### AMENDMENT OF SOLICITATION

#### RFP AHRQ-01-0007

**Patient Safety Coordinating Center**

##### Amendment No. 1 to RFP AHRQ-01-0007

**Date of Amendment to Solicitation: July 13, 2001**

###### Attention: All Prospective Offerors

The following questions and answers are provided:

**Note: The due date for receipt of proposals is extended to JULY 26,
2001, 12 NOON EDT**

1\. Can AHRQ provide a list of principal investigators, co-principal
investigators, and their respective organizational affiliations, for all
grants/RFAs awarded to date, who are subject to the Special Eligibility
Notice?

Answer: Awards to-date include six institutions/principal investigators.
They are listed in Section A (Background) of the RFP.

2.  For budgeting and evaluation purposes, can AHRQ provide an
    anticipated level of effort for each of the five domains (data
    collection and analysis, methodology, instrument development and
    selection, evaluation, and implementation strategies) under Task
    2.0, Technical Assistance? (b) Further, some sense of the phasing or
    percent of the effort in each year would be appreciated. For
    example, Item 31 in delivery schedule on p. 24 indicates that the
    level of effort for scrubbing/cleaning data \"will increase in a
    major way\" in the 3rd year, but this statement is not specific
    enough to develop a budget estimate.

Answer (a): There is no historical activity upon which to build accurate
estimates. However, for budgeting and proposal evaluation purposes only,
the following estimates may be used for years one and two:

-   Data collection and analysis: 160 hours/year

-   Methodology \-- 180 hours/year

-   Instrument development and selection \-- 160 hours/year

-   Evaluation \-- 100 hours/year

-   Implementation strategies \-- 80 hours/year

The following estimates may be used for year three:

-   Data collection and analysis \-- 1800 hours/year

-   Methodology \-- 100 hours/year

-   Instrument development and selection \-- 400 hours/year

-   Evaluation \-- 600 hours/year

-   Implementation strategies \-- 600 hours/year

Answer (b): It is anticipated that years 1 and 2 of this project will
each represent approximately 22% of the project's level of effort and
resources, with the third year representing the remainder (i.e., 56%).

3\. Item 28 in delivery schedule on p. 24 indicates that consolidated
progress report is due once, at 13 months EDOC. However, text of
paragraph 3.1 on p. 14 indicates this is an annual requirement,
necessitating one and perhaps two more deliverables. Please clarify.
Further, if the schedule is carried out at 12 month intervals, the third
draft consolidated progress report would be due at 37 months, past the
anticipated 3-year period of performance. Please clarify.

Answer: Item 28 in the schedule of deliverables should read "13, 25, and
35 months from EDOC."

4\. Item 32 in delivery schedule on p. 24 indicates that the
dissemination plan is implemented beginning in month 25 EDOC. However,
the SOW is not specific with respect to the activities to be conducted,
presumably because these will be defined in the plan. Please clarify how
the level of effort and budget for implementation activities should be
reflected in the proposal.

Answer: Each offeror is responsible for developing a plan, indicating
its proposed level of effort, and preparing a corresponding budget based
on the requirements as noted in Task 5 of the scope of work.

5\. Paragraph 4.2.1 beginning on p. 17 requires conference call support
\"for each component of the patient safety initiative\". Please clarify
the meaning of this phrase. Alternatively, please specify the number of
quarterly conference calls to be accomplished, and an estimated number
of participants. For example, we might anticipate a quarterly conference
call for each of the seven current and anticipated patient safety RFAs.
Would this be a reasonable assumption?

Answer: A component may be defined as the group of awardees funded under
a single RFA (e.g., clinical informatics to promote patient safety;
improving patient safety: health systems reporting, analysis, and safety
improvement research). A component may also be defined by function and
include awardees funded under different RFAs but focusing on a
particular topic (e.g., epidemiology, evaluation, implementation). For
budgetary and evaluation purposes only, offerors should anticipate a
minimum of 36 quarterly conference calls per year with up to 20
participants per call.

