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1
Request for Proposal ******************
Document Scanning and Imaging Project
MAY 2014
Project# 14/0012
MHMRA of Harris County
Purchasing Department
7011 Southwest Freeway
Houston, Texas 77074
1
INVITATION
Mental Health Mental Retardation Authority of Harris County (MHMRA) is accepting Proposals
from vendors Registered, State Certified, and capable to provide Document Scanning and
Imaging Project.
Mental Health Mental Retardation Authority of Harris County invites your firm to submit a
Proposal. If you are interested in submitting a proposal, please adhere to the General
Instructions and Requirements as outlined in the enclosed Request for Proposal.
Vendors shall pay particular attention to all INSTRUCTIONS, REQUIREMENTS and
DEADLINES indicated in the attached documents and should govern themselves accordingly.
In accepting Proposals, MHMRA reserves the right to reject any and all Proposals, to waive
formalities and reasonable irregularities in submitted documents, and to waive any requirements
in order to take the action, which it deems to be in the best interest of MHMRA, and is not
obligated to accept the lowest proposal.
At the time and place established for receipt of the Proposal, MHMRA of Harris County will
only release the names of the Independent Provider(s) and/or Provider Firm(s). No other
information will be released until after MHMRA‟s Evaluation Team has evaluated the Proposals,
and an award has been made and approved by Executive staff and MHMRA‟s Board of Trustees.
We greatly appreciate your efforts and look forward to reviewing your submission.
Nina Cook
Nina M. Cook, MBA, CPPB Purchasing Manager
MHMRA, Harris County
Joycie Sheba Joycie Sheba
Buyer II
1
Table of Contents
Section Page
I. Overview 1
II. Request For Proposal (RFP) Time 2
Line & Events
III. General Instructions 3
IV. Proposal Stipulations & Requirements 6
V. Insurance Requirements 9
VI. Proposal Evaluation Process 11
VII. Specialized Services To Be Performed 12
VIII. Proposal Contents 20
IX. Proposal Reply Page 21
X. Signature Page 22
XI. Attachment(s) 23
A. HUB Subcontracting Plan
(Historically Underutilized Business)
B. Deviation Form
C. Notice “Not to participate” form
D. Form W-9 - Request for
Taxpayer Identification Number and
Certification http://www.irs.gov/pub/irs-pdf/fw9.pdf
E. Sample Contract
F. Business Associate Agreement
1
SECTION I – OVERVIEW
BACKGROUND AND OBJECTIVES
The Mental Health Mental Retardation Authority of Harris County (MHMRA) is a Community Center
in Houston, Harris County, Texas providing Behavioral Health Services to approximately twenty-five
(25) to (30) thirty thousand Harris County residents each year. MHMRA is the largest community
based provider of clinical services to Mental Health and Intellectual Developmental Disabilities
consumers in the United States. It maintains operations at over 25 facilities throughout all parts of
Harris County and operates on an annual budget in excess of $231million. Our goal is to employ best
practices and cost effectiveness.
The Mental Health Mental Retardation Authority of Harris County (MHMRA) invites interested and
qualified vendor(s) / firm(s) to respond to this RFP for the Document Scanning and Imaging Project.
The Agency has fixed pricing budgets and all pricing quoted should remain fixed for the duration of
the contract. Our goal is to employ best practices and cost effectiveness.
Page 2 of 39
SECTION II - PROPOSAL (RFP) TIME LINE OF EVENTS
Solicitation Packet issue date: Monday, May 05, 2014
Mandatory RFP Project Meeting Monday, May 12, 2014
(Prospective Participants are invited to @ 1:30 – 2:30 pm. Meeting to be held
Attend a project discussion session with at 7011 Southwest Freeway, Houston, TX
Representatives from MHMRA‟s Project Team) 77074
Receive Questions from Prospective Proposer: Monday, May 19, 2014 by COB
Deadline to response to questions: Wednesday, May 21, 2014 by COB.
Deadline for submission of RFP: Wednesday, May 28, 2014 at 10:00am
Proposal Opening: Wednesday, May 28, 2014. A public
Proposal opening will be held at 10:15am,
7011 Southwest Freeway, Houston, Texas
77074
Anticipated Award Date: Contingent upon Board Approval
Page 3 of 39
SECTION III - GENERAL INSTRUCTIONS
A. Mandatory Project Meeting
A mandatory project meeting will be held on: Monday, May 12, 2014
Time: 1:30 – 2:30 pm
Location: MHMRA of Harris County
7011 SW Freeway, Houston, TX 77074
Upon arrival, all vendors/prospective participants to this RFP are required to: Check-in at the front desk in the lobby of 7011 Southwest Freeway, Houston, Texas 77074
Obtain a visitors badge
Remain in the lobby area until an MHMRA project team representative greets you
B. Questions
Deadline for questions from Providers: Monday, May 19, 2014 by 5:00 pm
Deadline for Response to Questions: Wednesday, May 21, 2014 by 5:00 pm
All questions concerning the PROPOSAL specifications must be submitted in writing and emailed to the below
listed team members. To ensure receipt of all questions in a timely manner, the preferred method is via email.
Joycie Sheba, Buyer II
Office: (713) 970 – 7116
Email: [email protected]
CC:
Sharon Brauner, Buyer III
Office: (713) 970 – 7279
Email: [email protected]
MHMRA Purchasing Department
Fax: (713) 970 – 7682
C. Submittal Procedure
The Proposal, subject to all conditions and specifications attached hereto, must be signed in INK by a person or
officer of the company submitting the Proposal that is authorized to enter into contractual agreements on behalf
of the company. Proposals received unsigned will be deemed non-responsive and therefore; will not be
accepted.
Deadline to submit “Final Proposal” is Wednesday, May 28, 2014 by 10:00am. The original Proposal, signed
in ink, five (5) additional photocopies and an electronic copy (Flash Drive) should be submitted in a SEALED
ENVELOPE and delivered to the attention of:
MHMRA of Harris County
Purchasing Department
Attn: Joycie Sheba, Buyer II
7011 Southwest Freeway,
Houston, Texas 77074
Data Scanning and Imaging Project “DO NOT OPEN UNTIL WEDNESDAY, MAY 28, 2014 AT 10:00AM.”
Page 4 of 39
No Proposal will be accepted after the stated deadline.
Respondents may mail or personally deliver their Proposals to the Purchasing Office of MHMRA at the above
address. MHMRA will not be responsible for any Proposal(s) that is (are) lost in the mail or not delivered to the
Purchasing Department by the stated deadline for any reason.
Proposals shall include all documentation as requested in the Request for Proposal.
D. Proposal Opening
A Public Proposal Opening will be held at 10:15AM immediately following receipt of Proposals on
Wednesday, May 28, 2014 at 7011 Southwest Freeway, Houston, Texas 77074.
E. Non-Discrimination Policy Statement The Mental Health Mental Retardation Authority of Harris County does not discriminate against any individual
or Vendor/Provider with respect to his/her compensation, terms, conditions, or award of contract because of race,
color, religion, sex, national origin, age, disability, political affiliation, or limit, segregate, or classify candidates
for award of contract in any way which would deprive or tend to deprive any individual or company of business
opportunities or otherwise adversely affect status as a Vendor/Provider because of race, color, religion, sex,
national origin, age, disability, or political affiliation.
F. Immigration Reform and Control Act Of 1986
By submitting their proposals, Offerors certify that they do not and will not during the performance of this
contract employ illegal alien workers or otherwise violate the provisions of the federal Immigration Reform and
Control Act of 1986.
G. References and Experience
All interested parties are required to submit with their Proposal a comprehensive list of references. Interested
parties are required to provide a minimum of three (3) references where interested party has provided services
(within the last six months) that pertain to this type of service. References shall include company name,
address, telephone number, fax number, contact person and email address. The interested parties must
agree to authorize clients to furnish any information required by MHMRA to verify references provided, and for
determining the quality and timeliness of previous work performed.
Vendor/Provider shall submit with their Proposal, documentation of past performance in projects of similar
magnitude and resulting customer satisfaction particularly in the areas of professionalism, contract performance,
quality of the personnel, responsiveness and flexibility, etc.
H. Proposal Guarantee/Award Procedure
It is anticipated that a recommendation for award for this Proposal will be made no more than thirty (30) days
after the PROPOSAL DUE DATE. All interested parties are required to guarantee their Proposals as an
irrevocable offer valid for one-hundred and twenty (120) days after the Proposal due date.
Mental Health Mental Retardation Authority of Harris County in its sole and absolute discretion shall have the
right to award Proposal(s) for any or all items/services listed in each Proposal, shall have the right to reject any
and all Proposal(s) as it deems to be in its best interest, to waive formalities and reasonable irregularities in
submitted documents, shall not be bound to accept the lowest Proposal and shall be allowed to accept partial or
total Proposal(s) of any one vendor.
Page 5 of 39
I. Permits
Any and all permits as required by authorities having jurisdiction; local, state, county, and/or federal, are the total
responsibility of the interested parties/vendor and must be obtained prior to commencement of any work or
service. Any and all expense/cost related to obtaining required permits is the sole responsibility of the vendor
J. Financial Information
Vendor/Provider must submit a copy of their last AUDITED financial statement. A letter from your CPA is an
acceptable alternative for Non Public companies, but must include a statement that financial solvency is adequate
to meet expenditures for at least one year.
K. Payments
Vendor/Provider is to submit properly completed invoice(s) to the address specified on the purchase order. To
insure prompt payment, each invoice should indicate purchase order number, discount terms and include
Vendor/Provider's name and return remittance address.
L. Price Adjustments
Vendor/Provider will be required to honor their proposed prices for the term of the contract period.
M. Historically Under-Utilized Business (HUB)
This Agency shall make a good faith effort to utilize Historically Underutilized Businesses (HUB‟S) in contracts
for construction, services, (including professional and consulting services), and commodities. Please submit
proof of Historically Underutilized Business “HUB” state certificate.
If your firm is not certified, please submit Attachment A, if you intend to subcontract services. If not, write
“none” on Attachment A and submit it.
N. Minority / Women and /or Disadvantaged Business
This Agency shall make a good faith effort to utilize Minority/Women and/or Disadvantaged Businesses
(M/W/DBE‟s) in contracts for construction, services, (including professional and consulting services), and
commodities. Please submit proof of City of Houston M/W/DBE certificate.
