Ethics Training Program Prescription

Prepared for: Health Care Cooperative Prepared by: Advanced Content Education Design, Inc. April 2, 2010


© 1997-2010 ACED. All Rights Reserved. Visit us on the web at:

Table of Contents
• Executive Summary 2 • About ACED 3 • Learner Needs Analysis 4 • Training Analysis 6
Content Development 6 Advantages of a Modular Design 8 . Ethics Training Tool Kit 8 Collaboration Tools 10

Quality Assurance 19

• Pricing Approach 20
Phase 1 Workshop 20 . ACED Prescription Platform ™ 21 .

• Return on Investment 25
Consistent and Effective Learning 25 . Meeting the Needs of your Geographically Dispersed Workforce 25 Offering Individualized Learning 25 . ACED Prescription Plan TM Three-Year Rate of Return 26 .

• Technical Solution 11
Technical Solutions 11 . ACED Prescription Plan 11 . Meeting Standards 13 Commitment to Quality 13 Usability 13

• Staffing Resources 27
Key Personnel 27 . ACED Organizational Chart 28

• Contact Information 29

• Project Plan 14
Working Relationship .15 Scheduling 15 .

• Risk Mitigation & Analysis 17

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Executive Summary
ACED recognizes HCC’s need to maintain its reputation as an industry leader in its unique field by providing training that solidifies its serious commitment to conducting business ethically and complying with all laws that govern operations. Clearly, the landscape of American business has changed in recent years, and we at ACED are prepared to offer scalable solutions tailored to your business needs. Each solution will meet HCC’s expressed goals; in addition, our unique modular approach will also offer the flexibility to add more robust features today or to expand into these features if you choose to in the future. Our analysis and understanding of the HCC’s needs is that, while current in-person training offers critical content and information to employees, it could be modified in the following areas: • Scalability beyond annual meeting participants • Standardized training with a more enriched, consistent understanding and delivery of content • Measurement of training

• An improved communication platform • Collaborative tools • Training that allows HCC to share valuable ethics training more widely and efficiently • Alternative training sessions for new employees • Refresher training • Training for all employees, not just managers ACED’s solution will be efficient, scalable, and provide a prescribed standard set of ethics training.

Our goal is to apply problem solving and flexibility to the design prescription. We want all deliverables to meet HCC's needs. While we propose a training solution that is efficient and user-friendly, our process allows you clear insight into the final product. We provide unique, effective checkpoints that give us feedback to make certain that our solution meets your needs. Our approach encompasses all aspects of the project to ensure success.

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About ACED
ACED Prescription Plan
Based on the needs outlined in the request for proposal, our Prescription Plan offers unique benefits and is customized for HCC’s needs.

acquisition by Alsevier in 2008, we broadened our network of resources, including content experts and thought leaders, giving us the most current information. All of our lessons are powered by ACED’s learning management system (LMS), designed specifically to bring personalized interactive e-Learning systems to our clients and to provide e-Learning solutions that will impart knowledge, test understanding, and assess understanding to meet regulatory, organizational, and professional practice solutions. Our LMS not only delivers and tracks web courses, but also schedules, tracks, and generates reports for all your other learning activities, including classroom training, outside seminars, skill checks, and competencies. The ACED LMS is peer reviewed by the Healthcare Financial Management Association (HFMA). Since its inception, ACED has been on the leading edge of e-Learning, and will continue to bring our clients the best and most progressive integrated training solutions to meet their needs.

Our Story
For more than ten years, ACED has helped clients from leading companies in health care, managed care, pharmaceuticals, health-care technology, compliance and regulatory, and non-profit organizations. Our company began by partnering with companies such as Smith & Johnson, Saint John’s Occupation Healthcare, and United States Transplant Foundation to develop continuing education for nurses and physicians leading to improved patient care and enhanced revenue cycles. From there, we expanded to other related industries and developed learning programs for human resources, ethics and compliance (including code of conduct), and financial managers. With our

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Learner Needs Analysis
Compliance and ethics training is not a “one-size-fits-all” solution. ACED will conduct a comprehensive analysis of training needs prior to developing specific learning objectives. When performing an analysis, ACED’s long-term approach ensures that a performance improvement initiative ties in with HCC’s vision, mission, and values. For example, • Business Needs are linked to results • Job Performance Needs are linked to behavior • Training Needs are linked to learning • Individual Needs are linked to reaction In order to provide the most effective method to create a robust and well balanced learning experience for HCC, ACED strongly believes that a thorough analysis process includes a SWOT analysis, a pre-assessment, and a gap analysis to evaluate what the true needs are for your program. A SWOT

analysis will identify Strengths, Weaknesses, Opportunities and Threats to your current program.

