructor/student guides, web-based
media, or other media/method of delivery) produced and specifically edited for
the District and associated with the CCMS training plan shall be packaged and
provided to the District once training has been completed;

5. Description of the training that shall be conducted on-site by the Contractor;

6. Description of training that may be needed for District staff for any user
acceptance software tools to be used during testing, validation, or operational
readiness review;
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7. A plan for training new hires post-deployment; and

8. Transition documentation containing important functional information for all
users of any role.

C.5.6.2 The Contractor shall deliver, with the District’s approval, the necessary training
sessions, for the CCMS user community and District staff, prior to the Operations start
date.

C.5.6.3 The Contractor shall deliver to the District, for approval based on the Project Work
Plan and Schedule, the finalized reports and manuals required for the operational
contract phase. These will include, but not be limited to:

1. Operations Manual;
2. Web Portal User Manual;
3. Call Center Manual; and
4. Call Center Summary report template including number of calls received by
type of inquiry, average hold time, number of calls answered by a live
operator, average speed of answer, average time on hold, average call transfer
time, call resolution statistics for the previous month’s call, and number of
calls abandoned.

C.5.7 System Go Live Preparation

C.5.7.1 The Contractor shall develop and deliver to the District, for approval, a Disaster
Recovery Plan that describes how the system assets shall be safeguarded in the event of
a disaster and shall be delivered 30 days before go-live. The Disaster Recovery Plan
must, at a minimum, contain:

1. The identification of system functionality that meets each requirement related to
disaster recovery;
2. Description of system failover to the secondary hosting site and how this shall be
periodically tested and validated;
3. Description of the recovery plan for a physical disaster at either the primary or
secondary hosting sites;
4. Itemization of scheduled system and data backups, where backups are retained, and
how they are transported;
5. Identification of the various disaster types for which disaster recovery procedures
are developed;
6. Description of the triggering events for invoking the disaster recovery procedures
in the event of a disaster;
7. Description of the procedures to notify all impacted stakeholders in the event of a
disaster;
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8. Description of the procedures for relocation of people or system assets during a
disaster;
9. The CCMS shall interface with other District system(s), and the Disaster Recovery
Plan must address responsibility and testing for these interfaces;
10. Description of which system components shall be kept operational during each
identified disaster recovery type;
11. Description of where disaster recovery instructions shall be found if the disaster
recovery plan is activated;
12. Description of the Contractor and District responsibilities in the event of a disaster;
13. Description of how a test of the disaster recovery process shall be conducted before
system implementation and on an annual basis thereafter; and
14. Description of redundant and parallel systems in separate locations, if
separate/secondary hosting sites are available, that can be used to lessen disaster
impacts and allow for rapid recovery.

C.5.7.2 The Contractor shall develop and deliver to the District, for approval, an Operational
Authorization Approval package. After the District reviews and accepts the package 30
days before the system go-live date. the Contractor shall prepare a transmittal letter to
request final acceptance of the entire authorization package. The authorization package
must include at a minimum the following documents:

1. Transmittal Letter;

2. The most current version of all plans and documentation delivered to date; and

3. An operational POA&M may be included if the Contractor and the District have
agreed any DDI artifacts' deliverable dates shall extend beyond the Go-Live date.

C.5.8 System Go Live
C.5.8.1 The Contractor shall implement the solution to replace the existing system. The
Contractor shall develop and deliver to the District, for approval, an Implementation
Plan detailing the planned solution implementation activities. This is the plan for
activities directly associated with the cutover to the new system. The Implementation
Plan shall give details on how the new system will be implemented, including but not
limited to the installation of the system, the installation of the new website(s), cutover
to the system and website, setting up the Call Center, dissemination of phone numbers,
start dates and dependencies. As updates or new issues are identified, the
Implementation Plan shall be updated and the updates approved by the District
throughout the DDI phase up to and including the System Go-Live Preparation Phase.
The Implementation Plan at a minimum shall include:

1. Execution of the data migration activities described within the Data Migration
plan;

2. Execution of the activities described within the Testing, Validation;
29
3. Operational Readiness plan including any contingency plans;
4. Demonstration of the Disaster Recovery process and procedures prior to
implementation;

5. Demonstration of the system operation;

6. Demonstration that all the system access and security measures of the System
Security plan are in effect at the point of system implementation;

7. Execution of the Project Communications Plan; and

8. Execution of the Implementation plan.

C.5.9 System Operations and Maintenance

C.5.9.1 The Contractor shall ensure the operational hours for the CCMS shall remain
24x7x365(366).

C.5.9.2 The Contractor shall ensure that all system users and helpdesk staff can perform their
daily tasks using the CCMS. The Contractor shall supplement deficiencies and
remedies by use of an Operational POA&M. The Operational POA&M will be used for
tracking procedural or other issues that are not directly associated with the system
features or documented functionality.

C.5.9.3 The Contractor shall ensure system availability 99.98% per week between the hours of
6 am through 11 pm eastern standard time for all hardware, software, and network
components of the CCMS under the Contractor’s control.

C.5.9.4 The Contractor shall ensure no single, unscheduled outage of service is to extend
beyond 15 minutes per week.
C.5.9.5 The Contractor shall house, and maintain all hardware, software, network connectivity,
and data storage for both the production and any/all disaster recovery site(s) of the
CCMS.

C.5.9.6 The Contractor shall develop and implement reports to monitor CCMS network status.
These reports will include but not be limited to:

1. Network Activity Report identifying network availability and downtime in total
minutes;
2. System availability and downtime in total minutes:

a) Weekly (Sunday – Saturday) network and application, independently and
combined, availability as a percentage of minutes available over total minutes
in a week (minutes that system is operational this week) / (minutes in a week);
b) Minutes (rounded to the nearest minute) of District-pre-approved downtime
will be deducted from both the numerator and the denominator; and
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c) Root cause analysis of each network or application outage during the month
that exceeded 15 minutes during each 60-minute period. The Contractor shall
notify the DHCF by e-mail within 15 minutes at any time the system is
unavailable for use by system users and again when it is available for use.

3. All Defects identified by DHCF or Contractor shall be corrected by the
Contractor at its expense and at no additional cost to DHCF;

4. The Contractor will maintain routine System performance and Operations
while correcting the Defects;

5. The Contractor shall communicate, in advance, to CCMS stakeholders
including beneficiaries, workers, providers, DHCF and other District
Agencies system modifications that are approved by the District or system
modifications that are necessary to comply with changes in Federally
mandated or National Standards such as, but not limited to CMS, HIPAA,
or MITA, and to meet the deadlines imposed for such changes, for the
duration of this contract, as part of the Contractors normal system
maintenance of the CCMS System pursuant to this Contract; and

6. The Contractor shall make online training materials available to all CCMS
user groups such as DHCF, DDS, Providers, workers (including direct
service workers), case management agencies, managed care organizations,
and others as deemed necessary by DHCF as part of the Contractors
normal system maintenance of the CCMS System pursuant to this
Contract.

C.5.10 CMS Required Outcomes Based Certification Requirements

C.5.10.1 The Contractor shall assist the District in achieving CMS Certification of the CCMS. The
CMS authority for requiring federal Certification is based, in part, on language found in
Public Law 92-603, and the code of Federal Regulations (CFR) at 42 CFR 433 and 45 CFR
95.611(d).
C.5.10.2 The Contractor shall compile documentation/reports on the CCMS and the Contractor's
CCMS processes and procedures, and any other CMS-required artifacts at the District's
request that will address questions raised by CMS during the process of certifying the
Contractor's solution. The Contractor's CCMS will be certified as a stand-alone module.

C.5.10.3 Each CMS-Required outcome is based on statutory or regulatory requirements. CMS-
Required Outcomes and Metrics are used to demonstrate that the CCMS system is
compliant with the applicable federal regulations which pertain to the specific CCMS
module. CMS-Required outcomes form the baseline for system/module functionality,
which must continue to receive enhanced federal funding for operations. The full process
overview of CMS LTSS Outcome-Based Certification requirements can be found here:
https://cmsgov.github.io/CMCS-DSG-DSS-
Certification/Outcomes%20and%20Metrics/Long%20Term%20Services%20&%20Suppor
ts%20(LTSS)/
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C.5.10.4 The Contractor shall provide documentation for the following metrics for purposes of CMS
Outcomes-based certification. The table below, taken directly from the CMS LTSS
Outcome-Based Certification requirements website, describes the CMS-Required Outcomes
and Metrics used to demonstrate that a CCMS System is compliant with the applicable
federal regulations:

Requirement/ Functionality CMS Required
Outcomes
Default Metrics
Reference #
LTSS1 The CCMS system generates
notifications including eligibility
determination; termination of state
waiver (30 days in advance); and
inspections taking place in a
beneficiary's home when a beneficiary
receives services in his/her own home
or the home of a relative (HCBS
waiver for individuals 65 and older)
(48 hours in advance).
- Percent of notifications and decisions sent to
the correct individuals within the required
timeframe.
LTSS2 The CCMS system stores proof of
beneficiary consent to enroll in HCBS
state plan or waiver-based programs.
- Percentage of beneficiaries with proof of
consent stored in system
LTSS3 The CCMS system assigns, tracks and
changes beneficiary prioritization and
waiver waitlist status.
- Verify assigning and changing of beneficiary
prioritization.
- Verify assigning and changing waitlist status.
- Verify researching and finding prioritization
and waitlist status.
- Verify ability to report on waitlist and
prioritization status.
LTSS4 The CCMS system maintains a record
of beneficiaries who have left the
waiver program due to death or loss of
eligibility for Medicaid under the State
Plan to replace those beneficiaries
with others on the waitlist.
- Verify ability to update beneficiary records
for death, loss of eligibility
– Pass/Fail
LTSS5 The CCMS system stores the person-
centered plan, including any updates
or changes containing all required
information and consent signatures.
- Percentage of beneficiaries with current and
complete person-centered plan
LTSS6 The CCMS system supports conflict-
free case management via role-based
access, proper firewalls, and
mitigation strategies that provide
beneficiaries appropriate access to
records.
- Pass/Fail for the following:
- Verify that only correctly assigned/authorized
logins can view care plans.
- Verify that 'not authorized logins' are unable
to view plans.
- Verify that 'not authorized logins' cannot
update or change data.
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Requirement/ Functionality CMS Required
Outcomes
Default Metrics
Reference #
LTSS7 The CCMS System supports
completion of CMS Form 372.
- Timeliness of reporting to CMS
LTSS8 The CCMS system collects and saves
prior authorizations to exchange with
MMIS as needed to prevent the
provision of unnecessary or
inappropriate services and supports.
- Pass/Fail for the following:
- Verify the capability to save and track prior
authorization information on LTSS
beneficiaries.
- Verify capability to send/exchange prior
authorization data to required interfaces.
LTSS9 The CCMS system documents and
tracks reportable events related but not
limited to instances of abuse, neglect,
exploitation, and unexplained death
from case initiation to case closeout.
- Average number of days it takes from a
critical incident to completion of an
administrative review
- Pass/Fail for the following:
- Verify capability to receive reportable events
from various media such as phone, tablet, text
message, online.
- Verify capability to track reportable events
through to closure.
- Verify capability to search for and view a
reportable event using information such as
beneficiary name and/or date of reportable
event.
LTSS10 The CCMS system collects grievances
related but not limited to instances of
abuse, neglect, exploitation, and
unexplained death from case initiation
to case closeout.
- Average number of days it takes from a
grievance reported to completion of an
administrative review.
- Pass/Fail for the following:
- Verify capability to receive grievances from
various media such as phone, tablet, text
message, online (per state-specified
requirements).
- Verify capability to collect grievance data
required for audits/hearings.
- Verify capability to track grievances through
closure.
- Verify capability to search for and view a
grievance by using information such as
beneficiary name and/or date of reportable
event.
LTSS11 The CCMS system creates trend
reports of critical incident causes and
tracks trends of critical incidents after
operational implementation of
interventions/mitigations/corrective
actions.
- Trend data of critical incidents.
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C.5.11 Transition/Turnover

C.5.11.1 The Contractor shall prepare and deliver to the District, for approval, an initial Turnover
Management Plan thirty business days after the request from the CA. The Turnover
Management Plan, at a minimum, shall include the following components:
a. Proposed Schedule for meetings between DHCF and Contractor;
b. Communication strategy to address needs and concerns between Contractor
and DHCF regarding all turnover deliverables;
c. Proposed turnover Schedule (i.e., a GANTT chart) in standardized Microsoft
Project software accessible to DHCF; and
d. Statement of Resources, which shall include an organization chart and
description of responsibilities during turnover activities.

C.5.11.2 The District shall have 15 business days to accept or reject the Turnover Management
Plan deliverable. The District shall provide written feedback to the Contractor. The
Contractor shall revise and submit the Turnover Management Plan within five business
days. If Contractor does not receive notice of rejection and the detailed basis for
rejection within 15 business days, the deliverable is deemed to be accepted.

C.5.11.4 Turnover Preparation
The Parties expressly acknowledge the following:
DHCF may submit one request for Contractor to deliver work-in-progress documentation
as requested by the CA. If this request is received, the Contractor shall deliver the
information no later than the District’s requested date.

C.5.11.5 The Contractor shall answer, within five business days, any questions from DHCF
regarding, but not limited to, the following:
a. System changes;
b. Interface control documents;
c. Initial and subsequent data extracts;
d. Data Conversion documents; and
f. Copybooks and data dictionaries.

C.5.11.6 The Contractor shall begin preparation of systems and operations documentation listed
below for eventual turnover:
a. A listing with explanations of system changes, as described in existing
system documentation, that have been implemented since CCMS was
certified by CMS;
b. The current interface control documents for all the CCMS interfaces;
c. The current versions of the External CCMS copybooks and data dictionaries;
d. Provider Training Materials; and
g. General Systems Operational Information.
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C.5.11.7 The Contractor shall provide a Turnover Plan Status Report on a bi -weekly basis, once
the Turnover Process begins, which details the status of all requested work products for
DHCF.
C.5.11.8 Key Staffing Resources
The Contractor shall provide a Turnover Project Management Professional. This is a
remote position and work hours will vary over the course of the Turnover period.
Duties include, but are not limited to the following:

a. Oversee all Turnover workplan activities

b. Prepare and submit the deliverable required under C.5.11 with the assistance
of other Contractor personnel.

C.5.11.4 CMS Seven Conditions and Standards

The Contractor shall continue to follow the CMS Seven Conditions and Standards,
develop, and provide a CMS Seven Conditions and Standards plan that identifies and
describes the related aspects of the CCMS solution and how each aspect satisfies the
standard/condition:

1. Modularity Standard;
2. Medicaid Information Technology Architecture Condition;
3. Industry Standards Condition;
4. Leverage/reuse Condition;
5. Business Results Condition;
6. Reporting Condition; and
7. Interoperability.
More information regarding CMS Medicaid Seven Conditions and Standards can be found
on the Medicaid.gov website.
https://www.medicaid.gov/medicaid/data-systems/medicaid-information-technology-
architecture/medicaid-information-technology-architecture-framework/index.html
C.5.12 Business Requirements

C.5.12.1 Core Business Requirements

The CCMS system, at a minimum, shall support the following core business processes:

1. Have expanded user access to include LTC providers, Medicaid health
management organizations (DCHFP, PACE, DSNP, etc.), District Government
Agencies, the District’s Medicaid Contractors, and other Program designees;
2. Support all LTSS Intake, Screening, and Clinical Needs Assessments functions;
3. Standardized Assessment Instrument (i.e., InterRAI) capable of supporting MDS
and PDPM systems used for person-centered care planning, acuity and clinical
determinations, quality improvement, resource allocation, and population research
for the District’s LTSS recipients. The Standardized Assessment Instrument
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functionality in the new CCMS shall include the approved and implemented system
changes from the legacy CCMS solution, as detailed in the Nursing Facility
MDS/OSA Change Request. Please refer to the Attachment J.20, CR # 808022.
4. Support Medicaid LTC eligibility determinations;
5. Support Care Coordination and service delivery (e.g., transfers, discharges,
transitions across settings, prior authorizations, program referrals, etc.) functions
for enrolled Medicaid beneficiaries;
6. Support the management of Person-Centered Service Planning, Plan of care, and
Outcomes;
7. Support the creation of various dynamic forms used for program administration
(e.g., Person-Centered Service Plan, Bill of Rights, Freedom of Choice, electronic
prescription orders, Advanced Directives, PASRR, Surveys, Programmatic
Monitoring Tools, Screening Questionnaires, etc.);
8. Support the extraction of data from created dynamic forms, documents, and related
workflows;
9. Have automated alerts for activities, forms, documents, and workflows based on
user-configurable settings or business rules;
10. Be interoperable with the District’s Medicaid Enterprise IT systems;
11. Have a notifications or communications message center platform capable of
bidirectional direct messaging between the CCMS users and external systems (e.g.,
HIE, DCAS, EHRs);
12. Have reporting capabilities including but not limited to:

a) Predefined or templated standard reports with one or more prompts or
parameters for users to enter desired data to produce the report;
b) Displaying data via report query or dashboards based on users’
authorization level;
c) Canned and Ad hoc reporting;
d) Report building;
e) Transmission of data to and from the Medicaid Data Warehouse; and
f) Real-time analytics (e.g., the ability to collect multiple sources of
information to identify opportunities for beneficiaries, providers, or the
District to improve clinical and financial outcomes).