O. Direct or Indirect Assignment
The successful Vendor/Provider will not be permitted to directly or indirectly assign rights and duties under the
contract without express approval by MHMRA.
P. Form W-9
Offerors are to complete Form W-9 and Submit with their Proposal documents. http://www.irs.gov/pub/irs-
pdf/fw9.pdf (Attachment D)
Page 6 of 39
SECTION IV - PROPOSAL STIPULATIONS AND REQUIREMENTS
A. Modification or Withdrawal of Proposals
Any Proposal may be modified or withdrawn prior to the deadline, provided such modification or withdrawal is
submitted prior to the deadline. Any modification received after the deadline shall be deemed late and will not
be considered.
B. Offer and Acceptance Period
All Proposals must be an irrevocable offer valid for one-hundred and twenty (120) days after the Proposal
opening.
C. Late Proposals
Proposal received after the stated deadline shall be deemed late and will not be considered.
D. Irregularities in Proposals
Except as otherwise stated in this Request for Proposal, evaluation of all Proposals will be based solely upon
information contained in the Vendor/Provider's response to this Proposal. MHMRA shall not be held responsible
for errors, omissions or oversights in any Vendor/Provider's response to this Proposal. MHMRA may waive
technical irregularities, which do not alter the price or quality of the services.
MHMRA shall have the right to reject Proposals containing a statement, representation, warranty or certification
which is determined by MHMRA and its counsel to be materially false, incorrect, misleading or incomplete.
Additionally, any errors, omissions, or oversights of a material nature may constitute grounds for rejection of any
Proposal.
The inability of a Vendor/Provider to provide one or more of the required components or specified features or
capabilities required by this Proposal does not, in and of itself, preclude acceptance by MHMRA of the Proposal.
All Proposals will be evaluated as a whole in the best interest of MHMRA.
E. Oral Presentations
Any Vendor/Provider that submits a Proposal in response to this request may be required to make an oral
presentation for further clarification upon MHMRA‟s request.
F. Amendments to the Proposal
If it becomes necessary to revise any part of this Proposal package or if additional information is necessary to
clarify any provision, the revision and/or additional information will be provided to each Vendor/Provider via
faxed amendment or e-mail.
G. Availability of the Proposal
After opening, each Proposal, except those portions for which a Vendor/Provider has included a written request
for confidentially (e.g., proprietary information), shall be open to public inspection.
Page 7 of 39
H. Retention of Proposals
All Proposals considered by MHMRA shall become the property of MHMRA and shall not be returned.
I. Notice “Not to Participate” Form
Vendors must respond to the Proposal request whether they can or cannot provide the products, supplies and/or
services listed in the Proposal request. (See Attachment C – Notice “Not to Participate” Form)
J. Incurred Expenses
MHMRA shall not be responsible for expenses incurred by a Vendor/Provider in the preparation and submission
of a Proposal. This provision also includes any costs involved in providing an oral presentation of the Proposal.
K. Deviation Form Each Proposal shall contain a Deviation Form, which states the perspective Provider‟s commitment to the
provisions of this Request for Proposal. An individual authorized to execute contracts shall sign the Deviation
form. Any exceptions taken to the terms and conditions identified in this Proposal Package including the sample
contract must be expressly stated in the Deviation Form. (See Attachment B)
L. Subcontractors All provisions and/or stipulations within this Request for Proposal also apply to any authorized subcontractors.
M. Term of Contract
The intent of the RFP is to award this contract to the qualified vendor who can provide and meet all specified
requirements of this request for proposal. The contract shall commence with a tentative award date for a two (2)
years base period with three (3) years one-year renewal options at the sole discretion of MHMRA based upon
satisfactory performance, which will be reviewed on an annual basis.
N. Licensure
The vendor shall submit, with their Proposal, a copy of any other license(s), certification(s), registration(s),
permit(s), etc. as required by authorities having jurisdiction; local, state, county, and/or federal.
O. Pricing
Each vendor shall provide responses to “Proposal Reply” page with total pricing.
P. Conflict of Interest Provision
The Health and Human Services Commission organizational conflict of interest provision is applicable, in that
vendors who develop of draft specifications, requirements, statements of work and/or RFP for a proposed
procurement shall be excluded from Proposal or submitting a proposal to compete for the award of such
procurement. (HHSC Uniform Contract Terms & Conditions Version 1.3).
Q. Indemnification
To the extent permitted under the Constitution and the laws of the State of Texas, Contractor hereby agrees to
indemnify and hold harmless the Agency and all of its directors, officers, employees, and agents from all suits,
actions, claims, or cost of any character, type, or description brought or made on account of any injuries, death,
or damage received or sustained by any person or persons or property, including but not limited to clients, arising
Page 8 of 39
out of or occasioned by any acts or negligence of Contractor or Contractor's personnel, if any, or its agents or
employees whether occurring during the performance of the services hereunder or in the execution of the
performance of any of its duties under this Agreement.
R. Vendor Requirements and Responsibilities
The Vendor agrees to perform all work and to take any required actions, including the furnishing of all
supervision, labor, insurance, services, and transportation required for the accomplishment of Document
Scanning and Imaging Project as described in these specifications. Services are to be rendered in a workmanlike
manner, and in accordance with the provisions of this contract.
Page 9 of 39
SECTION V - INSURANCE REQUIREMENTS
A. Policies, Coverages, and Endorsements.
Vendor agrees to maintain, or to cause its personnel providing services under this Agreement to maintain,
at its sole cost and expense or the cost and expense of his personnel, the following insurance policies, with
the specified coverages and limits, to protect and insure the Agency and Vendor against any claim for
damages arising in connection with Vendor‟s responsibilities or the responsibilities of Vendor's personnel
under this Agreement and all extensions and amendments thereto.
1- Commercial General Liability
General Aggregate $1,000,000
Each Occurrence $500,000
2 - Professional Liability
General Aggregate $2,000,000
Each Occurrence $1,000,000
3 - Business Automobile if transporting our consumers if applicable
Combined Single Limit Bodily Injury & $500,000
Property Damage
4 - Workers‟ Compensation & Employers‟ Liability if applicable
Medical & Indemnity Statutory Requirements
Bodily Injury by Accident $500,000 Each Accident
Bodily Injury by Disease $500,000 Each Employee
Bodily Injury by Disease $500,000 Policy Limit
A CURRENT “CERTIFICATE OF INSURANCE”
MUST ACCOMPANY ALL PROPOSALS
B. Insured Parties
All policies shall contain a provision naming the Agency (and its officers, agents and employees) as
Additional Insured parties on the original policy and all renewals or replacements during the term of this
Agreement.
C. Subrogation
All policies must contain a Waiver of Subrogation endorsement to the effect that the issuer waives any
claim or right in the nature of subrogation to recover against the Agency, its officers, agents or employees.
D. Proof of Insurance
The policies, coverages and endorsements required by this provision shall be shown on a Certificate of
Insurance on which the Agency must be listed as an Additional Insured party and the Certificate
Holder and which should be furnished to the Agency prior to the commencement of this Agreement. All
such insurance shall be secured and maintained with an insurance company, or companies, licensed to do
business in the State of Texas. The Agency may withhold payments under the terms of this Agreement
until the Contractor furnishes the Agency copies of all Certificates of Insurance from the insurance carrier,
or carriers, showing that such insurance is in full force and effect.
Page 10 of 39
E. Cancellation.
New Certificates of Insurance shall be furnished to the Agency at the renewal date of all policies named on
these Certificates. Contractor shall give the Agency thirty (30) days prior written notice of any proposed
cancellation of any of the above described insurance policies.
Page 11 of 39
SECTION VI – PROPOSAL EVALUATION PROCESS
Not all evaluation factors are equal in importance and each factor is weighted in accordance with its
importance to MHMRA. Each item has been assessed a percentage upon which the final score will
determined. A total of 100 percentage points for the following items will be considered a perfect score.
The following will be significant factors in evaluating proposals, but the evaluation will not be limited to
these items when making a final recommendation.
A. Understanding of Agency
and Project 25%
Indication that the vendor understands the nature of
MHMRA services and constraints in providing those
services. In addition, that the vendor has thoroughly
analyzed MHMRA's needs and requirements.
B.
Experience and Capacity/
Coordination and Project
Management Services
30%
Evidence that the vendor has successfully completed
work of comparable magnitude, complexity, scope, and
has personnel who have demonstrated experience in
completing a project of this size and magnitude.
C. Financial Condition 10% Verifiable proof of company financial viability and
solvency.
D. References 20%
Provide the names, telephone numbers, emails, and
addresses of at least 3 business references that the
vendor has provided the same or comparable level of
service as described in this RFP. Particular attention
will be given to the quality of the response from those
references, particularly in the Houston area.
E. Cost 15%
Final cost may be negotiated with the successful
proposer. Cost will only become a determining factor
when all other conditions are equal.
Page 12 of 39
SECTION VII – SPECIALIZED SERVICES TO BE PERFORMED
Scope of Services:
SECTION 1. GENERAL TERMS AND CONDITIONS
CONTRACT TERM: The contract shall commence with a tentative award date for a two (2) years base
period with three (3) years one-year renewal options at the sole discretion of MHMRA based upon
satisfactory performance, which will be reviewed on an annual basis.
SUBCONTRACTING: No subcontracting is allowed.
OPTION TO EXTEND THE CONTRACT TERM: The Mental Health and Mental Retardation
Authority of Harris County (MHMRA) has the option to extend the term of this contract for a period of 12
months by written notice to the contractor not later than 60 days before the contract expires. If MHMRA
exercises this option, the extended contract shall be considered to include this clause, except, the total
duration of the contract may not exceed 5 years as a result of, and including, any extension(s) added under
this clause.
PRE-AWARD SURVEY: In order to determine the responsibility of the prime contractor, MHMRA
reserves the right to conduct an on-site pre-award survey at the contractor's facility or to require other
evidence of technical, production, managerial, financial, and similar abilities to perform, prior to the award
of a contract.