Figure 1. Analysis Phase

The Pre-Assessment will be given to a segment of your employees to identify the desired goals and needs. The Gap Analysis will identify additional opportunities to explore in order to build a well-designed program. This initial consultation is essential in ensuring successful knowledge acquisition by your employees, as well as an effective and efficiently successful launch of your program.

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Figure 2. Learner Needs Analysis & Profile

and ACED will identify and collaborate with Subject Matter Once this process is complete, ACED will use data gathered from the target audience and key players to analyze and synthesize the information to hone in on the exact needs of your employees. The above illustration identifies key components essential for the learner needs analysis and the learner profile to further fine-tune and develop program goals and objectives. HCC Once the program is finalized, we Alpha and Beta Test to further fine-tune any edits, revisions, and adjustments. Experts (SMEs) who will review existing content to make certain that it meets current needs as well as to develop new content identified by the needs analysis. The Instructional Designer will further develop, design, and implement content that is well-constructed for knowledge and skill acquisition.

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Training Analysis
HCC has a strong record of business ethics in the healthcare arena. ACED’s goal is to implement training that continues to build on the company’s spotless record in ethics violations. HCC is choosing to put this training in place as a precautionary measure to ensure that its employees act ethically and in character in all business affairs. ACED, Inc. is committed to helping HCC detect, prevent, and correct fraud, waste, and abuse. We want to make sure that the company is also in compliance with all federal laws including the Federal False Claims Act and the Federal Sentencing Guidelines, state rules, laws and regulations, Medicare Parts A, B, C, D, Medicaid requirements, and other requirements as they pertain to providing services to your clients. More and more, health-care related companies run the risk of ethical violations occurring, contributing to the rise of hidden costs that put a burden on the company. Effective ethics training helps reinforce the message that HCC does not approve of ethics violations in any workplace. It allows HCC to show that the company is serious about enforcing ethics policies. Such training is thus a critical element in creating

and maintaining an ethical culture. And, training developed by ACED, Inc. in collaboration with HCC will help put HCC at the forefront of industry ethics education.

Content Development
Our approach to content development will be flexible and collaborative. As we meet with key stakeholders in the process, including members of HR and IT, we will rely on their guidance and support in customization of content that will be relevant, practical, and effective. The needs assessment and analysis of the current training content will determine which training methods we use, and to what extent. Initial analysis will also examine your existing ethics program and other relevant policies and factors such as geography and location. We are making an assumption that HCC thinks that there was value in the previous training model, and that some of its content should be incorporated into a training model that will be supported by technology. A blended e-Learning approach can combine both instructor-led training (ILT), essentially the “train the trainer” approach, in conjunction with web-based training (WBT) that will help standardize and organize the content. ACED will then develop course learning objectives

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Figure 3. ACED's Design Process

using a time-tested design process cycle of analyze, design, develop, and deploy. HCC has specified two content areas to be covered in initial training: Employee Personal Conduct and Appropriate Use of Company Assets. Through ACED’s past experience with ethics training for the health-care industry, we suggest the following titles for content areas: • The Key to Integrity • Getting Answers to Business Ethics Questions

• Reporting and Investigation of Violations • Compliance with Federal and State Laws • Anti-Kickback Laws • Antitrust Laws • Fraud, Waste and Abuse • Integrity of Company Information • Doing Business with the Government • Conflicts of Interest • Gifts to Health Care Professionals, Entities and Vendors

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Instructional System Design
A variety of instructional strategies, including a range of learning experiences, can adapt to best meet your business needs. ACED will create content, test items, and strategies to deliver content specific to training goals. We suggest a modular approach to learning, allowing learners to access the content 24/7, whether it is OJT or self-paced learning with an ability to “chunk” learning for immediate application. Through the design process, we will determine the best way to measure the effectiveness of the dissemination of content to employees to make certain that HCC’s devotion to ethics compliance is solid and unquestionable. If employee performance is the sole indicator of training results, then management should have options to communicate their training knowledge within the instructional design. Our design process will include storyboarding that clearly explains every step in the process.

