Technical Quotation Information Sheet.pdf

Federal Bureau of Prisons

Community Treatment Services

Contract

IMPORTANT INFORMATION TO KNOW:

Technical Quotation forms posted with this solicitation must be completed in their entirety and submitted with attachments required; no other format utilized will be accepted for review.

It is imperative that the Technical Quotation information is legible, detailed oriented and limited to the requested information (e.g., do not provide the history of Cognitive Behavioral Therapy, or the benefits of such; do not provide an explanation of what a Clinical Assessment is, or why it is beneficial).

The Technical Quotation forms must reference only the specific location for the quote submitted (e.g., provide specific information such as the hospital that will be utilized during a crisis; if the quotation is for a city in Baltimore

MD.

All information must be answered on the Technical Quotation form provided, unless otherwise specified. Limit the number of attachments submitted to those specifically requested. Information submitted beyond what is required or sections written in as will not be considered for review or evaluation.

The Technical Quotation form provides directions on labeling attachments. Please ensure that attachments are sequential, labeled correctly, and correspond to the appropriate question.

The Decision Rule Criteria (DRC) is located on second page of this document and also located on the solicitation posted on FedBizOpps. Please refer to this when completing the packet for submission. Failure to provide the requested documentation will delay the ability to review the quotation in its entirety.

Technical Quotation information responses with use of subcontractor(s) and/or multiple site locations (within the geographical restrictions) must adhere to the following:

Submission of one, comprehensive Technical Quotation (from only the Primary Contractor), that addresses all factors on the form, including providing required attachments.

The Technical Personnel form must be organized per site. The Authorized Negotiator must be identified on the prime contractor’s form, and sign all of the Technical Personnel form(s) submitted.

DECISIONAL RULE CRITERIA – LPTA – COMMUNITY TREATMENT SERVICES 2019

1. Operational Requirement – Cognitive Behavioral Therapy (CBT): The Quoter must demonstrate adherence to the CBT model of treatment or other evidence-based programming compatible with CBT. [SOW 1.3]

a. Submit the cognitive behavioral methods or techniques that will be used with Bureau inmates in the delivery of Community Treatment Services (CTS).

2. Operational Requirement – Crisis Interventions: The Quoter must provide emergency crisis interventions, if necessary. When applicable, the Quoter must have the ability to complete a Crisis Intervention Assessment contract line item number (CLIN) 6000, within 24 hours of the request made by CTS staff. [SOW 7.2.5]

a. Submit a plan to provide an emergency crisis intervention, if the need arises at the facility. Include specific local information to include emergency psychiatric care facility, local hospital with crisis unit, or other emergency crisis intervention resources.

b. If applicable, submit a plan to conduct a crisis intervention session within 24 hours of referral, and submit the assessment within one business day.

3. Operational Requirement – Inmate Accountability: The Quoter must have a comprehensive accountability program that ensures every Bureau inmate is accounted for while at the facility. [SOW 12.2]

a. Submit a plan for notifying CTS and the Residential Reentry Center (RRC) of any late arrivals or absences from scheduled sessions.

b. Submit a plan to maintain accountability of inmates from arrival until departure from the facility, include all common areas, and inmate restroom facilities at the performance site.

4. Operational Requirement – Confidentiality: The Quoter must ensure complete confidentiality of all Bureau treatment records and sessions.

a. Submit a plan to ensure the privacy and confidentiality of individual and group sessions. [SOW 11.1.1]

b. Submit the agency’s policies and procedures to comply with all applicable provisions of HIPAA. [SOW11.3.2]

c. Telehealth (if applicable): Identify the communication system and software application that will be used.