Bidders to Note: The security and confidentiality of MHMRA documents handled and stored by the
contractor during the execution of this contract are of critical importance. Accordingly, MHMRA
representatives will be especially attentive to how MHMRA documents will be handled, processed and
stored during any pre-award survey(s) initiated by the MHMRA. Should the pre-award survey reveal a
security deficiency that jeopardizes or otherwise compromises the secure and the confidential operation of
this contract as specified herein, MHMRA reserves the right to declare the contractor non-responsible if
such a deficit cannot or will not be remedied by the contractor in a timely fashion at no additional expense
to MHMRA.
SECURITY: This contract requires the reproduction of confidential MHMRA documents such as patient
records, PHI and other documents protected by state and federal law. The contractor shall provide the
necessary means, methods and facilities to ensure secure custody and strict accountability of all job
materials while in the contractor‟s possession. All work performed (scanning, copying, binding, and
packing, etc.) must be done in a secured area accessible only to authorized personnel to ensure strict
confidentiality of sensitive documents. See „Contractor to Furnish‟ section. MHMRA reserves the right to conduct both on-site pre-award and post-award Safeguard Reviews at any
time during the term of the contract. The contractor‟s employees must have background checks and have
signed annual non-disclosure and confidentiality agreements.
The contractor must have had a physical address in the Houston area for at least 2 years. The contractor will
be able to maintain 3 shifts running a minimum of 4 scanners during those 3 shifts. Contractor must submit
a current Service Organization Controls (SOC) Type 2 Audit Report with their bid submission.
The work area should be located in a commercial facility that is in full compliance with all local building
and fire codes. For offices located on the ground floor with glass windows, security glass breaks must be
incorporated in the intrusion system. The contractor production facility must have digital surveillance with
an off-site corporate security team to monitor the facility, employees and visitors 24 hours a day, 7 days a
week and 365 days a year. All access doors should be equipped with high security locks that are not easily
Page 13 of 39
compromised. The locking devices should be high-security, pin-tumbler cylinder locks that are key
operated mortised or rim-mounted dead-bolt lock. The locks should have no less than one-inch throw and at
least five pin tumblers. If bolt is visible when locked, it must contain hardened inserts or be made of steel.
Both the keys and the lock must be "off master". All keys issued to this space must be accounted for and
controlled, even when not in use. If combination locks are used, they should have no less than four digits in
the combination with a recorded audit trail. Electronic security/locking systems which meet or exceed the
specifications above will also be considered acceptable. The space must also have a current access list of
employees allowed to access the space. All perimeter doors must be solid cored or metal. The door hinges
must be non-removal or installed on the interior of the door so that they cannot be removed from the
outside of the space. If the door has a glass insert it must have wire mesh sandwiched between the glasses
to prevent unauthorized access into the space. The space should be cleaned during daytime hours in the
company of the contractor employees. If daytime cleaning is not possible, the cleaning personnel will be
advised of nondisclosure of information requirements set out in MHMRA.
Due to the sensitivity of the MHMRA furnished materials, all pick-up and return of MHMRA furnished
materials must be made by an employee of the contractor in a contractor-owned vehicle.
During transportation, the contractor will ensure that MHMRA documents are not co-mingled with other
non-MHMRA documents. The documents should be transported in marked containers and segregated from
other documents during transportation. The markings should not disclose the name or any other identifying
information of the records. Records/materials requiring pre-production or non-working hour storage must
be stored in locked containers within a secured area with the access controlled. The vehicle that the
contractor uses to transport the furnished job materials must be locked at all times unless loading and
unloading cartons. If authorized personnel must make more than one trip to load or unload cartons, the
contractor must have another authorized person guarding the cartons in the vehicle. Cartons in a locked
vehicle left unattended by an authorized person are in direct violation of the contract. The only time the
cartons can be left unattended is in the secure area of the plant.
MHMRA shall have the right to send its employees into the offices and plants of the contractor for
inspection of the facilities and operations provided for the performance of any work under this contract. On
the basis of such inspection, the Contracting Officer of MHMRA, may require specific remedial measures
in cases where the contractor is found to be non-complaint with the required contractor safeguards.
SECTION 2. - SPECIFICATIONS
SCOPE: These specifications are designed for digital scanning/copying of sensitive MHMRA medical
record documents, requiring such operations as pickup of the furnished materials by the contractor in a
contractor-owned vehicle, disassembly and hand-feeding of original documents, digital scanning, OCR
document processing, electrostatic thermal or other copying process, “Bates” serial numbering,
Xerographic generation of “blowback” hardcopies from furnished digital copy, archiving onto (as well as
copying of) DVD-R, CD-R disc(s), hard drives, reassembly of furnished documents into their original state,
packing, delivery of the reproduced copy, and return of the furnished materials by the contractor in a
contractor-owned vehicle.
QUANTITY: Approximately 5,000,000 documents will require scanning and digitization to MTIF, TIFF,
and/or PDF files onto CD/DVD or other optical media. The MTIF/TIFF/PDF files will typically not need
to be text-searchable (“Bates” numbered) nor require blowback hard copies.
However, an occasional order may require one or more of the following:
(1) OCR scanning with conversion to text-searchable PDF files, electronic “Bates” numbering;
(2) Producing blowback hard copies from PDF files generated: One to three (avg. 1) copy per order.
(3) Copying/duplicating of furnished originals (no digital capture), “Bates” numbering: One to three (avg. 1) copy per order;
(4) Conversion of digital files (usually Microsoft Office files) to PDF, and/or production of blowback
hard copies from the original digital files or from the PDF produced: One to three (avg. 1) copy
per order.
Page 14 of 39
FURNISHED ORIGINALS: It is estimated that the order will consist of approximately 5,000,000
documents.
Trim Sizes:
Format “A”: Up to and including 8-1/2 X 11”
Format “B”: Over 8-1/2 X 11” up to and including 8-1/2 X 14” (Legal Size)
Format “C”: Over 8-1/2 X 14” and up to and including 11 X 17”
It is anticipated that most of the pages will be Format “A”.
MHMRA TO FURNISH: Original MHMRA documents packed in cartons including patient records,
PHI, and other HIPAA documents, etc. on various sizes and colors of stock to be reproduced at 100% or
95% and occasionally at other rates of reduction. It is estimated that less than one percent of the furnished
originals will include color elements. The individual print order will specify the rate of reduction, if
applicable. Furnished material may be single and/or multiple leaf documents held together with numerous
staples or other fasteners in envelopes, folders, binders, boxes, etc.
Reproduce same size or at various focuses as indicated.
Based upon past performance, it is estimated that:
Approx. 10% of the total furnished source materials shall consist of stapled or clipped documents,
requiring slight deconstruction and reconstruction of attachments, including removal of affixed Post-It
slips.
Approx. 5% of the total furnished source materials shall consist of stapled or clipped letter and legal size
documents, requiring folder tabs and/or tab dividers to be copied or inserted, moderate deconstruction and
reconstruction of attachments.
Approx. 5% of the total furnished source materials shall consist of variable-contrast stapled or clipped
letter and legal size documents plus odd-sized receipts, envelopes, etc, requiring folder tabs and/or tab
dividers to be copied or inserted, frequent machine adjustments, extensive deconstruction and
reconstruction of attachments.
CONTRACTOR TO FURNISH: All materials and operations, other than those listed under
"MHMRA to Furnish," necessary to produce the product(s) in accordance with these specifications. This
will include but not be limited to all boxes needed for records transportation.
The contractor shall also furnish the means and measures to ensure that the furnished MHMRA materials
will be handled in a secure fashion to ensure strict confidentiality of their contents, as specified hereafter:
Collection of Employee Information: All contractor employees authorized to work on MHMRA documents
must have completed a background check and drug testing as well as signed annual non-disclosure and
confidentiality agreements prior to any work being performed.
Secured Area: The contractor must be able to store all of the 5,000,000 MHMRA documents at their
production facility and work performed (scanning/duplicating/copying, binding, and packing, etc.) must be
accomplished in a secured area within the contractor‟s facility that the general public is unable to access or
view any documents being processed. All retained copies/furnished materials shall be stored in locked
containers, and shall be located in a locked or secured area during non-duty hours. MHMRA will make
periodic unannounced site visits to confirm that security measures are in compliance with contract
requirements.
Accordingly, the release of any MHMRA file materials to any person or party not expressly authorized by
the MHMRA is strictly prohibited. The contractor shall take all appropriate action and measures to
minimize exposure of the furnished materials to a minimum number of employees. The contractor will be
required to account for all furnished originals and manufactured copies. Unless otherwise indicated, all
extra copies (in any format), waste, spoilage sheets, and so forth are to be destroyed beyond recognition
Page 15 of 39
and reconstruction. All electronic files and data shall be completely purged from all data storage
components of the contractor's computer facility.
Pursuant to the Privacy Act, any contractor employee who willfully discloses the content of the retained
MHMRA material to any person or agency not entitled to receive it shall be subject to criminal penalty and
a fine.
Safe Custody: The contractor has the responsibility to ensure that all copy materials constantly remain in
safe custody from the time they are picked-up until the time they are returned.
Safe custody ensures the legal documents remain in the sealed cartons until they arrive at the contractor's
secure area within contractor‟s plant. The legal document cartons and litigation copy cartons must always
remain in view of authorized personnel. No unauthorized personnel are to handle the cartons.
The vehicle that the contractor uses to transport cartons must be locked at all times unless loading and
unloading cartons. If authorized personnel must make more than one trip to load or unload cartons, the
contractor must have another authorized person guarding the cartons in the vehicle. Cartons in a locked
vehicle left unattended by an authorized person are in direct violation of the contract. The only time the
cartons can be left unattended is in the secure area of the plant.
The contractor must provide a procedure for safeguarding documents and chain of custody. The procedure
should set forth all precautions that will be taken to ensure integrity of documents.
„Chain of Custody‟ form is required to be signed by contractor upon receipt of materials to be copied.
DIGITAL SCANNING: Contractor must have experience in the digital scanning of paper source
documents utilizing equipment and techniques consistent will all of the specifications below:
ADF (Automated Document Feeder) minimum capacity of 100 pages;
Paper size up to and including 432 x 279 mm (17 x 11”);
Resolution range up to 300 dpi;
Frame/border control on all sizing perimeters;
Skew detection feature available on scanners;
Contrast and brightness manipulation for client image viewer;
All scanning shall be performed in accordance with ANSI/AIIM MS44-1993, Recommended Practice for
Quality Control of Image Scanners, including frequent use of calibration test targets to optimize gray
scales, resolution, continuous tones, precision measurement marks, linearity, scan size, alignment of page
and text characters.