6\. Section L.9. Past performance, and questionnaires. p. 75. Given that
the list of relevant contracts and subcontracts completed and currently
in progress might be voluminous in some cases, we suggest that AHRQ
limit past performance information to a defined number of relevant
projects performed within a specific time period. We suggest a maximum
of 20-30 projects within the past 5 years. This in turn, limits the
number of past performance questionnaires that must be completed prior
to the due date, and the burden on respondents. Alternatively, retain
past performance as unrestricted but limit the number of references from
whom questionnaires must be obtained.

Answer: In order for us to fully evaluate your past performance, it is
requested that you submit the information requested for projects of
similar products or services. The solicitation requests information for
the past three years---since June 1, 1998, not five years.

7\. The Communication paragraph on p. 11 indicates a requirement for

electronic bulletin boards and chat rooms. However, these capabilities
are not described in detail in the specific requirements on pp. 15-17.
Please clarify. If these capabilities are required, please provide
additional specifications for them (e.g., reliability, \# of users,
frequency of use, etc.).

Answer: Page 11 is part of Section A, Background. Pages 15 through 18
are the requirements of the scope of work which include electronic
communication and conference calls. As noted in the RFP, electronic
communication includes distribution list software, e-mail, and website
components. Offerors may, but are not required, to include electronic
bulletin boards/chat rooms.

8\. Re: Website requirements pp. 16-17.

8a. Will the number of project-specific web pages be limited to the 13
grantees under the Health System Reporting RFA, or will web pages for
the entire range of 65-75 grantees across all RFAs be required? If the
latter, please indicate any phasing contemplated or envisioned.

Answer: Section 4.1.3 of the RFP states "The Contractor shall establish
and maintain a website for the entire program of AHRQ-funded projects
included under the coordinating center contract." If an offeror
anticipates phasing the implementation of the website and web pages, its
proposal should include a plan and the rationale for this approach.

8b. There is no mention of the need for the contractor to update or
refresh the contents of the website once it becomes operational at 3
months EDOC, although the Item 8 in the delivery schedule on p.22
indicates a need to keep the web pages current. Please clarify AHRQ\'s
expectations for how this process would work, including review and
approval of new content, frequency of updates, and division of
responsibility between the PSRCC contractor and AHRQ staff for posting
new/updated content on the website.

Answer: The periodicity of updates to keep the web pages current shall
be part of the offeror's plan, and a rationale for the offeror's
approach should be included in its proposal. It will be the
responsibility of the contractor to post information on the web site
after approval by the coordinating center's project officer and the
project officer for the individual grant (i.e., in consultation with the
principal investigator for each grant). The project officers' responses
shall be provided to the contractor within two weeks of receipt of
material submitted for approval. Furthermore, AHRQ's web master shall be
involved in coordinating center discussions about any web sites or web
pages that the coordinating center may create to ensure that the web
site and pages properly mesh with and link to the content on AHRQ's web
site.

8c. We\'re assuming that the website will be accessible to the general
public, and not limited to members of the AHRQ research community. Is
this a correct assumption?

Answer: Yes.

9\. Will AHRQ consider a 3 or 4 p.m. due date on July 19 rather than a
12 noon date, to help bidders be sure to make the deadline?

Answer: The due date for submission of proposals has been changed to
12:00 p.m. local prevailing time on July 26, 2001.

10. Does AHRQ contemplate any \"best and final\" round of consideration
    of high-ranking proposals?

Answer: AHRQ anticipates that discussions will be required with those
offerors determined to be within the competitive range. However, we also
reserve the right to make an award without discussion, as stipulated in
the solicitation.

11. Can the government clarify who are the grantees on all six of these
    areas, where awards have already been made, with names of grantee
    institutions and PIs; when no awards have yet been made, can the
    government clarify when funding decisions will be decided and awards
    made?

Answer: Refer to question 1 for the names of grantee institutions
to-date. Funding decisions and awards for applications submitted in
response to the six RFAs released this fiscal year will be made no later
than September 30, 2001.

