MOWCM RFP

Meals on Wheels of Central Maryland, Inc.
Request for Proposal
Client Services and Volunteer Services Databases
Monday May 21, 2012
I. Summary
Meals on Wheels of Central Maryland, Inc. (MOWCM) is accepting proposals for a
comprehensive automated software program that will effectively and efficiently address the needs
of our Meals on Wheels operations. The purpose of this RFP is to provide a fair evaluation for all
candidates, to provide comprehensive information to propose accurate cost/timeline estimates, and
to provide the candidates with the evaluation criteria against which they will be judged.
II. Organizational Background
Meals on Wheels of Central Maryland, Inc. is a 501(c)(3) charitable organization, which was
founded in 1960 and continues to serve nutritious meals to homebound individuals so that they
may age gracefully in place. More than 2,000 active volunteers help make this mission possible
with more than 250-300 volunteers used on a daily basis. Last fiscal year, more than 743,000
nutritious meals were delivered to 2,964 clients in Baltimore City as well as Arundel, Baltimore,
Carroll, Frederick, Harford, Howard, Montgomery, & PG counties.
III. Proposal Guidelines
 This is an open and competitive process.
 MOWCM reserves the right to reject any or all proposals, as well as to accept the
proposal which will be to the best advantage as determined at the sole discretion of
MOWCM.
 All questions, clarifications, and requests for additional information should be made to
Melissa Kaiza, IT Manager by Friday May 31st
.
 MOWCM reserves the right to request a best and final offer based on the need for
further clarification or revisions to the submitted proposals.
IV. Evaluation Criteria
The following criteria will form the basis upon which MOWCM will evaluate proposals. The
mandatory criteria must be met and include:
 Scope of Work and Requirements (30 points)
 Comprehensive Timeline/Implementation Plan (20 points)
 Price Quote (20 points)
 Technical Support Service Level Agreement (15 points)
 Qualifications and Experience (15 points)
 One (1) original signed copy and a digital signed copy due no later than 4:00 p.m.
EST, Wednesday, June 6, 2012.
Deliver the proposal to the attention of:
Melissa Kaiza
515 S. Haven St.
Baltimore, MD 21224
Email: Kaiza@mowcm.org Phone: 443-573-0936
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V. Contract Terms
 MOWCM will negotiate contract terms upon selection. All proposals and contracts are
subject to review by MOWCM legal counsel, and a project will be awarded upon
signing of a contract, which outlines the terms, scope, budget, and other necessary
items.
 MOWCM has made their best effort to disclose all the necessary information for the
proposer to present a solid proposal that will be incorporated into the awarded contract
if an award results from the proposal.
 MOWCM reserves the right to add or change needs/requirements set forth in the RFP
and the proposal should address how such changes will be handled in regards to the
timeline and price quotes.
VI. Scope of Work
MOWCM prepares approximately 5000 meals to 1600 clients daily, including a cold and a hot
meal which are delivered on 140 routes. Meal types include: Regular, Kosher, Texture Modified,
No Sweets, No Pork, No Fish, No Sweets/Pork, no Sweet/Fish, No Pork/Fish, No
Sweet/Pork/Fish, Emergency Meals Kits, Korean and we intend to serve frozen meals in addition
in the near future. MOWCM also serves approximately 1650 congregate meals to 33 sites and
390 meals to 8 adult daycares and occasionally cater senior expos and other small related events.
MOWCM has a central office/kitchen site which prepares 97% of all meals served and 91% of all
home delivered meals. In addition, there are 14 other distributions sites, 5
kitchen/packing/distribution sites, 3 drop off sites and 4 smaller satellite offices. Most of the
home delivered meals (approx. 1136) are unitized but some of the home delivered meals (approx.
288) go out in bulk to our 5 smaller kitchen/packing sites to be unitized there for delivery to the
assigned routes. Kosher meals (approx. 250) are delivered to our Kosher kitchen/site from a third
party where it is then unitized for delivery.
MOWCM clients are served though multiple funding sources. In addition to serving meals we
provide the following services to clients: extensive social services, referrals, volunteer companion
services, volunteer grocery shoppers, peer to peer phone pals, etc., which all need to be tracked
and reported to various funders and agencies according to specific requirements. We also offer
special programs such as distribution of Emergency Meal Kits which also need to be tracked.
This program must be automated and be able to track, report, and bill all service delivery,
including the daily management of client assessments, home delivered meals, congregate meals,
including managing orders, daily kitchen production reports. MOWCM has roughly 30 total users
of the client services system with roughly 15-20 concurrent users and roughly 17 total users of the
volunteer services system with roughly 7 concurrent users (these numbers do not need to be added
together if one system is used for both client services and volunteer services). It should be noted
that MOWCM has a goal to serve 3000 clients a day by 2020, which might add up to 5,000
unduplicated clients per year.
MOWCM has the need to keep track of our 2000 volunteers that help run our daily operations.

a. General Requirements
All Proposals must address each item in the MOWCM General Requirements List
provided in Addendum A and Addendum B (will only be supplied upon receipt of
signed Non-Disclosure Agreement).
b. Invoicing and Reporting Requirements
All Proposals must address each item in the MOWCM Invoicing and Reporting
Requirements List provided in Addendum C, Addendum D, and Addendum E (will
only be supplied upon receipt of signed Non-Disclosure Agreement).
c. Data Conversion and Migration Requirements
All Proposals must address the Data Conversion and Migrating List provided In
Addendum F (will only be supplied upon receipt of signed Non-Disclosure
Agreement).
d. Security Requirements
All proposals must address the following questions:
o Can you control users for view, add, modify, and delete?
o Do the user controls for viewing information comply with HIPAA?
o Is there an audit trail to track changes? Which changes? What does the log
look like?
 Must be HIPAA compliant.
 Must have authentication system that will mandate minimum password lengths,
complexity, and change frequently
 Must use authentication system to allow for assigning rights to groups of individual
users.
 Must have an audit trail to track changes by user.
e. System Requirements
All Proposals in which the database will reside on our servers must specify in detail the
requirements for equipment needed such as, server/processor speed, server memory,
hard disk space, OS, compatibility with Symantec BackupExec11d and higher,
whether the software works on a virtual server, desktop/laptop, additional software,
compatibility with Citrix XenApp, etc. necessary to use the system.
All Proposals in which the database will be hosted online on their servers must specify
in detail the requirements for equipment needed such as, desktop/laptop, additional
software, web browser compatibility, etc. necessary to use the system. In addition they
must address the following questions:
 How is the data backed up?
 Is there data redundancy for a 24-7 availability and disaster planning?
 What security measures do you take to ensure no one can access client
information?
 Do the security measures comply with HIPAA, SOX, NIST, and/or PCI?

 What is the recommended internet bandwidth for 20-30 users using online software
at once?
f. Training Requirements
All proposers must provide the option of on-site as well as live web based training that
is comprehensive so that it enables MOWCM to operate and maintain the system.
g. Maintenance, Technical Support, and Upgrades
 Must provide unlimited free (included in support price quote) phone and remote
technical support from the date of installation.
 Must provide a copy of the support and maintenance Service Level Agreement
with the proposal. Service Level Agreement and/or proposal should address the
following questions:
f. Is there a guarantee of satisfaction?
g. What is the turn around time for getting “bugs” fixed?
h. How often to system updates/fixes go out and how do you notify
customers?
 Must provide telephone support from 8:00 a.m. to 4:30 p.m., Eastern Standard
Time, all year with the exception of proposer stated holidays.
 Must respond to emergency calls initiated by agency within two hours from the
time they were reported.
 Must be able to resolve all support calls within 48 hours from the time they were
reported.
 Proposers must detail the process and cost for System Upgrades during the life of
the agreement.
VII. Proposal Format
Proposers are to use the following format for the preparation and submission of their proposals.
Failure to follow this format may be just cause for rejections of proposals. Failure to include
any of the requested information may result in the proposer being disqualified. Cost of
preparation of proposals is the sole responsibility of the proposer.
Section 1. Proposer Information
a. Company name and Contact(s) information (address, telephone, fax, email)
b. Signed Statement from person authorized to submit proposal
c. Company/staff history, qualifications, and experience
Section 2. Scope of Work
Proposers are to detail their response to the scope and requirements provided by MOWCM.
a. General Requirements
b. Invoicing and Reporting Requirements
c. Data Conversion and Migration Requirements
d. Security Requirements
e. System Requirements
f. Training Requirements
g. Maintenance, Technical Support and System Upgrades Requirements