Contractor must also be able to also capture data during the scanning process (typically one global
identification field, at no additional cost to MHMRA of Harris County).
The contractor shall maintain optimum image quality with continual monitoring and adjustment of the
imaging process by the scanning technician to accommodate the varying characteristics of different
document populations (including medical X-rays and high-quality photographs requiring individual
attention and equipment adjustment for best results).
The contractor will be required to scan the furnished black-only and any color documents at 300 dpi.
Contractor shall archive the scanned contents as single-page or multiple-page files (as specifically
instructed) CCITT Group IV TIFF files.
Unless otherwise instructed, color images (not more than 1% of the total furnished originals) will be
scanned and archived as RGB files.
Contractor shall name the created TIFF/PDF files in accordance to furnished instructions and/or naming
convention.
Page 16 of 39
Unless otherwise instructed, if a source document includes a Post-It note the contractor shall scan the
applicable page twice: Once with the Post-It affixed to the parent sheet, and a second time with the Post-It
removed from the parent sheet.
Scanned documents must not be split across directories or archival CD-R and/or DVD-R discs.
Second-pass verification will be required on all orders, and is defined as a visual comparison to verify that
100% of the document(s) were captured in scanning.
The contractor shall maintain the document integrity and security throughout the scan processing cycle.
The proper collation and integrity of documents, document packets (several documents fastened together),
file folders and file drawers must not be lost.
DOCUMENT PROCESSING: Contractor will be required to remove all fasteners from furnished material prior to reproducing, with the
exception of perfect and case bound spines.
Contractor to scan/copy any image on envelope(s), file folders and etc. that contain furnished material.
Material furnished on unusually small stock (receipts, match book covers, personal checks, etc.) must be
reproduced individually on 216 x 279 mm (8½ x 11”) sheets unless otherwise indicated. Contractor may
image more than one small stock item per sheet as appropriate.
Furnished originals will include documents with Post-It style note(s) affixed. The contractor is make two
copies of such documents: One copy of the original document with the Post-It note(s) affixed; and one
copy of the original without the Post-It note(s) affixed.
Tab dividers: Contract orders may require the contractor to copy the tab and/or body areas of furnished
dividers. At contractor‟s option, contractor may use preprinted tab divider sets consisting of: (a) one bank
of 1/26th
-cut tabs alphabetically printing A through Z, and/or; one bank of 1/25th
-cut tabs numerically
printing nos. 1 thru 25, and/or; (c) one bank of 1/25th
-cut tabs numerically printing nos. 26 thru 50. Some
orders may require additional imaging on the face-side of the body of the divider.
Reproduced files may require the contractor to substitute a blank or printed colored 216 x 279 mm (8-1/2 x
11”) sheet of paper for each original tab divider, as instructed by MHMRA.
COPYING, GENERATION OF PAPER COPIES: An occasional contract order will require black-
only Xerographic copying of furnished originals not requiring digital capture by the contractor.
Unless otherwise expressly indicated, all documents (including color documents) reproduce single-sided in
black only. All furnished two-sided originals (including color documents) shall be reproduced and
delivered as two single-sided sheets in black.
MARGINS: Various. Follow copy furnished. Original documents smaller than 216 x 279 mm (8-1/2 x
11") should be centered. BINDING: Unless otherwise indicated, the contractor shall return all furnished material and deliver
contractor-furnished copies as follows:
When stapled originals have been furnished: Assemble the reproduced copies in the same sequence as the
furnished originals and band with a minimum of one rubber band around the short dimension, with one
wire stitch (staple) at upper-left corner or loose as specified on the Purchase Order.
After copying the contractor shall staple (at upper left corner) the original documents in the same sequence
and manner as furnished.
When loose-leaf originals, bound with a rubber band, have been furnished: After copying, the contractor
shall rubber band both the originals and the contractor-produced copies in the same sequence and manner
as the furnished originals, unless otherwise indicated.
Page 17 of 39
When loose-leaf originals within a folder or binder have been furnished: After copying, contractor shall
insert the originals back into the furnished folder or binder in the same sequence and manner as furnished.
Contractor shall rubber band the contractor-produced copies of the originals that were furnished in a folder
or binder.
When case bound, perfect bound, saddle-stitched originals have been furnished: After copying, the
contractor shall rubber band the contractor-produced copies in the same sequence as the furnished bound
publication. Combing or intermixing of separate publications is not permitted.
DIGITAL ARCHIVING: All duplicate (burned) CD-R discs shall be manufactured in accordance with the Phillips Orange Book, Part
II: CD-R, Vols. 1 and 2 (Version 3.1, 1998).
Duplicate CD-R discs manufactured under the terms of this contract will be 650 MB (74-minute) or 700
MB (80 minute) capacity discs, to be used on consumer quality target CD-ROM drives within a Microsoft
Windows operating system environment.
All duplicate (burned) DVD-R discs shall be manufactured in accordance with DVD Forum Book D (using
applicable version) specifications.
Duplicate DVD-R discs manufactured under the terms of this contract will be single-layer 4.7 GB capacity
(DVD-5) discs, to be used on consumer quality target DVD-ROM drives.
Warning: All electronic media made by the contractor must be kept accountable and under reasonable
security to prevent their unauthorized release. Disks are not to be duplicated in whole or part for any other
purpose than to create material to be used in the performance of this contract. All duplicate media shall be
degaussed or securely overwritten and any printouts and non-erasable media shall be destroyed by the
contractor.
Disc labeling: Before labeling the DVD/CD-R master(s), the contractor shall call the MHMRA contact(s)
cited on the Purchase Order to discuss the DVD/CD-R naming convention(s) to be used for any given
order. Unless otherwise indicated by the MHMRA, the contractor shall label each DVD/CD-R in a
professional manner to most accurately reflect the contents archived thereon.
Disc packaging: The contractor shall first slip each DVD/CD disc into a common commercially available
DVD/CD-R jewel case with the labeled side of the disc facing up. The contractor shall then insert each
jewel case with disc into a common commercially available DVD/CD mailer suitable for USPS mailing
purposes.
REASSEMBLY OF ORIGINALS: Unless otherwise instructed, the contractor will be required to
reassemble, refasten and return the original documents in the same sequence and same condition as
furnished. (See preceding “BINDING” section.) PACKING: Furnished originals: Contractor shall re-box, re-pack and seal the furnished originals within the original
container(s) in exactly the same way that they were furnished.
Reproduced copy (ies) of furnished originals: Contractor shall pack copied contents in sealed shipping
carton(s) suitable for secure handling and delivery. Each shipping container must not exceed 28-32 pounds
when fully packed. Shipping containers must be corrugated or solid fiberboard containers with a minimum
bursting strength of 275 p.s.i. Note: The title of the case file or documents must not appear on the exterior
surface of any shipping container. Reproductions shall be packed in the same manner as the furnished
originals.
DISTRIBUTION: Pickup and delivery of furnished materials: Agency furnished materials provided for reproduction shall be
picked-up and returned by the contractor using a contractor-owned vehicle, as indicated within the
following contract categories.
Page 18 of 39
Furnished materials picked up from, and returned to MHMRA of Harris County, 7011 Southwest
Freeway, Houston, Texas 77074. This is subject to change depending on location of documents to be
digitized. All locations will be located within boundaries of Harris County.
The contractor will be required to deliver the reproductions to MHMRA of Harris County, 7011
Southwest Freeway, Houston, Texas 77074. This is subject to change depending on location of
documents to be digitized. All locations will be located within boundaries of Harris County.
A specific point of contact and telephone number for each of the pickup sites will be furnished with
issuance of the Purchase Order.
All expenses incidental to pick up and return of the MHMRA furnished materials must be borne by the
contractor.
Delivery of document reproductions:
Delivery shall be made via traceable means, including an overnight delivery service.
SCHEDULE: Adherence to this schedule must be maintained.
Furnished material must be picked up from and returned to the facility listed under "DISTRIBUTION".
If the contractor is notified of the availability of the furnished materials for pickup by the contractor before
11:00 AM, the following schedule begins on the day and at the time notified. If the contractor is notified of
the availability of the furnished materials for pickup after 11:00 AM, then following schedule begins on the
following day notified at 9:00 AM.
SECTION 3. - Pricing
Procurement under this solicitation will be as follows:
The award for this request for proposal will be determined by applying the prices offered to the following
units of production which are the estimated requirements to produce orders under this contract. These units
do not constitute, nor are they to be construed as a guarantee of the volume of work which may be ordered
under this contract.
Prices quoted shall include the cost of all required materials and operations (including scanning of RGB
elements, provision of paper, and boxes for transportation) necessary for the complete production and
distribution of the products listed in accordance with these specifications.
1
Scanning of Furnished 8-1/2'' x 11'' or 8-1/2'' x 14'' originals:
(a) Digital Scanning, MTIF conversion - no auditing - price per scanned page
(b) Digital Scanning, MTIF conversion - 50% auditing - price per scanned page
(c) Digital Scanning, MTIF conversion - 100% auditing - price per scanned page
(d) Digital Scanning, PDF conversion - no auditing - price per scanned page
(e) Digital Scanning, PDF conversion - 50% auditing - price per scanned page
(f) Digital Scanning, PDF conversion - 100% auditing - price per scanned page
(g) OCR processing, creation of text-searchable content per scanned page
(h) Burning, labeling, packing DVD-R disc(s) - per disk
(i) Burning, labeling, packing CD-R disks - per disk
(j) Copying scanned files to provided hard drive, per hard drive
Page 19 of 39
2
Scanning of Furnished 11'' x 17'' originals:
(a) Digital Scanning, MTIF conversion - no auditing - price per scanned page
(b) Digital Scanning, MTIF conversion - 50% auditing - price per scanned page
(c) Digital Scanning, MTIF conversion - 100% auditing - price per scanned page
(d) Digital Scanning, PDF conversion - no auditing - price per scanned page
(e) Digital Scanning, PDF conversion - 50% auditing - price per scanned page
(f) Digital Scanning, PDF conversion - 100% auditing - price per scanned page
(g) OCR processing, creation of text-searchable content per scanned page
(h) Burning, labeling, packing DVD-R disc(s) - per disk
(i) Burning, labeling, packing CD-R disks - per disk
(j) Copying scanned files to provided hard drive, per hard drive
NOTE: Please be advised that MHMRA is permitted by its Policies and Procedures to expedite
the contracting process by “piggybacking/tagging” on existing contracts a firm might have with
other governmental entities.