13. Support the generation of automated notices, correspondence, and letters (e.g.,
Clinical assessments and screenings, referrals and service authorizations, program
letters, etc.);
14. Support system users including District government entities or the District’s
designees making program referrals across delivery systems and care settings (with
automated (re)triggers for unacknowledged or declined referrals) and authorizations
for the initiation of service for Medicaid beneficiaries or applicants;
15. Have program monitoring tools (e.g., Monthly visits, questionnaires, provider
audits, surveys, etc.) to collect, track, and manage information on programmatic
requirements;
16. Have global navigation tabs and menus (home, people, assignments, to-do lists,
alerts, reports, KPIs, general administration, user information, tools, etc.)
17. Support all critical incident management functions;
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18. The CCMS solution shall adopt the MITA framework, industry standards, and
other nationally recognized standards for the Design, Development, and
Implementation phases;
19. Be workflow driven and provide functionality for the development of configurable
multi-branching complex workflows;
20. Provide end-user training throughout the life of the contract; and
21. Have predictive modeling capabilities (e.g., predictive analytics function that can
utilize clinically relevant predictive risk modeling tools to calculate a Risk Score to
identify and stratify high-risk populations that will most benefit from some form of
care management intervention).
C.5.12.2 General System Requirements

C.5.12.2.1 The Contractor shall ensure that the CCMS is a web or application-based with point-
and-click navigation and open and view multiple screens concurrently.

C.5.12.2.2 The Contractor shall ensure that the CCMS provides a single sign-on for a user to
securely log in to the portal to perform case management, analytics, and administrative
duties.

C.5.12.2.3 The Contractor shall ensure that the CCMS supports remote access.

C.5.12.2.4 The Contractor shall ensure that the CCMS provides editing ability within cases (i.e.,
free-text) and on forms shall be role/permission-based.
C.5.12.2.5 The Contractor shall ensure that the CCMS displays summary data in the form of to-do
lists.

C.5.12.2.6 The Contractor shall ensure that the CCMS provides a means of delivering and
managing help content for users, including but not limited to FAQs, instructions,
manuals, guides, and informational worksheets.

C.5.12.2.7 The Contractor shall ensure that the CCMS establishes consistent communication
patterns and protocols for data exchange with external entities. Interfaces shall be
developed using common, widely used transport protocols.

C.5.12.2.8 The Contractor’s CCMS system shall develop a collection of well-defined, independent
services as per MITA’s most recent guidance.

C.5.12.2.9 The Contractor shall ensure that the CCMS includes a manual scheduling function.
C.5.12.2.10 The Contractor shall ensure that the CCMS can flag and monitor recipients per service
classification type.
C.5.12.2.11 The Contractor shall ensure that the CCMS has role-based security as specified by the
requirements.
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C.5.12.2.12 The Contractor shall ensure that the CCMS provides a workflow process that organizes
and presents scheduled activities and “tickler” items for all users.

C.5.12.2.13 The Contractor shall ensure that the CCMS provides recipient-level and case-level
alerts that quickly caution the Case Worker/Case Worker/Service Coordinator to a
specific condition (e.g., enrollment in a specific program, an in-process quality review,
in-process appeal or litigation, and ESL recipients).

C.5.12.2.14 The Contractor shall ensure that the CCMS routes activities for multiple users and user
groups.
C.5.12.2.15 The Contractor shall ensure that the CCMS provides context-intuitive on-screen help.
C.5.12.2.16 The Contractor shall ensure the CCMS includes outcome tracking (e.g., activities,
goals, and eligibility issues).

C.5.12.2.17 The Contractor shall ensure that the CCMS contains message-center board
functionality for communications purposes (i.e., instead of external emails).

C.5.12.2.18 The Contractor shall ensure that the CCMS is designed by applying a modular, flexible
approach to system development, including the using open interfaces and Application
Programming Interfaces as per MITA’s most recent guidance.

C.5.12.2.19 The Contractor shall ensure that the CCMS is designed with a flexible approach that
enables high-level integration of process flow and information flow with business
partners external to DHCF as per MITA’s most recent guidance.
C.5.12.2.20 The Contractor shall ensure that the CCMS employs a web service architecture and
SOA to ensure standards-based interfaces to link business partners and information as
per MITA’s most recent guidance. API capability is available (as needed).

C.5.12.2.21 The Contractor shall ensure that the CCMS adheres to all industry standards defined by
regulation, including HIPAA, Section 508 of the Rehabilitation Act, and Section 1104
and 1561 of ACA.

C.5.12.2.22 The Contractor shall ensure that the CCMS implements services using industry
standards and best practices, such as Simple Object Access Protocol, Java Messaging
Service, and Web Services Description Language as per MITA’s most recent guidance.

C.5.12.2.23 The Contractor shall ensure that the CCMS promotes the sharing, leverage, and reuse
of technologies within and amongst states as per MITA’s most recent guidance.

C.5.12.2.24 The Contractor shall ensure that the CCMS provides for automated identification and
referral according to pre-determined, critical factors.
C.5.12.2.25 The Contractor shall ensure that the CCMS electronic and paper forms continue to be
available in the following languages: English, Amharic, French, Korean, Mandarin
Chinese, Spanish, and Vietnamese.
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C.5.12.2.26 For all roles, the Contractor shall ensure that the CCMS tracks assignments by a
worker, duration of activities and tasks, and completion of tasks, activities, and cases.

C.5.12.2.27 The Contractor shall ensure that the core systems functionality allows users to search
by Medicaid ID and display results even if the latest Medicaid ID for Person is no
longer current.

C.5.12.2.28 The Contractor shall ensure that the CCMS allows DHCF system administrators/super-
users permission to edit certain form fields post-submission. (e.g, LOC dates even after
an assessment has been completed and the form is locked down).
C.5.12.2.29 The Contractor shall ensure that the CCMS allows the update of the
assessment backend mapping for assessment questions and their corresponding
responses.

C.5.12.2.30 The Contractor shall ensure that the CCMS allows users to enter prospective or
retroactive deactivation dates for agency assignments.

C.5.12.2.31 The Contractor shall ensure that the CCMS tracks activities related to (re)Certification
for beneficiaries enrolled in the EPD waiver program.

C.5.12.2.32 The Contractor shall ensure that the CCMS allows users (e.g., Assessors, Supervisors,
and Administrators) to create clinical assessments for initial, redetermination,
significant change, and other types of assessment requests available in the assessment
application module.
C.5.12.32.3 The Contractor shall ensure that the CCMS supports care coordination workflow
management across the delivery systems (e.g., discharges, transfers, transitions)

C.5.12.2.34 The Contractor shall ensure that the CCMS has the functionality for Provider
monitoring that enables DHCF to track provider performance and maintain care
management standards.

C.5.12.2.35 The Contractor shall ensure that the CCMS enables providers (including health plans)
to communicate with each other about beneficiaries they are supporting to enable
quick, smooth, and ultimately efficient transition through business processes –
especially where there are hand-offs between different agencies or users of the system.

C.5.12.2.36 The Contractor shall ensure that the CCMS can verify a beneficiary’s status (including
Medicaid eligibility span, assessments, and authorized services as part of the business
rules).

C.5.12.2.37 The Contractor shall ensure that the CCMS allows a provider to search within forms
(e.g., PCSP, Provider Choice Form, etc.).
C.5.12.2.38 The Contractor shall ensure that the CCMS has a multi-sectioned Monthly Visit
Clinical Note Monitoring tool.
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C.5.12.2.39 The Contractor shall ensure that the CCMS has a settings questionnaire within a
person’s record.

C.5.12.2.40 The Contractor shall ensure that the CCMS has a large-size text box for entering new
case notes within a person’s record.

C.5.12.2.41 The Contractor shall ensure that the CCMS can default agency information to their
agency name and automatically populate by default when the providers search for a
person using the person search functionality.
C.5.12.2.42 The Contractor shall ensure that the CCMS permits the addition of a representative and
other related information from the person’s overview page or from within a PCSP.

C.5.12.2.43 The Contractor shall ensure that the CCMS allows users to track the progress made on
various LTSS activities (e.g., intake, transfers, discharges, transitions, assessments,
eligibility, EVV, etc.).

C.5.12.2.44 The Contractor shall ensure that the CCMS has a My List function available to all
providers and DHCF and will consist of information related to milestone activities
(e.g., intake, eligibility, care coordination, service delivery, etc.).

C.5.12.2.45 The Contractor shall ensure that the CCMS defaults sort order by person’s first name
and display output in alphabetical order.

C.5.12.2.46 The Contractor shall ensure that the CCMS user permissions are tiered (e.g., nurse
assessors’ assignment to assessments is limited to the assessor agency, and DHCF user
administrators can edit specified assessment fields post-submission).

C.5.12.2.47 The Contractor shall ensure that the CCMS allows manual updates to selected fields
(e.g., LOC determination section of assessments to ensure recommendations are scored
accurately).

C.5.12.2.48 The Contractor shall ensure that the CCMS displays questions on forms (e.g., PCSPs,
Incident Reports, Assessments, etc.) based on program type.

C.5.12.2.49 The Contractor shall ensure that the CCMS processes care coordination functions (e.g.,
person discharges, transfers, transitions) at the program and agency level.

C.5.12.2.50 The Contractor shall ensure that the CCMS converts digital forms in the predecessor
system with persons’ data into electronic versions of the same and migrate them into
the CCMS to ensure there is no loss of historical data documented for persons.

C.5.12.2.51 The Contractor shall ensure that the CCMS can add and maintain new agency/provider
types and user roles received from the MMIS.

C.5.12.2.52 The Contractor shall ensure that the CCMS has user roles for LTC providers, and
Medicaid health management organizations (e.g., DCHFP, PACE, DSNP).
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C.5.12.3 Business Rules Management Requirements

C.5.12.3.1 The Contractor shall ensure that the CCMS has a user-friendly, graphical front-end to
the business rules module.

C.5.12.3.2 The Contractor shall ensure that the CCMS creates rules using language easily
understood from a business perspective rather than in code.

C.5.12.3.3 The Contractor shall ensure that the CCMS creates rules using templates.
C.5.12.3.4 The Contractor shall ensure that the CCMS tracks and reports rules usage.
C.5.12.3.5 The Contractor shall ensure that the CCMS provides the flexibility to execute business
rules by inclusion or exclusion.

C.5.12.3.6 The Contractor shall ensure that the business rule engine can enable or disable a rule.

C.5.12.3.7 The Contractor shall describe the proposed lifecycle for implementing and managing
rules from creation to deployment, including ongoing rule maintenance.

C.5.12.3.8 The Contractor shall ensure that the business rules component supports policy (ruleset)
versioning, along with archival of historic policy versions for audit and regulatory
purposes.

C.5.12.3.9 The Contractor shall ensure that the business rules component provides the ability to
perform rules impact analysis, allowing users to assess the impact of a change to a
given ruleset or policy.
C.5.12.3.10 The Contractor shall ensure that the CCMS controls access and changes to rules or
parameters based on the user role and security profile.

C.5.12.3.11 The Contractor shall ensure that the CCMS allows rules to be implemented in a real-
time enterprise environment and applied immediately.

C.5.12.3.12 The Contractor shall ensure that the CCMS produces warnings on impacted rules
before implementing a new rule and/or changes to an existing rule (e.g., generate an
informational message or popup window or list of impacts on other rules.)

C.5.12.3.13 The Contractor shall ensure that the CCMS allows rules to be tested against production
data before installation.

C.5.12.3.14 The Contractor shall ensure that the CCMS business rules are separate from core
programming and are provided in both human and machine-readable formats.
C.5.12.3.15 The Contractor shall ensure that the CCMS enables the business rules to be accessible
and adaptable by other states.

C.5.12.3.16 The Contractor shall ensure that the CCMS submits business rules to a federally
designated repository, as available.
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C.5.12.3.17 The Contractor shall ensure that the CCMS updates dependent data elements and
updates, or flag text associated with a rule when a rule is updated, as well as update or
flag text for review that is affected by the rule change.

C.5.12.3.18 The Contractor shall ensure that the CCMS has the capability for the user to view rules
online and trace rule dependencies, including exceptions.

C.5.12.3.19 The Contractor shall ensure that the CCMS is structured so that the same business rules
engine can be used by different services or be called as a service itself.
C.5.12.3.20 The Contractor shall ensure that the CCMS provides a debugging process that
automatically analyzes and identifies logical errors (i.e., conflict, redundancy, and
incompleteness) across business rules.

C.5.12.3.21 The Contractor shall ensure that the CCMS produces documentation regarding all
business rules in electronic format and accessible via the CCMS.

C.5.12.3.22 The Contractor shall ensure that the CCMS assigns effective start and end dates for
each rule and reference table value.

C.5.12.3.23 The Contractor shall ensure that the CCMS manages rules through version control (e.g.
the level at which versioning is provided and the techniques used for versioning).

C.5.12.3.24 The Contractor shall ensure that the CCMS inactivates incorrect rules while still
maintaining version control.
C.5.12.3.25 The Contractor shall ensure that the CCMS maintains retroactive business rules and
apply them when necessary.

C.5.12.3.26 The Contractor shall ensure that the CCMS categorizes rules or group rules to manage
and organize them. (e.g., by program, policy type, common rules across programs, or
private rules).

C.5.12.3.27 The Contractor shall ensure that the CCMS allows an existing program business rule to
be used as a template for the configuration of a new program.

C.5.12.3.28 The Contractor shall ensure that the CCMS has alert functionality that allows System
Administrators to see other alerts for users in their agency to provide more visibility
into the process and track work being done by the individual agency users.

C.5.12.3.29 The Contractor shall ensure that the CCMS assessment includes workflow statuses
(e.g., QA users review of assessment, clarification request on assessment, LOC review,
and clarification requests).
C.5.12.3.30 The Contractor shall ensure that the CCMS allows users to update forms (e.g.,
assessment and LOC determination information, PCSPs/Plan of Care) and have the
corresponding to-do lists for these forms with workflow statuses.
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C.5.12.4 Workflow Management Requirements

C.5.12.4.1 The Contractor shall ensure that the CCMS has a workflow management system to
document all business processes and maximize the use of workflow to control business
processes.

C.5.12.4.2 The Contractor shall ensure that the CCMS provides an "inbox" for each user with
items to be reviewed or other tasks.
C.5.12.4.3 The Contractor shall ensure that the CCMS carries out multiple operations or tasks
simultaneously within a workflow.
C.5.12.4.4 The Contractor shall ensure that the CCMS defines variable components within a
workflow that allows parameters to be changed by a business administrative workflow
user (e.g. change the number of days workflow step can remain idle before being
escalated).

C.5.12.4.5 The Contractor shall ensure that the CCMS configures reminders for time-sensitive
workflows and events.

C.5.12.4.6 The Contractor shall ensure that the CCMS has automated processing functionalities
(e.g., auto-triggers for additional referrals after a duration or denial based on clinical
assessment determinations)
C.5.12.4.7 The Contractor shall ensure that the CCMS's workflow component supports the
escalation of overdue work list items, based on configurable business rules.

C.5.12.4.8 The Contractor shall ensure that the CCMS automatically routes tasks to a user, steps,
or group after a specific time of inactivity.

C.5.12.4.9 The Contractor shall ensure that the CCMS provides business activity
“sensors/receptors” for monitoring and reporting on task and activity queues.

C.5.12.4.10 The Contractor shall ensure that the CCMS supports long-running workflows, for
example, workflows that span multiple days.