Section 3. Proposal Timeline/Implementation Plan
All proposals must include a timeline starting June 11, 2012 to include but not be limited to, data
conversion/migration, customization, installation, testing, training, and acceptance. This may
include a range of days or weeks.
Section 4. Proposal - Price Quote
All responses are to include all costs for the first year as well as broken down separately one
additional year, including all scope of work requirements specified in the RFP for data conversion
and migration, project management/implementation from inception of project to “Go Live” date,
customization, and training. Costs must be broken down to per unit (such as price per
hour/month/user/year/module/# clients), the number proposed to be needed, and totals for each
item. If the number of users or number of clients/volunteers affects the pricing of the system then
a key should be given for MOWCM to price out projected growth of users/clients/volunteers.
Section 5. Additional Information

1) Client basic demographics
a. Last Name, First Name, Middle Initial, Title, Nickname
b. Address, City, State, Zip Code, County
c. Phone Number – Home, – Cell
d. Email address
e. Social Security Number
f. Birth date (calculate age)
g. Marital Status
h. Spouse’s Name & Spouse’s Birth date (Needed to
determine T3 eligibility.)
i. Is spouse on service - checkbox
i. If disabled minor, Name and Age of parent (Needed to
determine T3 eligibility.)
i. Is parent on service - checkbox
j. Speaks English – Yes, No
k. Language Spoken (drop down list, with addition possible)
i. Translator – Name, Phone, Address
ii. Back-up Translator - Name, Phone, Address
l. Primary Contact
i. Client
ii. Other Contact
1 When to contact alternate (all contacts, specific situations)
2 Has Power of Attorney? (Complete, Financial Only, No)
3 Client Ok’d - checkbox
4 Reason for alternate contact (text field)
5 Contact’s Name, Address, Phone
m. Social worker/case worker, agency name, phone number.
(Multiple possible)
i. Text field for notes
n. Client cannot terminate on own – Check box
o. Household Composition
i. Alone
ii. Others living there (multiple possible)
1 Name
2 Relationship
3 Age
4 Reason they cannot prepare meals
5 Note field
2) Client detailed demographics
a. Sex – M, F
b. Marital Status S, M, W, D, U(Unidentified)
c. Race (multiple possible) White, Black, Asian, Latino,
Native American, Unidentified
d. Nationality
General Requirements List - Client Services Included in
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Addendum A: General Requirements List
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e. Veteran status – Veteran, spouse of veteran, spouse of
deceased veteran, Child of veteran/deceased veteran, no
veteran connection (Note: Multiple answers possible)
f. Previous occupations (Multiple answers possible)
i. Teacher, firefighter, etc.
g. Previous employers (Multiple answers possible)
h. Congressional districts (should lookup and auto fill -
http://mdelect.net/)
i. US senator and US representative
ii. State Senator
iii. State Delegates (multiple)
i. Memberships - past & present (Multiple answers possible
– Must be able to add organizations)
i. Masons, Kiwanis, Lions, B’nai Brith, etc.
ii. Religious affiliations – voluntary
iii. Church – voluntary (multiple possible)
3) How did applicant hear about MOW? (drop down menu)
4) Status
a. Query only – checkbox
i. Date
ii. Referred to other Meals on Wheels
iii. Ineligible for Meals on Wheels service
b. intake – checkbox
i. Date
c. pending – checkbox
i. Date
d. wait list – checkbox
i. Date
ii. Program(s) waiting for (should be able to add programs)
1 In House Subsidy
2 Title 3
3 EFSP
iii. Priority ranking.
1 1 - low
2 “2” will stand for folks who could genuinely use the meals
and the subsidy, but who really should not be considered
emergency cases.
3 3 mid-level need (i.e. need service to ensure more
nutritionally balanced diet.)
4 4 – High need, Can briefly manage but with serious
difficulty
5 5 – Highest need, unable to survive at home without
immediate service We will also have “8” for folks who had
been on the list as a 1 through 5 but now have moved off
the list as they have started receiving a subsidy; and “9” for
folks who have dropped off the list for whatever reason.
e. active – checkbox
i. Start date
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f. inactive – checkbox
i. Date of termination
ii. Reason for termination (Dropdown - Death, Moved to
nursing home, No longer able to eat, Can’t eat MOW food,
Dislikes food, Unable/unwilling to pay (costs too much),
MOW cancelled for past due balance, Moved, Repeated
not-at-home-for-delivery, Inappropriate behavior,
Sanitation issues, Improved condition, Can manage,
Unspecified,
iii. Ability to add a note for further explanation to any
cancelation
g. Deceased
i. Date
5) Meal information (Additions possible in future)
a. Type – Regular, Kosher, Korean, (added types possible in future.)
b. Texture Modified – Yes, No
c. No Pork – Yes, No
d. No Fish – Yes, No
e. (Additions possible in future, i.e. low salt)
6) Cancellations
a. Start date for cancellation
b. End date for cancellation (optional)
c. Reason for cancellation – Doctor’s visit, away, One Day
Only (automatic reopen on following day) etc
d. If away for x amount of days, they are considered Inactive
(whereas, if they were in hospital, they would be off
production report but still considered Active for Holiday-
emergency contact reports, mailings, etc.)
e. Ability to credit someone for just a hot meal or just a cold
meal on a particular day
7) Emergency Meal Kits
a. Number ordered
i. Date
b. Type (ability to add types later needed)
i. Regular
ii. Kosher
iii. Texture modified
c. Number delivered (Multiple entries possible)
i. Date(Multiple entries possible)
8) Delivery information
a. Days of Delivery (Monday, Tuesday, Wednesday,
Thursday, Friday)
i. Weekend supplement- check box
ii. Once a week delivery preferred if possible - check box
b. Service Office – Baltimore, Harford, Howard, Carroll, Anne
Arundel
c. Site (i.e.: Brown, Faith, Bain)
d. Drop Site
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e. Route (i.e. F1, CT3), for each day of week. Defaulting to
same route 5 days a week, with option to override and
have different routes different days.
f. Once a week delivery assigned - check box
9) Map code (should auto fill)
10)
11)
a. Client has enough food in house to last 2+ days without
MOWCM delivery
i. Yes/No
b. Can someone be counted on to get food to client if
MOWCM can’t deliver due to snow etc
i. Yes/No
c. Contents of refrigerator and cupboards – text box
12) Socially isolated – check box (text box for details if needed)
13) Emergency Contacts (Multiple possible)
a. Priority Order number
b. Last Name, First Name, Middle Initial, Title, Nickname
c. Relationship
d. HIPAAA approved - check box
i. Contact for routine issues – check box
ii. Contact if serious deterioration in health, mental condition,
etc. – check box
iii. Contact to discuss financial matters
iv. Note field
e. Address, City, State, Zip Code, County
f. Phone Number – Home – Cell – Work
g. Has key to clients home – check box
h. Notes – text box
14) Family Contacts
a. Not home at delivery time
b. Other concern
c. Who was contacted
d. Date and Time contacted
e. Result (text box)
15) Medical Information – Multiple answers possible. Check boxes.
a. Amputations
i. Which extremity
b. Arthritis (Pull down list with ability to add types and ability
to have more than one type)
i. Rheumatoid
ii. Osteoporosis
c. Blindness or impaired vision
i. Cataracts
ii. Glaucoma
d. Cancer
i. Type of cancer
High Risk (Client cannot survive 2 days without MOWCM food delivery)
check box
Google map (auto lookup) (Adds condensed directions to cardex cards
#30)
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e. Deafness or hearing loss
f. Diabetes
g. Fractures (Recent – still impacting health or within one
year)
i. Which bone (more than one possible)
h. Heart Disease
i. High Blood Pressure
j. Lung disease (Pull down list with ability to add types and
ability to have more than one type)
i. Asthma (severe)
ii. COPD (Chronic Obstructive pulmonary disease)
iii. Emphysema
iv. Other __________________
k. Mental Health
i. Alzheimer’s
ii. Confusion
iii. Dementia
iv. Depression
v. Manic depression
vi. Schizophrenia
vii. Other Mental Health ___________
viii. Alcoholism
ix. Drug abuse
l. Multiple Sclerosis
m. Parkinson’s
n. Seizures
o. Stroke
p. Surgery (Recent – still impacting health or within one year)
q. Vertigo
r. Other ________________________
16) Mobility impairment
a. Walks extremely slowly and/or can only walk very short
distances
b. Cane
c. Walker
d. Wheelchair/Motorized chair
e. Confined to bed
f. Other __________________
17) Doctor (multiple possible)
a. Name, address, city, state, zip, phone number, specialty
b. No Doctor (checkbox)
18) Finances
a. Income level (must have fields to match attached
Addendum B Monthly Income and Expenses form)
i. Below poverty line
ii. Low income (up to 300% of poverty line)
iii. Not low income
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b. Financial information form as follows. (Note: Totals should