Submit evidence of the proposed system’s ability to meet the Bureau’s electronic security requirements:

HIPAA-compliant, FIPS 140-2 certified, 256- bit encryption, and housed in Continental US. [SOW 2.2.7]

d. Telehealth (if applicable): Submit a plan that specifically addresses the telehealth policies and regulations for the state where services will be rendered. Identify on the office diagram required in 5c where the inmates will receive telehealth sessions at the performance site. The plan should identify which National Crime

Information Center (NCIC) cleared, and Bureau approved, staff member will be present at all times during every telehealth session and will ensure telehealth sessions are conducted in a secure and confidential setting. [SOW 2.2.7 & 11.1.1]

5. Facility Requirement – Proposed Location(s): The Quoter must provide treatment at performance sites that meet the specified restrictions, space requirements, ADA compliance guidelines, and that do not present safety risks to the community. [SOW 11.1.1. & 12.2.5]

a. List addresses for all proposed performance sites, to include psychiatric services, and any subcontractors, that are within: 5-mile radius of the Federal Courthouse at 101 West Lombard Street, Baltimore, MD 21201 and within a 0.5 mile walk from public transportation.

b. Submit a deed, lease, bill of sale, option to lease, or option to buy in the name of the Quoter, or subcontractor, if applicable, for all addresses listed in 5a.

c. Submit an office diagram (see attached example) for each proposed performance site listed in 5a that identifies all rooms, provides room dimensions, and specifies the number of people each group room can comfortably accommodate. Therapeutic group rooms must be primarily dedicated to treatment or reserved for outpatient community treatment services.

d. Complete and submit the attached Americans with Disabilities Act (ADA) Checklist for each proposed performance site listed in 5a.

e. Submit photographs for each proposed performance site listed in 5a to include front entrance, emergency exits, restrooms, lobby, individual treatment rooms, and group room(s). Photographs must clearly indicate evidence of ADA compliance.

f. Complete and submit the attached Local Areas of Concern document. This document must identify the following areas of concern that are within a 500 foot radius. This must include the same space and/or same building, of each proposed performance site, and include a plan to mitigate risk to children and other vulnerable populations:

Schools, day-care centers, playgrounds, developed or improved parks, athletic fields, churches, school bus stops, and any facilities/businesses that primarily care for/educate/entertain minors or other vulnerable populations.

6. Facility Requirement – Facility License: The facility must be appropriately licensed and/or certified to provide all required services on, or by, the contract effective date by the state authority where services will be rendered.

[SOW 11.2]

a. Submit the required state facility license and/or certification to provide all treatment services at the proposed performance site(s) listed in 5a.

If in the process of obtaining a valid license, submit the completed application, provisional license, official email correspondence, and/or other official documentation as proof. Documentation must show that the Quoter may begin services on, or by, the contract effective date.

If state or local law does not require facility licensing, the Quoter must provide a copy of the statute that this factor does not apply, or submit official documents that allow services to be performed (e.g., email from regulatory board).

7. Staffing Requirement: The Quoter must have key personnel to meet the solicitation requirements. The Quoter must ensure all personnel providing clinical services to Bureau inmates meet the experiential, educational, and appropriate licensure/certification as required by the state authority where the services will be rendered.

a. Submit the Technical Personnel document that identifies the position and responsibility of all personnel proposed to meet or exceed the minimum staffing requirements of key personnel in table 7a below. All key personnel must be identified on this document. [SOW 2.1]

b. Submit resumes for personnel providing direct clinical services to Bureau inmates. [SOW 1.3.4]

c. Submit copies of current and valid professional licenses for clinical staff. Clinical licenses submitted must be listed in table 7c below and must correspond to the respective clinical duties performed. [SOW 2.2]

If unable to produce an original license, provide a license verification sheet with a copy of a government-issued photo identification card for the staff member.

If submitting a non-medical license that is not listed on the table below, complete the Mental

Health/Behavioral Health Professionals Scope of Practice Summary. Any licenses other than those listed below will be reviewed on a case-by-case basis.

d. Psychiatric (if applicable): Submit a Drug Enforcement Agency Controlled Substance Registration Certificate for a qualified practitioner with prescriptive authority who meets the standards of practice established by the state’s professional regulatory board to provide psychiatric evaluations and medication monitoring.