ties. Short and interruptible, learning segments can then be followed up by face-to-face interactions, allowing for collaborative opportunities within the intranet and company-wide. HCC is searching for a standardized approach to content design that improves how managers share content with employees at all levels of the company. Content will be in modular format using an LMS platform. If training is segmented, then it is not a quick fix solution, but becomes a company’s way of operating, allowing for easy management to meet emerging business needs. The modules can then be easily re-segmented, keeping courses current with changing company requirements and federal and state laws and rules. Given HCC’s unique situation, and ACED’s experience with similar situations experienced by our other health-care clients, we would bring additional learning tools, depending on our analysis, such as an Ethics Training Toolkit for Managers.

Ethics Training Tool Kit
For this solution, we are training senior- and mid-level managers and have some expectation that they would be able to disseminate this information to their subordinates. So, in effect, by training the target audience, we will be, by proxy, conducting a form of “train-the-trainer” programming. It’s imperative that managers develop an expert knowledge of business ethics.

Advantages of a Modular Design
Learning modules can build on one another, which has many advantages. Training can expand on what the managers have learned previously, allowing them to make connections with the content on a more personal, meaningful level. This saves HCC time and money by not re-teaching topics that have already been addressed in previous training opportuni-

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The tool kits will gain the attention of the learners by using connect activities that will close the gap between learning and the rest of their lives. They prepare learners to apply learning in situations they encounter at work. It will include real-life work situations developed from our initial analysis working with HCC’s experts. These connect activities will also help managers to recall prior knowledge about workplace ethics, and show them how to apply that knowledge when training other employees. Managers will also be informed of the course objectives that describe learner outcomes, and will help them better understand the final goal of building strong workplace ethics at HCC. ACED’s goal is to create effective and efficient instruction that meets the learners’ needs and is meaningful and pertinent to their work lives. Managers first must learn the principles of workplace ethics before they can competently communicate them to staff. The following are connect strategies that will present information and provide guided practice: Ponder activities that require learners to think deeply and broadly about and focus attention on the subject, inviting learners to adopt a new perspective regarding the subject. Types of ponder activities include rhetorical questions, meditations, and citeexample activities.

Meditation activities that help broaden the focus and emphasize context, getting learners to step back and see how a subject fits into a broader scheme. Cite-example activities that challenge learners to identify existing instances of a concept being described and illustrated. Summary activities that ask learners to recap what they have learned. They must review a subject area, select what is important, organize the selection logically, and express it clearly in their own words. Knowledge assessments will be given for each learning module that provides feedback to learners. If the needs analysis findings necessitate, ACED will design more rigorous testing activities that provide quantitative data for each learner. This data can be stored easily, and reports can be generated from the assessment. Job aids will be available in PDF format throughout each learning module. Managers can print these documents whenever needed.

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Collaboration Tools
HCC sees peer collaboration as one of the strengths of its previous approaches to ethics training and wants to continue the collaboration between managers, both in the same and in different locations across the company. ACED can create a unique community environment with the latest social media technologies to help managers more quickly participate in discussions, search for information, connect with colleagues, and share documents and files. These collaboration tools can be created specifically for your organization, or set up through open-source media such as Google Groups, depending on the cost package you choose.

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Technical Solution
Our instructional system design (ISD) will provide a solution for the following HCC needs: • A standardized, consistent organization of training products and delivery options as a valuable business investment • Accessible, customized content for management at a variety of locations • Evaluation and measurement in the effectiveness of the training • Improvement in effective communication and sharing of ethics training content with employees at all levels of the company • Collaboration among managers and peers, both in the same and in different locations across the company

Technical Solutions
Our process for delivering e-Learning will take a systemic approach to address your training needs. Our technical solutions, first and foremost, will support the instructional system design process. Additional features include: • collaboration tools • permissions-based content access to allow content delivery to a variety of employee groups (Managers, Non-Managers, Clerical Staff, etc.) and • automated course completion measurement to provide protection to the organization by ensuring successful employee completion of the training program.