**PLEASE INCLUDE ANY ADDITIONAL DESCRIPTIVE LITERATURE, WHICH
MIGHT BE OF ASSISTANCE IN THE DECISION-MAKING PROCESS. **
Page 20 of 39
SECTION VIII- PROPOSAL CONTENTS
Title Page:
Name of Vendor/Provider, local address, telephone number, fax number, e-mail address and contact name.
Table of Contents:
All Proposals must include the following information:
Clear identification of information by section and page.
List of at least three (3) references, including contact person, telephone number, fax number and email
address.
Identification of all services provided.
Proposal: Vendor/Provider must provide a brief history of company and ownership, date started business, current
total number of employees, and include any special accommodations/services that could be provided.
Description of services available under this Proposal.
Must bear the original signature of a principal or authorized officer of the interested party.
Must be typed.
Must make provision to meet and comply with all applicable laws and regulatory criteria.
Interested parties are encouraged to submit along with their Proposal any additional descriptive
information about their services, which they believe, might be helpful.
All Proposals must be submitted with one original and five (5) copies and an electronic copy
(Flash Drive), mailed or delivered in a sealed envelope to MHMRA of Harris County.
Additional documents to be submitted:
Please provide a sample copy of your purchase, contract, warranty and extended
warranty agreement.
Vendor must submit a copy of their latest AUDITED financial statement. A letter from your CPA is
an acceptable alternative for Non Public companies, but must include a statement that financial
solvency is adequate to meet expenditures for at least one year.
Reference list must be comprehensive – Reference List must be inclusive of contact name, telephone
number, fax number and e-mail address. (Local and or Non-local)
Documentation of experience addressing professionalism, contract performance, quality of personnel,
responsiveness and flexibility, etc. to achieve overall customer satisfaction.
Proof of Insurance
Submit proof of Historically Underutilized Business “HUB” State Certificate and/or City of
Houston M/W/DBE Certificate. (Attachment A)
If your firm is not certified, provide a statement to the effect if you intend to subcontract or affiliate
with a certified firm and what percentage of work will be given to them.
Deviation Form (Attachment B)
Notice “not to participate” Form (Attachment C)
Policy & Procedure for criminal background checks of personnel or subcontractor that would gain
entrance to or provide service to MHMRA properties.
Completed Form W-9
Completed Business Associate Agreement
Page 21 of 39
SECTION IX –PROPOSAL REPLY PAGE
Procurement under this solicitation will be as follows:
The award for this request for proposal will be determined by applying the prices offered to the following
units of production which are the estimated requirements to produce orders under this contract. These units
do not constitute, nor are they to be construed as a guarantee of the volume of work which may be ordered
under this contract.
Prices quoted shall include the cost of all required materials and operations (including scanning of RGB
elements, provision of paper, and boxes for transportation) necessary for the complete production and
distribution of the products listed in accordance with these specifications.
1 Scanning of Furnished 8-1/2'' x 11'' or 8-1/2'' x 14'' originals: Cost:
(a) Digital Scanning, MTIF conversion - no auditing - price per scanned page
(b) Digital Scanning, MTIF conversion - 50% auditing - price per scanned page
(c) Digital Scanning, MTIF conversion - 100% auditing - price per scanned page
(d) Digital Scanning, PDF conversion - no auditing - price per scanned page
(e) Digital Scanning, PDF conversion - 50% auditing - price per scanned page
(f) Digital Scanning, PDF conversion - 100% auditing - price per scanned page
(g) OCR processing, creation of text-searchable content per scanned page
(h) Burning, labeling, packing DVD-R disc(s) - per disk
(i) Burning, labeling, packing CD-R disks - per disk
(j) Copying scanned files to provided hard drive, per hard drive
2
Scanning of Furnished 11'' x 17'' originals:
(a) Digital Scanning, MTIF conversion - no auditing - price per scanned page
(b) Digital Scanning, MTIF conversion - 50% auditing - price per scanned page
(c) Digital Scanning, MTIF conversion - 100% auditing - price per scanned page
(d) Digital Scanning, PDF conversion - no auditing - price per scanned page
(e) Digital Scanning, PDF conversion - 50% auditing - price per scanned page
(f) Digital Scanning, PDF conversion - 100% auditing - price per scanned page
(g) OCR processing, creation of text-searchable content per scanned page
(h) Burning, labeling, packing DVD-R disc(s) - per disk
(i) Burning, labeling, packing CD-R disks - per disk
(j) Copying scanned files to provided hard drive, per hard drive
Page 22 of 39
SECTION X -SIGNATURE PAGE
MENTAL HEALTH MENTAL RETARDATION AUTHORITY OF HARRIS COUNTY
IN ITS SOLE AND ABSOLUTE DISCRETION SHALL HAVE THE RIGHT TO AWARD
CONTRACTS FOR ANY OR ALL MATERIALS LISTED IN EACH PROPOSAL,
SHALL HAVE THE RIGHT TO REJECT ANY AND ALL PROPOSALS, AND SHALL
NOT BE BOUND TO ACCEPT THE LOWEST PROPOSAL AND SHALL BE
ALLOWED TO ACCEPT THE TOTAL PROPOSAL OF ANY ONE VENDOR.
THIS SUBMISSION IS GUARANTEED AS AN IRREVOCABLE OFFER VALID FOR
ONE-HUNDRED AND TWENTY (120) DAYS AFTER THE PROPOSAL OPENING
DATE.
Authorized Signature Vendor/Provider‟s Name
Typed or Printed Name Number and Street Address
Title City, State, Zip Code
( ) ( )
Telephone Number Fax Number
_____________________________________
E-Mail Address
This Proposal Will NOT Be Accepted If This Page is NOT
Signed By An Authorized Representative
Page 23 of 39
SECTION XI - ATTACHMENTS
A – HUB SUBCONTRACTING PLAN
(Historically Underutilized Business)
B – DEVIATION FORM
C - NOTICE “NOT TO PARTICIPATE” FORM
D – FORM W-9, Rev. August 2013, REQUEST FOR TAXPAYER IDENTIFICATION
NUMBER AND CERTIFICATION
http://www.irs.gov/pub/irs-pdf/fw9.pdf
E – SAMPLE CONTRACT
F – BUSINESS ASSOCIATE AGREEMENT
Page 24 of 39
ATTACHMENT A
HUB SUBCONTRACTING PLAN
HISTORICALLY UNDERUTILIZED BUSINESS
(HUB-LOI IS USED BY POTENTIAL VENDOR/PROVIDER TO IDENTIFY
SUBCONTRACTORS SELECTED FOR WORK ON THE CONTRACT)
Vendor_________________ Vendor/Provider Identification Number: _____________________
Address: _________________________________________________________________
Phone: ____-____-____ Proposal Number: _____________Contract Amount: __________
Description of commodities/specifications: ______________________________________
Duration of Contract: _______________________________________________________
Name of Subcontractor/Vendor:______________________________________________
Address: _________________________________________________________________
Phone: ____-____-____ Is the subcontractor a certified HUB? _____Yes______No
If yes, enter the GSC Certificate (VID) number: __________________________
Dollar amount of contract with subcontractor/vendor: $____________________
Percentage amount of contract with subcontractor/vendor:%________________
Description of materials/services performed under agreement with the subcontractor
for amount indicated above:
_____________________________________________________________________________
_____________________________________________________________________________
PLEASE SUBMIT A SEPARATE FORM FOR EACH SUBCONTRACTOR/VENDOR
Page 25 of 39
ATTACHMENT B
DEVIATION FORM
All deviations to this Solicitation (RFP) must be noted on this sheet. In the absence of any entry on this Deviation
Form, the prospective vendor/firm assures MHMRA of their full agreement and compliance with the Specifications,
Terms and Conditions including all provisions of the Sample Contract.
Each response to this Solicitation shall contain a Deviation Form, which states the prospective Vendor/Firm
commitment to the provisions of this Solicitation and Sample Contract. An individual authorized to execute contracts
must sign the Deviation Form. Any exceptions taken to the terms and conditions identified in this Solicitation Package
including the Sample Contract must be expressly stated in the Deviation Form. (ATTACHMENT B)
THIS DEVIATION FORM MUST BE SIGNED BY EACH PROSPECTIVE VENDOR WHETHER THERE ARE
DEVIATIONS LISTED OR NOT, AND SUBMITTED WITH THIS SOLICITATION
SPEC #
Section #
Or Page # DEVIATION
Company Name Authorized Signature Date
Page 26 of 39
ATTACHMENT C
NOTICE “NOT TO PARTICIPATE” FORM
Dear Vendor
Please check the appropriate box below, complete the remainder of this form and return it PRIOR
to the scheduled Date and Time:
I/Our Company cannot provide the products, supplies and/or services listed in this
request. Please MOVE my/our name and address to the following category(ies) so
that we may Proposal at a later date:
Category (ies):
I/We have chosen NOT to submit a Proposal at this time, but would like to remain on
your list for this Proposal category. We did not submit a Proposal because:
Reason(s):
Please REMOVE my/our name from all MHMRA Harris County lists until further notice.
Reason(s):
Independent Provider and/or Provider Firm Name:
Representative:
Please Print
Address: Phone ( )
E-mail: Fax ( )
PLEASE RETURN THIS FORM ONLY TO:
MHMRA Harris County
Purchasing Department
Notice “Not to Participate” – DOCUMENT SCANNING AND IMAGING
PROJECT
7011 Southwest Freeway
Houston, Texas 77074
Authorized Signature: __________________________________________________________
Title: __________________________________________ Date: ________________________ VENDORS WHO RESPOND TO THIS INVITATION WITH A COMPLETED PROPOSAL FORM WILL REMAIN ON OUR
MAILING LIST. VENDORS MAKING NO RESPONSE MAY BE REMOVED FROM THAT LISTING.
Thank you for your time and assistance.