[SOW 2.2.6]

7a. Minimum Staffing Requirements of Key Personnel

Identify the following on the Technical Personnel Document:

1. Authorized Negotiator

2. Key Personnel for Substance Use Disorder Services

3. Key Personnel for Mental Health Services

4. Key Personnel for Psychiatric Services

5. Key Personnel for Sex Offender Treatment Services

7c. Clinical Licensing Requirements for Counselors

All clinicians must be licensed or certified in the state of MARYLAND.

Mental Health/Sex Offender/Substance Use Substance Use

Clinical Professional Counselor Licensed Certified Social Worker – Clinical (LCSW-C) Licensed Psychologist

Certified Alcohol and Drug Counselor (CAC-AD) Licensed Certified Social Worker (LCSW-G)

FEDERAL BUREAU OF PRISONS

COMMUNITY TREATMENT SERVICES

TECHNICAL QUOTATION INFORMATION

Name of Company: Click or tap here to enter text.

Authorized Negotiator: Click or tap here to enter text.

Solicitation Number: Click or tap here to enter text.

Subcontracting: ☐ Will be utilized ☐ Will not be utilized

Location(s): ☐ One location ☐ More than one location

Directions: Provide a detailed and concise written response to all of the areas below and submit all supplementary documentation as a completed technical quotation packet. Please limit your responses to what is requested in this document.

1. Operational Requirement – Cognitive Behavioral Therapy (CBT): The Quoter must demonstrate adherence to the CBT model of treatment or other evidence-based programming compatible with CBT.

[SOW 1.3]

a. Submit the cognitive behavioral methods or techniques that will be used with Bureau inmates in the delivery of Community Treatment Services (CTS).

RESPONSE: Click or tap here to enter text.

2. Operational Requirement – Crisis Interventions: The Quoter must provide emergency crisis interventions, if necessary. When applicable, the Quoter must have the ability to complete a Crisis Intervention Assessment, contract line item number (CLIN) 6000, within 24 hours of the request made by CTS staff. [SOW 7.2.5]

a. Submit a plan to provide an emergency crisis intervention, if the need arises at the facility. Include specific local information to include emergency psychiatric care facility, local hospital with crisis unit, or other emergency crisis intervention resources.

b. If applicable, submit a plan to conduct a crisis intervention session within 24 hours of referral, and submit the assessment within one business day.

3. Operational Requirement – Inmate Accountability: The Quoter must have a comprehensive accountability program that ensures every Bureau inmate is accounted for while at the facility. [SOW 12.2]

a. Submit a plan for notifying CTS and the Residential Reentry Center (RRC) of any late arrivals or absences from scheduled sessions.

b. Submit a plan to maintain accountability of inmates from arrival until departure from the facility, include all common areas, and inmate restroom facilities at the performance site.

4. Operational Requirement – Confidentiality: The Quoter must ensure complete confidentiality of all Bureau treatment records and sessions.

a. Submit a plan to ensure the privacy and confidentiality of individual and group sessions. [SOW 11.1.1]

b. Submit the agency’s policies and procedures to comply with all applicable provisions of HIPAA.

[SOW 11.3.2]

c. Telehealth (if applicable): Identify the communication system and software application that will be used.

Submit evidence of the proposed system’s ability to meet the Bureau’s electronic security requirements:

HIPAA-compliant, FIPS 140-2 certified, 256- bit encryption, and housed in Continental US. [SOW 2.2.7]

RESPONSE: System specifications addressing security requirements attached ☐

d. Telehealth (if applicable): Submit a plan that specifically addresses the telehealth policies and regulations for the state where services will be rendered. Identify on the office diagram required in 5c where the inmates will receive telehealth sessions at the performance site. The plan should identify which National

Crime Information Center (NCIC) cleared, and Bureau approved, staff member will be present at all times during every telehealth session and will ensure telehealth sessions are conducted in a secure and confidential setting. [SOW 2.2.7 & 11.1.1]

