Technical Quotation Sheet.pdf.docx
DOCX document 110 KB Posted
- Attached to
- SU/MH/SOT in Baltimore, MD Federal contract opportunity
- Solicitation number
- 15BCTS20Q00000034
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Technical Quotation Information Sheet.pdf | ||
| Cover letter FBO.pdf | ||
| Small Business Subcontracting Template.pdf | ||
| Business Quotation Information.pdf | ||
| Whistleblower Information.pdf | ||
| 15BCTS20Q00000034.pdf | ||
| Section 2.1, Continuation of SF-1449.pdf | ||
| 2017SEP_CTS_SOW.pdf |
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FEDERAL BUREAU OF PRISONS
COMMUNITY TREATMENT SERVICES
TECHNICAL QUOTATION INFORMATION
Name of Company:
Authorized Negotiator:
Solicitation Number:
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.
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]
Submit the cognitive behavioral methods or techniques that will be used with Bureau inmates in the delivery of Community Treatment Services (CTS).
RESPONSE:
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]
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.
RESPONSE:
If applicable, submit a plan to conduct a crisis intervention session within 24 hours of referral, and submit the assessment within one business day.
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]
Submit a plan for notifying CTS and the Residential Reentry Center (RRC) of any late arrivals or absences from scheduled sessions.
RESPONSE:
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.
Operational Requirement – Confidentiality: The Quoter must ensure complete confidentiality of all Bureau treatment records and sessions.
Submit a plan to ensure the privacy and confidentiality of individual and group sessions. [SOW 11.1.1]
RESPONSE:
Submit the agency’s policies and procedures to comply with all applicable provisions of HIPAA.
[SOW 11.3.2]
RESPONSE:
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
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]
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]
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).
RESPONSE:
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
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
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
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
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
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]
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
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.
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
Submit resumes for personnel providing direct clinical services to Bureau inmates. [SOW 1.3.4]
RESPONSE: Resumes for clinical staff listed on 7a attached
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
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
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.
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? | ☐ | ☐ | |
| 2 | Is there an accessible route to an accessible entrance from parking, drop-off points, public transportation, and public sidewalks? | ☐ | ☐ | |
| 3 | Is there at least one entrance that is accessible (e.g., with a level entrance or ramp)? | ☐ | ☐ | |
| 4 | If there is more than one floor or level, is each connected by an elevator with accessible controls? | ☐ | ☐ | ☐ |
| 5 | 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? | ☐ | ☐ | |
| 7 | Are accessible restrooms provided with accessible stalls and lavatories and directional signage? | ☐ | ☐ | |
| 8 | 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 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. | Click or tap here to enter text. |
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
| 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. | 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: | implementation of professional counseling treatment interventions including evaluation, treatment planning, assessment, and referral; | direct counseling services to individuals, groups, and families; | counseling strategies that effectively respond to multicultural populations; | knowledge of relevant laws and ethics impacting practice; | crisis intervention; | consultation; and | 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: | assessment | case management ‘ | client-centered advocacy | client education and counseling | crisis intervention | referral | (S.W. 148D.050) | Requires Supervision |
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