Page 27 of 39
ATTACHMENT D – FORM W-9, Rev. August 2013, REQUEST FOR TAXPAYER
IDENTIFICATION NUMBER AND CERTIFICATION /
Link:
http://www.irs.gov/pub/irs-pdf/fw9.pdf
Form W-9, Pages 1 – 4
Attached
Vendor/Providers are to complete this form and submit with their Proposal
documents. Go to attached link for W-9, if Proposal/Bid was emailed.
http://www.irs.gov/pub/irs-pdf/fw9.pdf
Page 28 of 39
ATTACHMENT E SAMPLE CONTRACT
Contract ID No. ______
STANDARD PROFESSIONAL SERVICES CONTRACT
THIS AGREEMENT is made and entered into this ___________, 2014 by and between the MENTAL
HEALTH AND MENTAL RETARDATION AUTHORITY OF HARRIS COUNTY, at 7011
Southwest Freeway, Houston, Texas 77074, a community center and an agency of the State of Texas,
under the provisions of Chapter 534 of the Texas Health & Safety Code Ann. (Vernon 1992), as amended,
(the “Agency”) and (“Contractor”) with offices at _________________, Houston, Texas ______ for
the purpose of providing specialized services currently not available to the Agency through its present staff
of employees.
RECITALS
WHEREAS, Agency is the state designated mental health and mental retardation community center
established to provide, arrange for, and coordinate mental health and mental retardation services for the
residents of Harris County, Texas; and
WHEREAS, the Agency desires that Contractor provide Data Scanning and Imaging Project services
under the terms and conditions set forth in this Agreement;
WHEREAS, each of the parties is committed to the delivery of services in an effective, cost efficient, and
quality manner; and
WHEREAS, this Agreement sets forth the terms and conditions evidencing the Agreement of the parties
hereto;
NOW THEREFORE, in consideration of the mutual covenants, rights, and obligations set forth herein, the
benefits to be derived therefrom, and other good and valuable consideration, the receipt and sufficiency of
which are acknowledged, the parties agree as follows:
I.
PERSONNEL
The Agency staff member authorized to approve billing is Bob Stakem, Director of Quality
Management.. The Agency staff member responsible for overseeing this Agreement is Bob Stakem,
Director of Quality Management.
II.
INDEPENDENT CONTRACTOR RELATIONSHIP BETWEEN THE PARTIES
Independent Contractor. The relationship between the Agency and Contractor shall be that of an
independent contractor. It is agreed that Contractor and Contractor‟s personnel will not be considered an
employee, agent, partner, joint venturer, ostensible or apparent agent, servant or borrowed servant of the
Agency.
Contractor understands and agrees that Agency:
a) Will not withhold on behalf of Contractor any sums for income tax, unemployment insurance,
social security, or any other withholding;
b) Will not give to Contractor any of the benefits given to employees of Agency.
2. Professional Judgment. Professional Judgment. Contractor and its personnel shall exercise its
own professional judgment in the performance of services to the persons served.
III.
Page 29 of 39
OBLIGATIONS OF CONTRACTOR
1. Services. The Data Scanning and Imaging services to be provided by Contractor to persons referred
by the Agency; the schedule of hours Contractor will deliver such services; and the locations where
such services shall be delivered by Contractor are set forth in Exhibits A and A1.
2. Qualifications. Contractor will comply with relevant Texas Health and Human Services Commission
(HHSC) rules and community standards, certifications, accreditation's, and licenses and any other
professional and educational qualifications.
3. Agency Approval of Contractor Personnel. Contractor agrees not to contract any services until
approval of such subcontractor is obtained from the Agency. Any subcontractor or employees of
Contractor are the direct responsibility of Contractor.
4. Representations.
(a) Contractor represents and warrants that it is not currently an employee of the Agency.
(b) Contractor agrees that it shall comply with all applicable federal and state laws, rules and
regulations including Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation
Act of 1973, the Americans with Disabilities Act of 1990 (ADA) and the Age Discrimination in
Employment Act of 1967.
5. Receipts and Records. Contractor agrees to provide the Agency, upon request, with original
receipts for the purchase of all goods and services involving the use of Agency funds as well as all other
financial and supporting documents and statistical records. Contractor shall retain these and any other
records pertinent to the services for which a claim or cost report was submitted to the Agency, for a period
of six (6) years.
6. Disclosure. Contractor declares that neither Contractor nor any of its subcontractors or employees
rendering services pursuant to this Agreement is held in abeyance or barred from the award of a federal or
state contract at the time of executing this Agreement; and Contractor will give immediate notification to
the Agency if such occurs anytime during the term of this Agreement.
7. Immigration Reform and Control Act. Contractor agrees to maintain appropriate identification
and employment eligibility documents and complete a W-9 form to meet requirements of the Immigration
Reform and Control Act of 1986.
8. Required Reporting Regarding Licensure. Contractor shall report to Agency any allegation
that a professional licensed or certified by the State of Texas and employed by the Contractor has
committed an action that constitutes grounds for the denial or revocation of the certification or license.
Contractor will further report to Agency if any professional has had his/her professional license revoked. If
Contractor's employee has such a denial or revocation, and Contractor fails to remove such employee, then
this Agreement may be terminated without prior notice.
9. Contractor's Governing Body. Contractor agrees to provide Agency with a list of the members
of Contractor's governing body, if applicable.
10. Access. Contractor agrees, pursuant to Texas Health and Safety Code, Section 534.060, that the
Agency and its representatives, including independent financial auditors, shall have unrestricted access to
all facilities, service providers, records, data, and other information under the control of the contracting
entity or its Contractors/subcontractors as necessary to enable the HHSC or the Agency to audit, monitor,
and review all financial or programmatic activities and services associated with this Agreement.
In compliance with Section 2262.003, Government Code, as amended by House Bill 905 of the 79th
Regular Session of the Texas Legislature, effective on June 18, 2005, the Mental Health Mental
Retardation Authority of Harris County (MHMRA) and the Contractor do hereby agree that:
(a) The State Auditor‟s Office (SAO) may conduct an audit or investigation of any entity receiving
funds from the state directly under the contract or indirectly through a subcontract under the contract;
Page 30 of 39
(b) Acceptance of funds directly under the contract or indirectly through a subcontract under the
contract acts as acceptance of the authority of the state auditor, under the direction of the legislative audit
committee, to conduct an audit or investigation in connection with those funds; and
(c) Under the direction of the legislative audit committee, an entity that is the subject of an audit or
investigation by the SAO must provide the state auditor with access to any information the state auditor
considers relevant to: (A) evaluating the entity‟s performance under the contract or subcontract; (B)
determining the state‟s rights or remedies under the contract; (C) evaluating whether the entity has acted in
the best interest of the state.
IV.
OBLIGATIONS OF THE AGENCY
1. Payment.
(a) In consideration of the obligations undertaken by Contractor, the Agency agrees to pay Contractor,
in accordance with the fee schedule attached as Exhibit A.
(b) The payment amount will be based on a monthly invoice, which shall reflect the services provided
by the Contractor, and is approved by the Agency employee(s) authorized to approve billing(s) as set forth
above. Invoices or claim forms for services rendered are to be submitted by the fifth (5) calendar day of the
month following that in which the services were rendered.
(c) Invoices or claim forms for services must be received no later than 45 calendar days after
the end of the month in which services were rendered. Invoices or claim forms for services received
later than 45 days after the end of the month in which the services were rendered will not be paid.
Invoices shall be submitted in duplicate as follows:
(i) Invoices must include a MHMRA purchase order number, which will be
indicated on the final fully executed copy of the contract.
(ii) Original sent to Agency staff member authorized to approve billing
(iii) Duplicate to be marked “Duplicate” sent to Accounts Payable as follows:
Mental Health Mental Retardation Authority of Harris County
P.O. Box 25381
Houston, Texas 77265
Attn: Accounts Payable
Fax (713) 970-7681
(d) Payment shall be made 45 days after receipt of goods, services, or invoice, whichever is latest.
Payment may be delayed, adjusted or withheld, where a deficiency is noted in goods, services, or invoices
received. MHMRA retains the right to offset payments for prior invoices paid where a deficiency is noted
after payment has been processed.
2. Staff and Facilities. The Agency agrees to allow Contractor the use of its staff and facilities necessary
for carrying out the services provided by the Contractor.
3. Franchise Tax. If Contractor is a corporation and is or becomes delinquent in the payment of its
Texas franchise tax, then payments to the Contractor due under this Agreement may be withheld until such
delinquency is remedied.
V.
INSURANCE
A. Policies, Coverages, and Endorsements.
Contractor agrees to maintain, or to cause its personnel providing services under this Agreement to
maintain, at its sole cost and expense or the cost and expense of his personnel, the following insurance
policies, with the specified coverages and limits, to protect and insure the Agency and Contractor against
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any claim for damages arising in connection with Contractor‟s responsibilities or the responsibilities of
Contractor's personnel under this Agreement and all extensions and amendments thereto.
1- Commercial General Liability
General Aggregate $1,000,000
Each Occurrence $500,000
2 - Professional Liability
General Aggregate $2,000,000
Each Occurrence $1,000,000
3 - Business Automobile if transporting our consumers if applicable
Combined Single Limit Bodily Injury & $500,000
Property Damage
4 - Workers‟ Compensation & Employers‟ Liability if applicable
Medical & Indemnity Statutory Requirements
Bodily Injury by Accident $500,000 Each Accident
Bodily Injury by Disease $500,000 Each Employee
Bodily Injury by Disease $500,000 Policy Limit
B. Insured Parties
All Policies shall contain a provision naming the Agency (and its officers, agents and employees) as
Additional Insured parties on the original policy and all renewals or replacements during the term of this
Agreement.
C. Subrogation
All Policies must contain a Waiver of Subrogation endorsement to the effect that the issuer waives any
claim or right in the nature of subrogation to recover against the Agency, its officers, agents or employees.
D. Proof of Insurance
The policies, coverages and endorsements required by this provision shall be shown on a Certificate of
Insurance on which the Agency must be listed as an Additional Insured party (except for professional
liability, employer’s liability and workers compensation) and the Certificate Holder and which should
be furnished to the Agency prior to the commencement of this Agreement. All such insurance shall be
secured and maintained with an insurance company, or companies, licensed to do business in the State of
Texas. The Agency may withhold payments under the terms of this Agreement until the Contractor
furnishes the Agency copies of all Certificates of Insurance from the insurance carrier, or carriers, showing
that such insurance is in full force and effect.