5. Facility Requirement – Proposed Location(s): The Quoter must provide treatment at performance sites that meet the specified restrictions, space requirements, ADA compliance guidelines, and that do not present safety risks to the community. [SOW 11.1.1 & 12.2.5]

a. List addresses for all proposed performance sites, to include psychiatric services, and any subcontractors, which are within the solicitation’s restrictions in the Decisional Rule Criteria (2.1 of SF

1449).

b. Submit a deed, lease, bill of sale, option to lease, or option to buy in the name of the Quoter, or subcontractor, if applicable, for all addresses listed in 5a.

RESPONSE: Documents for all addresses listed on 5a attached ☐

c. Submit an office diagram (see attached example) for each proposed performance site listed in 5a that identifies all rooms, provides room dimensions, and specifies the number of people each group room can comfortably accommodate. Therapeutic group rooms must be primarily dedicated to treatment or reserved for outpatient community treatment services.

RESPONSE: Diagram with dimensions for all addresses listed on 5a attached ☐

d. Complete and submit the attached Americans with Disabilities Act (ADA) Checklist for each proposed performance site listed in 5a.

RESPONSE: ADA Checklist completed for all addresses listed on 5a attached ☐

e. Submit photographs for each proposed performance site listed in 5a to include front entrance, emergency exits, restrooms, lobby, individual treatment rooms, and group room(s). Photographs must clearly indicate evidence of ADA compliance.

RESPONSE: Photographs labeled for all addresses listed on 5a attached ☐

f. Complete and submit the Local Area of Concerns document. This document must identify the following areas of concern that are within the solicitation restrictions listed in the Decisional Rule Criteria (2.1 of

SF 1449), to include the same space and/or same building, of each proposed performance site, and include a plan to mitigate risk to children and other vulnerable populations:

Schools, day-care centers, playgrounds, developed or improved parks, athletic fields, churches, school bus stops, and any facilities/businesses that primarily care for/educate/entertain minors or other vulnerable populations.

RESPONSE: Local Area of Concern form completed for all addresses listed on 5a attached ☐

6. Facility Requirement – Facility License: The facility must be appropriately licensed and/or certified to provide all required services on, or by, the contract effective date by the state authority where services will be rendered. [SOW 11.2]

a. Submit the required state facility license and/or certification to provide all treatment services at the proposed performance site(s) listed in 5a.

If in the process of obtaining a valid license, submit the completed application, provisional license, official email correspondence, and/or other official documentation as proof. Documentation must show that the Quoter may begin services on, or by, the contract effective date.

If state or local law does not require facility licensing, the Quoter must provide a copy of the statute that this factor does not apply, or submit official documents that allow services to be performed (e.g., email from regulatory board).

RESPONSE: Facility documents for all addresses listed on 5a attached ☐

7. Staffing Requirement: The Quoter must have key personnel to meet the solicitation requirements. The

Quoter must ensure all personnel providing clinical services to Bureau inmates meet the experiential, educational, and appropriate licensure/certification as required by the state authority where the services will be rendered.

a. Submit the Technical Personnel document that identifies the position and responsibility of all personnel proposed to meet or exceed the minimum staffing requirements of key personnel identified in the

Decisional Rule Criteria (2.1 of SF 1449). All key personnel must be identified on this document.

[SOW 2.1]

RESPONSE: Technical Personnel document is completed and attached ☐

b. Submit resumes for personnel providing direct clinical services to Bureau inmates. [SOW 1.3.4]

RESPONSE: Resumes for clinical staff listed on 7a attached ☐

c. Submit copies of current and valid professional licenses for clinical staff. Clinical licenses submitted must be listed in the Decisional Rule Criteria (2.1 of SF 1449) and correspond to the respective clinical duties performed. [SOW 2.2]

If unable to produce an original license, provide a license verification sheet with a copy of a government-issued photo identification card for the staff member.

