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1 DATE: SEPTEMBER 18, 2015 UNIVERSITY HEALTH SYSTEM-BUSINESS CENTER PURCHASING DEPARTMENT-2 ND FLOOR SPENCER LANE SAN ANTONIO, TX SOLICITATION: BLOOD DONOR, THERAPEUTIC APHERESIS, AND THERAPEUTIC PHLEBOTOMY SERVICES MANAGEMENT ADDENDUM NO. 1 RE: Pre-Submittal Conference NOTICE TO BIDDERS: Due: On or before October 16, at 2:00 PM CST A. Receipt of this Addendum shall be acknowledged on the Bid Form. B. Bidders are required to sign this addendum acknowledging receipt and return a copy by . Corresponding for this purpose is Michael Llanas, UHS Purchasing, Contract Specialist, at C. This Addendum is part of the RFP# LAB documents for the above referenced project and shall be incorporated integrally therewith. D. Each bidder shall make necessary adjustments and submit their proposal with full knowledge of all modifications: clarifications and supplemental data include therein. Company Name: Vendor Signature Date:

2 PRE-SUBMITTAL CONFERENCE A pre-bid conference and a walk through will be held in the 3 rd floor Rio Tower, Pathology Conference Room # E0316 at the University Hospital, located at 4502 Medical Drive, San Antonio, Texas on Tuesday, September 22, 2015, at 8:30 a.m. Parking is available in the visitor s parking garage for a fee. This conference will be each Respondent s opportunity to ask representatives of UHS questions and clarify provisions of the RFP if necessary. After the conference, prospective Respondents may submit written questions to the RFP until 2:00 pm. Central Time on September 25, UHS will not accept questions after that time. UHS is not obligated to respond to each question and only responses designated as formal Addenda to the RFP will be binding. However, if UHS decides to answer questions in writing, then UHS will post the responses to those questions and answers in the UHS website. Attendance is not required for the pre-response meeting in order to submit a response, however it is strongly encouraged. End of Addendum 1

3 DATE: OCTOBER 2, 2015 UNIVERSITY HEALTH SYSTEM-BUSINESS CENTER PURCHASING DEPARTMENT-2 ND FLOOR SPENCER LANE SAN ANTONIO, TX SOLICITATION: BLOOD DONOR, THERAPEUTIC APHERESIS, AND THERAPEUTIC PHLEBOTOMY SERVICES MANAGEMENT ADDENDUM NO. 2 RE: Questions and Answers Due: On or before October 16, 2015 at 2:00 PM CST NOTICE TO BIDDERS: The purpose of Addendum NO. 2 is to provide answers to the questions that were on or before September 25, 2015 as instructed on RFP. A. Receipt of this Addendum shall be acknowledged on the Bid Form. B. Bidders are required to sign this addendum acknowledging receipt and return a copy by . Corresponding for this purpose is Michael Llanas, UHS Purchasing, Contract Specialist, at C. This Addendum is part of the RFP# LAB documents for the above referenced project and shall be incorporated integrally therewith. D. Each bidder shall make necessary adjustments and submit their proposal with full knowledge of all modifications: clarifications and supplemental data include therein. Company Name: Vendor Signature Date:

4 1 Do you use low-titer A liquid plasma and if not, would you if there were cost savings? We currently do not collect low-titer A liquid plasma. 2 Do you use accrodose pooled platelets and, if not, We currently do not collect accrodose pooled would you if there were cost savings? platelets. 3 If it were financially beneficial to do so would you award separate contracts for the different services No 4 5 We cannot provide a Worker s Compensation This is not required for the submission of proposal. Insurance Certificate since we are a non-subcriber However please state that you will be able to as allowable in the State of Texas. Is this status provided this if contract is awarded to your company. acceptable for this RFP? How many RBC s do you transfuse annually and Total RBC s Transfused in ,277 what is the percentage breakdown by blood type. Percentage Breakdown: Data not available. 6 AMEX BIP who pays the associated fee? UHS does not pay any associated fees. 7 How would you define sell back Products collected at UHS on behalf of UHS that are sold back to UHS at a cost What is your expectation of a management company? (What does each party provide and may other pertinent detail?) How many blood products, by product type, does University Health System collect annually? The RFP states that University Health transfuses approximately 25,000 blood products annually. How is that 25,000 products broken down by product type (RBC, platelet, FFP, Cryo, etc) Will the party who is rewarded this contract be required to continue using DonorLogix? If so, for Are blood products currently carried on Airlife medical transport vehicles? If a regulatory agency makes changes to current regulatory requirements and those changes cause increase in the costs for vendor to meet those requirements, would UHS be willing to review fees associated with that part of the contract? Please clarify if this language means that once the vendor is selected that the contract must fully negotiated, executed and signed by both parties within 30 days and is there any leeway with this timeframe? Is a stage implementation of a fully executed contract acceptable? We would like the vendor to manage the staff for the donor room, supplies and operations RBC 6,405 FFP 6,776 Single Donor Platelet 1, :00:00 RBC-15,277 Single Donor and Irradiated Single Donor Platelets 2,521 Cryo 1,403 Thawed plasma 6,736 Whole Blood Platelets 215 No Yes Negotiable There is leeway with this time frame. This is negotiable.

5 17 Please provide an example of transitional period clause Page 8 of 21, B # 13 is the Transitional Period Clause. 18 Please provide an example of system contract terms sheet Not available. 20 Explain expectation for regular utilization data Monthly activity reports (Monthly reports of data reflecting work done on UHS s behalf by the vendor) DonorLogix partnership for telerecruitment Is a contract in place and if so, what are the terms and the length of contract and is it possible to use the vendors telerecruitment process instead of DonorLogix It states the Health System may select more than one vendor but one page 16 Selection A, it states the award will not be split among multiple vendors. Clarification please. What metrics do you use to evaluate the success of Donor Logix and would you please provide the most recent YTD results? Please provide insight on UHS interpretation of cobranding. Is the 200 mile requirement door to door from the blood center HQ to UHS 31 Please clarify what is meant by sell-back Scope of Work: Of the 25,000 blood products transfused, how many of each type are collected and manufactured by UHS? How many donors make up the UHS pool of donors? Please provide metrics that show YTD production rates? Will UHS provide all medical oversight of therapeutic apheresis and therapeutic phlebotomy collections? Please clarify what the word delivery is referring to.what is being delivered? If a presentation is scheduled, will the final decision makers be present at that time? There is a contract in place which expires on 12/31/15. No Page 16, Section A is striked fromt this RFP. For this RFP, award will not be split among multiple vendors. 2014:00:00 RBC: 6,405 FFP: 6,779 Single Donor Platelets: 1,257 Total donors: 50, Registered donors: 3,030 Number of Donors Recruited and the increase in donors recruited. Because this is a 3 rd party vendor, we can not share YTD data. The donor room will continue to maintain a UHS presence and face to the community. However, management and ownership will belong to the vendor. 2015:00:00 Single Donor Platelets 661 RBC 3,916 FFP 4,075 The vendor should have a facility within a 200 mile radius Products collected at UHS on behalf of UHS that are sold back to UHS at a cost. Yes Delivery of services to donors and patients Yes

6 After one year, what would a successful partnership That would depend on the proposal accepted 35 look like and what metrics will be used to monitor negotiable. activity toward success? What is the decision making time line and based on the timeline, is the implementation date negotiable based on when the decision is made? What metrics are currently used to evaluate the performance of the donor room, mobile blood drives, manufacturing and the donor staff, and may we have the recent reports? Are there same staff to collect and manufacture components? What quality reports are in place for deviations such as QIR s/capa, product waste, and may we have examples of them? Is any part of the donor qualifications process automated, and if so, please describe? How many unique donors make-up the UHS donor base? Decision wil be made as soon as possible. Timeline depends on factors not known at this time. i.e, number of proposals, quality of proposals, etc. Number of Donors, Number of Components, Apheresis Split Rate we can not provide recent reports as these reports are internal quality documents. Yes Data internal and not available. Not currently will be with SCC 50, What are the demographics of the current donor base such as age groups, gender and blood type? What percentage of whole blood collections occur in the donor room and on mobile? By month, how many mobile drives are conducted each month What type and how many of automated collections are performed in the donor room? Data not available. 44% - whole blood donations donor room 56%- whole blood donations on mobile drives 2014:00:00 13-Jan 14-Feb 12-Mar 13-Apr 12-May 8-Jun 10-Jul 7-Aug 14-Sep 9-Oct 10-Nov 9-Dec apheresis donations Apheresis products collected: SDP FFP 557 RBC 68