C.5.12.4.11 The Contractor shall ensure that the CCMS monitors case workloads in real time.

C.5.12.4.12 The Contractor shall ensure that the CCMS allows all workflows to resume following
system outages, scheduled maintenance, and disaster recovery scenarios.

C.5.12.4.13 The Contractor shall ensure that the CCMS can add, delete, or modify workflows
according to defined roles.

C.5.12.4.14 The Contractor shall ensure that the CCMS Monitors workloads and tasks in real-time
through workload reports and dashboards that can be filtered by criteria like office,
43
group, worker, supervisor, and other criteria.

C.5.12.4.15 The Contractor shall ensure that the CCMS routes workflow to multiple destinations
(e.g., route back to the previous person for correction, route forward if no changes are
made, re-route the task/document to the beginning of the workflow process if initial
steps/data missing, route anywhere within the workflow process).

C.5.12.4.16 The Contractor shall ensure that the CCMS drives workflow based on changes in the
status of a task.
C.5.12.4.17 The Contractor shall ensure that the CCMS shows a task as incomplete, and
automatically updates the status once complete.

C.5.12.4.18 The Contractor shall ensure that the CCMS displays workflow task and step statuses
including approved, denied, and pending statuses.

C.5.12.4.19 The Contractor shall ensure that the CCMS tracks and reports workflow tasks at each
step within a workflow and their associated status.

C.5.12.4.20 The Contractor shall ensure that the CCMS has multiple levels of approvals for tasks
based on security profile and other user-defined criteria.

C.5.12.4.21 The Contractor shall ensure that the CCMS performs flexible, rule-based automation
(e.g. a document requiring approval can automatically be routed to a different approver
if the first approver has not handled it within a required timeframe).
C.5.12.4.22 The Contractor shall ensure that the CCMS provides pre-determined event triggers
(e.g. task expiration, change of age group of a customer) that will be sent to appropriate
staff or online/batch processes.

C.5.12.4.23 The Contractor shall ensure that the CCMS provides an "out of office" feature and
redirect tasks to another worker within the same workflow so that work is not
interrupted.

C.5.12.4.24 The Contractor shall ensure that the CCMS carries out multiple operations or tasks
simultaneously within a workflow.

C.5.12.4.25 The Contractor shall ensure that the CCMS stores and utilizes organizational structures
in the management of workflow relationships.

C.5.12.4.26 The Contractor shall ensure that the CCMS supports role-based workflow routing in
which tasks are assigned to job functions.
C.5.12.4.27 The Contractor shall ensure that the CCMS establishes a flexible assigned workload
management hierarchy that identifies the responsible organizational unit (e.g., agency,
provider, region, program, unit, specialist, county).
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C.5.12.4.28 The Contractor shall ensure that the CCMS records and maintains rules within a
workflow that describe the workflow process.

C.5.12.4.29 The Contractor shall ensure that the CCMS updates rules in a workflow without
changing the workflow process.

C.5.12.4.30 The Contractor shall ensure that the CCMS assigns activities and tasks among users
using flexible criteria (e.g., alphabetic, program, application status, queue, weighted
caseload, or task).
C.5.12.4.31 The Contractor shall ensure that the CCMS permits multiple user assignments (e.g.,
more than one user can work on the same case without changing data that another
person has already updated).

C.5.12.4.32 The Contractor shall ensure that the CCMS can transfer a task or set of tasks in mass
(e.g., batch assignments, deactivations, etc.) including all electronic supporting
documentation.

C.5.12.4.33 The Contractor shall ensure that the CCMS can close outdated or outstanding tasks in
mass (e.g., PSCPs, assessments, Transfers, discharges, incident reports).

C.5.12.5 Web Portal and User Interface Requirements

C.5.12.5.1 The Contractor shall ensure that the CCMS allows any web browser-based component
to operate consistently and fully across web browsers in widespread use for all users,
including support at the minimum for the following browser platforms: Microsoft
Internet Explorer; Apple Safari; Mozilla Firefox and Google Chrome. The Contractor
shall identify the complete list of browsers (including version numbers) the system will
support.
C.5.12.5.2 The Contractor shall ensure that the CCMS provides 24x7 access to the Web Portal for
all authorized users according to role-based security access.

C.5.12.5.3 The Contractor shall ensure that the CCMS provides a navigation structure and
navigation clues for the user to keep track of their location within any tab, program,
form, report, or document.

C.5.12.5.4 The Contractor shall ensure that the CCMS provides the ability for a viewer to
customize or make basic adjustments (e.g., font size) to portal presentation directly
from the browser.

C.5.12.5.5 The Contractor shall ensure that the CCMS meets the requirements of HIPAA and the
HITECH Act.
C.5.12.5.6 The Contractor shall ensure that the CCMS meets or exceeds user interface
requirements/standards of the Americans with Disabilities Act (ADA)
http://www.ada.gov/, Older Americans Act, and the Rehabilitation Act Section 508
Subpart B Section 1194.21.
45
C.5.12.5.7 The Contractor shall ensure that the CCMS provides the functionality to support the
utilization of electronic signatures in compliance with HIPAA standards, and SOA
electronic signature standards and regulations. The Contractor shall manage the digital
keys.

C.5.12.5.8 The Contractor shall ensure that the CCMS provides the capability to organize multiple
open windows using standard methods such as cascade and tile, and frames within a
window.

C.5.12.5.9 The Contractor shall ensure that the CCMS provides hyperlinks to media files (e.g.,
video, audio) that route users to external sites/pages from within the CCMS homepage.

C.5.12.5.10 The Contractor shall ensure that the CCMS includes a customizable acronym
dictionary.

C.5.12.5.11 The Contractor shall ensure that the CCMS has hover text functionality.
C.5.12.5.12 The Contractor shall ensure that the CCMS has keyword hyperlink functionality.
C.5.12.5.13 The Contractor shall ensure that the CCMS has a home page as the central access to
functionality.

C.5.12.5.14 The Contractor shall ensure that the CCMS can log off users automatically from the
portal after a set amount of inactivity. A warning message shall continue to display
before the session timeout.
C.5.12.5.15 The Contractor shall ensure that the CCMS can post banner messages or alerts to users
when technical issues or errors prevent users from performing tasks.

C.5.12.5.16 The Contractor shall ensure that the CCMS provides banner messages or alerts
informing the users of the resolution of the technical issues.

C.5.12.5.17 The Contractor shall ensure that the CCMS maintains archives of posted
announcements, banner messages, and alerts including the date and message. The
archived materials shall be selectively retrievable for viewing using multiple selection
criteria (e.g., creator, date posted, and subject).

C.5.12.5.18 The Contractor shall ensure that the CCMS provides online Frequently Asked
Questions (FAQ) organized and searchable by topic.

C.5.12.5.19 The Contractor shall include a Section 508 Product Assessment package as part of their
SDLC and shall perform regularly scheduled (i.e., automatic) scans and manual testing
for Section 508(C) compliance for all types of user interface screens (static, dynamic,
Web, mobile, etc.).
C.5.12.5.20 The Contractor shall ensure that the CCMS allows users to view notifications via the
portal.
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C.5.12.5.21 The Contractor shall ensure that the CCMS allows users to receive notifications via
email.

C.5.12.5.22 The Contractor shall ensure that the CCMS employs consistent error handling that
catches both known and unknown errors and displays "user-friendly" error messages.

C.5.12.5.23 The Contractor shall ensure that the CCMS provides context-sensitive help functions at
multiple levels, including but not limited to page help, field-level help, and system-
wide help.
C.5.12.5.24 The Contractor shall ensure that the CCMS user interface aligns with the respective
business processes and shall mirror actual forms in content and layout.

C.5.12.5.25 The Contractor shall ensure that the CCMS supports users with a username and or
password access issues.

C.5.12.5.26 The Contractor shall ensure that the CCMS allows authorized workers to obtain and
retrieve information via Portal log-in to view relevant cases they have permission to
view.

C.5.12.5.27 The Contractor shall ensure that the CCMS allows users to print blank forms (PDF).

C.5.12.5.28 The Contractor shall ensure that the CCMS allows users to download (PDF) documents
from the portal to a local device for storage.
C.5.12.5.29 The Contractor shall ensure that the CCMS allows users to view notifications via the
portal.

C.5.12.5.30 The Contractor shall ensure that the CCMS can timeout due to inactivity or idleness,
based on predetermined time parameters.

C.5.12.5.31 The Contractor shall ensure that the CCMS automatically saves a user's information
(work-in-progress) upon automatic time-out.

C.5.12.5.32 The Contractor shall ensure that the CCMS provides the functionality to link uploaded
documents or images to other system documents/images/cases using the following
protocols: EDI, FTP, and XML.

C.5.12.5.33 The Contractor shall ensure that the CCMS provides the functionality to upload
electronic documents or images in a variety of formats (i.e., BMP, PNG, PDF, JPEG,
and GIF).

C.5.12.6 Data Management Requirements
C.5.12.6.1 The Contractor shall ensure that the CCMS produces electronically accurate data that
are necessary for oversight, administration, and evaluation.

C.5.12.6.2 The Contractor shall ensure that the CCMS accepts client data and the following
inputs:
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1. Provider data;
2. Client assessment file;
3. Client health services file (including clinical record information);
4. Updates from the LTCA workers; and
5. Current ICD, revenue, DRG, CPT and HCPCS code tables.

C.5.12.6.3 The Contractor shall ensure that the CCMS provides a complete recipient's case file,
populated with data derived from the eligibility system interface. Data shall include
patient and member demographics, benefit plan summary and history, Primary Care
Practitioner/OBGYN designations, and unlimited custom data fields that users can add
without intervention from developers.

C.5.12.6.4 The Contractor shall ensure that the CCMS provides complete provider records,
populated with data derived from the provider system.

C.5.12.6.5 The Contractor shall ensure that the CCMS data includes provider demographics,
specialty designation(s), network affiliation, and contact information.

C.5.12.6.6 The Contractor shall ensure that the CCMS data is available for retrieval through the
DSS/DW function.

C.5.12.6.7 The Contractor shall ensure that the CCMS allows agency and staff assignment types
for various Medicaid LTSS Programs (e.g., EPD Waiver, PACE, DSNP, State Plan,
Managed Care).
C.5.12.6.8 The Contractor shall ensure that the CCMS indicates what services are received under
the specified Medicaid LTSS program giving users visibility to keep track of all
beneficiaries they provide services to in the system.

C.5.12.6.9 The Contractor shall ensure that the CCMS maintains an online audit trail of all
updates to CCMS data at the case level.

C.5.12.7 Reporting Requirements

C.5.12.7.1 The Contractor shall ensure that the CCMS generates reports through open interfaces
to designated federal repositories or data hubs, with appropriate audit trails.

C.5.12.7.2 The Contractor shall ensure that the CCMS supports ad-hoc reporting, data analysis,
and graphical data presentation. The CCMS shall produce a set of standards and
parameter-driven management reports.

C.5.12.7.3 The Contractor shall ensure that the CCMS conducts real-time analytics that includes
the ability to collect multiple sources of information to identify opportunities for a
Member or Provider to improve clinical, care coordination, financial, and operational
outcomes.
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C.5.12.7.4 The Contractor shall ensure that the CCMS provides the capability to query based on
record number, the recipient and provider ID, name and date of birth, or social security
number, or by medical condition/diagnosis.

C.5.12.7.5 The Contractor shall ensure that the CCMS can provide a high-cost Member report to
determine potential participation in Care Management Programs or services.

C.5.12.7.6 The Contractor shall ensure that the CCMS saves and exports dashboards, reports, or
queries into other file formats such as: - Adobe Acrobat Portal Document format (.pdf),
Microsoft Excel (.xls), Microsoft Access (.mdb), Text (.txt), Comma-Separated Values
(.csv), etc.

C.5.12.7.7 The Contractor shall ensure that the CCMS provides the ability to receive external data
to be used as part of a query or report.

C.5.12.7.8 The Contractor shall ensure that the CCMS generates the following reports to include,
but not limited to:

1. Standard reports;
2. Cost savings reports;
3. Tracking reports of referrals and appeals;
4. To-do list reports;
5. HEDIS-like reporting;
6. Letter generation to integrate text into correspondence (e.g., custom text fields,
CCMS fields, and MMIS fields);
7. Ad hoc reports;
8. Graphical reports presentations;
9. Causation/correlation;
10. Cost expenditure comparison;
11. Diagnostic coupling;
12. Cost-benefit analysis;
13. Staff performance; and
14. Audit Trails.
C.5.12.7.9 The Contractor shall ensure that the CCMS reports are made available in data format
for export and import purposes and through multiple media including paper, CD-ROM,
electronic file, USB-enabled data drives, and digital imaging in PDF formats.
C.5.12.7.10 The Contractor shall ensure that the CCMS includes outcome tracking (using industry-
standard or user-defined tools).

C.5.12.7.11 The Contractor shall ensure that the CCMS maintains an online audit trail of all
updates to clinical case management data.

C.5.12.7.12 The Contractor shall ensure that the CCMS generates audit trail reports showing before
and after changes in the user interface, the ID of the person making the change, and the
change date.
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C.5.12.7.13 The Contractor shall ensure that the CCMS has unlimited custom fields for reporting
purposes.

C.5.12.8 Correspondence/Forms/Notifications/Document Management Requirements

C.5.12.8.1 The Contractor shall ensure that the CCMS's document generation service supports
various output formats for generated documentation, including but not limited to PDF,
Postscript, XML, HTML, and other formats as dictated by the business requirements.

C.5.12.8.2 The Contractor shall ensure that the CCMS’ document generation service supports the
creation of secure, read-only, and non-alterable output (e.g., secure PDF) in compliance
with federal and district standards for sensitive content output.

C.5.12.8.3 The Contractor shall ensure that the CCMS can generate letters for at least the
following situations:

1. Reduction of Service (e.g., PCA hours);
2. Discharges;
3. Fair hearings;
4. Prior authorizations;
5. Change requests;
6. New admissions;
7. Redeterminations;
8. Transfers; and
9. Waiting list.
C.5.12.8.4 The Contractor shall ensure that the CCMS can send electronic notification letters
securely and confidentially through e-mail or an application. Delivery and read
notifications shall be enabled where technically possible.

C.5.12.8.5 The Contractor shall ensure that the CCMS can create letter data files for export to
automated letter/billing Systems. The System shall have the capability to create and log
web services for notification data for export to the automated letter, SMS, and billing
Systems.

C.5.12.8.6 To record notes at the recipient level and case level, the Contractor shall ensure that the
CCMS provides text fields of at least 1000 characters capacity each.

C.5.12.8.7 The Contractor shall ensure that the CCMS provides online, updateable letter templates
for provider or recipient letters to add free-form text specific to a provider or recipient.
C.5.12.8.8 The Contractor shall ensure that the CCMS isolates and automatically scans all user-
uploaded documents for viruses before submission to the proposed document
management solution for storage.
C.5.12.8.9 The Contractor shall ensure that the CCMS provides document-related workflows and
approval processes.
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C.5.12.8.10 The Contractor shall ensure that the CCMS configures electronic forms to be rendered
in either wizard format or classic forms entry format from the same base form
definition.

C.5.12.8.11 The Contractor shall ensure that the CCMS executes web service calls from the
electronic form process for real-time validation of user data inputs or the execution of
asynchronous processes as needed.

C.5.12.8.12 The Contractor shall ensure that the CCMS provides the end user the ability to render a
flattened output (e.g., PDF) of electronic forms completed online to save or print
locally.

C.5.12.8.13 The Contractor shall ensure that the CCMS includes standard barcodes in flattened
output forms and shall be capable of providing 2-D barcodes.

C.5.12.8.14 The Contractor shall ensure that the CCMS stores and restores the transient state of
forms data entry to enable completion of forms data entry across multiple web
sessions.

C.5.12.8.15 The Contractor shall ensure that the CCMS includes a reusable document generation
service for creating outbound content.

C.5.12.8.16 The Contractor shall ensure that the CCMS’ document generation service generates
documents on-demand as well as on scheduled frequencies.
C.5.12.9 Interface Requirements

C.5.12.9.1 The Contractor shall ensure that the interfaces for data transfer include at a minimum:

1. Provider data from MMIS to CCMS;
2. Recipient data from MMIS to CCMS;
3. Claims data from MMIS to CCMS;
4. Eligibility data from MMIS to CCMS;
5. Prior authorization data from MMIS to CCMS;
6. Data warehouse extracts from CCMS to DSS/DW;
7. Eligibility data from HIE to CCMS; and
8. Eligibility data from CCMS to HIE.