ACED Prescription Plan
ACED Prescription Plan includes the integration of your content into our learning content management system (LMS) along with a web-based training program (WBT). Since HCC currently has no e-Learning platform, our LMS would manage the content with built-in controls for maintaining a standardized, consistent method of training delivery. Accessibility of content in one place would provide management a modular design, along with meeting HCC’s expecta-

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tion that the solution provides increased communicative and collaborative opportunities. Internal support from both HR and IT departments would be required to address security, compatibility, and maintenance issues. ACED, Inc. and HCC would need to work together to establish e-Learning specifications and guidelines. A partnership could enable the content to be routinely updated, with new learning activities and training expanded to address long-term business needs. In our “Ethics Training Toolkit for Managers,” the WBT would provide learning modules, a content resource library, and additional collaborative tools. If HCC desires, ACED could perform maintenance and update the e-Learning within a blended e-Learning approach. HCC would continue to deliver course content, but would have a structure in place to standardize course content while continuing to expand training options.
Figure 4. ACED Prescription Plan Initial Wireframe Concept

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Meeting Standards
ACED Prescription Plan would use open acceptable standards within the industry. All of our technical solutions would be compatible and comparable to other e-Learning solutions. With a learning management system, LMS, our learning modules would be able to operate on multiple systems. Our Prescription Plan would be compatible with IBM PCcompatible desktop computers and would run on Windows software (XP or Version 7) with Internet connection. The Prescription Plan would be effective on all browsers currently utilized within HCC: Microsoft Internet Explorer (version 8), Mozilla Firefox (version 3.5 or higher), and Google Chrome. All content would be developed in accordance with ADA compliance. Our goal is to offer you a simple interface to help you maintain training and content needs with a way to update content if you choose.

Commitment to Quality
To manage concerns and issues before deployment, we would meet with HCC’s IT department to communicate our technical needs before the design phase. Our review process would focus on quality. We would apply client feedback to all stages of our model as well as to our deliverables. We would include any focus groups used for the prototype also in usability tests to get feedback and make any necessary changes prior to final deployment. With assistance from your HR and IT departments, we would also perform the following quality assurance checks: network stress tests, browser compatibility tests, platform tests, and reliability stress tests. We want to develop e-Learning that will best meet not just your technological needs but will also meet your business and training needs.

Our designs undergo rigorous internal usability reviews to ensure compliance to industry best practices regarding ease of use. Because we use prototypes to convey our designs to clients, product use flow can be measured early and our clients can be assured of the quality underlying our solutions.

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Project Plan

Project definition session and initial cycle planning: • User profiles, scenarios, and a task analysis • Vision Document aka Business Requirements Documentation: Fonts, colors, graphics, etc. for prototype.

Analysis comes to fruition. • High-fidelity prototype (following user testing and client feedback cycles) • Functional Specifications Document

Working version of e-Learning product • F i n al courseware for client sign-off • Courseware evaluation

Deployment Phase • Launch of final courseware • Project retrospective and evaluation

Figure 5. ACED’s Approach to Projects

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Working Relationship
Core Project Team ACED will meet with HCC and then carefully select members of the core project team who are best suited to collaborate with HCC. The subject matter expert(s) that will be provided by HCC will become part of the core project team. ACED will rely on this expertise to make certain that we are meeting HCC’s needs. Members of the ACED team will demonstrate multiple expert capabilities throughout the course life cycle. The core project team, headed by the project manager, supports a positive working relationship with HCC. At our kick-off meeting, we will firm-up lines of communication, including telephone, conference calls, email, FTP sites, as well as scheduled face-toface meetings. ACED and HCC will also negotiate the appropriate staffing needs for each project phase, including the beta testing and usability testing groups, as part of our quality assurance. ACED assumes that this program will target management, so managers would be the primary members of these groups, although we recommend that other key stakeholders be involved.

Upon being awarded the contract, we will also delineate the course deliverables at the kick-off meeting (see Figure 5 above). Following the kick-off meeting, ACED will begin analyzing the design and development of each course. Delivery cycle meetings with HCC will be set up by the project manager. ACED will be able to start as early as May 11, 2010, and deliver both modules of the Ethics Training Program by September 7, 2010.