12a. If the Developing Centers awards have not yet been made, can the
government specify at least the number of awards likely to be made, so
that travel budgets for Task 3.3 site visits can be estimated?

Answer: As noted on page one of the RFA for Developmental Centers for
Evaluation & Research in Patient Safety, approximately 10 centers will
be funded. Refer to the following URL:
<http://grants.nih.gov/grants/guide/rfa-files/RFA-HS-01-007.html> for
more detailed information on the RFA.

12b. Are the additional 5 site visits in Task 3.3 to additional
Developing Centers, or to other types of grantees?

Answer: The additional site visits mentioned are "place holders." They
may be used for developing centers if more than 10 awards are made, or
they may be used for site visits to other grantees based on Agency
needs.

13. Please clarify the number and timing of the report on the Health
    Reporting Demos that the CC should prepare.

Answer: The report on the Health System Reporting Demonstration grantees
will be a stand-alone report, separate and apart from the annual
progress report requirement. One electronic and 10 hardcopies of the
draft report on the Health System Reporting Demonstration grantees shall
be due to AHRQ 24 months from EDOC. One electronic and 10 hardcopies of
a final draft shall be due to AHRQ two weeks after receipt of Agency
comments (i.e., approximately 25 ½ months from EDOC). These reports
shall be deliverables 33 and 34 respectively.

14. If the AHRQ conference space is not available or will not
    accommodate 150 people (more or less) in plenary sessions for the
    annual conferences, are we correct in assuming that the
    contractors\' budget does NOT need to cover space costs in another
    venue?

Answer: The contractors\' budget does not need to include costs for
space in another venue

15. Reference bottom of p. 16/top of p. 17: Contractor shall accommodate
    on-site visits by Project Officer, etc: Does the ability of the
    Contractor to accommodate site-visits within 2 hours' time a
    requirement that forces the physical location to be within a 2-hour
    travel time from Rockville, Maryland)?

Answer: No.

16. Can AHRQ clarify whether the \"progress report\" in deliverables 28
    and 29 are on progress for all grantees in all six areas (with or
    without the initial \"best practices\" grantees?) or only on
    progress of the health System Reporting Demos and the framework for
    feedback. Note that the SOW on p. 14 indicates that the CC should do
    this report \"after two years\" \-- the delivery dates for
    deliverables 28 and 29 are at 13 and 14 months respectively.

Answer: Progress report is to include all grantees -- including "best
practices" grantees. In addition, there is a separate report required on
the progress of Health System Reporting Demonstration grantees as noted
in question 13.

17. No deliverable is specified for the \"reports and data \... on
    patient safety that may become part of the National Quality
    Report.\" Can the government be more specific about what might be
    required, in what numbers (e.g., once? annually?), and in what
    format?

Answer: For the purposes of budgeting and proposal evaluation only,
offerors shall anticipate an annual report in years two and three of the
coordinating center contract. The report may include data on a number of
medical error/patient safety variables that could be developed from the
reporting demonstration grantees and others.

18. Is the HUBZone small business inclusion goal the same as the others
    or not? (stated as a % of total contract value versus % of total
    contract value for base period)

# 

# Answer: Yes 

19. Does the \"base period\" reference in small business representation
    goals refer to year one only as the base budget period? If not,
    please define the base period.

# 

Answer: As this is a three year contract with no option periods, the
base period would be the entire three years.

20. Reference page 14 of the RFP\--Do we assume that the Contractor is
    to budget for all meeting handout materials and refreshments for the
    2-day annual meetings and the day-long steering committee meetings?

Answer: The Coordinating Center contractor shall budget for handout
materials for the annual meetings and steering committee meetings as
well as lunch/refreshments for the steering committee meetings. The
contractor does not need to budget for lunch for the 2-day annual
meetings for the awardee participants as they will incur those costs as
part of their grant awards. However, the contractor shall make
arrangements for and collect money from attendees who wish to
purchase/participate in these lunches. Morning and afternoon
refreshments for the annual meetings shall be costs incurred by the
Coordinating Center contractor.