E. Cancellation
New Certificates of Insurance shall be furnished to the Agency at the renewal date of all policies named on
these Certificates. Contractor shall give the Agency thirty (30) days prior written notice of any proposed
cancellation of any of the above described insurance policies.
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VI.
INDEMNIFICATION
To the extent permitted under the Constitution and the laws of the State of Texas, Contractor hereby agrees
to indemnify and hold harmless the Agency and all of its directors, officers, employees, and agents from all
suits, actions, claims, or cost of any character, type, or description brought or made on account of any
injuries, death, or damage received or sustained by any person or persons or property, including but not
limited to clients, arising out of or occasioned by any acts or negligence of Contractor or Contractor's
personnel, if any, or its agents or employees whether occurring during the performance of the services
hereunder or in the execution of the performance of any of its duties under this Agreement.
VII.
TERM AND TERMINATION
1. Term. This Agreement is effective from ___________, 2014 to ____________ , 2017.
2. Renewal Options. This Agreement may be renewed at the sole discretion of Agency based on
satisfactory performance and service for up to Two (2) one-year renewal options at rates and placement
fees specified in Exhibits A and A2.
3. Immediate Termination. Agency may terminate this Agreement immediately if
(a) Agency does not receive the funding to pay for designated services under this Agreement from the
Texas Legislature;
(b) Agency has cause to believe that termination of the Agreement is in the best interests of the health
and safety of the mentally disabled persons served under this Agreement,
(c) Contractor has become ineligible to receive Agency funds;
(d) Contractor has its Texas license or certification suspended or revoked;
(e) In the case of the Contractor providing direct services to clients, failure to disclose a criminal
conviction;
(f) If the Contractor submits falsified documents or fraudulent billings, or if the Contractor makes
false statements.
4. Termination Upon Default. Either party may terminate this Agreement after sixty (60) days written
notice if the other party is in default of any of the provisions herein and/or any of the provisions in the
bid forms or specifications, which are attached hereto and incorporated herein by reference as if set out
in full. Such termination shall be ineffective if within said sixty (60) day period Contractor cures such
default to the satisfaction of the Agency. The Agency at its sole discretion may extend the period to
cure the default for a reasonable time if the Agency determines that the Contractor has initiated action
to cure the default within the sixty (60) day period. The Agency reserves the right to suspend services
provided by the Contractor and payment for services not authorized during the sixty (60) day cure
period, if at the Agency‟s sole discretion it is determined that suspension is in the best interest of the
Agency and/or its consumers.
5. Termination Without Cause. This Agreement may be terminated by either party, without cause,
after thirty (30) days written notice to the other party.
6. Termination by Mutual Consent. This Agreement may be terminated by the mutual consent of
both parties after thirty (30) days written notice to the other party.
VIII.
MISCELLANEOUS
1. Nondiscrimination. Each party to this Agreement agrees that no person, on the basis of race,
color, national origin, religion, sex, age, handicap, or political affiliation, will be excluded from
participation, be denied the benefits of, or be subject to discrimination in the provision of any services
hereunder. The parties hereto agree to comply with the Civil Rights Act of 1964, the Americans with
Disabilities Act of 1990 and the Civil Rights Act of 1991 as amended.
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2. Business Ethics. During the course of pursuing contracts, and the course of contract performance,
MHMRA will maintain business ethics standards aimed at avoiding real or apparent impropriety, abuse,
fraud, waste, or conflicts of interest. No substantial gifts, entertainment, payments, loans or other
considerations beyond that which would be collectively categorized as incidental shall be made to any
employees or officials of Contractor by MHMRA employees, directors, officers and agents. At any time
Contractor believes there may have been a violation of this obligation or any business ethics standard,
Contractor shall notify MHMRA of the possible violation.
3. Certification of Non-Violation. Under Texas Government Code §2261.053, Contractor certifies
that Contractor has not been convicted of violating federal law in connection with contracts relating to
relief, recovery, or reconstruction as a result of Hurricane Rita, Hurricane Katrina, or any other disaster
occurring after September 24, 2005.
4. Use and Disclosure of Protected Health Information (“PHI”).
Contractor Agrees To:
a. General.
(1) Hold all protected health information (“PHI”) confidential except to the extent that
disclosure is required by Federal or State law, including the Texas Public
Information Act, Chapter 552, Texas Government Code. TEX. GOV‟T CODE
ANN.§§ 552.001 et seq., as amended. PHI is defined in 45 CFR § 164.501 and is
limited to information created or received by the Contractor from or on behalf of the
Agency.
(2) Be bound by all applicable Federal and State of Texas licensing authorities‟ laws,
rules, and regulations regarding records and governmental records, including the
Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), PL 104-
191, the HIPAA regulations (codified at 42 CFR parts 160 and 164), and Chapter
181, Texas Health and Safety Code, as amended, and the HITECH ACT, Public Law
111-005, collectively referred to herein as “Privacy Requirements”.
b. Representations.
(1) Contractor represents that Contractor and their employees have received training
regarding the Privacy Requirements.
5. Amendment. Unless otherwise specifically provided herein, this Agreement may be amended or
changed only by mutual written consent of an authorized representative of the Agency and Contractor.
6. Entire Agreement. This Agreement constitutes the sole and only agreement of the parties hereto
and supersedes any prior understandings, written or oral agreement between the parties respecting the
subject matter herein.
7. Electronic or Facsimile Signatures and Duplicate Originals. Pursuant to the requirements of
the Uniform Electronic Transactions Act in Chapter 322 of the Texas Business and Commerce Code and the
Federal Electronic Signatures in Global and National Commerce Act (beginning at 15 U.S .C. Section 7001),
the Parties have agreed that the transactions under this Agreement may be conducted by electronic means.
Pursuant to these statutes, this Agreement may not be denied legal effect or enforceability solely
because it is in electronic form or because it contains an electronic signature. This Agreement may be
executed in duplicate counterparts and with electronic or facsimile signatures with the same effect as if the
signatures were on the same document. Each multiple original of this document shall be deemed an
original, but all multiple copies together shall constitute one and the same instrument.
8. Additional Requirements. If Contractor is required to comply with an additional requirement
pursuant to compliance with HHSC rule, state or federal law, or community standard, regulations,
resolutions, settlements, or plans, and compliance results in a material change in Contractor's rights or
obligations under the contract or places a significant financial burden on the Contractor, the Contractor
may, upon giving sixty (60) days notice of such intention, be entitled to renegotiate the Agreement.
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9. Governing Law and Venue. This Agreement shall be construed and enforced in accordance with
the laws of the State of Texas, and venue shall lie in Harris County, Texas.
10. Notices. Any required notice shall be in writing and shall be sent, postage prepaid, by certified
mail, return receipt requested, to Agency or Contractor at the address below. The notice shall be effective
on the date of delivery indicated on the return receipt.
If to the Agency:
Steven B. Schnee, Ph.D.
Executive Director
MHMRA of Harris County
PO Box 25381
Houston, Texas 77265-5381
If to Contractor:
_____________________
_____________________
_____________________
_____________________
11. Remedies. All rights, powers, and remedies granted either party by any particular term of this
Agreement are in addition to, and not in limitation of, any rights, powers, or remedies which it has under
any other term of this agreement, at common law, in equity, by statute, or otherwise, and all such rights,
powers, and remedies may be exercised separately or concurrently, in such order and as often as may be
deemed expedient by either party. No delay or omission by either party to exercise any right, power, or
remedy shall impair such right, power, or remedy or be construed to be a waiver of any breach or default or
an acquiescence therein. A waiver by either party of any breach or default thereunder shall not constitute a
waiver of any subsequent breach or default.
12. Dispute Resolution. In the event a dispute arises between the parties involving the provisions or
interpretation of any term or condition of the Agreement, and if both parties desire to attempt to resolve the
dispute prior to termination or expiration of the Agreement, or withholding payments, then the parties may
refer the issue to a mutually agreeable dispute resolution process.
13. Severability. The invalidity or unenforceability of any term or provision hereof shall not affect
the validity or enforceability of any other term (s) or provision (s).
14. Exhibits. All Exhibits referred to in this Agreement and attached hereto are incorporated herein
by this reference.
The Contractor warrants and assures MHMRA of Harris County that it possesses adequate legal authority
to enter into this Agreement. The Contractor‟s governing body, where applicable, has authorized the
signatory official(s) to enter this Agreement and bind the Contractor to the terms of this Agreement and any
subsequent amendments hereto.
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CONTRACTOR
_______________________________________
Signature
Printed/Typed Name: _______________________________________
Title: _______________________________________
Date: _______________________________________
MENTAL HEALTH MENTAL RETARDATION AUTHORITY OF HARRIS COUNTY
___________________________________________
Steven B. Schnee, Ph.D. Date
Executive Director
___________________________________________
Approved As To Form By Date
MHMRA General Counsel
UNIT(S) TO BE CHARGED: ______-553002
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EXHIBIT A
CONTRACTOR:
CONTRACT ID#:
CONTRACT PERIOD: _____________, 2014 – __________
SERVICE: Data Scanning and Imaging Project
SERVICE DESCRIPTION: Contractor will provide Data Scanning and Imaging services
as described in the specifications attached as Exhibit __ for
approximately 5,000,000 documents that will require scanning
and digitization to MTIF, TIFF, and/or PDF files onto
CD/DVD or other optical media. The MTIF/TIFF/PDF files
will typically not need to be text-searchable; “Bates”
numbered or required blowback hard copies.
The specifications as described in the RFP are designed for
digital scanning/copying of sensitive MHMRA medical record
documents, requiring such operations as pickup of the
furnished materials by the contractor in a contractor-owned
vehicle, disassembly and hand-feeding of original documents,
digital scanning, OCR document processing, electrostatic
thermal or other copying process, “Bates” serial numbering,
Xerographic generation of “blowback” hardcopies from
furnished digital copy, archiving onto (as well as copying of)
DVD-R, CD-R disc(s), hard drives, reassembly of furnished
documents into their original state, packing, delivery of the
reproduced copy, and return of the furnished materials by the
contractor in a contractor-owned vehicle.