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Resource and Deliverables Schedule
Deliverable Workshop Meeting Date 5/11/10 HCC Resources ACED Resources Project Manager CEO Subject Matter Dir of Technology Expert Sr. Mgr Prog Mgr. Other stakeholders Sr. Mgr Inst Design as deemed by HCC Sr. Mgr Prog Mgr Dir of Technology Sr. Mgr Inst Design Project Manager IT Director IT Director Director of Tech Mgr. IT Sr. Mgr Prog Mgr. Sr. Mgr Inst Design Sr. Mgr Inst Design Project Manager Project Manager Stakeholders Sr. Mgr Inst Design Sr. Mgr Inst. Design Sr. Mgr Prog Mgr Sr. Mgr Prog Mgr Sr. Mgr Inst. Design

Analysis Phase -- Program Management (Meetings, project plans, deliverable coordination, client relationship) Technology Kick-Off Meeting Technology Initial Requirements HCC Sign-Off Establish Vision User Profile Documents Learning Scenarios and Task Analysis Document HCC Sign Off Vision Document HCC Sign Off Instructional Design Phase – Program Management (Meetings, project plans, deliverable coordination, client relationship) Learner Analysis and SWOT Analysis

5/12/10 – 5/25/10

5/12/10 5/12/10 – 5/31/10 5/12/10 – 5/21/10 5/14/10 5/18/10 – 5/19/10 5/19/10 – 5/21/10 5/13/10 – 7/13/10

Module 1 – Appropriate 6/4/10 – Use of Company Assets 6/11/10 User Interface and Taxonomy Design HCC Sign Off Module 1 – Appropriate 6/11/10 – Use of Company Assets 6/16/10 Legal Review and Sign Off HCC Module 2 – Employee Per- 7/1/10 – sonal Conduct 7/8/10 User Interface and Taxonomy Design HCC Sign Off Module 2 – Employee Per- 7/8/10 – sonal Conduct 7/9/10 Legal Review and Sign Off HCC Development Phase -7/23/10 – Program Management 10/18/10 (Meetings, project plans, deliverable coordination, client relationship and rollout plan) Release of UAT to HCC for 10/11/10 – Sign Off 10/18/10 Deployment Phase 10/18/10 – 10/25/10 HCC Project Sign Off 10/25/10

IT Director

HCC Stakeholders

IT Director

HCC Stakeholders

Sr. Mgr Prog Mgr. Sr. Mgr Inst. Design, Sr. Mgr Content Developer, Dir of Technology HCC Stakeholders IT Director Project Manager Beta Testers HCC Stakeholders

5/13/10 – 5/17/10

Sr. Mgr Inst Design

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Risk Mitigation & Analysis

Figure 6. ACED's approach to risk management Flow of Risk Analysis provide by ACED

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Throughout the project, ACED will act in accordance with HCC’s five foundational principles: accountability, honesty, integrity, openness, and respect. ACED takes pride in our collaborative communication model. Drawing from our vast development experience, we plan mitigation of the risks of budget and schedule overruns throughout our project delivery cycle to make certain that we are meeting HCC’s vision of the ethics-training program. To ensure on-target staffing and budgeting, we use prototypes to provide our clients with a clear understanding prior to entering the most costly phase of development. We build our staffing needs to peak throughout the design and development phases. During the analysis and deployment phases, we will rely more on HCC’s resources to limit costs and to avoid inefficiencies. If HCC does not have the resources, or if HCC needs to allocate resources elsewhere, then ACED will make necessary adjustments to the staffing plan.

To mitigate overstaffing or understaffing concerns, we will include a determination of ACED vs. HCC resources early in the development phase. Additionally, we will update our staffing plan, communicating changes to HCC, as additional resources are warranted. From a budget perspective, risk mitigation also guarantees that we are able to keep our projects on track. Any changes to the initial requirements by HCC will be determined by ACED; if these changes require additional cost, then a fully executed change order form and authorization to proceed will be required. If ACED were to anticipate a cost overrun during the course of the project, we would contact HCC immediately to discuss an order to quickly solve the issue.

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Quality Assurance
Learning Effectiveness a. b. c. a. b. a. b.

Customer Satisfaction
Client-centered training representative of the task at hand as per needs of facility Robust content equivalent to face-to-face Previewing, reviewing, updating Offer best option for customer while being fiscally efficient. Ensure products meet latest industry standards while providing cost effective solutions. Institution/Facility to deem course training module(s) as a need or mandatory or optional training. Institution/Facility to deem who is essential personnel/healthcare providers to complete module(s) with assigned completion dates as deemed by Hospital Compliance Officer. Identify faculty/instructor as a customer and identify criteria to assess job satisfaction in teaching and learning goals. Identify effectiveness of curriculum development, online environment policies (copyright, royalties and collaborative design and delivery). Upon course completion satisfaction will be based on the following items Pedagogy: clear objectives, assignments if any matched to assessments and interactive media to promote the attainment of knowledge acquisition. ii. Internal quality assurance: availability of selected tools and appropriateness of use for content iii. Provider services iv. Ease of use v. Collaboration vi. Technology competency and support i.