C.5.12.9.2 The Contractor shall ensure that the CCMS interfaces with a new MMIS which will
have similar data elements as the current MMIS.
C.5.12.9.3 The Contractor shall ensure that the CCMS transmits data leveraging the HIPAA
270/271 transaction set for eligibility data and HIPAA 834 transaction set for
enrollment data.
C.5.12.9.4 The Contractor shall ensure that the CCMS employs XML-based interfaces as the
primary integration vehicle for internal and external interfaces.
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C.5.12.9.5 The Contractor shall ensure that the continuous updates to demographic information
entered, flows between the CCMS to MMIS.

C.5.12.9.6 The Contractor shall ensure that the CCMS integrates with the MMIS System utilizing
industry standard transaction formats in batch and near real-time.

C.5.12.9.7 The Contractor shall ensure that the CCMS has the capability of providing an
automated interface to the claim system(s) to ensure the timely and complete
transmittal of all data necessary to the claims process. (PA will be generated).
C.5.12.9.8 The Contractor shall ensure that the CCMS provides access to the claims history and
shall contain diagnoses, procedures, encounters, prescriptions, institutional stays, and
episodes of care.

C.5.12.9.9 The Contractor shall ensure that the CCMS is capable of exporting data to the data
warehouse and continue to replicate the CCMS data in the internal ad hoc reporting
system.

C.5.12.9.10 The Contractor shall ensure that the CCMS has an external interface with commercially
available clinical criteria. The CCMS shall continue to expose important internal
functions as web services (e.g., create new client records from external MMIS payload)
and consume external web services.

C.5.13 Operational Services Requirements
C.5.13.1 The Contractor shall be responsible for the operation of CCMS after completion of the
DDI phase (which includes acceptance by the District). The District requires that the
Contractor provides suitably qualified personnel, equipment resources, facilities, and
supplies necessary to support the production and operation of the CCMS.

C.5.13.2 The Contractor shall ensure that the production operations support includes the
managerial and technical services required to manage and operate the CMMS. Specific
requirements include scheduling and monitoring batch production runs, including
actively participating in the scheduled production meetings, facilitating network
connectivity for the CCMS, administering the database, and performance tuning.

C.5.13.3 The Contractor shall provide a Maintenance and Operations Plan that addresses
ongoing operations services, including all processes, resources, and required
applications/tools. The tasks associated with maintenance and operations include all
tasks necessary to operate a complete and certifiable system and to ensure at a
minimum, that cases are opened, processed, transferred, closed, and archived with
100% accuracy and in accordance with federal and State policy.

C.5.13.4 In the Maintenance and Operations plan, the Contractor shall provide all services
associated with production operations support including the following activities:

1. Batch cycle scheduling specifications, including job turn-around time monitoring
and problem resolution;
2. Database administration;
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3. Problem identification and resolution;
4. Software migration, release, and emergency implementation; change,
configuration, and version management;
5. Response time monitoring and problem resolution;
6. Security implementation and monitoring;
7. Daily, weekly, and monthly production status reporting; and
8. All other activities required to meet the requirements and the performance
specifications of the contract.
C.5.13.5 Also, as a part of the Maintenance and Operations plan, the Contractor shall ensure that
the CCMS provides the capability to monitor and report business processes against
established key performance indicators (KPIs) which will be established jointly by the
District and the Contractor.

C.5.13.6 Upon the Contractor’s discovery of any issue or problem that may jeopardize the
successful or timely completion of its obligations, the Contractor shall notify the
Contract Administrator (CA) verbally and via email. The verbal notification shall occur
no later than the close of business of that day if the problem is discovered before 4:30
p.m. If the problem is discovered after 4:30 p.m. or on a Non-Business Day,
notification shall occur no later than 7:00 a.m. on the succeeding Business Day. The
Contractor shall follow the oral notification with a written analysis within one (1)
Business Day. The written analysis shall be sent to the CA and shall include a
recommendation for expeditious resolution of the problem. Where the operational
problem results in delays in report distribution or problems with online access during
defined business hours, the Contractor shall notify the CA within fifteen (15) minutes
of discovery of the problem.
C.5.14 Operation Support Services Requirements

C.5.14.1 For support services, the Contractor shall provide a minimum of one toll-free number
for all DHCF CCMS Case Workers, and DHCF CCMS vendor partners.

C.5.14.2 The operating hours of support services shall be 7 am – 7 pm, Monday – Friday.
Except for District holidays.

C.5.14.3 Services to be provided shall include:

1. Day-to-day system functionality in accordance with contractual SLAs;
2. System performance in accordance with contractual SLAs;
3. Application network connectivity and response time;
4. Bug reporting and fixing;
5. Problem ticketing and issue resolution;
6. Problem tickets shall be able to be submitted verbally and electronically; and
7. Electronic tickets shall be able to be submitted 24x7x365(366).
C.5.15 System Configuration, Modification, and Maintenance Requirements

C.5.15.1 The Contractor shall be responsible for maintaining and modifying CCMS throughout
the term of the contract. Additionally, the Contractor shall continuously update and
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maintain all CCMS functions according to all federal mandates, District requirements,
statutes, and regulations.

C.5.15.2 The Contractor shall characterize ongoing changes, corrections, or enhancements to the
system as either maintenance-related or as a modification effort. Maintenance may
result from a determination by the District or by the Contractor that a deficiency exists
within CCMS, including deficiencies found after the implementation of modifications
incorporated into CCMS.

C.5.15.3 The Contractor shall ensure that the various types of maintenance support include, but
are not limited to:

1. Activities necessary to provide for continuous effective and efficient operation of
the system to keep it ready and fit to perform at the standard and condition for
which it was approved;
2. Activities necessary to modify the system to meet the requirements; and
3. Addition of new values and changes to existing system tables and conversion of
prior records, as necessary.

C.5.15.4 The Contractor shall develop and deliver to the District. For approval, a Corrective
Action Plan (CAP), to correct any material system non-compliance or continued
underperformance that impacts the Contractor’s delivery of services to the District.

C.5.16 CCMS Enhancements and New Features
C.5.16.1 The Contractor shall ensure that the CCMS meets any additional requirements.
Software Configurations or modifications may result when the District or the
Contractor determines that the CCMS requires additional features. Examples of
configuration or enhancements include, but are not limited to:

1. Implementation of capabilities or approved change orders from DDI activities; and
2. Change orders to establish new workflows, reporting structures, or business rules to
facilitate specific policies.

C.5.16.2 The Contractor shall designate a Configuration and Modification Manager to liaison
between the Configuration and Modification team and the District for all CCMS changes.

C.5.16.3 The Contractor shall provide programmers/analysts on an ongoing basis required to fully
support the District’s CCMS project.
C.5.16.4 During the base year, the Contractor shall be required to allow for up to one thousand
(1000) hours of change order hours for DDI.

C.5.16.5 The change request process for system enhancements shall include but is not limited to:

1. Requirements gathering;
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2. Development of a level of effort detailing the description of the proposed change;
3. Impact summary/reason for the change;
4. Estimated duration; and
5. Project resource allocation/total cost.

C.5.16.6 The Contractor’s Configuration and Modification Manager shall perform the following
tasks related to managing CCMS enhancement:
1. Implement and track change request deliverables and ensure completion at the
approved delivery date;
2. Prepare timely status reports and work plan updates monthly;
3. Take all necessary actions to keep each CCMS enhancement project on schedule
and budget; and
4. Provide a formal remediation plan to the District for CCMS enhancement
deliverables that do not meet the approved requirements or the enhancement
production date.

C.5.17 Data Retention Requirements

C.5.17.1 The Contractor shall agree to retain CCMS data for at least 10 years. In addition,
sufficient capacity must be present to allow for future expansion of additional
populations or services in the future.
C.5.17.2 The Contractor shall agree with DHCF enforcing data retention in
compliance with federal and District requirements.
C.5.17.3 The Contractor shall agree to the data requirements enforced by DHCF to
ensure that data that will never be purged or will be purged on a different
schedule. DHCF will approve, in advance, all data purge schedules and
procedures.

C.5.18 Key Personnel

The Contractor shall provide the following key personnel positions to successfully
perform the required services:

C.5.18.1 An Account Manager for the CCMS System and Supporting Services
Contract. The Account Manager is the Contract primary point of contact to
maintain communication with DHCF's CCMS Contract Administrator and
Agency Management for activities related to contract administration,
correspondence between DHCF and contractor, and status reporting to DHCF.
The Account Manager shall be in place at the Contract effective date.

C.5.18.2 A Project Manager for the CCMS System and Supporting Services contract to
participate in all phases, requirements elaboration and verification, system’s
design, development, implementation, and testing. The Project Manager
manages activities related to contractor resources, deliverable reviews, system
development and testing activities during the DDI effort of the new CCMS
System implementation. The Project Manager is also responsible for
managing the Operational Transitional and Readiness activities. The Project
55
Manager shall be in place at the contract effective date and be dedicated to the
CCMS System implementation full-time.

C.5.18.3 A DDI Manager and Certification Manager for the CCMS System and
Supporting Services contract to participate in all phases, system’s design,
development, and implementation. The DDI Manager manages activities related
to Contractor resources, Deliverable reviews, system development and testing
activities during the DDI effort of the CCMS System. The Certification
Manager will oversee the CCMS Certification process from the vendor’s
prospective and ensure that the certification checklists and artifacts are prepared
and submitted to the District. The DDI Manager and Certification Manager shall
be dedicated to the CCMS System and Supporting Services project full-time.

C.5.18.4 A Systems Manager for the design, development, and implementation of the
CCMS System and Supporting Services solution as well as during the ongoing
maintenance of the System. The Systems Manager coordinates System
Customization and Configuration. The Systems Manager shall be in place at
the system’s configuration tasks begin.

C.5.18.5 A Data Migration Lead is responsible for all data migration/conversion into the
new system. In addition, they are responsible for testing, addressing, and
resolving any data conversion related defects.

C.5.18.6 A Quality and Assurance (Q&A) Test Lead is responsible for development and
overseeing the testing of the system to ensure the system meets the
requirements in accordance with Section C.5 of the contract.

C.5.18.7 A Training Lead is responsible for ensuring the District and Contractor’s staff
are trained to be able to efficiently use the system. The Training Lead shall
also lead the development and execution of the training plan in accordance
with the requirements of the contract.

C.5.18.8 Other Key personnel include Business Analysts and Testers
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SECTION D: PACKAGING AND MARKING
D.1 The packaging and marking requirements for this contract shall be governed by clause number
(2), Shipping Instructions-Consignment, of the Government of the District of Columbia's
Standard Contract Provisions for use with Supplies and Services Contracts, dated July 2010.
(Attachment J.1)
57
SECTION E: INSPECTION AND ACCEPTANCE
E.1 The inspection and acceptance requirements for this contract shall be governed by clause
number five (5) Inspection of Supplies AND clause number six (6), Inspection of Services of
the Government of the District of Columbia's Standard Contract Provisions for use with
Supplies and Services Contracts, dated July 2010. (Attachment J.1)
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SECTION F: PERIOD OF PERFORMANCE AND DELIVERABLES
F.1 TERM OF CONTRACT

The term of the contract shall be for a period of twelve months from date of award specified on
the cover page of this contract.

F.2 RESERVED

F.3 DELIVERABLES

The Contractor shall perform the activities required to successfully complete the District’s
requirements and submit each deliverable to the Contract Administrator (CA) identified in
section G.9 in accordance with the following:

CLIN Deliverable Quantity Format/Method of Delivery Due Date
0001
Kick-Off Meeting
Presentation
C.5.1.1
1
Presentation
PowerPoint or
PDF/Electronically
Date agreed with
DHCF
0001 Draft Project
Management Plan
C.5.1.2
1 Word Document or
PDF/Electronically
30 days from
Kick-Off Date

0001
Draft
Communications Plan
C.5.1.3

1 Word Document or
PDF/Electronically
30 days from
Kick-Off Date
0001
Draft Risk
Management Plan
C.5.1.4
1 Word Document or
PDF/Electronically
30 days from
Kick-Off Date
0001 Draft Staffing Plan
C.5.1.5 1 Word Document or
PDF/Electronically
30 days from
Kick-Off Date
0001
Project Work Plan
and Schedule
C.5.1.6
1 Word Document or
PDF/Electronically
2 weeks after
Kick-off
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CLIN Deliverable Quantity Format/Method of Delivery Due Date
Meeting and
updated weekly
0001
Project Status Report
C.5.1.7 1 Word Document or
PDF/Electronically Weekly
0001
Deliverables Status
Summary
C.5.1.8
1 Word Document or
PDF/Electronically Weekly
0001 Change Control Plan
C.5.1.9 1 Word Document or
PDF/Electronically
Per project
schedule
0001
Quality Management
Plan
C.5.1.10
1 Word Document or
PDF/Electronically
Per project
schedule

0002
Functional
Requirements
Document
C.5.2.2

1 Word Document or
PDF/Electronically
Per Project
schedule

0002
Business Process
Maps and Workflow
Diagrams
C.5.2.3

1 Word Document or
PDF/Electronically
Per Project
schedule
0002
Conference Room
Pilot Presentation
C.5.2.4
1 Word Document or
PDF/Electronically
Per Project
schedule

0002
Proposed content for:
Operations Manual
Web Portal user
Manual
Call Center Manual
Call Center Summary
Call Center Report
Template
C.5.2.5

1

Word Document or
PDF/Electronically

Per Project
schedule
0005 System Security Plan
C.5.2.6 1 Word Document or
PDF/Electronically
Per Project
schedule
0005
Security Risk
Assessment Response
C.5.2.7.1
1 Word Document or
PDF/Electronically
Per Project
schedule

0005
External
Vulnerability
Assessment
Certification Report
C.5.2.7

1

Word Document or
PDF/Electronically

Per Project
schedule

0005
Security Plan of
Action and
Milestones
(POA&M) document
C.5.2.7.2

1

Word Document or
PDF/Electronically

Per Project
schedule
60

CLIN Deliverable Quantity Format/Method of Delivery Due Date
0003
Design Specifications
Document
C.5.3.1
1 Word Document or
PDF/Electronically
Per Project
schedule
0003
Interface Control
Document
C.5.3.2
1 Word Document or
PDF/Electronically
Per Project
Schedule

0004
Data
Conversion/Migration
Plan
C.5.4.1

1 Word Document or
PDF/Electronically
Per Project
Schedule

0004
Data Conversion
Technical
Specifications
C.5.4.2

1 Excel or Word
PDF/Electronically
Per Project
Schedule

0005
Test and Operational
Readiness Plan
C.5.5.1

1 Word Document or
PDF/Electronically
Per Project
schedule
0005 User Acceptance Plan
C.5.5.2 1 Word Document or
PDF/Electronically
Per Project
schedule
0005
User Acceptance Test
Cases and Scripts
C.5.5.3
As required Excel/Word/PDF/Electronically Per Project
Schedule
0005
User Acceptance Test
Status Report
C.5.5.4
1 Word Document or
PDF/Electronically
Weekly during
UAT

0005
User Acceptance Test
Results Summary
Report
C.5.5.5

1 Word Document or
PDF/Electronically
Per Project
schedule

0006 Training Plan
C.5.6.1

1 Word Document or
PDF/Electronically
Per Project
schedule
0006
Deliver Training
Sessions
C.5.6.2
1 On-site, Video Conference, On-
Line Seminars
Per Project
schedule

0006
Finalized manuals
Operations Manual
Web Portal user
Manual
Call Center Manual
Call Center Summary
Report
C.5.6.3

1

Word Document or
PDF/Electronically

Per Project
schedule
0007
Disaster Recovery
Plan
C.5.7.1
1 Word Document or
PDF/Electronically
Per Project
schedule

0007
Operational
Authorization
Approval Package
C.5.7.2

1 Word Document or
PDF/Electronically
Per Project
schedule
0007 Implementation Plan
C.5.8.1 1 Word Document or
PDF/Electronically
Per Project
schedule
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CLIN Deliverable Quantity Format/Method of Delivery Due Date
0007
System Go-live
1 CCMS System Per Project
schedule

0008
Certification artifacts,
reports,
documentation
required to
successfully achieve
CMS required
Outcome-based
certification
C.5.10

Per CMS
Requirements

Format required by CMS

Per Project
schedule

1001

Transition and
Turnover Plan
C.5.11.1

1

Word Document or
PDF/Electronically
Release and
before the
beginning of the
last year of the
contract, or upon
request from the
District

1001
Turnover
Requirements
Statement
C.5.11.2

1

Word Document or
PDF/Electronically
Release and at
least six months
before the end of
the contract
period, or upon
request from the
District
1001
Maintenance and
Operations Plan
C.5.13.3
1 Word Document or
PDF/Electronically
Per Project
schedule

F.3.1 The Contractor shall submit to the District, as a deliverable, the report described in section
H.5.5 that is required by the 51% District Residents New Hires Requirements and First Source
Employment Agreement. If the Contractor does not submit the report as part of the
deliverables, final payment to the Contractor shall not be paid pursuant to section G.3.2.
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SECTION G: CONTRACT ADMINISTRATION
G.1 INVOICE PAYMENT

G.1.1 The District will make payments to the Contractor, upon the submission of proper invoices,
at the prices stipulated in this contract, for supplies delivered and accepted or services
performed and accepted, less any discounts, allowances or adjustments provided for in this
contract.