7 How many whole blood donations are collected ,607 annually? 47 How often does your WB donor give annually? 6 times per year How many platelet donors are collected annually and what is the average split rate? How often does your average platelet donor give platelets? 50 Are concurrent products collected on automation? donations average split rate 49% (SDP) Once every 4 weeks All components are collected on apheresis instruments 51 Is the cost per unit collected (CPUC) monitored and if so, will you provide that information? Yes we will not provide that data Would you be willing to share cost data for the donor room, such as employee cost and donor incentive cost? What is the average cost per donor for your donor incentive plan? Do you have required hours/days of operations for you donor room? What type of equipment do you own or lease for your donor room, mobile collections, and therapeutic apheresis as well as the age of the equipment? How many of your donors have been tested for the HLA antibody? Donor Incentive cost per donation - $28.61 (this includes PTO incentive) $28.61 (this includes PTO incentive) No Attached 58 Do you have a rare donor program? No 59 What are the current staffing levels/number of FTE s for donor room/mobiles and therapeutic apheresis and do they have any roles or 9 FTEs no outside roles responsibilities outside of the donor room or therapeutic apheresis? 60 What type of components do you produce from whole blood collections> Leuk. Reduced Red Blood Cells and FFP 2014 data: 61 i. Therapeutic plasma exchange How many therapeutic apheresis collections and ii.rbc exchange - 1 what type of collections are performed annually? iii.leukocyte reduction - 2 iv.platelet reduction 0 62 How many physicians oversee therapeutic 2 Attending physicians and 1 Resident rotating every apheresis collections? 6 weeks 63 Is it possible to get copies of current SOP s for therapeutic apheresis? Not at this time 64 Do you expect blood collected at UHS to be transfused at UHS? Yes None

8 65 66 How are medical residents used to support the donor room and therapeutics? Will UHS continue to provide donor incentives to their employees at their own costs? Fully support therapeutic apheresis and are present for procedures. Used as resource in donor room for donor safety/eligibility questions. Negotiable Current UHS collection staff become blood center employees or remain UHS employees managed by UHS employees remain Negotiable blood center? Will the current donor room and lab space be rented to the blood center or will the current donor Negotiable For Board approval what is the approval criteria for board voting to approve RFP? Is 100% approval required or 51% approval required? Who will be providing medical oversight over the therapeutic apheresis service? Therapeutic Apheresis: Is a blood center MD required to be onsite for the duration of the therapeutic apheresis procedure? Therapeutic Apheresis: Is an LVN or RN preferred for the administration of therapeutic apheresis? Therapeutic Apheresis: If medical oversight is with the UHS pathology staff, will they also be managing the nurses? Therapeutic apheresis: Regarding billing, will this be a fee for service or will we be required to bill insurance? Therapeutic phlebotomies: A majority vote is required for approval. UHS/UTHSCSA With current staff (Laboratory Technologists), yes Regulatory guidelines for performance of therapeutic apheresis should be followed They will provide medical oversight. Negotiable 2014: 282 phlebotomies 75 How many phlebotomies are performed a year? Average 23 per month 2015 increased to 35 average per month 76 Therapeutic phlebotomies: Who provides medical oversight for therapeutic UHS/UTHSCSA phlebotomies? Donor gifts does UHS have a patient replacement Yes, $15 credit for each replacement donation program? If so, what are the program details? Approximately 80 per year 79 What % of collections is from whole blood? 88% 80 What % of collections is from automation? 12% 81 What hours and days of the week is the fixed site open? Mon-Wed 8:30-7:00pm Thurs-Fri 7:00-5:00pm Saturday 8am-12pm