Instructor Satisfaction

a. b.

Student/Participant Satisfaction


ACED’s evaluation and quality assurance program emphasizes five pillars of quality with customer satisfaction in mind.

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Pricing Approach
Phase 1 Workshop
ACED’s approach is aligned along the project phases identified in the Initial Learning Plan. Our process brings the ACED project team together with business and technology client representatives from HCC’s team to build a common understanding and to develop a shared vision that promotes optimal decision-making. This phase will include preparation work in analyzing and The following sections provide additional details about the activities, resources, and costs for each phase. developing the initial project analysis, workshop planning, execution of the workshop, and documentation of the results. ACED’s price for the Phase 1 workshop is $4,515.00. The line item cost breakdown for this work is as follows: Project Details and Requirements Project Benefits The first activities of this project will be initiated by a facilitated planning workshop that will develop a shared understanding of the project including:

ACED Prescription Platform ™


Workshop Preparation and Meeting CEO (No Charge) Director of Technology Senior Manager, Program Management Senior Manager, Instructional Design Total Cost of Workshop

Hourly Rate $90.00 $73.85 $54.17



16 24 24

$1,440 $1,772 $1,300 $4,515

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ACED Prescription Platform ™
Amounts highlighted in yellow represent those fees that will go down significantly with subsequent module development, due to the robust scalability features built into our software.

ACED’s price for ACED Prescription Platform ™ Design Phase delivery is $38,931. The line item breakdown is as follows:

Design Phase Director of Technology

ACED’s price for ACED Prescription Platform ™ Analysis Phase delivery is $24,683. The line item breakdown is as follows:

Analysis Phase Director of Technology Manager Information Technology Senior Manager, Program Management Senior Manager, Instructional Design Senior Manager, Content Design Application Architect Total Cost of Analysis

Hourly Hours Rate $90.00 $61.15 $73.85 $54.17 $48.40 $62.88

Cost 20 20 80 80 80 120 $1,800 $1,223 $5,908 $4,334 $3,872 $7,546 $24,683

Manager Information Technology Senior Manager, Program Management Senior Manager, Instructional Design Senior Manager, Content Design Web UI Designer (HCC Template Creation) Visual Designer (HCC Design Pattern Creation) Total Cost of Design Phase

Hourly Hours Cost Rate $90.00 8 $720 $61.15 32 $1,957 $73.85 $54.17 $48.40 $62.88 $62.88 160 160 40 $11,815 $8,668 $1,936

160 $10,062 60 $3,773 $38,931

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ACED’s price for ACED Prescription Platform ™ development Phase delivery is $76,655. The line item breakdown is as follows:

ACED’s price for ACED Prescription Platform ™ Deployment Phase delivery is $2,397. The line item breakdown is as follows:

Development Phase Director of Technology Manager Information Technology Senior Manager, Program Management Deployment Administrator Application Architect Web UI Developer Visual Designer Total Cost of Development Phase

Hourly Hours Rate $90.00 $61.15 $73.85 $54.17 $62.88 $68.65 $62.88

Cost 40 $3,600

Deployment Phase Director of Technology Manager Information Technology Senior Manager, Program Management Deployment Administrator Total Cost of Deployment Phase

Hourly Hours Rate $90.00 $61.15 $73.85 $54.17

Cost 5 8 8 16 $450 $489 $591 $867 $2,397

220 $13,454 400 $29,538 120 140 60 $6,501 $8,804 $3,773 $76,655

160 $10,985

Technology costs for the ACED Prescription Platform ™ are as follows:

Technology Fees LMS Licenses Collaboration Tool Licenses Total Technology Costs

#Users 80 80

Fee $12,000 $4,000 $16,000

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On-going incremental costs of ACED Prescription Platform ™ would include:

On-going incremental costs will be due by the 15th of each month, with a 10% late fee to be assessed if payment is not received by the 25th of each month. Cancellation of incremental services requires a 30-day notice. ACED’s estimated price for future modules in present values is