G.1.2 The District will pay the Contractor on or before the 30th day after receiving a proper
invoice from the Contractor.

G.2 INVOICE SUBMITTAL

G.2.1 The Contractor shall create and submit payment requests in an electronic format through
the DC Vendor Portal, https://vendorportal.dc.gov.

G.2.2 The Contractor shall submit proper invoices monthly or as otherwise specified in G.4.

G.2.3 To constitute a proper invoice, the Contractor shall enter all required information into the
Portal after selecting the applicable purchase order number which is listed on the
Contractor’s profile.

G.3 FIRST SOURCE AGREEMENT REQUEST FOR FINAL PAYMENT

G.3.1 For contracts subject to the 51% District Residents New Hires Requirements and First
Source Employment Agreement requirements, final request for payment must be
accompanied by the report or a waiver of compliance discussed in section H.5.5.

G.3.2 The District shall not make final payment to the Contractor until the agency CFO has
received the CO’s final determination or approval of waiver of the Contractor’s compliance
with 51% District Residents New Hires Requirements and First Source Employment
Agreement requirements.

G.4 PAYMENT

G.4.1 PARTIAL PAYMENTS

Unless otherwise specified in this contract, payment will be made on partial deliveries of
goods and services accepted by the District if:

a) The amount due on the deliveries warrants it; or
b) The Contractor requests it and the amount due on the deliveries is in accordance
with the following:

• "Payment will be made on completion and acceptance of each item for which
the price is stated in the Schedule in Section B"; and
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c) Presentation of a properly executed invoice.

G.5 ASSIGNMENT OF CONTRACT PAYMENTS

G.5.1 In accordance with 27 DCMR 3250, the Contractor may assign to a bank, trust company,
or other financing institution funds due or to become due as a result of the performance of
this contract.

G.5.2 Any assignment shall cover all unpaid amounts payable under this contract, and shall not
be made to more than one party.
G.5.3 Notwithstanding an assignment of contract payments, the Contractor, not the assignee, is
required to prepare invoices. Where such an assignment has been made, the original copy
of the invoice must refer to the assignment and must show that payment of the invoice is to
be made directly to the assignee as follows:

“Pursuant to the instrument of assignment dated , make payment of this
invoice to (name and address of assignee).”

G.6 THE QUICK PAYMENT ACT

G.6.1 Interest Penalties to Contractors

G.6.1.1 The District will pay interest penalties on amounts due to the Contractor under the Quick
Payment Act, D.C. Official Code § 2-221.01 et seq., as amended, for the period beginning
on the day after the required payment date and ending on the date on which payment of
the amount is made. Interest shall be calculated at the rate of at least 1.5% per month. No
interest penalty shall be paid if payment for the completed delivery of the item of property
or service is made on or before the required payment date. The required payment date
shall be:
G.6.1.1.1 The date on which payment is due under the terms of the contract;

G.6.1.1.2 Not later than 7 calendar days, excluding legal holidays, after the date of delivery of meat
or meat food products;

G.6.1.1.3 Not later than 10 calendar days, excluding legal holidays, after the date of delivery of a
perishable agricultural commodity; or

G.6.1.1.4 30 calendar days, excluding legal holidays, after receipt of a proper invoice for the amount
of the payment due.
G.6.1.2 No interest penalty shall be due to the Contractor if payment for the completed delivery of
goods or services is made on or after:
G.6.1.2.1 3rd day after the required payment date for meat or a meat food product;

G.6.1.2.2 5th day after the required payment date for an agricultural commodity; or
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G.6.1.2.3 15th day after any other required payment date.

G.6.1.3 Any amount of an interest penalty which remains unpaid at the end of any 30-day period
shall be added to the principal amount of the debt and thereafter interest penalties shall
accrue on the added amount.

G.6.2 Payments to Subcontractors
G.6.2.1 The Contractor must take one of the following actions within seven (7) days of receipt of
any amount paid to the Contractor by the District for work performed by any
subcontractor under the contract:
G.6.2.1.1 Pay the subcontractor(s) for the proportionate share of the total payment received from the
District that is attributable to the subcontractor(s) for work performed under the contract;
or

G.6.2.1.2 Notify the CO and the subcontractor(s), in writing, of the Contractor’s intention to
withhold all or part of the subcontractor’s payment and state the reason for the
nonpayment.

G.6.2.2 The Contractor must pay any subcontractor or supplier interest penalties on amounts due
to the subcontractor or supplier beginning on the day after the payment is due and ending
on the date on which the payment is made. Interest shall be calculated at the rate of at least
1.5% per month. No interest penalty shall be paid on the following if payment for the
completed delivery of the item of property or service is made on or before the:
G.6.2.2.1 3rd day after the required payment date for meat or a meat product;

G.6.2.2.2 5th day after the required payment date for an agricultural commodity; or

G.6.2.2.3 15th day after any other required payment date.

G.6.2.3 Any amount of an interest penalty which remains unpaid by the Contractor at the end of
any 30-day period shall be added to the principal amount of the debt to the subcontractor
and thereafter interest penalties shall accrue on the added amount.

G.6.2.4 A dispute between the Contractor and subcontractor relating to the amounts or entitlement
of a subcontractor to a payment or a late payment interest penalty under the Quick
Payment Act does not constitute a dispute to which the District is a party. The District may
not be interpleaded in any judicial or administrative proceeding involving such a dispute.

G.6.3 Subcontract requirements. The Contractor shall include in each subcontract under this
contract a provision requiring the subcontractor to include in its contract with any lower-
tier subcontractor or supplier the payment and interest clauses required under paragraphs
(1) and (2) of D.C. Official Code § 2-221.02(d).

G.7 CONTRACTING OFFICER (CO)
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Contracts will be entered into and signed on behalf of the District only by contracting
officers. The contact information for the Contracting Officer is:

Jarad Dorsey
Office of Contracting and Procurement
441 4th Street, N.W. Suite 330 South
Washington, DC 20001
(202) 478-2436
Jarad.dorsey4@dc.gov
G.8 AUTHORIZED CHANGES BY THE CONTRACTING OFFICER
G.8.1 The CO is the only person authorized to approve changes in any of the requirements of this
contract.
G.8.2 The Contractor shall not comply with any order, directive or request that changes or
modifies the requirements of this contract, unless issued in writing and signed by the CO.
G.8.3 In the event the Contractor effects any change at the instruction or request of any person
other than the CO, the change will be considered to have been made without authority and
no adjustment will be made in the contract price to cover any cost increase incurred as a
result thereof.

G.9 CONTRACT ADMINSTRATOR (CA)
G.9.1 The CA is responsible for general administration of the contract and advising the CO as to
the Contractor’s compliance or noncompliance with the contract. The CA has the
responsibility of ensuring the work conforms to the requirements of the contract and such
other responsibilities and authorities as may be specified in the contract. These include:
G.9.1.1 Keeping the CO fully informed of any technical or contractual difficulties encountered
during the performance period and advising the CO of any potential problem areas under the
contract;
G.9.1.2 Coordinating site entry for Contractor personnel, if applicable;

G.9.1.3 Reviewing invoices for completed work and recommending approval by the CO if the
Contractor’s costs are consistent with the negotiated amounts and progress is satisfactory
and commensurate with the rate of expenditure;

G.9.1.4 Reviewing and approving invoices for deliverables to ensure receipt of goods and services.
This includes the timely processing of invoices and vouchers in accordance with the
District’s payment provisions; and
G.9.1.5 Maintaining a file that includes all contract correspondence, modifications, records of
inspections (site, data, equipment) and invoice or vouchers.
G.9.2 The address and telephone number of the CA is:
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Don Shearer
Director, HCOA
Department of Health Care Finance (DHCF)
441 4th Street, N.W.
10th Floor
Washington, DC 20001
Telephone: (202) 698-2007 Email: donald.shearer@dc.gov
G.9.3 The CA shall NOT have the authority to:
1. Award, agree to, or sign any contract, delivery order or task order. Only the CO
shall make contractual agreements, commitments or modifications;
2. Grant deviations from or waive any of the terms and conditions of the contract;
3. Increase the dollar limit of the contract or authorize work beyond the dollar limit of
the contract,
4. Authorize the expenditure of funds by the Contractor;
5. Change the period of performance; or
6. Authorize the use of District property, except as specified under the contract.

G.9.4 The Contractor will be fully responsible for any changes not authorized in advance, in
writing, by the CO; may be denied compensation or other relief for any additional work
performed that is not so authorized; and may also be required, at no additional cost to the
District, to take all corrective action necessitated by reason of the unauthorized changes.
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SECTION H: SPECIAL CONTRACT REQUIREMENTS

H.1 HIRING OF DISTRICT RESIDENTS AS APPRENTICES AND TRAINEES

H.1.1 For all new employment resulting from this contract or subcontracts hereto, as defined in
Mayor’s Order 83-265 and implementing instructions, the Contractor shall use its best
efforts to comply with the following basic goal and objectives for utilization of bona fide
residents of the District of Columbia in each project’s labor force:
H.1.1.1 At least fifty-one (51) percent of apprentices and trainees employed shall be residents of
the District of Columbia registered in programs approved by the District of Columbia
Apprenticeship Council.
H.1.2 The Contractor shall negotiate an Employment Agreement with the Department of
Employment Services (DOES) for jobs created as a result of this contract. The DOES shall
be the Contractor’s first source of referral for qualified apprentices and trainees in the
implementation of employment goals contained in this clause.
H.2 DEPARTMENT OF LABOR WAGE DETERMINATIONS

The Contractor shall be bound by the Wage Determination No. 2015-4281, Revision No.:
30, dated July 22, 2024, issued by the U.S. Department of Labor in accordance with the
Service Contract Act, 41 U.S.C. § 351 et seq., and incorporated herein as Section J.2. The
Contractor shall be bound by the wage rates for the term of the contract subject to revision
as stated herein and in accordance with clause 24 of the SCP. If an option is exercised,
the Contractor shall be bound by the applicable wage rates at the time of the exercise of the
option. If the option is exercised and the CO obtains a revised wage determination, the
revised wage determination is applicable for the option periods and the Contractor may be
entitled to an equitable adjustment.

H.3 PREGNANT WORKERS FAIRNESS
H.3.1 The Contractor shall comply with the Protecting Pregnant Workers Fairness Act of 2016,
D.C. Official Code § 32-1231.01 et seq. (PPWF Act).

H.3.2 The Contractor shall not:

(a) Refuse to make reasonable accommodations to the known limitations related to
pregnancy, childbirth, related medical conditions, or breastfeeding for an employee, unless
the Contractor can demonstrate that the accommodation would impose an undue hardship;

(b) Take an adverse action against an employee who requests or uses a reasonable
accommodation in regard to the employee's conditions or privileges of employment,
including failing to reinstate the employee when the need for reasonable accommodations
ceases to the employee's original job or to an equivalent position with equivalent:

(1) Pay;

(2) Accumulated seniority and retirement;
68
(3) Benefits; and

(4) Other applicable service credits;

(c) Deny employment opportunities to an employee, or a job applicant, if the denial is
based on the need of the employer to make reasonable accommodations to the known
limitations related to pregnancy, childbirth, related medical conditions, or breastfeeding;

(d) Require an employee affected by pregnancy, childbirth, related medical conditions, or
breastfeeding to accept an accommodation that the employee chooses not to accept if the
employee does not have a known limitation related to pregnancy, childbirth, related
medical conditions, or breastfeeding or the accommodation is not necessary for the
employee to perform her duties;

(e) Require an employee to take leave if a reasonable accommodation can be provided; or

(f) Take adverse action against an employee who has been absent from work as a result of
a pregnancy-related condition, including a pre-birth complication.

H.3.3 The Contractor shall post and maintain in a conspicuous place a notice of rights in both
English and Spanish and provide written notice of an employee's right to a needed
reasonable accommodation related to pregnancy, childbirth, related medical conditions, or
breastfeeding pursuant to the PPWF Act to:

(a) New employees at the commencement of employment;
(b) Existing employees; and

(c) An employee who notifies the employer of her pregnancy, or other condition covered
by the PPWF Act, within 10 days of the notification.

H.3.4 The Contractor shall provide an accurate written translation of the notice of rights to any
non-English or non-Spanish speaking employee.

H.3.5 Violations of the PPWF Act shall be subject to civil penalties as described in the Act.

H.4 UNEMPLOYED ANTI-DISCRIMINATION

H.4.1 The Contractor shall comply with the Unemployed Anti-Discrimination Act of 2012, D.C.
Official Code § 32-1361 et seq.
H.4.2 The Contractor shall not:
(a) Fail or refuse to consider for employment, or fail or refuse to hire, an individual as an
employee because of the individual's status as unemployed; or

(b) Publish, in print, on the Internet, or in any other medium, an advertisement or
announcement for any vacancy in a job for employment that includes:
69
(1) Any provision stating or indicating that an individual's status as unemployed
disqualifies the individual for the job; or

(2) Any provision stating or indicating that an employment agency will not consider or
hire an individual for employment based on that individual's status as unemployed.

H.4.3 Violations of the Unemployed Anti-Discrimination Act shall be subject to civil penalties as
described in the Act.
H.5 51% DISTRICT RESIDENTS NEW HIRES REQUIREMENTS AND FIRST
SOURCE EMPLOYMENT AGREEMENT
Delete Article 35, 51% District Residents New Hires Requirements and First Source
Employment Agreement, of the Standard Contract Provisions dated July 2010 for use with
District of Columbia Government Supplies and Services Contracts and substitute the
following Section H.5 51% DISTRICT RESIDENTS NEW HIRES
REQUIREMENTS AND FIRST SOURCE EMPLOYMENT AGREEMENT in its
place:

H.5 51% DISTRICT RESIDENTS NEW HIRES REQUIREMENTS AND FIRST
SOURCE EMPLOYMENT AGREEMENT

H.5.1 For contracts for services in the amount of $300,000 or more, the Contractor shall comply
with the First Source Employment Agreement Act of 1984, as amended, D.C. Official
Code § 2-219.01 et seq. (First Source Act).
H.5.2 The Contractor shall enter into and maintain during the term of the contract, a First Source
Employment Agreement (Employment Agreement) with the District of Columbia
Department of Employment Service’s (DOES), in which the Contractor shall agree that:

(a) The first source for finding employees to fill all jobs created in order to perform the
contract shall be the First Source Register; and
(b) The first source for finding employees to fill any vacancy occurring in all jobs covered
by the Employment Agreement shall be the First Source Register.
H.5.3 The Contractor shall not begin performance of the contract until its Employment
Agreement has been accepted by DOES. Once approved, the Employment Agreement
shall not be amended except with the approval of DOES.
H.5.4 The Contractor agrees that at least 51% of the new employees hired to perform the
contract shall be District residents.
H.5.5 The Contractor’s hiring and reporting requirements under the First Source Act and any
rules promulgated thereunder shall continue for the term of the contract.
H.5.6 The CO may impose penalties, including monetary fines of 5% of the total amount of the
direct and indirect labor costs of the contract, for a willful breach of the Employment
Agreement, failure to submit the required hiring compliance reports, or deliberate
submission of falsified data.
70
H.5.7 If the Contractor does not receive a good faith waiver, the CO may also impose an
additional penalty equal to 1/8 of 1% of the total amount of the direct and indirect labor
costs of the contract for each percentage by which the Contractor fails to meet its hiring
requirements.