If submitting a non-medical license that is not listed on the table below, complete the Mental

Health/Behavioral Health Professionals Scope of Practice Summary. Any licenses other than those listed below will be reviewed on a case-by-case basis.

RESPONSE: Professional licenses for clinical staff listed on 7a attached ☐

d. Psychiatric (if applicable): Submit a Drug Enforcement Agency Controlled Substance Registration

Certificate for a qualified practitioner with prescriptive authority who meets the standards of practice established by the state’s professional regulatory board to provide psychiatric evaluations and medication monitoring. [SOW 2.2.6]

RESPONSE: DEA certificate for psychiatric staff listed on 7a attached ☐

Example Office Diagram – Figure 5C

Example Office Diagram – Figure 5C

Please show the following on the office diagram submitted for each proposed performance site:

The use of each room.

The dimensions of each room.

The number of people each group room can comfortably accommodate.

13 people

ADA Compliance Checklist – Table 5D

ADA Compliance Checklist – Table 5D

Submit the following checklist to assess each proposed performance site for accessibility.

Please note this is not a complete or detailed checklist for ADA compliance.

More information can be found at: www.ada.gov

Name of Company: Click or tap here to enter text.

Proposed Performance

Site Address:

Click or tap here to enter text.

Solicitation Number: Click or tap here to enter text.

Existing Buildings and Facilities Yes No NA

1 Are accessible entrances clearly marked? ☐ ☐

Is there an accessible route to an accessible entrance from parking, drop-off points, public transportation, and public sidewalks?

Is there at least one entrance that is accessible (e.g., with a level entrance or ramp)?

If there is more than one floor or level, is each connected by an elevator with accessible controls?

Do doors have a 32-inch clearance and usable hardware (e.g., lever handles)?

6 Are signs accessible to people who are blind or have low vision? ☐ ☐

Are accessible restrooms provided with accessible stalls and lavatories and directional signage?

If the site where services will be provided are not accessible, can the services be moved to accessible locations or can other modifications be made to ensure participation by those who have disabilities?

Provide a plan for ADA compliance and estimated completion date for any “NO” responses above:

Click or tap here to enter text.

Local Areas of Concern – Table 5F

Local Areas of Concern – Table 5F

Identify any of the following areas of concern, including those in the same space and/or same building, that are within the restrictions of 2.1 of

SF1449 for each proposed performance site and submit a plan to mitigate risk to children and other vulnerable populations: schools, day-care centers, playgrounds, developed or improved parks, athletic fields, churches, school bus stops, and any facilities/businesses that primarily care for/educate/entertain minors or other vulnerable populations.

The plan to mitigate risk to children and other vulnerable populations must include details to limit or eliminate contact with the local areas of concern identified.

The following table must be completed fully with all appropriate information for each proposed performance site.

Name of Company: Click or tap here to enter text.

Proposed Performance

Site Address:

Click or tap here to enter text.

Solicitation Number: Click or tap here to enter text.

Area of concern:

(name and location/address)

Distance from proposed perfor-mance site:

Days & hours of operation:

Potential risk or negative impact of proposed site to area of concern.

Plan to mitigate potential risk or negative impact.

Click or tap here to enter text.

Click or tap here to enter text.

Click or tap here to enter text.

Click or tap here to enter text.

Click or tap here to enter text.

Click or tap here to enter text.

Click or tap here to enter text.

Click or tap here to enter text.

Click or tap here to enter text.

Click or tap here to enter text.

Click or tap here to enter text.

Click or tap here to enter text.

Click or tap here to enter text.

Click or tap here to enter text.

Click or tap here to enter text.

Click or tap here to enter text.

Click or tap here to enter text.

Click or tap here to enter text.

Click or tap here to enter text.

Technical Personnel List – Table 7A Key Personnel: AN (authorized negotiator), SU (substance use tx), MH (mental health tx), PY (psychiatric tx), SO (sex offender tx)

Technical Personnel List – Table 7A

Name of Company: Click or tap here to enter text.