21. Do we assume that there will be no space or a.v. costs to the
    Contractor even if another venue is selected at the discretion of
    the Project Officer?

Answer: See answer to question 14.

22. If response to these questions takes longer than a week would AHRQ
    consider extending the due date from July 19^th^ to August 2^nd^?

# 

Answer: The proposal due date has been extended to 12:00 noon on July
26, 2001.

23. Does AHRQ want the projects submitted as past performance projects
    to be relevant to the proposed effort or simply the most recent
    projects conducted by the bidder? In Section L.9 of the RFP,
    Item (1) says "A list of the last five (5) contracts" while Item (4)
    says offerors will be evaluated on projects \"for similar products
    or services.\" Also, Item (1) asks for "all contracts and
    subcontracts currently in progress." This can potentially include
    dozens of projects with multiple funding agencies. Is that what AHRQ
    desires?

Answer: Past performance projects relevant to the current scope of work
are most desirable.

24. In the business proposal instructions on page 77 (Section L.11) it
    refers to an Attachment 6. Are you actually referring to Attachment
    5? The RFP did not include an Attachment 6, is there such?

# 

Answer: The reference should have read Attachment 5. There is no
Attachment 6.

25\. This is a complicated project requiring a comprehensive proposal.
In order ensure high-quality proposals from bidders, will AHRQ consider
extending the due date for the proposal? At a minimum,if AHRQ is worried
about meeting internal award deadlines, perhaps the deadline for time of
day could be extended to 5:00 on 7/19.

# 

Answer: The proposal due date has been extended to 12:00 noon on July
26, 2001.

26. Can you provide additional information on the type of involvement
    you expect the CC to have with the additional 20 grantees from
    unspecified programs at HRSA, VA, RWJ? For budgeting and staffing
    purposes, more guidance would be helpful.

Answer: Refer to Task 1.3 of the RFP \[The Coordinating Center
contractor shall extend invitations to its annual meetings to medical
error/patient safety projects funded through other sources (e.g., VA,
RWJ, HRSA, AHRQ's CERTS)\].

27\. When does AHRQ expect to award contract? When are
discussions/proposal revisions expected to occur?

# 

Answer: The contract will be awarded prior to September 28, 2001.
Discussions, if required, will take place during late August/early
September.

28. When will awards be in place for each of the six RFAs?

Answer: All RFA awards will be made on or before September 30, 2001.

29. What resources can we expect grantees to have dedicated to
    interactions with the CC?

Answer: Each RFA includes a preamble that, in general, notes that the
"Agency will also support a coordinating center to provide guidance and
facilitate interaction between the entities funded under the Agency's
patient safety programs." Furthermore, each grantee funded under the
Systems-related Best Practices RFA as well as the six RFAs released in
the current fiscal year are expected to participate in the annual
meetings that are part of the SOW for the Coordinating Center RFP.
Grantees will be expected to provide input material/raw data for a web
page or provide a link to their own relevant web pages to facilitate the
development of the web site under the Coordinating Center SOW. For the
specific reference to activities related to the coordinating center in
each of the RFAs, refer to http://www.ahrq.gov/fund/grantix.htm.

30. Section H.1 details the publication restrictions for the CC. Please
    confirm that these restrictions are removed following the end of the
    contract.

# 

Answer: Any requests for modifications to terms and conditions contained
in the solicitation and resultant contract will be handled on a case by
case basis during negotiations.

31. Can AHRQ provided any guidance on the total level of effort expected
    (number of FTE\'s) across the entire contract?

Answer: Refer to question 2.

32. In section 4.1.3.1 the RFP refers to \"Scrolling for Information.\"
    Please clarify that refers to browsing a list of topics/sub-topics,
    like one would do when navigating in Yahoo?

Answer: In section 4.1.3.2 "Scrolling for Information," refers to
browsing a list of topics or sub-topics on the website in order to
collect and analyze data for research purposes.