H.5.8 Any contractor which violates, more than once within a 10-year timeframe, the hiring or
reporting requirements of the First Source Act shall be referred for debarment for not
more than five (5) years.

H.5.9 The contractor may appeal any decision of the CO pursuant to this clause to the D.C.
Contract Appeals Board as provided in clause 14 of the SCP, Disputes.

H.5.10 The provisions of the First Source Act do not apply to nonprofit organizations which
employ 50 employees or less.

H.6 RESERVED

H.7 RESERVED

H.8 CITYWIDE CLEAN HANDS CERTIFICATE

H.8.1 The Contractor shall submit a copy of their Citywide Clean Hands Certificate with their
proposal submission.

H.9 FAIR CRIMINAL RECORD SCREENING

H.9.1 The Contractor shall comply with the provisions of the Fair Criminal Record Screening
Amendment Act of 2014, effective December 17, 2014 (D.C. Law 20-152) (the “Act” as
used in this section). This section applies to any employment, including employment on a
temporary or contractual basis, where the physical location of the employment is in whole
or substantial part within the District of Columbia.

H.9.2 Prior to making a conditional offer of employment, the Contractor shall not require an
applicant for employment, or a person who has requested consideration for employment by
the Contractor, to reveal or disclose an arrest or criminal accusation that is not then
pending or did not result in a criminal conviction.
71
H.9.3 After making a conditional offer of employment, the Contractor may require an applicant
to disclose or reveal a criminal conviction.

H.9.4 The Contractor may only withdraw a conditional offer of employment, or take adverse
action against an applicant, for a legitimate business reason as described in the Act.

H.9.5 This section and the provisions of the Act shall not apply:
(a) Where a federal or District law or regulation requires the consideration of an
applicant’s criminal history for the purposes of employment;
(b) To a position designated by the employer as part of a federal or District government
program or obligation that is designed to encourage the employment of those with
criminal histories;

(c) To any facility or employer that provides programs, services, or direct care to,
children, youth, or vulnerable adults; or

(d) To employers that employ less than 11 employees.

H.9.6 A person claiming to be aggrieved by a violation of the Act may file an administrative
complaint with the District of Columbia Office of Human Rights, and the Commission on
Human Rights may impose monetary penalties against the Contractor.

H.10 DISTRICT RESPONSIBILITIES
H.10.1 Orientation for the Contractor relative to the terms of the contract and program mandates

H.10.2 Continuous contract performance evaluations and program monitoring

H.10.3 Monitor and evaluate contractor compliance with the requirements of this contract
recommend corrective actions when necessary

H.10.4 Provide copies of applicable Medicaid policy changes on a timely basis

H.10.5 Provide the names, addresses and provider numbers of Medicaid providers for
which the District has determined review and notification is required.

H.10.6 Maintain reasonable liaison and cooperation with the Contractor, including
providing timely management decisions and approvals of forms and procedures
and the like that are necessary for the Contractor to properly perform contractual
duties.

H.10.7 Attend required meetings with the Contractor to discuss issues, changes, status of
deliverables, and specific agenda items proposed by the District or the Contractor.
The Contractor shall chair the meetings; however, the CA shall retain the option, in
his discretion, to chair the meetings.

H.10.8 To the fullest extent allowed by law, the District agrees to maintain, and to cause its
72
employees, agents or representatives to maintain on confidential basis information
concerning the Contractor's relations and operations as well as any other
information compiled or created by Contractor which is proprietary to Contractor
and which Contractor identifies as proprietary to the District in writing.

H.10.9 The District will have access to approved change request hours of available time for
system enhancements each contract year.
H.10.10 The District will determine when change request hours will be used and must approve all
hours before the commencement of any CCMS enhancements. (Attachment J.19)
H.10.11 The District shall determine if the system is authorized to proceed based on District
requirements outlined in the Contract. The CA shall deliver to the Contractor a letter of
authorization specifying any limitations or restrictions placed on the operation of the
system.

H.10.12 If the CA denies the authorization, the District shall continue to work with the Contractor
until an acceptable level of residual risk for the system implementation is achieved. This
work would include the continued remediation listed in the Operational POA&M.

H.11 CONTRACTOR RESPONSIBILITIES

H.11.1 The Contractor shall be responsible for maintaining and modifying CCMS throughout the
contract term. Additionally, the Contractor shall update and maintain all CCMS functions
according to federal mandates, District requirements, statutes, and regulations. The
Contractor shall assess potential modifications to determine if a change request is required.
H.11.2 Ongoing changes, corrections, or enhancements to the system will be characterized as
either maintenance-related or as a modification effort. Maintenance may result from a
determination by the District or the Contractor that a deficiency exists within CCMS,
including defects found after implementing modifications incorporated into CCMS.

H.11.3 The various types of maintenance support shall include, but are not limited to:

(a) Activities necessary to provide for continuous effective, and efficient operation
of the system to keep it ready and fit to perform at the standard and condition
for which it was approved.
(b) Activities necessary to modify the system to meet contract requirements.
(c) Addition of new values and changes to existing system tables and conversion of
prior records, as necessary.

H.11.4 The Contractor shall provide sufficient staff to perform all normal systems maintenance
responsibilities. The Contractor shall utilize shared resources and have team members
primarily responsible for maintenance and support activities. The Contractor's team
members work both with modifications and defects, depending on the nature of the
requested change. It is not feasible to completely segregate these work activities.

H.12 HIPAA BUSINESS ASSOCIATE COMPLIANCE

H.12.1 See Attachment J.8, DHCF Business Associate Agreement
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H.13 DIVERSION, REASSIGNMENT, AND REPLACEMENT OF KEY PERSONNEL

H.13.1 The key personnel specified in the contract are considered to be essential to the work being
performed hereunder. Prior to diverting any of the specified key personnel for any reason,
the Contractor shall notify the CO at least thirty (30) Calendar Days in advance and shall
submit justification, including proposed substitutions, in sufficient detail to permit
evaluation of the impact upon the contract. The Contractor shall obtain written approval of
the CO for any proposed substitution of key personnel.

H.14 ADVISORY AND ASSISTANCE SERVICES
H.14.1 This contract is a “nonpersonal services contract”. The Contractor and the Contractor’s
employees: (1) shall perform the services specified herein as independent contractors, not
as employees of the government; (2) shall be responsible for their own management and
administration of the work required and bear sole responsibility for complying with any
and all technical, schedule, financial requirements or constraints attendant to the
performance of this contract; (3) shall, pursuant to the government’s right and obligation to
inspect, accept or reject work, comply with such general direction of the CO, or the duly
authorized representative of the CO as is necessary to ensure accomplishment of the
contract objectives.

H.15 PURCHASES OF IT HARDWARE AND EQUIPMENT

H.15.1 The Contractor shall, for new purchases, provide only the most current models,
components, and accessories in new, fully operational, factory-sealed condition, with all
applicable licenses. The Contractor warrants and represents that the equipment is eligible
for the manufacturer’s normal and extended warranty and support within the United States
to Authorized Users. Previously owned, damaged, refurbished, remanufactured,
counterfeit, “gray market,” or substitute third-party items will not be accepted. The
Contractor shall provide evidence of its authorized reseller agreement or Certification.
H.16 FRAUD, WASTE AND ABUSE PROVISION AND PROTECTIONS

H.16.1 Cooperation with the District

H.16.1.1 The Contractor is subject to all State and Federal laws and regulations relating to
fraud, waste and abuse in health care and the Medicaid program.

H.16.1.2 The Contractor shall cooperate and assist the District of Columbia and any State or
Federal agency charged with the duty of identifying, investigating, or prosecuting
suspected fraud, waste and abuse.

H.16.1.3 The Contractor shall provide originals and/or copies of all records and information
requested and allow access to premises and provide records to DHCF or its
authorized agents, CMS, the U.S. Department of Health and Human Services, FBI
and the District’s Medicaid Fraud Control Unit. All copies of record shall be
provided free of charge.
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H.16.1.4 The Contractor shall be responsible for promptly reporting suspected fraud,
abuse or violation of the terms of the Contract to the CA, Office of Program
Integrity and the Contracting Officer, taking prompt corrective actions consistent
with the terms of any subcontract, and cooperating with District investigations.

H.16.1.5 The Contractor shall allow the District’s Medicaid Fraud Control Unit or its
representatives to conduct private interviews of Contractor’s employees,
subcontractors and their employees, witnesses and patients. The Contractor shall
honor requests for information in the form and the language specified.
H.16.1.6 The Contractor shall insure that its employees and its subcontractors and their
employees cooperate fully and be available in person for interviews, consultation,
grand jury proceedings, pre-trial conference, hearings, trial and in any other process.

H.17 PUBLICITY CLAUSE
H.17.1 The Contractor shall at all times obtain the prior written approval from the Contracting
Officer before it, any of its officers, agents, employees or subcontractors, either during or
after expiration of termination of the contract, make any statement, or issue any material,
for publication through any medium of communication, bearing on the work performed or
data collected under this contract.
H.18 FINANCIAL REQUIREMENTS
H.18.1 The Contractor shall insure through its contracts, subcontracts and in any other
appropriate manner that the District is not held liable for the Contractor’s debts in
the event of the Contractor’s insolvency.
H.19 SOLVENCY AND FINANCIAL RESERVES
H.19.1 The Contractor shall maintain a positive financial net worth, and insolvency
reserves or deposits that provide a sound financial foundation for the Contractor to
perform the operations and services required under the Contract.
H.20 FIDUCIARY RELATIONSHIP
H.20.1 Any director, officer, employee, or partner of any Contractor who receives,
collects, disburses, or invests funds in connection with the activities of such
Contractor shall be responsible for such funds in a fiduciary relationship to the
Contractor.
H.21 SECURITY REQUIREMENTS
H.21.1 The Contractor's employees shall not bring into the facility any form of weapons or
contraband; shall be subject to search; shall conduct themselves in a professional
manner at all times; shall not cause any disturbance in the facility; and shall be
subject to all other rules and regulations of the facility and DHCF. The Contractor
shall be provided a copy of all applicable rules and regulations of the facility. The
Contractor shall ascertain that each employee is issued a copy of said rules and
signs a statement acknowledging the receipt of said rules. The Contractor shall
maintain the acknowledgement of receipt in the individual employee's personnel
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folder.
H.22 AUDITS AND RECORDS
H.22.1 This provision H.23 does not diminish or modify in any way the audit rights established in
the HIPAA provision, Attachment J.8, and the Audit rights established by the HIPAA
provision do not diminish or modify in any way the audit rights established by this
provision.

H.22.2 As used in this clause, "records" includes books, documents, accounting procedures
and practices, and other data, regardless of type and regardless of whether such
items are in written form, in the form of computer data, or in any other form.
H.23 EXAMINATION OF COSTS.
H.23.1 If this is a cost-reimbursement, incentive, time and materials, labor-hour, or price
redeterminable contract, or any combination of these, the Contractor shall maintain
and the Contracting Officer, or an authorized representative of the Contracting
Officer, shall have the right to examine and audit all records and other evidence
sufficient to reflect properly all costs claimed to have been incurred or anticipated
to be incurred directly or indirectly in performance of this contract. This right of
examination shall include inspection at all reasonable times of the Contractor’s
plants, or parts of them, engaged in performing the contract.
H.24 COST OR PRICING DATA
H.24.1 If the Contractor has been required to submit cost or pricing data in connection with any
pricing action relating to this contract, the Contracting Officer, or an authorized
representative of the Contracting Officer, in order to evaluate the accuracy, completeness,
and currency of the cost or pricing data, shall have the right to examine and audit all of the
Contractor’s records, including computations and projections, related to:
1. The proposal for the contract, subcontract, or modification;
2. The discussions conducted on the proposal(s), including those related to
negotiating;
3. Pricing of the contract, subcontract, or modification; or
4. Performance of the contract, subcontract or modification.
H.25 COMPTROLLER GENERAL
H.25.1 The Comptroller General of the United States, or an authorized representative, shall
have access to and the right to examine any of the Contractor’s directly pertinent
records involving transactions related to this contract or a subcontract hereunder.

H.25.2 This paragraph may not be construed to require the Contractor or subcontractor to
create or maintain any record that the Contractor or subcontractor does not
maintain in the ordinary course of business or pursuant to a provision of law.
H.26 REPORTS
H.26.1 If the Contractor is required to furnish cost, funding, or performance reports, the
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Contracting Officer or an authorized representative of the Contracting Officer shall
have the right to examine and audit the supporting records and materials, for the
purpose of evaluating:

a. The effectiveness of the Contractor's policies and procedures to produce
data compatible with the objectives of these reports; and
b. The data reported.
H.27 AVAILABILITY
H.27.1 The Contractor shall make available at its office at all reasonable times the records,
materials, and other evidence described in clauses under Section H.23 for
examination, audit, or reproduction, until 3 years after final payment under this
contract, or for any longer period required by statute or by other clauses of this
contract. In addition:

a. If this contract is completely or partially terminated, the Contractor shall
make available the records relating to the work terminated until 3 years
after any resulting final termination settlement; and
b. The Contractor shall make available records relating to appeals under the
Disputes clause or to litigation or the settlement of claims arising under or
relating to this contract until such appeals, litigation, or claims are finally
resolved.

H.28.2 The Contractor shall insert a clause containing all the terms of this clause, including this
section H.28.2, in all subcontracts under this contract that exceed the small purchase
threshold of $100,000, and:

a. That are cost-reimbursement, incentive, time-and- materials, labor
hour, or price-redeterminable type or any combination of these;
b. For which cost or pricing data are required; or
c. That require the subcontractor to furnish reports as discussed in H.27 of this
clause.
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H.28 PERFORMANCE STANDARDS – DAMAGES FOR DELAY

Performance Indicator Performance Level Assessed Payment/Recoupment
(deducted from next invoice)
The new CCMS solution
must be designed,
developed, tested, approved
and be operational in
production mode no later
than twelve (12) months
following the Start-Up
Kick-Off Meeting
C.5.1.6
The Project Work Plan
must, at a minimum,
support a DDI contract
phase of up to twelve (12)
months resulting in the
CCMS solution going live
within twelve (12) months
of the Kick-Off Meeting.
Liquidated damages in an amount equal to
(actual cost per month of the extension of the
pre-existing contract plus 10%) for each
calendar month the contract with the pre-
existing CCMS Contractor must be extended
to account for the inability of the Contractor
under this award to assume the CCMS
System and Supporting Services
requirements as laid out in the contract within
the 12 months following the
Kick-Off Meeting or as revised, extended,
and mutually agreed upon through the
Change Management Process, for any
unexcused reason which is rooted in the
performance of its system, hardware, or
management.
H.28.1 Assessed payment/recoupment shall be deducted from the next invoice
until the assessment is collected in full.

H.28.2 Contractor is to describe any exception taken to any performance indicator,
level or payment/recoupment in their proposal (see Technical Proposal in
Section L).
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SECTION I: CONTRACT CLAUSES
I.1 APPLICABILITY OF STANDARD CONTRACT PROVISIONS

The Standard Contract Provisions for use with District of Columbia Government Supplies
and Services Contracts dated July 2010 (“SCP”) are incorporated as part of the contract.
To obtain a copy of the SCP go to http://ocp.dc.gov, under Quick Links click on “Required
Solicitation Documents”.

I.2 CONTRACTS THAT CROSS FISCAL YEARS

Continuation of this contract beyond the current fiscal year is contingent upon future fiscal
appropriations.

I.3 CONFIDENTIALITY OF INFORMATION

The Contractor shall keep all information relating to any employee or customer of the
District in absolute confidence and shall not use the information in connection with any
other matters; nor shall it disclose any such information to any other person, firm or
corporation, in accordance with the District and federal laws governing the confidentiality
of records.

I.4 TIME
Time, if stated in a number of days, will include Saturdays, Sundays, and holidays, unless
otherwise stated herein.

I.5 RIGHTS IN DATA

Delete Article 42, Rights in Data, of the Standard Contract Provisions dated July 2010 for
use with District of Columbia Government Supplies and Services Contracts and substitute
the following Article 42, Rights in Data) in its place:

A. Definitions

1. “Products” - A deliverable under any contract that may include commodities,
services and/or technology furnished by or through Contractor, including
existing and custom Products, such as, but not limited to: a) recorded
information, regardless of form or the media on which it may be recorded; b)
document research; c) experimental, developmental, or engineering work; d)
licensed software; e) components of the hardware environment; f) printed
materials (including but not limited to training manuals, system and user
documentation, reports, drawings); g) third party software; h) modifications,
customizations, custom programs, program listings, programming tools, data,
modules, components; and i) any intellectual property embodied therein,
whether in tangible or intangible form, including but not limited to utilities,
interfaces, templates, subroutines, algorithms, formulas, source code, and object
code.
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2. “Existing Products” - Tangible Products and intangible licensed Products that
exist prior to the commencement of work under the contract. Existing Products
must be identified on the Product prior to commencement of work or else will
be presumed to be Custom Products.