automatically add)
i. Ability to change “Spouse” to something else (ie. Daughter,
Friend)
ii. Ability to add expenses for Child #1, Child #2, Aunt,
Caregiver, etc.
iii. See attached Monthly Income and Expenses Sheet
iv. (Have database automatically fill in the recommended
weekly fee. (Note: If this is too difficult, we can do this
manually.)
v. If the “Pay in full, no disclosure required” box is checked –
place the highest possible fee in the “Recommended
weekly fee” field
vi. If the “Client will pay based on gross income scale, no
“expenses” disclosure required box” is checked – place
the appropriate fee from that scale in the “recommended
weekly fee” field.
vii. If the “Client will pay on sliding fee and subsidy scale” box”
is checked – place the appropriate fee from that scale in
the “recommended weekly fee” field.
viii. ACTUAL WEEKLY FEE OR SUGGESTED PLEDGE:
$__________ (Default to copy the amount from the
recommended weekly fee, but allow us to overwrite that
and place a different amount in that field.)
19)
a. Title 3
b. Medicaid Waiver Older Adults (multiple possible)
i. Authorized start date
ii. End authorized date
c. Medicaid Waiver Living at Home(multiple possible)
i. Authorized start date
ii. End authorized date
d. EFSP
e. Private
f. Senior Care Program (Carroll County)
g. Community Care Partnership (Anne Arundel)
h. Other ______________
20) Waiting for/Applied for
a. Title 3
b. In-house subsidy
i. In-house subsidy application mailed to applicant
ii. Documentation received at MOWCM – checkbox, followed
by comment field. (Ability to scan documents and save
them under this field to be viewed at anytime)
iii. Food Stamps application made – checkbox
iv. Medicaid Waiver application made – checkbox
v. Johns Hopkins Plus application made – checkbox
vi. Other relevant programs applied for – checkbox
FEE TYPE (Drop down box. Must be able to add categories. Currently
only one per client. But we need the ability in future to have 2 per client
with each having an Invoice)
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vii. Client has been approved for in-house subsidy
1 Date client was placed on subsidy
21) Status while waiting
a. Private pay while waiting
b. No service while waiting
i. Reason declined service (pull down)
1 Unable/unwilling to pay (Costs to much)
2 Other
22) Nutritional Risk Screening
a. Has illness/condition that made him/her change kind or
amount of food eaten.
i. Yes – 2 points No – 0 points
b. Client eats fewer than 2 meals a day
c. Client eats few fruits or vegetables or milk products each
day
d. Client has more than three drinks of beer, wine, or liquor
almost ever day
e. Client has tooth or mouth problems that make it hard for
him/her to eat
f. Client does not always have enough money to buy the
food he/she needs
g. Client eats alone most of the time
h. Client takes three or more different prescription or over the
counter drugs each day.
i. Without wanting to, client has gained or lost 10 or more
pounds during last 6 months.
j. Client is not always able to shop, cook, or feed him/or
herself.
k. Total Score (Total above numbers)
l. Referred to nutritionist - date
23) Setting up Initial Home Assessment
1 We want to figure out a way to assign a client a date for
their home assessment based on their zip code. We want
assessments assigned a date by zip codes to help staff
members save gas.
2 We want the staff members names assigned automatically
but rotated so that staff members are not out in the field
simultaneously. (staff members names can be manually
changed if needed)
3 We want the ability to assign one staff member to a
specific location/jurisdiction only.
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4 Date Initial Assessment Completed (automatically place
date in ‘Home Visit Evaluation’ as one year from Initial
Assessment Date – with the ability to manually change if
needed)
5 Staff member completing assessment
24)
a. Date of visit (red flag on page 1 if client’s visit is
approaching or overdue)
i. Reason for visit (multiple answers possible)
1 Initial qualifying home visit,
2 annual reassessment,
3 verify continued eligibility,
4 possible abuse or neglect,
5 personal hygiene,
6 condition of home environment,
7 delivery problems,
8 assess for additional services,
9 uncooperative client
10 Title III Waitlisted (for reports)
b. Name of person conducting visit
c. Name of family members/friends present during visit (text
box)
d. Physical Condition of Home (checkbox)
i. Relatively neat and clean
ii. Some belongings scattered throughout, but relatively neat
and clean
iii. Home full of clutter, belongings and trash; help needed to
clean and organize
iv. Strong odor/stench; home in complete disarray.
v. Comments (text box)
e. Reason client needs home delivered meal service
i. Text box
f. Mental/emotional condition
i. Highly Functioning
ii. Mid-range
iii. Significant deficits
iv. Comments
g. Current major stressors
i. Death of someone close
ii. Major illness of family member or friend
iii. Family conflict
iv. Recent move or relocation
v. Financial problems
vi. Victim of crime
vii. Failing health
viii. Comments (text box)
h. Support systems
Home Visit Evaluation (ability to add multiple Home Visit Evaluations -
throughout the years)
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i. Client has one or more people in home who provide all the
support that his needed. Meals on Wheels is not needed
at this time.
ii. One or more people are living with client, but more
assistance is needed.
iii. Client is living alone, but has people who genuinely care
for and support him/her
iv. Client has no effective support system
v. Client has family/others living at home who provide no
support.
vi. There is possible neglect or abuse occurring
vii. Comments/observations (text box)
i. Activity level
i. Client participates in some form of regular activity
ii. Client does not participate in regular activity, but would like
to
iii. Client does not participate in regular activity, and has no
interest in doing so.
25) Functional Status/ADLs & IADLs
a. Bathing
i. Score
1 2=completely independent,
2 1=semi-independent,
3 0= totally dependent.
ii. Assistance in place?
1 Needed assistance is in place or arranged
2 Needs Assistance but doesn’t have it.
b. Toileting
i. Score
c. Transferring
i. Score
d. Dressing
i. Score
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e. Eating
i. Score
f. Grooming
i. Score
g. Ambulating
i. Score
h. Heavy Chores/Laundry
i. Score
i. Light chores/Making Bed
i. Score
j. Light Meal Preparation
i. Score
k. Money Management
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i. Score
l. Shopping
i. Score
m. Using the telephone
i. Score
n. Arranging transportation
i. Score
o. Handling medications
i. Score
p. Plans &/or makes decisions
i. Score
q. Functional Status score
26) Referrals – Multiple possible for each client -- each with needs, referrals
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a. Type (Categories and subcategories needed, all with drop
down boxes (see below.) Ability to add categories and
additional types of referrals in the future if needed.
i. Emergency situations
1 AERS
2 APS
3 911
4 311
5 Family
6 Other __________
ii. Transportation
1 MTA Senior Reduced Fare Program
2 MTA Mobility
3 CountyRide
4 Action in Maturity
5 Taxi Service
6 Escort
7 Other ____________
iii. Isolation
1 Companion
a. MOWCM
b. Other ___________
2 Phone Pal
3 Senior Community Center
4 Adult Day Care
iv. Housing
1 Section 8
2 Rental Allowance Program
3 Public Housing
4 HUD
5 Emergency Shelter
6 St. Ambrose Homesharing
7 Assisted Living
8 Nursing Home
9 Home Repair
a. Baltimore Christian Workcamp
b. CHAI
c. We Build Together
d. Senior Home Maintenance Program
e. Other _______________
10 Rodents/Insects
11 Project Light bulb
12 Free smoke detector
13 Clean-up/Hoarder Services
14 Landscaping
15 Weatherization Assistance
16 Relocation Services
17 Other _____________
v. Utilities
1 Heat/Fuel
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a. Maryland Energy Assistance Program (MEAP)
b. Joe for Oil
c. Maryland Energy Assistance Program (MEAP)
d. Lineap
e. Other ______________
2 Electric
a. Electric Universal Service Program (EUSP)
3 Water
a. Senior Citizen Water Discount Program
4 Other
a. Utility Service Protection Program (USPP)
b. Extension due to Turn-Off Notice
c. Other ______________
vi. Food Related
1 Out of area Meals on Wheels
2 Feeding the People
3 Moveable Feast
4 Food Stamps
5 Food Cupboard
6 Volunteer Shopper
7 Grocery Delivery Service
8 MD Hunger Solutions
9 Other ______________
vii. In-Home Assistance
1 In-Home Aide
a. IHAS Program
b. Care.com
c. Visiting Angels
d. Other ______________
2 Housekeeping Services
3 Emergency Life Alert System
4 In-Home Medical Equipment
a. Ambulation
i. Scooter
ii. Wheelchair
iii. Walker
iv. Cane
b. Ramps, Lifts & Handrails
i. Stair Ramp
ii. Chair Lift
iii. Handrail
c. Toileting & Bathing
i. Commode
ii. Toilet Chair
iii. Grab Bars
iv. Shower/Tub Chair
d. Other ______________
5 Personal Medical Supplies
6 Other ____________________
viii. Communication
Page 13 of 21