33\. What is the role of ARHQ\'s Office of Health Care Information
(OHCI) in this project? What is the boundary between their dissemination
work and the CC? The RFP is not clear on this task.

Answer: The coordinating center dissemination plan will be implemented
in partnership with AHRQ to include but not be limited to project staff
in its Office of Health Care Information who will be assigned to work on
activities in the coordinating center. OHCI staff will help ensure that
the goals and objectives in the dissemination plan are met in a mutually
agreeable way and will provide any clarification needed on which
activities will be carried out by AHRQ and which will be carried out by
the coordinating center. The coordinating center activities shall not be
implemented before or without input from OHCI, especially on issues
related to publication of any materials about the coordinating center's
work. Furthermore, AHRQ's web master shall be involved in coordinating
center discussions about any web sites or web pages that the
coordinating center may create to ensure that the web site and pages
properly mesh with and link to the content on AHRQ's web site.

34. Can AHRQ specify the minimum level of technical assistance required
    for the grantees? Without greater specification, it is difficult to
    scope out and budget this task.

Answer: Refer to question 2.

35\. What is the timing for interactions with the National Quality
Report?

Answer: Refer to question 17.

36. The RFP specifies one contract staff member for site visits (page
    15). Should the contractor plan to include a subject matter expert
    as well as the project director, if the project director is not an
    expert in patient safety?

Answer: The RFA for the Developmental Centers for Evaluation & Research
in Patient Safety, page 6 of 18, notes that, "each DCERPS will have a
site visit conducted by staff from the coordinating center and AHRQ to
serve as a consultative visit to aid recipient DCERPS in their design
and completion of a pilot study." It is each offeror's option to develop
an approach that is acceptable from both technical and budget
perspectives.

37. What are the expected number of and planned schedule for awards for
    the six types of solicitations listed on page 9 of the RFP?

Answer: Refer to question 11.

38. What are AHRQ's expectations on level of effort for Task 2
    (research, methodological, and design support) as a percentage of
    the entire effort?

Answer: Refer to question 2.

39. Item #32 on the list of deliverables (page 24) lists "5.2, Implement
    dissemination plan." However, the corresponding section of the
    Statement of Work does not discuss implementation of the
    dissemination plan. Is the purpose of the task to develop a
    dissemination plan only or to be involved in and actually begin the
    implementation? Please clarify the discrepancy.

Answer: Offerors shall both develop and implement their dissemination
plan in consultation and coordination with AHRQ's Office of Health Care
Information.

40. Is the dissemination task focused only on dissemination and
    diffusion of information, or does the task also involve dealing with
    related aspects of facilitating adoption into practice, such as
    promoting models for moving new ideas and technology into practice?

Answer: Implementation of the dissemination plan shall include
dissemination and diffusion of information. In addition, the
coordinating center shall be responsible for "value added" work that
makes the transition from individual project/program findings to a
cohesive program. That is, the coordinating center shall synthesize
work/findings provided by included awardees and disseminate and diffuse
the synthesized information. The coordinating center shall not
facilitate, promote, or endorse practices.

41. In reference to page 15, section 3.3 of the Statement of Work, can
    you please clarify the role of the contractor staff for the site
    visit?

Answer: As noted in the RFP, the purpose of the site visit is to aid
recipient grantees in their design and completion of the pilot study. In
addition, the role of the contractor staff is to complete the logistics
of the site visit (e.g., establish a meeting date, meeting place,
agenda).

42. OMB Form SF-LLL is included in the solicitation but not referenced.
    Should this Disclosure of Lobbying Activities form be included in
    the Business Proposal?

# 

Answer: This form should be included in the original business proposal,
along with Section K, Representations and Certifications.

43. Do all electronic communication processes / solutions have to be
    secure (page 15, section 4.1)? If yes, what is the minimum
    encryption level (e.g., 128-bit encryption)?

## 

## Answer: Electronic communications (i.e., e-mail) shall not require encryption. However, Task 5 (deliverable 31) addresses cleaning and scrubbing data to facilitate data/information warehousing and sharing. The extent of the need to secure those data, which should be de-identified, is unknown at this time but could include a requirement for encryption at about month 14 and thereafter. 