3. “Custom Products” - Products, preliminary, final or otherwise, which are created
or developed by Contractor, its subcontractors, partners, employees, resellers or
agents for the District under the contract.

4. “District” – The District of Columbia and its agencies.
B. Title to Project Deliverables

The Contractor acknowledges that it is commissioned by the District to perform
services detailed in the contract. The District shall have ownership and rights for
the duration set forth in the contract to use, copy, modify, distribute, or adapt
Products as follows:

1. Existing Products: Title to all Existing Licensed Product(s), whether or not
embedded in, delivered or operating in conjunction with hardware or Custom
Products, shall remain with Contractor or third party proprietary owner, who
retains all rights, title and interest (including patent, trademark or copyrights).
Effective upon payment, the District shall be granted an irrevocable, non-
exclusive, worldwide, paid-up license to use, execute, reproduce, display,
perform, adapt (unless Contractor advises the District as part of Contractor’s
bid that adaptation will violate existing agreements or statutes and Contractor
demonstrates such to the District’s satisfaction), and distribute Existing
Product to District users up to the license capacity stated in the contract with
all license rights necessary to fully effect the general business purpose of the
project or work plan or contract. Licenses shall be granted in the name of the
District. The District agrees to reproduce the copyright notice and any other
legend of ownership on any copies authorized under this paragraph.
2. Custom Products: Effective upon Product creation, Contractor hereby
conveys, assigns, and transfers to the District the sole and exclusive rights,
title and interest in Custom Product(s), whether preliminary, final or
otherwise, including all patent, trademark and copyrights. Contractor hereby
agrees to take all necessary and appropriate steps to ensure that the Custom
Products are protected against unauthorized copying, reproduction and
marketing by or through Contractor.

C. Transfers or Assignments of Existing or Custom Products by the District
The District may transfer or assign Existing or Custom Products and the licenses
thereunder to another District agency. Nothing herein shall preclude the Contractor
from otherwise using the related or underlying general knowledge, skills, ideas,
concepts, techniques and experience developed under a project or work plan in the
course of Contractor’s business.
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D. Subcontractor Rights

Whenever any data, including computer software, are to be obtained from a
subcontractor under the contract, the Contractor shall use this clause, Rights in
Data, in the subcontract, without alteration, and no other clause shall be used to
enlarge or diminish the District’s or the Contractor’s rights in that subcontractor
data or computer software which is required for the District.

E. Source Code Escrow
1. For all computer software furnished to the District with the rights specified in
section B.2, the Contractor shall furnish to the District, a copy of the source
code with such rights of the scope as specified in section B.2 of this clause.
For all computer software furnished to the District with the restricted rights
specified in section B.1 of this clause, the District, if the Contractor either
directly or through a successor or affiliate shall cease to provide the
maintenance or warranty services provided the District under the contract or
any paid-up maintenance agreement, or if the Contractor should be declared
insolvent by a court of competent jurisdiction, shall have the right to obtain,
for its own and sole use only, a single copy of the current version of the
source code supplied under the contract, and a single copy of the
documentation associated therewith, upon payment to the person in control of
the source code the reasonable cost of making each copy.
2. If the Contractor or Product manufacturer/developer of software furnished to
the District with the rights specified in section B.1 of this clause offers the
source code or source code escrow to any other commercial customers, the
Contractor shall either: (1) provide the District with the source code for the
Product; (2) place the source code in a third party escrow arrangement with a
designated escrow agent who shall be named and identified to the District,
and who shall be directed to release the deposited source code in accordance
with a standard escrow arrangement acceptable to the District; or (3) will
certify to the District that the Product manufacturer/ developer has named the
District as a named beneficiary of an established escrow arrangement with its
designated escrow agent who shall be named and identified to the District,
and who shall be directed to release the deposited source code in accordance
with the terms of escrow.

3. The Contractor shall update the source code, as well as any corrections or
enhancements to the source code, for each new release of the Product in the
same manner as provided above, and certify such updating of escrow to the
District in writing.

F. Indemnification and Limitation of Liability

The Contractor shall indemnify and save and hold harmless the District, its officers,
agents and employees acting within the scope of their official duties against any
liability, including costs and expenses, (i) for violation of proprietary rights,
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copyrights, or rights of privacy, arising out of the publication, translation,
reproduction, delivery, performance, use or disposition of any data furnished under
this contract, or (ii) based upon any data furnished under this contract, or based
upon libelous or other unlawful matter contained in such data.

I.6 OTHER CONTRACTORS

The Contractor shall not commit or permit any act that will interfere with the performance
of work by another District contractor or by any District employee.
I.7 SUBCONTRACTS
The Contractor hereunder shall not subcontract any of the Contractor’s work or services to
any subcontractor without the prior written consent of the CO. Any work or service so
subcontracted shall be performed pursuant to a subcontract agreement, which the District
will have the right to review and approve prior to its execution by the Contractor. Any
such subcontract shall specify that the Contractor and the subcontractor shall be subject to
every provision of this contract. Notwithstanding any such subcontract approved by the
District, the Contractor shall remain liable to the District for all Contractor's work and
services required hereunder.

I.8 INSURANCE

A. GENERAL REQUIREMENTS. The Contractor at its sole expense shall procure and
maintain, during the entire period of performance under this contract, the types of
insurance specified below. The Contractor shall have its insurance broker or insurance
company submit a Certificate of Insurance to the CO giving evidence of the required
coverage prior to commencing performance under this contract. In no event shall any
work be performed until the required Certificates of Insurance signed by an authorized
representative of the insurer(s) have been provided to, and accepted by, the CO. All
insurance shall be written with financially responsible companies authorized to do
business in the District of Columbia or in the jurisdiction where the work is to be
performed and have an A.M. Best Company rating of A- / VII or higher. Should the
Contractor decide to engage a subcontractor for segments of the work under this
contract and wish to propose different insurance requirements than outlined below,
then, prior to commencement of work by the subcontractor, the Contractor shall submit
in writing the name and brief description of work to be performed by the subcontractor
on the Subcontractors Insurance Requirement Template provided by the CA, to the
Office of Risk Management (ORM). ORM will determine the insurance requirements
applicable to the subcontractor and promptly deliver such requirements in writing to
the Contractor and the CA. The Contractor must provide proof of the subcontractor's
required insurance prior to commencement of work by the subcontractor. If the
Contractor decides to engage a subcontractor without requesting from ORM specific
insurance requirements for the subcontractor, such subcontractor shall have the same
insurance requirements as the Contractor.
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General liability, commercial auto, workers' compensation and property insurance
policies (if applicable to this agreement) shall contain a waiver of subrogation
provision in favor of the Government of the District of Columbia.

The Government of the District of Columbia shall be included in all policies required
hereunder to be maintained by the Contractor and its subcontractors (except for
workers’ compensation and professional liability insurance) as an additional insureds
for claims against The Government of the District of Columbia relating to this contract,
with the understanding that any affirmative obligation imposed upon the insured
Contractor or its subcontractors (including without limitation the liability to pay
premiums) shall be the sole obligation of the Contractor or its subcontractors, and not
the additional insured. The additional insured status under the Contractor’s and its
subcontractors’ Commercial General Liability insurance policies shall be effected
using the ISO Additional Insured Endorsement form CG 20 10 11 85 (or CG 20 10 07
04 and CG 20 37 07 04) or such other endorsement or combination of endorsements
providing coverage at least as broad and approved by the CO in writing. All of the
Contractor’s and its subcontractors’ liability policies (except for workers’
compensation and professional liability insurance) shall be endorsed using ISO form
CG 20 01 04 13 or its equivalent so as to indicate that such policies provide primary
coverage (without any right of contribution by any other insurance, reinsurance or self-
insurance, including any deductible or retention, maintained by an Additional Insured)
for all claims against the additional insured arising out of the performance of this
Statement of Work by the Contractor or its subcontractors, or anyone for whom the
Contractor or its subcontractors may be liable. These policies shall include a
separation of insureds clause applicable to the additional insured.
If the Contractor and/or its subcontractors maintain broader coverage and/or higher
limits than the minimums shown below, the District requires and shall be entitled to the
broader coverage and/or the higher limits maintained by the Contractor and
subcontractors.

B. INSURANCE REQUIREMENTS
1. Commercial General Liability Insurance (“CGL”) - The Contractor shall provide
evidence satisfactory to the CO with respect to the services performed that it carries
a CGL policy, written on an occurrence (not claims-made) basis, on Insurance
Services Office, Inc. (“ISO”) form CG 00 01 04 13 (or another occurrence-based
form with coverage at least as broad and approved by the CO in writing), covering
liability for all ongoing and completed operations of the Contractor, including
ongoing and completed operations under all subcontracts, and covering claims for
bodily injury, including without limitation sickness, disease or death of any
persons, injury to or destruction of property, including loss of use resulting
therefrom, personal and advertising injury, and including coverage for liability
arising out of an Insured Contract (including the tort liability of another assumed in
a contract) and acts of terrorism (whether caused by a foreign or domestic source).
Such coverage shall have limits of liability of not less than $1,000,000 each
occurrence, a $2,000,000 general aggregate (including a per location or per project
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aggregate limit endorsement, if applicable) limit, a $1,000,000 personal and
advertising injury limit, and a $2,000,000 products-completed operations aggregate
limit.
The contractor should be named as an additional insured on the applicable
manufacturer’s/distributer’s Commercial General Liability policy using Insurance
Services Office, Inc. (“ISO”) form CG 20 15 04 13 (or another occurrence-based
form with coverage at least as broad).

OCP should collect, review for accuracy and maintain all warranties for goods and
services.

2. Automobile Liability Insurance - The Contractor shall provide evidence
satisfactory to the CO of commercial (business) automobile liability insurance
written on ISO form CA 00 01 10 13 (or another form with coverage at least as
broad and approved by the CO in writing) including coverage for all owned, hired,
borrowed and non-owned vehicles and equipment used by the Contractor, with
minimum per accident limits equal to the greater of (i) the limits set forth in the
Contractor’s commercial automobile liability policy or (ii) $1,000,000 per
occurrence combined single limit for bodily injury and property damage.

3. Workers’ Compensation Insurance - The Contractor shall provide evidence
satisfactory to the CO of Workers’ Compensation insurance in accordance with the
statutory mandates of the District of Columbia or the jurisdiction in which the
contract is performed.

Employer’s Liability Insurance - The Contractor shall provide evidence satisfactory
to the CO of employer’s liability insurance as follows: $500,000 per accident for
injury; $500,000 per employee for disease; and $500,000 for policy disease limit.

All insurance required by paragraphs 1,2 and 3 shall include a waiver of
subrogation endorsement for the benefit of Government of the District of
Columbia.

4. Cyber Liability Insurance - The Contractor shall provide evidence satisfactory to
the Contracting Officer of Cyber Liability Insurance, with limits not less than
$5,000,000 per occurrence or claim, $5,000,000 aggregate. Coverage shall be
sufficiently broad to respond to the duties and obligations as is undertaken by
Contractor in this agreement and shall include, but not limited to, claims involving
infringement of intellectual property, including but not limited to infringement of
copyright, trademark, trade dress, invasion of privacy violations, information theft,
damage to or destruction of electronic information, release of private information,
alteration of electronic information, extortion and network security. The policy
shall provide coverage for breach response costs as well as regulatory fines and
penalties as well as credit monitoring expenses with limits sufficient to respond to
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these obligations. Limits may not be shared with other lines of coverage. A copy of
the cyber liability policy must be submitted to the Office of Risk Management
(ORM) for compliance review.
5. Professional Liability Insurance (Errors & Omissions) - The Contractor shall
provide Professional Liability Insurance (Errors and Omissions) to cover liability
resulting from any error or omission in the performance of professional services
under this Contract. The policy shall provide limits of $1,000,000 per claim or per
occurrence for each wrongful act and $2,000,000 annual aggregate. The Contractor
warrants that any applicable retroactive date precedes the date the Contractor first
performed any professional services for the Government of the District of
Columbia and that continuous coverage will be maintained or an extended
reporting period will be exercised for a period of at least ten years after the
completion of the professional services. Limits may not be shared with other lines
of coverage.

6. Commercial Umbrella or Excess Liability - The Contractor shall provide evidence
satisfactory to the CO of commercial umbrella or excess liability insurance with
minimum limits equal to the greater of (i) the limits set forth in the Contractor’s
umbrella or excess liability policy or (ii) $5,000,000 per occurrence and $5,000,000
in the annual aggregate, following the form and in excess of all liability policies.
All liability coverages must be scheduled under the umbrella and/or excess policy.
The insurance required under this paragraph shall be written in a form that annually
reinstates all required limits. Coverage shall be primary to any insurance, self-
insurance or reinsurance maintained by the District and the “other insurance”
provision must be amended in accordance with this requirement and principles of
vertical exhaustion.

C. PRIMARY AND NONCONTRIBUTORY INSURANCE
The insurance required herein shall be primary to and will not seek contribution from
any other insurance, reinsurance or self-insurance including any deductible or retention,
maintained by the Government of the District of Columbia.

D. DURATION. The Contractor shall carry all required insurance until all contract work
is accepted by the District of Columbia and shall carry listed coverages for ten years
for construction projects following final acceptance of the work performed under this
contract and two years for non-construction related contracts.
E. LIABILITY. These are the required minimum insurance requirements established by
the District of Columbia. However, the required minimum insurance requirements
provided above will not in any way limit the contractor’s liability under this contract.

F. CONTRACTOR’S PROPERTY. Contractor and subcontractors are solely responsible
for any loss or damage to their personal property, including but not limited to tools and
equipment, scaffolding and temporary structures, rented machinery, or owned and
85
leased equipment. A waiver of subrogation shall apply in favor of the District of
Columbia.

G. MEASURE OF PAYMENT. The District shall not make any separate measure or
payment for the cost of insurance and bonds. The Contractor shall include all of the
costs of insurance and bonds in the contract price.

H. NOTIFICATION. The Contractor shall ensure that all policies provide that the CO
shall be given thirty (30) days prior written notice in the event of coverage and / or
limit changes or if the policy is canceled prior to the expiration date shown on the
certificate. The Contractor shall provide the CO with ten (10) days prior written notice
in the event of non-payment of premium. The Contractor will also provide the CO with
an updated Certificate of Insurance should its insurance coverages renew during the
contract.

I. CERTIFICATES OF INSURANCE. The Contractor shall submit certificates of
insurance giving evidence of the required coverage as specified in this section prior to
commencing work. Certificates of insurance must reference the corresponding contract
number. Evidence of insurance shall be submitted to:
The Government of the District of Columbia
And mailed to the attention of:
Jarad Dorsey
Office of Contracting and Procurement
Servicing – Department of Health Care Finance
441 4th Street, NW, Suite 330 South
Washington, DC 20001
Office: 202-478-2436
Email: jarad.dorsey4@dc.gov

The CO may request and the Contractor shall promptly deliver updated certificates of
insurance, endorsements indicating the required coverages, and/or certified copies of
the insurance policies. If the insurance initially obtained by the Contractor expires
prior to completion of the contract, renewal certificates of insurance and additional
insured and other endorsements shall be furnished to the CO prior to the date of
expiration of all such initial insurance. For all coverage required to be maintained after
completion, an additional certificate of insurance evidencing such coverage shall be
submitted to the CO on an annual basis as the coverage is renewed (or replaced).