Price
Estimate
System
Has
System
Doesn’t
Have
Can be
Customized
1 Free Wireless Phone
2 Landline
3 Internet
ix. Financial
1 Social Security/SSI
a. Request for Verification of Benefits
2 Pension
a. Request for Verification of Pension
3 TANF
4 WIC
5 Title III Subsidy
6 MOWCM In-House Subsidy
7 Automatic Bill-Pay
8 Other ____________
x. Health Care & Insurance
1 Medical Insurance
a. Medicare
i. Medicare Savings Program
b. Medicaid
i. Older Adults Waiver Services Registry
ii. Medicaid Waiver
c. LAH (Living at Home Waiver)
d. PAC (Primary Adult Care Program)
e. Private Health Insurance
f. Other ______________
2 Life Insurance
3 Dental Care
4 Vision Care
5 Hearing Care
6 Health Clinic
7 Hospital
8 Burial Assistance
9 Johns Hopkins Elder Plus
10 Living with Grace Fund
11 Other ________________
xi. Prescription assistance
1 Discount Rx Card
2 Rx Delivery Service
xii. Hearing/Vision Impaired
1 Library for the Blind
2 National Federation of the Blind
a. Free White Cane Program
3 Services for the Deaf and Hard of Hearing
4 Telecommunications Relay Service
5 Assistive Devices (Phones, TTYs etc.)
6 In-Home Teaching Services for Blind
xiii. Other
1 Area Agency on Aging (include sub-lists for which one)
2 Free Benefits Check-up
3 United Way
Page 14 of 21

Price
Estimate
System
Has
System
Doesn’t
Have
Can be
Customized
4 Partners in Care
5 Veterans Administration
6 Legal Services
7 Church
8 Outreach Center
9 Counseling/Support Group Services
10 Family Investment Center
11 Shoes/Clothing
xiv. Gifts/Holidays
1 Meals on Wheels Cares basket
2 Salvation Army
3 Home Instead
4 Plants
5 Other ____________
xv. Pets
1 Pet Food
a. Kibble Connection
b. Other __________
2 Pet gifts (drop down organizations)
b. Referrals Needed
i. Type needed
ii. Date need established
iii. Staff Initials
iv. Comments
c. Referrals made
i. Type made
ii. Date Referral made
iii. Staff Initials
iv. Comments
d. Follow up to referral (multiple possible)
i. Dates
ii. Staff Initials
iii. Follow up required by MOW (check box to “flag for follow
up” with the ability to query which referrals made by a staff
member need follow up)
iv. Comments
e. Status
i. Information provided (this would be considered
“Complete”)
ii. Service Pending
1 Pending on Client
2 Pending on Organization
3 Pending on Meals on Wheels
iii. Service Obtained (this would also be considered
“Complete”)
iv. Client not approved for service
v. Client declined service
vi. Client withdrew application
vii. Service no longer needed
viii. Status unknown
Page 15 of 21

Price
Estimate
System
Has
System
Doesn’t
Have
Can be
Customized
ix. Comments
27) Referral letters
28) Case Notes (Unlimited)
a. Date
b. Staff Initials
Do Not Reopen without thorough investigation! –
Checkbox (Should appear on Page 1)
a. Comments – text field
30) Surveys
a. Survey year (note: multiple years with multiple results
possible)
b. Years on service: _______
c. Type of food: regular kosher texture
modified
d. Impact Survey
i. Do you believe Meals on Wheels services have extended
the length of time you have been, or will be able to, remain
living at home in the community? (As opposed to needing
to enter a nursing home, assisted living facility, move in
with someone else, etc.)
1 Yes/No
ii. Has participation in Meals on Wheels improved your
nutrition? (By ensuring that you eat more regularly, eat
healthier food, or eat more appropriate quantities of food.)
1 Yes/No
iii. Has participation in Meals on Wheels increased the
number of social interactions you have each day?
1 Yes/No
iv. How many individuals do you have the opportunity to
converse with each day, NOT INCLUDING MEALS ON
WHEELS VOLUNTEERS OR STAFF?
1 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 or more
v. Do you believe participation in Meals on Wheels programs
has improved your quality of life?
1 Yes/No
vi. Do you have regular contact with any other social service
agencies that are able to assist you in locating and
accessing critical resources on a regular basis?
1 Yes/No
e. Satisfaction Survey
i. Meals
1 Very Good (4 pts)
2 Good (3 pts)
3 Okay (2 pts)
4 Needs to Improve (1 pt)
ii. Delivery service
1 Very Good (4 pts)
2 Good (3 pts)
3 Okay (2 pts)
Page 16 of 21

Price
Estimate
System
Has
System
Doesn’t
Have
Can be
Customized
iii. Procedure to Order & Cancel Meals
1 Very Good (4 pts)
2 Good (3 pts)
3 Okay (2 pts)
iv. Procedure to Make Donations or Pay Bills
1 Very Good (4 pts)
2 Good (3 pts)
3 Okay (2 pts)
31) Billing
f. Put a blockage on adding a reopen activity record in the
client activity detail screen for clients who cancel service
with a past due balance
g. Bill to third party payee – checkbox
i. Name
ii. Address
iii. phone numbers (work, home, cell)
32) Printing client delivery information cards (for volunteer use.)
a. Name, address, city, state, zip
b. Driving directions
c. Pet information
d. Help needed
e. Note field for medical conditions of relevance (don’t
include HIPAAA restricted.)
33)
34) There should be check boxes for:
Permission given to tell volunteers or paid staff if client has
been admitted to a hospital or nursing home, moved, or
died
Permission given to give volunteers or paid staff contact
information (allowing them to call or visit) if client has been
admitted to a hospital or nursing home, moved, or died
35) “Button” to print out specific letters with client info filled in
a. Phone contact info needed for applicant letter
i. Date
b. Mailing an application letter
i. Date
c. Welcome letter (Fills in name, address, city, state, zip,
start date, meal type, fee type & amount.)
i. To client
ii. To third party payer
iii. Primary contact
iv. Date
d. Subsidy application letter
HIPAAA form completed and returned – checkbox (Ability to scan
documents and save them under this field to be viewed at anytime)
Page 17 of 21