9 82 What % of fixed site collections is from walk in donors? Approx. 30% 83 How many mobiles drives per week? 4-Feb What is the average drive size (# of procedures) of each mobile event? What are annual volumes for self-collected units: RBC? SDP? Cryo? Cryo Pools? WB FFP? Apheresis FFP equivalents? Rec plasma <24 hours (units)? Rec plasma >24 hours (units)? 18 mobile locations with drives 6 times per year 2 large with average donations medium with average donations small with average donations WB RBC 6,337 ApherRBC 68 WB FFP 6,219 Apher FFP Single Donor Platelet 1,

10 2014:00:00 86 RBC-15,277 What are the annual volumes transfused: RBC? Single Donor and Irradiated Single Donor Platelets SDP? Cryo? Cryo Pools? WB FFP? Apheresis FFP 2,521 equivalents? Rec plasma <24 hours (units)? Rec Cryo 1,403 plasma >24 hours (units)? Thawed plasma 6,736 Whole Blood Platelets What types of research products are needed? How Donor Room does not currently collect research many units of each? products 88 What are RBC and SDP testing losses (# of units)? RBC loss due to positive testing 4 Single donor platelet loss due to positive testing 89 What is RBC and SDP outdates (# of units)? 90 What is the expiration date of contract for blood product purchases (with community blood center)? Data not available this question pertains to transfusion department; not pertaining to donor services Data not available this question pertains to transfusion department; not pertaining to donor services Are there standing orders or volume commitment requirements for purchases with community blood center? If so, what are they? If able to increase self-collection volumes, how will that (what is) impact contract with community blood center? Does local community blood center purchase excess product? Using the formula INSERT HERE what is the current cost per unit collected? What is the current size of your donor base? (total registered donors) How far out have commitments for mobile collections been made with community partners? Data not available this question pertains to transfusion department; not pertaining to donor services Data not available this question pertains to transfusion department; not pertaining to donor services No excess product from Donor Services. Can not share this information Total donors: 50, Registered donors: 3,030 Scheduled through December What is the sq ft of the manufacturing area? 750 sq feet 98 What technology is used for xxxx? Clarify XXX? 100 What BECS (vendor and version) do you currently use? Cerner Classic Converting to SoftDonor on November 7 th What is the sq. ft. of the donor fixed site location? How many beds in fixed site location? 1665 sq feet 6 for Donor/Apheresis/Therapeutic Phlebotomy 2 recliners for Therapeutic Apheresis

11 103 What is the age of mobile coaches? No coaches. Donor van 8 years old used to carry equipment to mobile site. 104 How many beds on each donor mobile coach? N/A What is the net annual/ytd cells collected vs. net annual/ytd cells forecast? What are total FTE s for: collection staff? Manufacturing staff? Operations/administrative staff? Other staff? 2014 Total Blood Components collected: 14, Blood Components projected: 14,700 4 Collection staff 1 Manufacturing Staff 2 Operations/administrative 2 Therapeutic Apheresis/Component processing 107 Is staff dedicated to fixed or mobile collections? Cross trained for both. 108 What are credentials of staff in manufacturing/component lab? 109 What are the total/net procedures per FTE? Data not available 110 What are the total RBC+SDP products per FTE? Data not available 1 manufacturing staff HS diploma with clinical lab experience 2 Component processing MLS/MLT ASCP certification 111 What is % of staff turnover? 0% in What services does Donor Logix perform for you? Telerecruitment? Document Review? Telerecruitment 113 What is the effective term of your contract with Donor Logix? 114 What % donor base growth has Donor Logix achieved during contract term? Data not available 115 What are the donor base growth goals for Donor Logix? Data not available 31-Dec What is the effective term of your plasma contract? No contract. 117 Are there annual volume requirements for your plasma contract? If so, what are the requirements? N/A 118 Who currently performs donor testing? Qualtex Laboratories 119 What is the effective term of donor testing contract? 120 Are there volume commitments in donor testing contract? If so, what are the requirements? Qualtex Contract term is from 10/1/2014 through 9/30/2017. Volume commmitments are not available. 121 What contractual commitments exist (vendor and effective dates) for purchases of blood collection supplies? (bags, kits, snack, etc.)? What are the volume commitments? We have a contract in place for Blood Bags. Effective date is through November 1, cases annually.