PERFORMANCE: This contract requires the reproduction of confidential
MHMRA documents such as patient records, PHI and other
documents protected by state and federal law. Contractor
shall provide the necessary means, methods and facilities to
ensure secure custody and strict accountability of all job
materials while in the contractor‟s possession. All work
performed (scanning, copying, binding, and packing, etc.)
must be done in a secured area accessible only to authorized
personnel to ensure strict confidentiality of sensitive
documents.
RATE AND
RATE DESCRIPTION: As described on the attached Exhibit A2
NOT TO EXCEED: ____________
UNITS INVOLVED: _____ – 553002
PAYMENT DOCUMENTATION: Contractor will be paid through submission of an invoice for
approval by the Director of Quality Management or designee.
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ATTACHMENT F - BUSINESS ASSOCIATE AGREEMENT
This Business Associate Agreement (“BAA”) has an effective date of _______ , 2014, and is an
amendment to any Agreement (“the Agreement”) between Mental Health Mental Retardation Authority
of Harris County (“MHMRA”) and _____________________ (“the Contractor”). MHMRA and the
Contractor each may be referred to as a “Party” and together may be referred to as the “Parties” to the
BAA. The parties to this Agreement are MHMRA and _________________. Both parties agree that there
shall be no third party beneficiaries to this Agreement, including but not limited to individuals whose
protected health information is created, received, used, and /or disclosed by Contractor in its role as
Business Associate.
1. Amendment of Agreement. This BAA shall supplement and incorporate the terms and
definitions of any Agreement between the Parties. All capitalized terms are as defined in the
Agreement unless otherwise specifically defined herein. Except for the specific changes in the
BAA all other terms and conditions of any Agreement, as previously amended, remain unchanged
2. Purpose of BAA. The purpose of this BAA is to conform the Agreement to the requirements of
the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), as codified at
42U.S.C. Section 1320d, and its regulations, as codified at 45 CFR Parts 160 and 164 and as may
be codified in succeeding and related regulations, implementing 42 U.S.C. Section 1320d and
promulgated by the Secretary of the Department of Health and Human Services and the Health
Information Technology for Economic and Clinical Health (“HITECH”) Act of 2009, Public Law
111-005, (collectively referred to herein as “Privacy Requirements”). The Parties agree that this
BAA shall be interpreted consistently with the Parties intent to comply with HIPAA and HITECH
Requirements.
3. Business Associate Relationship. The Parties hereby acknowledge and agree that:
A. MHMRA is a covered entity and is required under the Privacy Requirements to take
precautions to safeguard certain protected health information (“PHI”), as that term is defined
in the Privacy Requirements, that it maintains or transmits to others;
B. Contractor may have access to PHI which belongs to or is maintained by MHMRA or its
employees, staff, consumers, and guests, and therefore Contractor is a business associate of
MHMRA (“Business Associate”), as defined in the Privacy Requirements;
C. This BAA shall ensure that MHMRA takes adequate precautions to safeguard MHMRA‟s
PHI, and that Contractor likewise takes measures to safeguard such PHI to the same extent as
MHMRA.
4. MHMRA Privacy and Security Policies. MHMRA will from time to time provide Contractor
with MHMRA‟s privacy and security policies that are applicable in whole or part to Contractor‟s
activities and obligations under the Agreement. These activities shall include, but are not limited
to, Contractor‟s access to PHI. Contractor hereby agrees to review and abide by such policies in
all material respects for the purpose of safeguarding MHMRA‟s PHI. Contractor shall incorporate
such operational procedures and additional measures as may be necessary to ensure compliance
with MHMRA‟s policies and Privacy Requirements.
5. Minimal use and Disclosure of PHI. Contractor will use MHMRA‟s PHI only as minimally
necessary to perform the scope of services delineated in Exhibit A of the Agreement. PHI may
exist in any physical form, including but not limited to: handwritten PHI, typed text, audio tapes,
electronic messages, digital or computer images, and the spoken word.
Contractor shall not use MHMRA‟s PHI under the Agreement for any other purpose, except as
listed herein:
A. Contractor may use MHMRA‟s PHI to produce aggregated reports as related and required to
provide services in which PHI is deidentified in accordance with Privacy Requirements so
that no individually identifiable health information remains.
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B. Contractor may disclose MHMRA‟s PHI to Contractor‟s employees, agents, and
subcontractors as necessary to perform, activities, or services for, or on behalf of MHMRA as
specified in the Agreement, provided that such use or disclosure would not violate the
Privacy Rule if done by MHMRA, the Covered Entity.
6. Security of Electronic Protected Health Information.
A. Security. Business Associate will establish and maintain appropriate administrative, physical
and technical safeguards that reasonably and appropriately protect the confidentiality,
integrity and availability of electronic protected health information. Business Associate will
follow generally accepted system security principles and requirements of the final HIPAA
rule pertaining to the security of health information (“the Security Rule” published at 45 CFR
Parts 160-164) as soon as practicable, but no later than April 21, 2005.
B. Agents and Subcontractors. Business Associate will ensure that any agent, including a
subcontractor, to whom it provides electronic protected health information agrees to
implement reasonable and appropriate safeguards to protect that information.
C. Security Incidents. Business Associate will report any security incident of which it becomes
aware to Covered Entity. For purposes of this Addendum, a “security incident‟ means the
attempted or successful unauthorized access, use, disclosure, notification, or destruction of
information or interference with system operations.
7. Obligations of Agents and Subcontractors. Contractor shall require its employees, agents,
subcontractors and consultants who may have access to MHMRA‟s PHI under the Agreement to
be subject to the same conditions and restrictions on use and disclosure of PHI as provided herein.
Contractor shall educate, instruct, and ensure that its employees, agents, subcontractors, and
consultants comply with these conditions and restrictions.
8. Contractor’s Security Safeguards. Contractor shall adopt appropriate safeguards to prevent
misuse and inappropriate disclosure of PHI. Contractor shall maintain an appropriate level of
security with regard to all personnel, systems, and administrative processes used by Contractor to
transmit, store or handle MHMRA‟s PHI.
9. Compliance with Privacy Requirements. As required by the Privacy Requirements, Contractor
will comply with the following:
A. If applicable Contractor agrees to provide access, at the request of MHMRA, and in the time
and manner designated by MHMRA, to PHI in a Designated Record Set to MHMRA, or as
directed by MHMRA, to an individual in order to meet the requirements under 45 CFR
164.524 (Access to Individuals to PHI).
B. If applicable, Contractor agrees to make any amendment(s) to PHI in a Designated Record Set
that MHMRA directs or agrees to, as needed.
C. Contractor shall maintain an accounting of disclosures of PHI to third parties, and shall make
its books and records available to MHMRA for purposes of providing an accounting of such
disclosures of PHI.
D. Contractor agrees to make internal practices, books and records relating to the use and
disclosure of PHI received from, or created or received by Contractor on behalf of, MHMRA
available to MHMRA, or at the request of MHMRA available to the Secretary of the
Department of Health and Human Service (“Secretary”), in a time and manner designated by
MHMRA or the Secretary, for purposes of the Secretary determining MHMRA‟s and/or
Contractor‟s compliance with the Privacy Rule.
10. Reporting Breach. Contractor shall report to MHMRA in writing as soon as Contractor becomes
aware of any breach, possible breach, or other interruption in the confidentiality and security of
MHMRA‟s PHI, regardless of whether Contractor is responsible for such breach. Immediate
action will be taken by MHMRA and/or Contractor to mitigate the effects of such breach.
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11. Contractor’s Breach. Upon Contractor‟s becoming aware the Contractor has materially breached
this BAA, or upon notice from MHMRA of a material breach by Contractor, Contractor shall
promptly seek to cure or mitigate the breach. If Contractor is unable to promptly cure or mitigate
a material breach of this BAA, then MHMRA, among other things, shall have the right to
immediately terminate the Agreement for cause, to report the matter to the Secretary, or both.
Any such action by MHMRA shall not limit or infringe upon other rights that MHMRA may have
against Contractor, in law or in equity.
12. Indemnification The Contractor hereby agrees to indemnify, defend, and hold harmless
MHMRA, including without limitations, its employees, agents, successors and assigns, from and
against any and all claims, causes of action, liabilities, damages, costs, or expenses, including
without limitation, attorneys‟ fees, court cost, costs of administrative or other proceedings, and
costs of investigation, arising out of or related to a breach of any of the terms and provisions of the
BAA or any party acting by or through contractor, including, without limitation, Contractor‟s
agents, employees, representatives, contractor or subcontractors.
13. Treatment of PHI upon Termination. Upon termination of the Agreement, for any reason,
Contractor shall return or destroy all PHI received from MHMRA, or created or received by
Contractor on behalf of MHMRA. This provision shall apply to PHI that is in the possession of
subcontractors or agents of Contractor. Contractor shall retain no copies of the PHI. In the event
that Contractor determines that returning or destroying the PHI is not feasible, Contractor shall
provide to MHMRA notifications of the conditions that make return or destruction infeasible.
Upon mutual agreement of the Parties that return or destruction of PHI is infeasible, the
Contractor shall extend the protections of this Agreement to such PHI and limit further uses and
disclosures of such PHI to those purposes that make the return or destruction infeasible, for so
long as Contractor maintains such PHI.
14. Regulatory References. A reference in this BAA to a section in the Privacy Rule means the
section as in effect or as amended, and for which compliance is required.
15. Amendment. MHMRA will promptly advise Contractor of any necessary action needed by
Contractor to amend this agreement from time to time as is required for MHMRA to comply with
the requirements of the Privacy Rule and HIPAA. Contractor agrees to expedite such action.
16. Survival. This BAA shall survive termination of the Agreement with respect to any PHI or copies
thereof that have been available to Contractor during the course of the Agreement.
17. Interpretation. Any ambiguity in this Agreement shall be resolved in favor of a meaning that
permits MHMRA to comply with the Privacy Rule.
In witness whereof, each Party has caused this BAA to be executed and delivered by its duly authorized
representative as of the date first listed above.
Mental Health Mental Retardation _____________________________
Authority of Harris County
By: _________________________ By: __________________________
Name: Steven B. Schnee, Ph.D. Name: ________________________
Title: Executive Director Title: ________________________
Date: ________________________ Date: ________________________