Price
Estimate
System
Has
System
Doesn’t
Have
Can be
Customized
i. To client
ii. To third party payor
iv. Date
e. Key release form
f. Just walk in waiver
g. EMK wanted?
i. To client
iv. Date
h. Initial Home visit required letter
i. First notice
ii. Second notice
iii. Service suspended until home visit completed
iv. Date
v. To client
vi. To third party payer
vii. Primary contact
viii. Date
i. Annual reassessment letter needed letter
i. First notice
ii. Second notice
iii. Service suspended until home visit completed
iv. To client
v. To third party payer
vi. Primary contact
vii. Date
j. Doctors letter needed to confirm eligibility letter
i. To client
iv. Date
k. Request for Guardianship to Override Client’s Wishes
Letter
i. To third party payer
ii. Primary contact
iii. Date
l. Change in fee type letter– Baltimore City
i. To client
iv. Date
m. Change Fee Type letter – Baltimore County
i. To client
iv. Date
n. Change fee
i. To client
Page 18 of 21

Price
Estimate
System
Has
System
Doesn’t
Have
Can be
Customized
iv. Date
o. Client wishing to send a donation letter
i. To client
iv. Date
p. Client or emergency contact info needed letter
q. Suspension due to multiple “not home for delivery”
incidents letter
r. Proper clothing needed letter
s. Pet must be restrained letter
i. Warning
ii. Cancellation
t. Dangerous conditions letter
u. Inappropriate behavior
v. Client no longer qualifies for home delivered meal service
letter
36) Case Notes
a. Ability to flag if client has any problem issues that make it
difficult for them to be served ie, ( a killer dog)
b. Client that refuses a home assessment visit
c. Client has missed meal deliveries consecutively and been
informed of policy
d. Client has been mailed a suspension notice
e. Client mailed a key waiver form
f. Client mailed a (Meals on Wheels subsidy form) Potential
or Current
g. Client unable to be contacted for a home visit
h. Ability to flag that client cannot be put back on service
i. Client concern addressed because of Volunteer concern
j. Client to be re-evaluated in say 3 months because of
extenuating circumstances, i.e., no income at time of
application, or currently awaiting benefits or verification
k. Client deemed ineligible for services (reasons)
37) Finance Specific Fields
a. Ins code
b. Ins account number
c. Ins eligible start
d. Ins eligible end
e. Ins provider code
f. Ins auto start
g. Person responsible for the bill/pay source
h. Mail code (who to mail the bill to)
i. Payments
i. Client #
ii. Date
iii. Payment type/write off code/debit adjustment code
Page 19 of 21

Price
Estimate
System
Has
System
Doesn’t
Have
Can be
Customized
iv. Payment Description (Check #, Card #) – 50 characters
v. Expiration Date
vi. Draft Date
vii. Person Responsible for bill name, Address, Telephone
number
viii. fee type
ix. credit amount
x. County
xi. Notes
xii. Credit total
j. Bill Activity
i. Bill type
ii. Fee type
iii. Billing period
iv. Number of service days
v. Fee per meal
vi. Day fee
vii. Total bill for period
viii. Last bill date
ix. Last bill amount
x. Last payment amount
xi. Balance Due
38) Additional Needs
a. Could applications submitted via the website automatically
populate some or all of our fields? (We would have to look
over the application first, and approve it.)
b. “Pop-up” box ability on client’s main page with any
information we need to “flag”
c. The ability to upload documents into client electronic file on
their client page.
d. All notes sections are populate staff according to login
automatically and are locked so that no one can update or
delete part or all of a note.
e. In screen process for credit card and independence card
payments
f. Process EFT
g. System must have the ability to export Daily Production &
Shipping Reports to excel or comma delimeted format to
upload into third party software Computrition.
h. System must have the ability to export AIM data (NAPIS
reporting requirements from AoA ) to excel or comma
delimited format to upload into Saber Corporation Software
a third party company used by the State of Maryland. I
have requested a Data Description Specifications
Page 20 of 21

Price
Estimate
System
Has
System
Doesn’t
Have
Can be
Customized
i. System should have the ability to export Medicaid Waiver
and Living at Home billing to eMedicaid via (EDI) in a
comma delimited format for the CMS 1500 form.
j. System must have the ability to auto fill the pre-printed
CMS 1500 Medicaid Waiver and Living at Home form for
Medicaid billing.
Page 21 of 21

1) Volunteer basic info
1 Volunteer Id #
2 Last Name, First Name, Middle Initial, Title, Suffix, Nickname
3 Address, City, State, Zip Code, Zip- Ext, County
4 Phone Number – Home, – Cell, Work
5 Email Address
6 Social Security Number
7 Birth Date (calculate age)
8 Marital Status
9 Sex
10 Race
11 Contact Last Name, First Name, Middle Initial, Title, Suffix,
Nickname
12 Contact Address, City, State, Zip Code, Zip- Ext, County
13 Contact Phone Number – Home, – Cell, Work
14 Volunteer Status
15 Start Date
16 Location
17 Site
18 Kitchen 1
19 Kitchen 2
20 Route 1
21 Route 2
22 Function 1
23 Function 2
24 Function 3
25 Referral Code
26 Referred By
27 Availability (M, T, W, TH, F, S, S, Holiday, Sub)
28 Drivers License
29 License Number
30 Points
31 Driver Points
32 Use of Car
33 Car Insurance
34 Car Insurance Policy Number
35 Car Liability Amt
36 Term Date
37 Term Code
38 Term Reason
39 Mail Code
40 Employer
41 Position
42 Retired from Occupation
2) Volunteer Tracking Info
1 Hours
Mileage
Included in
Price
Estimate
General Requirements List - Volunteer Services System Has System
Doesn’t
Have
Can be
Customized
Page 1 of 1

Addendum B: Monthly Income and Expenses Page 1 of 1
Addendum B: Monthly Income and Expenses
MONTHLY INCOME AND EXPENSES:
Client will pay full amount, no financial disclosure required.
Client will pay based on gross income scale, no “expenses” disclosure required
Client will pay on sliding fee and subsidy scale
INCOME CLIENT SPOUSE EXPENSES CLIENT SPOUSE
Social
Security $ $ Housing $ $
SSI $ $ Gas/Oil $ $
Pension $ $ Electric (Average monthly cost) $ $
Other
____________ $ $ Water (Average monthly cost) $ $
Dividends $ $ Taxes (include all taxes) $ $
Interest $ $ Insurance $ $
Food Stamps $ $ Phone $ $
Transportation $ $
Total Income $ $
Medicines (Average monthly
cost) $ $
Medical (Average monthly
cost) $ $
Personal Medical Care (home
nursing care, seeing eye dog,
Depends, etc.) $ $
Food $ $
Clothing, haircuts,
Housekeeping Supplies,
newspapers, gifts, etc. $146 $116
Other _______________
____________________ $ $
Other _______________
____________________
Total Expenses $ $
TOTAL DISPOSABLE INCOME: $__________
NUMBER OF PEOPLE IN HOUSEHOLD CLIENT IS RESPONSIBLE TO SUPPORT __________
RECOMMENDED WEEKLY FEE : $__________
(Have database automatically fill in the recommended weekly fee. (Note: If this is too difficult,
we can do this manually.)
 If the “Pay in full, no disclosure required” box is checked – place the highest possible fee in the
“Recommended weekly fee” field
 If the “Client will pay based on gross income scale, no “expenses” disclosure required box” is checked –
place the appropriate fee from that scale in the “recommended weekly fee” field.
 If the “Client will pay on sliding fee and subsidy scale” box” is checked – place the appropriate fee from
that scale in the “recommended weekly fee” field.
ACTUAL WEEKLY FEE OR SUGGESTED PLEDGE: $__________
(Default to copy the amount from the recommended weekly fee, but allow us to overwrite that and place a different hat
field.)