12 What type of (if any) automation is used in the collection of blood and blood products? What products do you currently manufacture? SDP, WB derived platelets, recovered plasma, transfusable plasma (FP24, plasma from automation?), double RBC, WB, LR or non-lr RBC, cryo pooled cryo etc Trima Accel collection instruments used for apheresis products. Hemoflow 400 instruments used for WB collection. SDP Apheresis FFP Apheresis RBC LR RBC (WB) FFP (WB) Recovered plasma (WB) Autologous WB Do you require/manufacture boutique products, if so what volume? Washed RBC, volume reduced platelets, CPDA-1, pediatric transfusable plasma, aliquot RBC, HLA products, antigen screened RBC What (if any) immune hematology reference testing is performed? What technology is used to perform hematology testing? Data not available products purchased from blood supplier None from Donor Services Sysmex XE What technology is used for bacterial detection? BD BACTEC 128 Do you perform irradiation, if yes what type of technology do you use? Not in Donor Services 129 Do you perform your own product Quality Control? Residual WBC for WB and Apheresis QC is performed by Qualtex laboratories. All other performed at UH What is your expectation in regards to staff/md? Do they work for BSI or for UHS? Structure: Please provide a detailed org chart that includes a) the staff involved in each component of services that are part of the RFP (donor center, manufacturing, THAP, etc) and the current support services, such as quality or hospital risk management, that support them (eg where do PDI's go). What are the specific functions of each staff or position identified? UHS Staff negotiable. MD serves provided by UTHSC/UHS Donor Staff: (1) Lead Technologist (1) Donor Coordinator (5) Technicians (2) Technologists Of these positions, Job Duties include: (4) Collection staff (1) Manufacturing Staff (2) Operations/administrative (2) Therapeutic Apheresis/Component processing Support Services Hospital Quality/Risk Management Hospital Administration Pathology Administration UT Medical Directors/Pathologists

13 Data: What kind of data do you currently measure for the services lines involved in the RFP? Howoften do you measure and review them? Who do you report them to (including hospital and administrative committees and leadership)? Will that kind of data be readily available in a transparent format for ongoing operations to the successful bidder? What type of data do you expect to come from the successful bidder? Do we have permission to partner/seek subcontractors for therapeutic apheris and/or therapeutic phlebotomy services? Internal quality data not able to provide negotiable

14 What type of apheresis procedures? What is the average number of procedures per year (for each)? 2014 data: i. Therapeutic plasma exchange i. Therapeutic plasma exchange ii. RBC exchange ii.rbc exchange - 1 iii. Leukocyte reduction iii.leukocyte reduction - 2 iv. LDL apheresis iv.ldl apheresis Do not perform v. Platelet reduction v.platelet reduction - 0 vi. MNC collection vi.mnc collection Do not perform vii. PBSC collection vii.pbsc collection Do not perform TPE increase: Average per month Average per month Are therapeutic apheresis or therapeutic phlebotomy procedures all in patient? Outpatient? Mix of both. Or a mix of both? What is the role of the blood center physician overseeing the program? Medical oversight. Donor/Patient safety. 137 Are the patients managed by ordering physician and the nurses are just there to do the procedure? Procedures performed by MLS staff. Physician must be present for entire procedure. 138 What is the estimated number of stat orders for procedures? 1 per month. 139 Who triages requests when the service is overloaded? Medical staff. 140 What are the credentials of staff working on the Technologists MLS/MLT ASCP certification 141 How many nurses/staff are working now? How many full time? Part time? 2 Therapeutic Apheresis FT technologists 142 Is the staff salaried or hourly employee and estimate of overtime if hourly? Hourly Overtime 1%