J. DISCLOSURE OF INFORMATION. The Contractor agrees that the District may
disclose the name and contact information of its insurers to any third party which
presents a claim against the District for any damages or claims resulting from or arising
out of work performed by the Contractor, its agents, employees, servants or
subcontractors in the performance of this contract.
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K. CARRIER RATINGS. All Contractor’s and its subcontractors’ insurance required in
connection with this contract shall be written by insurance companies with an A.M.
Best Insurance Guide rating of at least A- VII (or the equivalent by any other rating
agency) and licensed in the District.
I.9 EQUAL EMPLOYMENT OPPORTUNITY

In accordance with the District of Columbia Administrative Issuance System, Mayor’s
Order 85-85 dated June 10, 1985, the forms for completion of the Equal Employment
Opportunity Information Report are incorporated herein as Section J.3. An award cannot
be made to any offeror who has not satisfied the equal employment requirements.
I.10 ORDER OF PRECEDENCE
A conflict in language shall be resolved by giving precedence to the document in the
highest order of priority that contains language addressing the issue in question. The
following documents are incorporated into the contract by reference and made a part of the
contract in the following order of precedence:

(1) An applicable Court Order, if any
(2) State of Utah Cooperative Agreement Contract No.: AR2472
(3) Contract document
(4) Standard Contract Provisions
(5) Contract attachments other than the Standard Contract Provisions
(6) Quote

I.11 DISPUTES
Delete Article 14, Disputes, of the Standard Contract Provisions dated July 2010 for use
with District of Columbia Government Supplies and Services Contracts and substitute the
following Article 14, Disputes, in its place:
14. Disputes
All disputes arising under or relating to the contract shall be resolved as provided herein.
(a) Claims by the Contractor against the District: Claim, as used in
paragraph (a) of this clause, means a written assertion by the Contractor
seeking, as a matter of right, the payment of money in a sum certain, the
adjustment or interpretation of contract terms, or other relief arising under
or relating to the contract. A claim arising under a contract, unlike a claim
relating to that contract, is a claim that can be resolved under a contract
clause that provides for the relief sought by the claimant.

(1) All claims by a Contractor against the District arising under or relating to a
contract shall be in writing and shall be submitted to the CO for a decision. The
Contractor’s claim shall contain at least the following:

(i) A description of the claim and the amount in dispute;
(ii) Data or other information in support of the claim;
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(iii) A brief description of the Contractor’s efforts to resolve the dispute
prior to filing the claim; and
(iii) The Contractor’s request for relief or other action by the CO.

(2) The CO may meet with the Contractor in a further attempt to resolve the claim
by agreement.

(3) The CO shall issue a decision on any claim within 120 calendar days after
receipt of the claim. Whenever possible, the CO shall take into account factors
such as the size and complexity of the claim and the adequacy of the
information in support of the claim provided by the Contractor.

(4) The CO’s written decision shall do the following:

(i) Provide a description of the claim or dispute;
(ii) Refer to the pertinent contract terms;
(iii) State the factual areas of agreement and disagreement;
(iv) State the reasons for the decision, including any specific
findings of fact, although specific findings of fact are not
required and, if made, shall not be binding in any subsequent
proceeding;
(v) If all or any part of the claim is determined to be valid,
determine the amount of monetary settlement, the contract
adjustment to be made, or other relief to be granted;
(vi) Indicate that the written document is the CO’s final decision;
and
(vii) Inform the Contractor of the right to seek further redress by
appealing the decision to the Contract Appeals Board.

(5) Failure by the CO to issue a decision on a contract claim within 120 days of
receipt of the claim will be deemed to be a denial of the claim, and will
authorize the commencement of an appeal to the Contract Appeals Board as
provided by D.C. Official Code § 2-360.04.

(6) If a contractor is unable to support any part of its claim and it is
determined that the inability is attributable to a material
misrepresentation of fact or fraud on the part of the Contractor, the
Contractor shall be liable to the District for an amount equal to the
unsupported part of the claim in addition to all costs to the District
attributable to the cost of reviewing that part of the Contractor’s claim.
Liability under this paragraph (a)(6) shall be determined within six (6)
years of the commission of the misrepresentation of fact or fraud.

(7) Pending final decision of an appeal, action, or final settlement, the Contractor
shall proceed diligently with performance of the contract in accordance with the
decision of the CO.

(b) Claims by the District against the Contractor: Claim as used in
paragraph (b) of this clause, means a written demand or written assertion by
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the District seeking, as a matter of right, the payment of money in a sum
certain, the adjustment of contract terms, or other relief arising under or
relating to the contract. A claim arising under a contract, unlike a claim
relating to that contract, is a claim that can be resolved under a contract
clause that provides for the relief sought by the claimant.

(1) The CO shall decide all claims by the District against a contractor arising under
or relating to a contract.
(2) The CO shall send written notice of the claim to the contractor. The
CO’s written decision shall do the following:
(i) Provide a description of the claim or dispute;
(ii) Refer to the pertinent contract terms;
(iii) State the factual areas of agreement and disagreement;
(iv) State the reasons for the decision, including any specific
findings of fact, although specific findings of fact are not
required and, if made, shall not be binding in any subsequent
proceeding;
(v) If all or any part of the claim is determined to be valid, determine
the amount of monetary settlement, the contract adjustment to be
made, or other relief to be granted;
(vi) Indicate that the written document is the CO’s final decision;
and
(vii) Inform the Contractor of the right to seek further redress by
appealing the decision to the Contract Appeals Board.
(3) The CO shall support the decision by reasons and shall inform the
Contractor of its rights as provided herein.

(4) Before or after issuing the decision, the CO may meet with the Contractor to
attempt to resolve the claim by agreement.

(5) The authority contained in this paragraph (b) shall not apply to a claim or
dispute for penalties or forfeitures prescribed by statute or regulation which
another District agency is specifically authorized to administer, settle or
determine.

(6) This paragraph shall not authorize the CO to settle, compromise, pay, or
otherwise adjust any claim involving fraud.

(c) Decisions of the CO shall be final and not subject to review unless the Contractor
timely commences an administrative appeal for review of the decision, by filing a
complaint with the Contract Appeals Board, as authorized by D.C. Official Code §
2-360.04.

(d) Pending final decision of an appeal, action, or final settlement, the
Contractor shall proceed diligently with performance of the contract in
accordance with the decision of the CO.
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I.12 CHANGES

Delete clause 15, Changes, of the Standard Contract Provisions dated July 2010 for use
with District of Columbia Government Supplies and Services Contracts and substitute the
following clause 15, Changes in its place:
15. Changes:
(a) The CO may, at any time, by written order, and without notice to the surety, if any,
make changes in the contract within the general scope hereof. If such change
causes an increase or decrease in the cost of performance of the contract, or in the
time required for performance, an equitable adjustment shall be made. Any claim
for adjustment for a change within the general scope must be asserted within ten
(10) days from the date the change is ordered; provided, however, that the CO, if
he or she determines that the facts justify such action, may receive, consider and
adjust any such claim asserted at any time prior to the date of final settlement of
the contract. If the parties fail to agree upon the adjustment to be made, the dispute
shall be determined as provided in clause 14 Disputes.

(b) The District shall not require the Contractor, and the Contractor shall not require a
subcontractor, to undertake any work that is beyond the original scope of the
contract or subcontract, including work under a District-issued change order, when
the additional work increases the contract price beyond the not-to-exceed price or
negotiated maximum price of this contract, unless the CO:
(1) Agrees with Contractor, and if applicable, the subcontractor on a price for the
additional work;
(2) Obtains a certification of funding to pay for the additional work;
(3) Makes a written, binding commitment with the Contractor to pay for the
additional work within 30-days after the Contractor submits a proper invoice;
and
(4) Provides the Contractor with written notice of the funding certification.

(c) The Contractor shall include in its subcontracts a clause that requires the Contractor
to:

(1) Within 5 business days of its receipt of notice the approved additional funding,
provide the subcontractor with notice of the amount to be paid to the
subcontractor for the additional work to be performed by the subcontractor;
(2) Pay the subcontractor any undisputed amount to which the subcontractor is
entitled for the additional work within 10 days of receipt of payment from the
District; and
(3) Notify the subcontractor and CO in writing of the reason the Contractor
withholds any payment from a subcontractor for the additional work.

(d) Neither the District, Contractor, nor any subcontractor may declare another party to
be in default, or assess, claim, or pursue damages for delays, until the parties to
agree on a price for the additional work.
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I.13 NON-DISCRIMINATION CLAUSE

Delete clause 19, Non-Discrimination Clause, of the Standard Contract Provisions dated
July 2010 for use with District of Columbia Government Supplies and Services Contracts
and substitute the following clause 19, Non-Discrimination Clause, in its place:

19. Non-Discrimination Clause:
(a) The Contractor shall not discriminate in any manner against any employee or
applicant for employment that would constitute a violation of the District of
Columbia Human Rights Act, effective December 13, 1977, as amended (D.C.
Law 2-38; D.C. Official Code § 2-1401.01 et seq.) (“Act”, as used in this clause).
The Contractor shall include a similar clause in all subcontracts, except
subcontracts for standard commercial supplies or raw materials. In addition, the
Contractor agrees, and any subcontractor shall agree, to post in conspicuous
places, available to employees and applicants for employment, a notice setting
forth the provisions of this non-discrimination clause as provided in section 251 of
the Act.

(b) Pursuant to Mayor’s Order 85-85, (6/10/85), Mayor’s Order 2002-175 (10/23/02),
Mayor’s Order 2011-155 (9/9/11) and the rules of the Office of Human Rights,
Chapter 11 of Title 4 of the D.C. Municipal Regulations, the following clauses
apply to the contract:
(1) The Contractor shall not discriminate against any employee or applicant
for employment because of actual or perceived: race, color, religion,
national origin, sex, age, marital status, personal appearance, sexual
orientation, gender identity or expression, family responsibilities, genetic
information, disability, matriculation, political affiliation, or credit
information. Sexual harassment is a form of sex discrimination which is
prohibited by the Act. In addition, harassment based on any of the above
protected categories is prohibited by the Act.

(2) The Contractor agrees to take affirmative action to ensure that applicants
are employed, and that employees are treated during employment,
without regard to their actual or perceived: race, color, religion, national
origin, sex, age, marital status, personal appearance, sexual orientation,
gender identity or expression, family responsibilities, genetic information,
disability, matriculation, political affiliation, or credit information. The
affirmative action shall include, but not be limited to the following:

(a) employment, upgrading or transfer;
(b) recruitment, or recruitment advertising;
(c) demotion, layoff or termination;
(d) rates of pay, or other forms of compensation; and
(e) selection for training and apprenticeship.
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(3) The Contractor agrees to post in conspicuous places, available to
employees and applicants for employment, notices to be provided by the
contracting agency, setting forth the provisions in paragraphs 19(b)(1)
and (b)(2) concerning non-discrimination and affirmative action.

(4) The Contractor shall, in all solicitations or advertisements for employees
placed by or on behalf of the Contractor, state that all qualified applicants
will receive consideration for employment pursuant to the non-
discrimination requirements set forth in paragraph 19(b)(2).

(5) The Contractor agrees to send to each labor union or representative of
workers with which it has a collective bargaining agreement or other
contract or understanding, a notice to be provided by the contracting
agency, advising the said labor union or workers’ representative of that
contractor’s commitments under this nondiscrimination clause and the
Act, and shall post copies of the notice in conspicuous places available to
employees and applicants for employment.

(6) The Contractor agrees to permit access to its books, records, and accounts
pertaining to its employment practices, by the Chief Procurement Officer
or designee, or the Director of the Office of Human Rights or designee,
for purposes of investigation to ascertain compliance with the Act, and to
require under terms of any subcontractor agreement each subcontractor to
permit access of such subcontractors’ books, records, and accounts for
such purposes.
(7) The Contractor agrees to comply with the provisions of the Act and with
all guidelines for equal employment opportunity applicable in the District
adopted by the Director of the Office of Human Rights, or any authorized
official.

(8) The Contractor shall include in every subcontract the equal opportunity
clauses, i.e., paragraphs 19(b)(1) through (b)(9) of this clause, so that
such provisions shall be binding upon each subcontractor.

(9) The Contractor shall take such action with respect to any subcontract as
the CO may direct as a means of enforcing these provisions, including
sanctions for noncompliance; provided, however, that in the event the
Contractor becomes involved in, or is threatened with, litigation with a
subcontractor or vendor as a result of such direction by the contracting
agency, the Contractor may request the District to enter into such
litigation to protect the interest of the District.

I.14 COST AND PRICING DATA
Delete Article 25, Cost and Pricing Data, of the Standard Contract Provisions dated July
2010 for use with District of Columbia Government Supplies and Services Contracts.
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I.15 CONTINUITY OF SERVICES

I.15.1 The Contractor recognizes that the services provided under this contract are vital to the
District and must be continued without interruption and that, upon contract expiration or
termination, a successor, either the District or another Contractor, at the District’s option,
may continue to provide these services. To that end, the Contractor agrees to:

I.15.1.1 Furnish phase-out, phase-in (transition) training; and
I.15.1.2 Exercise its best efforts and cooperation to effect an orderly and efficient transition to a
successor.
I.15.2 The Contractor shall, upon the CO’s written notice:

I.15.2.1 Furnish phase-in, phase-out services for up to 90 days after this contract expires and

I.15.2.2 Negotiate in good faith a plan with a successor to determine the nature and extent of phase-
in, and phase-out services required. The plan shall specify a training program and a date
for transferring responsibilities for each division of work described in the plan and shall be
subject to the CO’s approval.

I.15.3 The Contractor shall provide sufficient experienced personnel during the phase-in, and
phase-out period to ensure that the services called for by this contract are maintained at the
required level of proficiency.
I.15.4 The Contractor shall allow as many personnel as practicable to remain on the job to help
the successor maintain the continuity and consistency of the services required by this
contract. The Contractor also shall disclose necessary personnel records and allow the
successor to conduct on-site interviews with these employees. If selected employees are
agreeable to the change, the Contractor shall release them at a mutually agreeable date and
negotiate the transfer of their earned fringe benefits to the successor.

I.15.5 Only in accordance with a modification issued by the CO, and approved by the Contractor,
the Contractor shall be reimbursed for all reasonable phase-in, phase-out costs (i.e., costs
incurred within the agreed period after contract expiration that result from phase-in, phase-
out operations) and a fee (profit) not to exceed a pro rata portion of the fee (profit) under
this contract.
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SECTION J: ATTACHMENTS
The following list of attachments is incorporated into the contract by reference.

Attachment
Number Document

J.1
Government of the District of Columbia Standard Contract Provisions for Use
with the Supplies and Services Contracts (July 2010)
available at http://ocp.dc.gov, Center of Excellence, “Required Solicitation
Documents”
J.2 U.S. Department of Labor Wage Determination 2015-4281, Revision No.: 30,
dated July 22, 2024

J.3
Way to Work Amendment Act of 2006 – Living Wage Notice
available at http://ocp.dc.gov, Center of Excellence, “Required Solicitation
Documents”

J.4
Way to Work Amendment Act of 2006 – Living Wage Fact Sheet
available at http://ocp.dc.gov, Center of Excellence, “Required Solicitation
Documents”

J.5
Equal Employment Opportunity Employer Information Report and Mayor’s
Order 85-85
available at available at http://ocp.dc.gov, under Quick Links click on “Required
Solicitation Documents”

J.6
Department of Employment Services First Source Employment Agreement
available at http://ocp.dc.gov, under Quick Links click on “Required Solicitation
Documents”
J.7 Cost Price Disclosure Certification Form available at http://ocp.dc.gov , under
Quick Links on “Required Solicitation Documents”
J.8 DHCF HIPAA Business Associate Agreement
J.9 BAA Exhibit A - Identity and Procedure Verification
J.10 Business Associate (BA) HIPAA Compliance Status Questionnaire
J.11 Subcontracting Plan (if required by law) available at http://ocp.dc.gov, under
Quick Links, click on “Required Solicitation Documents”
J.12 Past Performance Evaluation Form available at http://ocp.dc.gov , under Quick
Links click on “Required Solicitation Documents”
J.13 Bidder/Offeror Certification Form available at http://ocp.dc.gov,
under Quick Links click on “Required Solicitation Documents”
J.14
Contractor Experience Questionnaire Form
available at http://ocp.dc.gov, Center of Excellence, “Required Solicitation
Documents
J.15 Certificate of Clean Hands
available at http://mytax.dc.gov
J.16
First Source Initial Employment Plan (if contract is $300,000 or more) available
at http://ocp.dc.gov, under Quick Links click on “Required Solicitation
Documents”
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Attachment
Number Document
J.17 Tax Certification Affidavit available at http://ocp.dc.gov, under Quick Links
click on “Required Solicitation Documents”
J.18 Business License available at https://dlcp.dc.gov, DC Department of Licensing
and Consumer Protection
J.19 State of Utah Cooperative Agreement Contract No.: AR2472
J.20 Change Request Form – CR # 808022