Addendum C: Invoicing Requirements
Client Invoices
1. Private Pay
2. Title III -Must ask for pledge or donation!
3. NSIP - Must ask for pledge or donation!
Funding Invoices
1. LAH – Must fill pre-printed CMS 1500 form! Must have option to submit electronically.
2. Medicaid – Must fill pre-printed CMS 1500 form! Preferably have the ability to submit
electronically.
3. Title III & NSIP
Other Business Invoices
1. Congregate, Daycare (adult & child), and Catering
Invoicing Requirements System
Has
System
Doesn’t
Have
Can be
Customized
Included
in Price
Estimate
Client Invoices - 1. Private Pay
Client Invoices - 2. Title III - System must generate
pledge/donation invoices/letters
Client Invoices - 3. NSIP - System must generate
pledge/donation invoices/letters
Funding Invoices - 1. LAH - System must have the ability to
export Living at Home billing to eMedicaid via (EDI) in a
comma delimited format for the CMS 1500 form. System must
have the ability to auto fill the pre-printed CMS 1500 Medicaid
Waiver and Living at Home form for Medicaid billing.
Funding Invoices - 2. Medicaid - System must have the ability
to auto fill the pre-printed CMS 1500 Medicaid Waiver form for
Medicaid billing. System should have the ability to export
Medicaid Waiver to eMedicaid via (EDI) in a comma delimited
format for the CMS 1500 form.
Funding Invoices - 3. Title III and NSIP
Other Business - 1. Congregate, Day Care (adult/child), and
Catering
Addendum C: Invoicing Requirements Page 1 of 1

Production & Shipping Report (s)/Item 1 & 2 - System must have the
ability to export Daily Production & Shipping Reports to excel or comma
delimited format to upload into third party software Computrition.
Client Master Application/Item 3
New Client Welcome Letter/Item 4
Cardex Card/Item 5
MOW New Client List/Item 6
MOW Active Client List/Item 7
MOW Client Case Notes/Item 8
Reassessment Due for…Report/Item 9
Cancellation/Reopen Activity Record/Item 10
Client (Master) List for Emergency Meal Kit Orders/Item 11
Emergency Meal Kit Letter/Item 12
Emergency Meal Kit Summary/Item 13
Review Client (Web site) Application/Item 14
Review Client Information (Web site) Requests/Item 15
Baltimore County Title Client Cancellation/Reopen Report/Item 16
Meals on Wheels Start Report/Item 17
MOW Client Activity Report/Item 18
Client Cancellations Report/Item 19
Follow-Up Report/Item 20
Disbursement Account Information Report/Item 21
Bill Detail Record & Credit Detail Record/Item 22
Rate Your Nutritional Health/Item23
Universal Intake Form/Item 24
Central Route Changes/Item 25
Kosher & Regular Statistical Report: NSIP/Item 26 & 27
Receipts Summary/Item 28
III Client Payment Listing /Item 29
Daily Receipts/Item 30
New Clients/Item 31
Bill Detail Record /Item 32
Clients With Outstanding Balances/Item 33
Clients Cancellations /Item 34
Medicaid Waiver Statistical Report /Item 35
Credit Adjustment Report /Item 36
Billing Breakdown Report /Item 37
Kosher & Regular Statistical Report: Title III /Item 38 & 39
Congregate Data/Item 40
Meal Count by Jurisdiction for FY /Item 41
Fee Report for FY/Item 42
Unduplicated Client List Statistical Reporting/Item 43 (1,2,3) & Item 44
Addendum D: Reporting Requirements List
Included in
Price
Estimate
System
Has
System
Doesn’t
Have
Can be
Customized
Page 1 of 2

Addendum D: Reporting Requirements List
Included in
Price
Estimate
System
Has
System
Doesn’t
Have
Can be
Customized
Meal Count/Item 45
Volunteer Mileage Report/Item 46
Additional Reporting Needs
System must have the ability to export AIM data (NAPIS reporting
requirements from AoA ) to excel or comma delimited format to upload into
Saber Corporation Software a third party company used by the State of
Maryland.
Active Client Report
Monthly Birthday Report
Auto Detection of Sequential Activity Codes
Kosher Client Irregular Delivery Pattern Report
Automated Daily Client Changes Report
Monthly Referrals Made
Emergency Meal Kits
Survey results Median
Caseworker Caseload report
Medicaid Waiver eligibility date expiration approaching report
Aggregate client data, e.g., all Harford County clients, all Howard County
clients
Clients on service from one specific date to another specific date
Total time on service
Source of referral, i.e., doctor referred, self-referred, etc.
Reasons for Temporarily Stopping Service
Number/Type of Referrals to Other Services
Number at/above/below federal poverty level
Number of clients served at each site location
Clients who are veterans
Number of routes per site
Geographic boundaries of routes, e.g. Rte. 1 Harford County is for
Aberdeen area
Volunteer Hours Report
Active Volunteer Report
Page 2 of 2

Addendum E: Reporting Requirements Summary
Name : Production & Shipping Report (s)/Item 1 & 2
Frequency: Daily (note: Printed twice during the day/morning and late afternoon)
Usage : Used by the Food Services Dept to provide estimate of hot and cold meals.
Also provides Client Services with a daily list of clients receiving meal
service by site, route, and diet type. Automatic adjustments to the report
are made based on activity entered in the Client Master-Activity detail
screen(s) prior to printing the report.
Note : Currently the Production and Shipping report only reflect regular meals. CS
would like modifications to this report to also include kosher meals.
Name : Client Master Application/Item 3
Frequency: Generally printed daily as clients start service
Usage : Becomes a part of the client’s paper file and provides hard copy of the
information entered in Haven. A copy of the client application is sent to
Baltimore County Dept. of Aging whenever a client is referred for Title
III.
Name : New Client Welcome Letter/Item 4
Frequency : Generally printed daily as new clients start service
Usage : Becomes a part of client’s paper file and is sent to client or 3rd
party
payee to provide information on the client’s start date, fee/donation, and
procedure for mailing payment to Main Office.
Note : CS needs the ability to be able to program the number of letters
printed
Name : Cardex Card/Item 5
Frequency: Generally printed along with the Client Master Application when a new
client starts service.
Usage : Sent to sites and given to paid drivers and put in route books to enable
volunteers and Central paid drivers to deliver meals to clients.
Note : Because the total number of cardex cards needed vary from site-to-site, the
ability to have this as a programmable feature would be useful. Also add a
spot on the cardex card to indicate the date the card was printed.
Name : MOW New Client List/Item 6
Frequency: Printed by the IT Department on a daily basis
Usage : Mainly used by BC/BA Client Services Administrator. Provides a listing of
new clients by start date, site, location. Mainly used to check specific types
of data entry errors (e.g. fee basis, delivery pattern, location code).
Especially useful for spotting errors with respect to new clients being placed
on Title III when the subsidy is not available in a specific jurisdiction.
Name : MOW Active Client List/Item 7
Addendum E: Reporting Requirements Summary Page 1 of 9

Frequency: Printed by the IT Department on a weekly basis
Usage : List of all active clients on service for a specific week (e.g. week of
03/25/2012) by site and route.
Note : Little usage as much of the information contained in the report is already
apart of the Client Master Application. However, because it includes client
phone numbers, Howard County uses the printout to call clients on days
when the site is not delivering due to inclement weather.
Name : MOW Client Case Notes/Item 8
Frequency: Printed by CS staff as needed
Usage : Allows staff to provide and share important explanatory information on
clients that have special or unique situations pertaining to their service.
Hard copy of case notes printed and placed in client’s paper file.
Name : Reassessment Due for…Report/Item 9
Frequency: Monthly
Usage : Provides CS Department with a list of client who are up for reassessment
based on a specific time frame.
Name : Cancellation/Reopen Activity Record/Item 10
Frequency: Printed by CS staff as required
Usage : Hard copy of client activity entered in Client Master-Activity detail screen.
Given to BC/BA Kitchen Coordinator for documentation of client
activity entered in Haven by staff. Information also recorded on Kitchen
Coordinator’s “calendar” to provide Site Coordinators and paid drivers with
their daily client activity changes. Also used to adjust a,m. client counts on
Production and Shipping Report due to same day (i.e. morning of)
cancellations.
Name : Client (Master) List for Emergency Meal Kit Orders/Item 11
Frequency: Printed by IT Department in the fall. May be printed several times
depending on how many additional emergency meal kits need to be
distributed to certain clients starting service (e.g. Title III).
Usage : Provides Client Services staff with a list of names of clients who are
to receive emergency meal kits. Copy of Master List given to Site
Coordinators and paid drivers to enable volunteers and drivers to
deliver meal kits to clients on their route. Also provides documentation
as to the date and number of EMKs a client received for record keeping
purposes.
Name : Emergency Meal Kit Letter/Item 12
Frequency: Printed by the IT Department in the fall. Also printed manually by CS staff
when new private pay clients start service after the initial distribution of
letters to enable new clients to continue “ordering” meal kits.
Usage : Combination letter and order form provides notification to client or 3rd
party
payee and enables same to order kits.