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17 DATE: OCTOBER 5, 2015 UNIVERSITY HEALTH SYSTEM-BUSINESS CENTER PURCHASING DEPARTMENT-2 ND FLOOR SPENCER LANE SAN ANTONIO, TX SOLICITATION: BLOOD DONOR, THERAPEUTIC APHERESIS, AND THERAPEUTIC PHLEBOTOMY SERVICES MANAGEMENT ADDENDUM NO. 3 RE: Due date has been extended to 10/23/2015 Due: On or before October 23, 2015 at 2:00 PM CST NOTICE TO BIDDERS: The purpose of Addendum NO. 3 is to extend the due date for bids/offers to October 23, A. Receipt of this Addendum shall be acknowledged on the Bid Form. B. Bidders are required to sign this addendum acknowledging receipt and return a copy by . Corresponding for this purpose is Michael Llanas, UHS Purchasing, Contract Specialist, at C. This Addendum is part of the RFP# LAB documents for the above referenced project and shall be incorporated integrally therewith. D. Each bidder shall make necessary adjustments and submit their proposal with full knowledge of all modifications: clarifications and supplemental data include therein. Company Name: Vendor Signature Date:

18 DATE: OCTOBER 7, 2015 UNIVERSITY HEALTH SYSTEM-BUSINESS CENTER PURCHASING DEPARTMENT-2 ND FLOOR SPENCER LANE SAN ANTONIO, TX SOLICITATION: BLOOD DONOR, THERAPEUTIC APHERESIS, AND THERAPEUTIC PHLEBOTOMY SERVICES MANAGEMENT ADDENDUM NO. 4 RE: Due date has been extended to 10/23/2015 Due: On or before October 23, 2015 at 2:00 PM CST NOTICE TO BIDDERS: The purpose of Addendum NO. 4 is to provide the balance of the questions/answers and information requested on or before September 25, A. Receipt of this Addendum shall be acknowledged on the Bid Form. B. Bidders are required to sign this addendum acknowledging receipt and return a copy by . Corresponding for this purpose is Michael Llanas, UHS Purchasing, Contract Specialist, at C. This Addendum is part of the RFP# LAB documents for the above referenced project and shall be incorporated integrally therewith. D. Each bidder shall make necessary adjustments and submit their proposal with full knowledge of all modifications: clarifications and supplemental data include therein. Company Name: Vendor Signature Date:

19 1 What is your definition of " non-stck" items? N/A 2 Explain acess to non-stock items N/A 3 Will UHS provide Marketing budget for cobranding? No 4 Under Organization, it states" What are your statistics".please clarify what statistics you are requiring to review? How many donors collected in a month( by product type)? What areas are they collected in? Donor Criteria? 5 6 What is your Donor incentive plan? Please provide a schematic of manufacturing/component lab. Attached Attached

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22 DATE: OCTOBER 15, 2015 UNIVERSITY HEALTH SYSTEM-BUSINESS CENTER PURCHASING DEPARTMENT-2 ND FLOOR SPENCER LANE SAN ANTONIO, TX SOLICITATION: BLOOD DONOR, THERAPEUTIC APHERESIS, AND THERAPEUTIC PHLEBOTOMY SERVICES MANAGEMENT ADDENDUM NO. 5 RE: Due date has been extended to 11/6/2015 Due: On or before November 6, 2015 at 2:00 PM CST NOTICE TO BIDDERS: The purpose of Addendum NO. 5 is to extend the date for bids/offers to November 6, A. Receipt of this Addendum shall be acknowledged on the Bid Form. B. Bidders are required to sign this addendum acknowledging receipt and return a copy by . Corresponding for this purpose is Michael Llanas, UHS Purchasing, Contract Specialist, at C. This Addendum is part of the RFP# LAB documents for the above referenced project and shall be incorporated integrally therewith. D. Each bidder shall make necessary adjustments and submit their proposal with full knowledge of all modifications: clarifications and supplemental data include therein. Company Name: Vendor Signature Date:

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