44. Is there a list of approved or preferred distribution list software
    packages?

## 

## Answer: There is no preferred vendor's list for the distribution software.

45. Do e-mail and other electronic communication between the contractor
    and clients (i.e., individual projects, the Agency, and the patient
    safety research community) have to be secure?

Answer: See question 43.

If yes, then:

-   Does the proposed secure e-mail solution have to be completely
    within the contractor\'s control, or is a commercially hosted
    solution acceptable?

Answer: The stated requirement for an e-mail solution is that it be
compatible with Microsoft Exchange for document and text transfer. It is
expected that the recommended e-mail solution shall be managed and
maintained by the contractor. Thus a commercially hosted e-mail solution
is acceptable but the contractor shall manage the relationship with the
third-party vendor. Also refer to question 43.

-   Is a solution acceptable that requires installation of a new e-mail
    client or component on the clients\' computers?

Answer: The proposed solution shall be compatible with Microsoft
Exchange, including Exchange's digitally encrypted PKI solution. The
solution must first be proposed to AHRQ before a decision could be made
regarding the installation of components on AHRQ's computers.

-   Some secure e-mail services are subscription based. Is this
    acceptable? If yes, who will be responsible for managing and paying
    for the subscriptions? (i.e., Agency, clients, or contractor)?

Answer: Refer to the answer to the previous bullet 2 in question 45.
Also refer to question 43.

-   What is the minimum encryption level?

> Answer: Refer to question 43 and 45.

46. Will the Agency provide a subnet of TCP/IP addresses for use with
    the Web sites that are developed under this contract?

Answer: The Agency shall provide TPC/IP addresses for a web server if it
is housed on-site at AHRQ. Otherwise, the contractor shall make
provisions for IP addressing, and the IP information shall be provided
to AHRQ in order to modify the domain registration.

## 

47\. Can the Web sites be hosted on a server that also hosts other
(i.e., non-Agency) Web sites, if security requirements are met on the
Agency Web sites? In other words, is a dedicated, Agency-only Web server
required?

Answer: AHRQ has no requirements that preclude the hosting of the
web-site on a non-dedicated server but that server shall meet the
Agency's security requirements and service level expectations.

## 

48. In section 3.1, Progress Reporting, can the government specify the
    approximate number of grantees and contractors who will be
    submitting progress reports that must be reviewed? That is, shall we
    assume it will be only the 10 grantees under the HSRD program? Or
    all 65-75 grantees mentioned in the RFP?

Answer: Progress reports will include all grantees (i.e., 65 to 75).

49\. In section 3.3, it is not clear whether all of the dates are
calendar dates or whether some are fiscal dates. Please verify that the
site visits to assist Developing Centers and other unnamed projects are
requested as follows:

-   Ten 2-day site visits during Oct-Dec 2002 to Developing Centers
    (clearly specified in the RFP)

-   Five 2-day site visits during May-July 2002 to unnamed projects
    (specified as \"mid 2002\")

-   Five 2-day site visits during May-July 2003 to unnamed projects
    (specified as \"mid 2003\")

Answer: The dates included in task 3.3 are calendar dates.

50. For purposes of budgeting for conference calls under task 4.2,
    should the contractor assume there are six \"components of the
    patient safety research initiative\"? And that there will be six
    times four quarterly calls?

Answer: Refer to question 5.

51. In several places, Section C, Specific Requirements, refers to
    \"components\" of the patient safety initiative. Are these
    components the same as the RFA areas listed on page 9?

Answer: Refer to question 5.

52. Section L, paragraph L.9, "Past Performance Information",
    subparagraph (1) states "provide a list of the last five (5)
    contracts and subcontracts completed during the past three years and
    all contracts and subcontracts currently in process." Is there some
    way that this list could be narrowed down and provide you with
    information that is more pertinent to your review?

Answer: See answers to questions 6 and 23.