Note : Each staff person in the department needs to have the ability to print letters
for private pay clients when they began service. Currently, I am the only
person in the department who has a computer that is set up to perform this
task..
Name : Emergency Meal Kit Summary/Item 13
Frequency: Printed by BC/BA Client Services Administrator as needed.
Usage : Provides summary of clients who have received and were “billed” for
emergency meal kits for a specific time frame. The summary is provided to
the Director of Finance when required.
Name : Review Client (Web site) Application/Item 14
Frequency: Generally printed by CS staff on a daily basis or as required.
Usage : Allows staff to review applications of “potential” clients applying for
service.
Note : Currently after a new client starts service the information from the web site
application must be manually entered into the Client Master Application in
Haven. Additionally, some of the same information must be manually entered
in the Client Tracking database which is used to check the “status” of
someone who has applied for service. From a data entry standpoint, it would
be easier for staff if the information did not have to be reduplicated and
could “automatically” appear in the appropriate place in the client data base
where the specific information is required. (This I an FYI not a requirement).
Name : Review Client Information (Web site) Requests/Item 15
Frequency: Responded to daily by CS staff as a result of interest in the service by a
potential client.
Usage : Alerts CS staff of potential clients who need additional information about the
home delivered meal program and other services we provide prior to
submitting an application for service. (this is an FYI not a requirement).
Name : Baltimore County Title Client Cancellation/Reopen Report/Item 16
Frequency: Compiled by BC/BA Client Services Administrator on a monthly basis.
Usage : Provides Baltimore County Dept of Aging with a list of clients who have
cancelled service or cancelled and reopened service within a specific time
period. One of the ways the Dept. of Aging uses the report is to determine
which clients are still “active” and which clients need to have their Title III
subsidy “suspended” or “terminated” because of being off service for a
specific length of time.
Note : Compiling this report once a month is labor intensive because the activity for
each client on the report has to be manually searched in the client activity
detail screens to determine what type of activity occurred within a 2-3 month
time period. Any of the processes involved in producing this report that can
be automated would be helpful.
Name : Meals on Wheels Start Report/Item 17

Frequency: Printed by BC/BA Client Services Administrator or Director of Client
Services as needed.
Usage : Provides a summary of new clients who began service within a specific date
range. Also provides information on the number of new clients who start
service within a specific jurisdiction as well as information on the total
number of new clients who began service agency wide. Good report for
comparing new clients starting service on a month-to-month basis and to see
if the overall number of new starts is going up or down.
Name : MOW Client Activity Report/Item 18
Services as needed.
Usage : Provides information on the various types of client activity that occur within
a specific date range based on active and inactive activity codes. Can be used
to get an idea of how many clients cancelled service based on a specific
reason (e.g. hospital, dislike food, etc) during a specific time frame. We
would like to have a report which specifically identifies only those folks who
have missed a delivery for not being home 3 or more times during a month.
Name : Client Cancellations Report/Item 19
Services as needed
Usage : Similar in nature to item 18, but deals specifically with client cancellation
codes queried on during a specific date range.
Name : Follow-Up Report/Item 20
Usage : Provides a list of clients with follow-up date who need to be contacted
regarding some aspect of their service.
Note : Report would be more useful if the” reason” for follow-up was indicated in
addition to the follow-up date. An automatic “tickler” located on the first
page of the Client Master screen to alert staff that follow-up in due would
also be useful.
Name : Disbursement Account Information Report/Item 21
Frequency: Printed by BC/BA Client Services Administrator and designated staff
as needed.
Usage : Eligibility enrollment dates are provided for the Client Accounts Specialist
whenever a new plan of care document is submitted by case managers for
Medicaid Waiver clients receiving home delivered meal service. Client
Accounts Specialist enters information into their tracking data base and this
alerts said individual as to when the eligibility period for a MA Waiver client
is about to expire.
Name : Bill Detail Record & Credit Detail Record/Item 22

Usage : Provides staff with an overview of month-to-month total billing amounts
and payments made by the client or credit adjustments issued to the account.
It also indicates the dollar amount that needs to be “written off” when a client
is switched from private pay status to Title III or other subsidy program.
Name: Rate Your Nutritional Health/Item23
Note: This is not a report, but simply a form that is filled out by staff to determine
whether or not a client is at moderate to high nutritional risk (see form). Since
currently there is no field in the Haven client data base to put this information
(i.e. score) staff is putting a “+” or “-“ sign in the nickname field to track this
data. Information on “high risk” clients is compiled and provided to the Area
Office on Aging for all jurisdictions when quarterly statistical reports are
submitted. Copies of the form are also given to the agency’s nutritionist to provide
follow-up for clients who score high (i.e. 6 or more) on the evaluation.
Name: Universal Intake Form/Item 24
Note: This is not a report, but a form that is filled out by staff when clients receive an in-
home assessment. Currently the information on the form is only being sent to
the Baltimore City Commission on Aging (CARE). Assuming CARE mandates
that MOW begins using the AIMS system to track benefits and services clients are
eligible for, we will need to make sure all of the required fields on the form for
which information is needed are contained in the new client data base. Once the
new MOW data base is established and the AIMS system implemented, the two
agencies have agreed to exchange client information electronically.
Name: Central Route Changes/Item 25
Note : This is not a report, but a form that is filled out by the BC/BA Kitchen
Coordinator on a daily basis. The form provides route change information for all
Central routes as well as a few volunteer drop sites. The form has categories for
“new clients/reopens”, “cancellations”, and “other changes”. Currently, the
Kitchen Coordinator completes this form and gives it to the Distribution
Department each day so that the route books can be updated. The information on
this form is based on the various types on client activity (e.g. new starts, reopens,
cancellations, route changes) that are on the Kitchen Coordinator’s calendar. The
information on the calendar is based on all client activity entered in Haven.
Client Services would like to see if the procedure for completing this form can be
automated as well as a way to electronically provide the Distribution Department
with this information each morning so that the route books can be updated.
Name : Kosher & Regular Statistical Report: NSIP/Item 26 & 27
Frequency: Monthly
Usage : Used by Finance Department for NSIP billing to counties.
Note :

Name : Receipts Summary/Item 28
Frequency: Monthly
Usage : Used by Finance Department for Title III billing to counties.
Note : Broken down by the income that came in from client donations for county.
This report is used to subtract the amount billed to the county by the donations
the clients made for Title III clients.
Name : Title III Client Payment Listing/Item 29
Frequency: Monthly
Note : Broken down by client donations received from each client in a specific
County with a total income for the county.
Name : Daily Receipts/Item 30
Frequency: Daily
Usage : Used by Finance Department.
Note : Shows the daily receipts for transactions such as payments, credits, and
charge offs.
Name : New Clients/Item 31
Frequency: Monthly
Note : Shows the new clients broken down by site and route to include start date, fee
basis, location, when they became active
Name : Bill Detail Record/Item 32
Frequency:
Note : Shows the new clients broken down by site and route to include start date, fee
basis, location, when they became active
Name : Clients With Outstanding Balances/Item 33
Frequency: Monthly (but would like this to be daily in the future)
Note : Shows the clients broken down by location who have outstanding balances.
Name : Clients Cancellations/Item 34
Frequency: Monthly
Note : Shows the clients broken down by cancellation code to include: client
number, name, loc/kit, fee basis, referred by, started, cancelled, code, totals
each code and total for all codes.
Name :Medicaid Waiver Statistical Report/Item 35
Frequency: Monthly

