11-DHHS26105 Document Submission Checklist.pdf
PDF 212 KB Posted
- Attached to
- Residential Treatment Services
- Solicitation number
- DHHS26105
- Issued by
- Utah
About this file
This is a Document Submission Checklist for Solicitation #DHHS26105 issued by the Utah Department of Health and Human Services (DHHS) for Residential Treatment Services. The solicitation seeks qualified providers to deliver residential treatment programs for persons with serious emotional or behavioral disorders or disturbances. Offerors must submit a comprehensive proposal package including Form 1 (Data Sheet), Form 2 (State of Utah DHS Substitute Form W9), Form 3 (Conflict of Interest), and supporting attachments including a Facility Service Selection Template, Facility Organization Chart, Past Performance documentation, Medicaid Services information, and a Technical Proposal with a sample aftercare plan. The technical proposal must be formatted in 12-point Times New Roman font and address specific evaluation criteria related to program operations, family engagement, and aftercare services.
Offerors must meet four mandatory minimum requirements prior to contract award: two years of experience serving similar populations, a physical facility location within the State of Utah, a current license from the DHS Office of Licensing for residential treatment or intermediate secure care prior to the contract start date, and an existing Clinical Evaluation, Treatment, Wrap Services and Forensic Evaluations contract for psychotherapy, pharmacological, psychosocial rehabilitation, therapeutic behavioral, mentoring, day treatment, and clinical consultation services. The technical scoring criteria evaluate the applicant's program design using evidence-based models demonstrating recidivism reduction, adherence to admission and length-of-stay criteria, behavior intervention systems, family engagement and treatment approaches, and aftercare planning capabilities.
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Other files
| File | Type | Posted |
|---|---|---|
| 5-DHHS26105 Attachment A DHHS Client Service Terms.docx | DOCX document | |
| 6-DHHS26105 Attachment B Scope of Work.docx | DOCX document | |
| 9-DHHS26105 Attachment D Facility Service Selection Template 6.26.docx | DOCX document | |
| 12-DHHS26105 RFP Template Residential 6 2026.docx | DOCX document | |
| 2-DHHS26105 Form 3 Conflict of Interest Disclosure Statement.pdf | ||
| 4-DHHS26105 Form 1 - DHHS Data Sheet.pdf | ||
| 13-DHHS26105 Score Sheet.xlsx | XLSX spreadsheet | |
| 7-DHHS26105 Attachment E Facility Org Chart.docx | DOCX document | |
| 1-DHHS26105 Attachment C Established Rates for Residential Treatment Services 2026.docx | DOCX document | |
| 3-DHHS26105 Form 2 W-9 Form.pdf | ||
| 8-DHHS26105 Attachment F Past Perfomance.docx | DOCX document | |
| 10-DHHS26105 Attachment G Medicaid Services Attachment.docx | DOCX document |
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Document Submission Checklist
Solicitation # DHHS26105
Forms Form 1 - Data Sheet
Form 2 - State of Utah DHS Substitute Form W9
Form 3 - Conflict of Interest
Attachment D: Facility Service Selection Template
Attachment E: Facility Organization Chart
Attachment F: Past Performance
Attachment G: Medicaid Services Attachment
Technical Proposal including a sample aftercare plan.
Mandatory Minimum Requirements
Offeror must have 2 years of experience serving similar populations. Please certify that you meet this requirement.
Offeror must have a physical facility located in the State of Utah. Please certify that you meet this requirement and list the address:
Prior to the contract start date, the Contractor must have a current license from the DHS Office of Licensing (“DHS/OL”) for residential treatment or intermediate secure care.
Offeror must have a Clinical Evaluation, Treatment, Wrap Services and Forensic Evaluations contract for psychotherapy services; pharmacological evaluation and management of services;
psychosocial rehabilitation services; therapeutic behavioral services; mentoring services; day treatment services; and clinical consultation prior to contracting. Please provide the contract number for your Clinical Evaluation, Treatment, Wrap Services and Forensic Evaluations contract.
Technical Proposal Provide a response to all of the evaluation criteria listed below for each facility: 12 point Times
New Roman
Scoreable Technical Criteria
A. APPLICANTS PROGRAM
DHHS Residential Treatment Services
A1. Describe how the applicant will adhere to the admission criteria identified in the scope of work and admit all Persons that meet criteria referred to their program.
A2. Describe the program's length of stay and how it aligns with the targeted length of stay criteria described in the scope of work.
A3. Submit program manual that describes the evidence- based model used that is shown to reduce recidivism. How it is implemented from clinical intervention to group milieu. Describe the evidence-based treatment models utilized. If you utilize multiple evidence-based models, describe specifically how they are integrated.
A4. Describe the behavior intervention system and how it is related to your evidence-based treatments.
B. Family Engagement B1. Describe Family Treament including behavioral skills training for the family.
B2. Describe the program’s family visitation and other contact.
C. Aftercare Submit an example of an aftercare plan.
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