Proposed Performance Site Address: Click or tap here to enter text.

Solicitation Number: Click or tap here to enter text.

Last Name, First Name Required Key Personnel Professional License and Numb. or Admin

Position Title

License

Expiration Date

Employee or

Subcontractor?

EVALUATION

USE ONLY AN SU MH PY SO

1 Click or tap here to enter text. ☐ ☐ ☐ ☐ ☐ **** **** **** ⃝ R ⃝ L ⃝ PA

2 Click or tap here to enter text. ☐ ☐ ☐ ☐ ☐ **** **** **** ⃝ R ⃝ L ⃝ PA

3 Click or tap here to enter text. ☐ ☐ ☐ ☐ ☐ **** **** **** ⃝ R ⃝ L ⃝ PA

4 Click or tap here to enter text. ☐ ☐ ☐ ☐ ☐ **** **** **** ⃝ R ⃝ L ⃝ PA

5 Click or tap here to enter text. ☐ ☐ ☐ ☐ ☐ **** **** **** ⃝ R ⃝ L ⃝ PA

6 Click or tap here to enter text. ☐ ☐ ☐ ☐ ☐ **** **** **** ⃝ R ⃝ L ⃝ PA

7 Click or tap here to enter text. ☐ ☐ ☐ ☐ ☐ **** **** **** ⃝ R ⃝ L ⃝ PA

8 Click or tap here to enter text. ☐ ☐ ☐ ☐ ☐ **** **** **** ⃝ R ⃝ L ⃝ PA

9 Click or tap here to enter text. ☐ ☐ ☐ ☐ ☐ **** **** **** ⃝ R ⃝ L ⃝ PA

10 Click or tap here to enter text. ☐ ☐ ☐ ☐ ☐ **** **** **** ⃝ R ⃝ L ⃝ PA

Professionals Scope of Practice Summary – Table 7C

Professionals Scope of Practice Summary – Table 7C

State: Click or tap here to enter text.

Profession Licensing Board and Website Scope of Practice

Scope of

License

Click or tap here to enter text.

Click or tap here to enter text.

Click or tap here to enter text.

Choose an item.

Click or tap here to enter text.

Click or tap here to enter text.

Click or tap here to enter text.

Choose an item.

Click or tap here to enter text.

Click or tap here to enter text.

Click or tap here to enter text.

Choose an item.

Click or tap here to enter text.

Click or tap here to enter text.

Choose an item.

Professionals Scope of Practice Summary ***EXAMPLE*** State: Somewhere (SW), USA

Profession Licensing Board and

Website Scope of Practice

Scope of

License Licensed Professional

Clinical Counselors

(LPCC)

SW Board of Behavioral Health and

Therapy www.bbht.state.sw.us/Home/tabid/10

The scope of practice of a licensed professional clinical counselor includes, but is not limited to:

1. implementation of professional counseling treatment interventions including evaluation, treatment planning, assessment, and referral;

2. direct counseling services to individuals, groups, and families;

3. counseling strategies that effectively respond to multicultural populations;

4. knowledge of relevant laws and ethics impacting practice;

5. crisis intervention;

6. consultation; and

7. program evaluation and applied research.

(S.W. 148B.50)

Practice

Independently

Clinical Social

Worker (LICSW)

SW Board of Social Work www.socialwork.state.sw.us

May engage in clinical practice. Clinical practice is the diagnosis and treatment of psychosocial function, disability, or impairment, including addictions and emotional, mental, and behavioral disorders, including plans based on a differential diagnosis. Treatment may include psychotherapy.

(S.W. 148D.050)

Practice

Independently

Licensed Social

Worker (LSW)

SW Board of Social Work http://www.socialwork.state.sw.us/

Practices under supervision. May not engage in clinical practice.

Practice includes:

1. assessment

2. case management ‘

3. client-centered advocacy

4. client education and counseling

5. crisis intervention

6. referral

(S.W. 148D.050)

Requires

Supervision