Note : Shows the clients broken down by County (location) to include: client
number, name, loc/kit, site, route, Start date, activity date, meals served (hot,
cold, total), delivery pattern, service period, plus statistical totals page.
each code and total for all codes.
Name :Credit Adjustment Report/Item 36
Frequency: Monthly
Usage : Used by Finance Department for G/L entries.
Note :
Name :Billing Breakdown Report/Item 37
Frequency: Monthly
Usage : Used by Finance Department for G/L entries.
Note : Broken down by County and Fee Basis.
Name : Kosher & Regular Statistical Report: Title III/Item 38 & 39
Frequency: Monthly
Note : Is attached to the invoice for each county.
Name : Congregate Data/Item 40
Frequency: Monthly
Usage : Used by Finance Department for Congregate Billing.
Note : This report is currently printed out from Computrition and then entered into
an excel spreadsheet for billing. We would like to print off this billing from
the same database as the client billing.
Name : Meal Count by Jurisdiction for FY/Item 41
Frequency: Monthly
Usage : Used by Several Departments.
Note :
Name : Fee Report for FY/Item 42
Frequency: Monthly
Note :
Name : Unduplicated Client List Statistical Reporting/Item 43 (1,2,3) & Item 44
Frequency: Monthly/Quarterly provide Monthly data and FY year-to-date data /Last FY
year-to-date data
Note : This is very important that we get unduplicated client numbers broken down
by location, site, fee basis, and totals for a period of a month as well as our
totals for the fiscal year.

Name : Meal Coun/Item 45
Frequency: Monthly/ yearly
Note :
Name : Volunteer Mileage Report/Item 46
Frequency: Yearly
Usage : Used by the Volunteer Services Department as well as the Finance.
Note :
Additional Database Reporting Needs:
1. Active Client Report: The ability to print a list of active clients on service monthly.
Current options only allows for this report to be printed for a “weekly time
frame”.
2. Monthly Birthday Report: Ability to generate a client birthday list anytime during
the month by name, site, route, and date of birth in chronological order.
3. Auto Detection of Sequential Activity Codes: Ability to have the computer auto
“detect/flag” duplicate activity codes to prevent back-to-back cancellations or
reopen records from being entered in the Client Master-Activity detail by staff.
Normal sequence for entering activity records/codes in a cancel record followed by
a reopen record. Presently staff have the ability to enter two cancellations or
reopens back-to-back.
4. Kosher Client Irregular Delivery Pattern Report: Ability to generate list of clients
who have an irregular delivery pattern but would like to receive food on days off
service in order to get “double” meals on various Jewish holidays.
5. Automated Daily Client Changes Report: Instead of using a hard copy of
cancellation and reopen slips to manually record daily changes on the
Kitchen Coordinator’s calendar, BC/BA like the ability to print a report each
morning listing all types of changes that need to be verbally given to the sites. The
sites could receive the same report and then would only be required to make
adjustments to the report due to late (i.e. day of)
6. Monthly Referrals Made (Total each type of referral made, each category of referral
made, and each type of outcome, for each county and in total.)
7. Emergency Meal Kits
a. Emergency meal kits to order (Sorted by type and number)
b. Emergency meal kits delivered (Sorted by County, fee type, type of meal,
number of meals; with totals for each.)
8. Survey results Median, Mode, Average, by county and by all, for meal type, fee type,
amount of fee, and age

i. Impact Survey
ii. Satisfaction Survey
9. Caseworker Caseload report
10. Medicaid Waiver eligibility date expiration approaching report
11. Aggregate client data, e.g., all Harford County clients, all Howard County clients
12. Clients on service from one specific date to another specific date
13. Total time on service
14. Source of referral, i.e., doctor referred, self-referred, etc.
15. Reasons for Temporarily Stopping Service
16. Number/Type of Referrals to Other Services
17. Number at/above/below federal poverty level
18. Number of clients served at each site location
19. Clients who are veterans
20. Number of routes per site
21. Geographic boundaries of routes, e.g. Rte. 1 Harford County is for Aberdeen area

Addendum F: Data Conversion and Migration Requirements Page 1 of 2
Addendum F: Data Conversion and Migration Requirements
Volunteer Services Database and Client Services Database
Our database has data stored in it as old as the early 1990’s. It is the decision of the
management team that all of our data is converted and migrated to the new system. We
are contractually obligated to keep at least 10 years of data in the new system so an
estimate for half the data is requested as well. For purposes of the proposer to create an
accurate price/timeline estimate I have catalogued the number of tables, columns, and
rows that need to be converted and migrated to the new database.
 Must be able to extract all data that currently resides in our Unix Informix
Database or use table data exported to excel and import it into the new system.
 Must ensure a clean and stable data migration as well as a migration plan with
timeline.
 Must provide a database schema at least a two weeks prior to the conversion and
specify all the look-up tables that need to be created (modifications to our current
data going forward will need to be discussed in the implementation stage) in order
for the system to function, enabling appropriately clean/parse of existing data and
develop standardization of look-up tables entries to facilitate reporting and
mapping of implementation.
 Must provide accurate estimate of the time it will take and the price of converting
all of our data as well as 10 years of data (approx half the data).
Volunteer Services Database List
Volunteer Services
Database Table Name Columns
# Rows
(records) Type Needed
vol_hour 7 366750 Yes
vol_mstr 62 18359 Yes
vol_lunch_old 19 3067 ?
temp_vol 61 426 ?
vol_site 14 25 Yes
vol_kit 2 21 look-up Yes
vol_ref 2 16 look-up Yes
vol_site_info 30 14 ?
vol_hist 5 9 ?
vol_loc 2 9 look-up Yes
vol_term 2 9 look-up Yes
vol_func 5 7 look-up Yes
vol_site_type 3 3 look-up Yes
vol_lunch 0 ?
Client Services Database List
Client Services Database Table Columns # Rows (records) Type Needed

Addendum F: Data Conversion and Migration Requirements Page 2 of 2
Name
bil_act 13 399643 Yes
bil_credit 9 304291 Yes
bil_mstr 21 33833 Yes
cli_actv 22 676656 Yes
cli_codes 4 20 Yes
cli_doctor 2 20269 Yes
cli_feeb 13 6 Yes
cli_loca 12 10 Yes
cli_mstr 156 37081 Yes
cli_note 17 17324 Yes
cli_reas 3 34 look-up Yes
cli_relation 3 20920 look-up Yes
cli_site 12 23 Yes
cs_staff 10 110 Yes
d_animal 3 7 look-up Yes
d_bil_type 2 4 look-up Yes
d_cc_resolve 2 8 look-up Yes
d_charge_type 5 7 look-up Yes
d_concern_code 2 5 look-up Yes
d_credit_type 3 19 look-up Yes
d_diet 3 9 look-up Yes
d_disab_aide 4 17 look-up Yes
d_disability 4 14 look-up Yes
d_eligible 3 11 look-up Yes
d_followup 3 8 look-up Yes
d_help 3 16 look-up Yes
d_household 3 5 look-up Yes
d_language 3 7 look-up Yes
d_learnserv 3 11 look-up Yes
d_mealpattern 6 5 look-up Yes
d_need 3 15 look-up Yes
d_race 3 6 look-up Yes
d_ref_title 3 5 look-up Yes
d_referral 3 25 look-up Yes
d_relatedserv 5 4 look-up Yes
d_relation 3 11 look-up Yes
doctor 28 7948 Yes
emk_deliv 11 2050 Yes
emk_mstr 6 1591 Yes
fee_incr 12 1171 Yes
fee_sched 12 60 Yes
fema 3 1177 Yes
meal_stat 17 334827 Yes
meal_subsidy 14 1 ?
stat_actv 6 45475 Yes
t_cli_asci 2 91 ?
t_diet_asci 2 1464 ?
v_actv_reason20 2 35547 Yes

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