Monthly Fees LMS Hosting Collaboration Tool Hosting

Fee $500.00 $500.00

5 hours support each month is included for the LMS Hosting and Collaboration Tools; additional hours will be invoiced at $60 per hour. Payment schedule would be as follows:

$71,770.00 (price subject to change based on future market conditions). The line item breakdown is as follows on the next page:

Deliverable Initial Payment Analysis Phase Completion Design Phase Completion Development Phase Completion Deployment Phase Completion

Amount % of Total Due $32,635.54 20% $32,635.54 20% $32,635.54 20% $32,635.54 20% $32,635.54 20%

Delivery Date 5/12/2010 5/25/2010 7/13/2010 10/18/2010 11/05/2010

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Return on Investment
ACED understands today’s new economy, and we are committed to building brand stewardship for HCC by providing a cost-effective, efficient and effective learning platform designed to grow with HCC’s needs moving forward. At ACED, we see this as a long-term partnership. To demonstrate our commitment to this mutually beneficial relationship, we provide the following return on investment to help you quantify the value of our training platform. In comparison to your current solution, ACED’s Prescription Plan will make your ethics training more efficient while also providing these additional benefits: • • • • content consistency learning effectiveness measurements meeting the needs of your geographically dispersed workforce offering individualized instruction based on geographic location or other user attributes

Consistent and Effective Learning
Past experience has shown us that our web-based training plans typically provide time savings of 35-45% over in- person instruction, while obtaining equivalent or better gains in learning retention and transfer. These findings are consistent with research in the field.

Meeting the Needs of your Geographically Dispersed Workforce
ACED has a long track record of reducing our client’s travel and entertainment costs associated with in-person training, as well as minimizing the time your employees spend away from work. The collaboration tools provided will increase communication efficiency among your employees both overall and as it pertains to ethics training.

Offering Individualized Learning
The ACED Prescription Plan can be easily configured to provide conditional content based on a user’s geographic location or an organizational role, creating a learning experience tailored to an individual’s needs. Because our plan is selfpaced, a trainee is free to go at his or her own pace, return for refresher updates, or to revisit sections to further his or her retention.

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ACED Prescription Plan TM Three-Year Rate of Return
Total Cost of Solution Total Savings in Year 1 Total Savings in Year 2 Total Savings in Year 3 IRR= $(163.177.70) $69,070.00 $77,177.00 $86,095.00 19%

As this is thought to be a very conservative estimate, the actual rate of return could actually be higher.

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Staffing Resources
Key Personnel
CEO, Director of Technology-Kimberly Dunwoody, MA Kimberly specializes in technology & branding. She is a thirteen-year veteran in the usability/user experience field. She was drawn to eLearning because many usability problems actually stem from an inability of Interaction Designers to 'teach' users what it is that they want them to do. Senior Manager of Instructional Design-Amy Priest, MA When designing education and training, Amy draws from her experience with a multiplicity of learners. She has been a teacher in the educational field for over ten years, with leadership experience in creating curriculum, evaluating programs, and coordinating diversity training sessions. She also has research, organizational, planning, and writing skills. Senior Manager of Project Management, Client RepresentativeEllen Reeder, MA Ellen has been creating training and instructional design courses for ten years, specializing in health care. She draws from her years as a

communications consultant and project manager when developing a project plan. Our clients look forward to working with her on a daily basis. She also has extensive writing and editing skills. Senior Manager of Content Design-Marisa Tapia, RN, MA, MSN, CNS Marisa is our content expert, working closely with our health industry clients. She is an RN with a Master’s in Nursing and an Advanced Practice Nurse (APN); additionally, she holds a Master of Arts in Instructional Design. She has over twenty years of experience in the clinical practice area and over fifteen years of experience in content development and training experience as a Perioperative Nurse Educator. Other work requirements will be contracted with industry experts and/ or temporary employees as needed.

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ACED Organizational Chart

Ethics Training Program PrescriptionTM

Prepared for Health Care Cooperative

Page 28

Contact Information
Please feel free to contact our client representative with any questions regarding this proposal. Ellen Reeder 10488 Main Street Denver, Colorado 80222

Ethics Training Program PrescriptionTM

Prepared for Health Care Cooperative

Page 29

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