3. Technical Quotation Information Request.docx

FEDERAL BUREAU OF PRISONS

COMMUNITY TREATMENT SERVICES

TECHNICAL QUOTATION INFORMATION

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

*Authorized Negotiator must be identified and listed in Technical Personnel document as well.

Authorized Negotiator: * Click or tap here to enter text.

Solicitation Number: Click or tap here to enter text.

Directions: Provide detailed and concise written responses to all the areas below and submit all supplementary documentation as a complete technical quotation packet. Please limit your responses to what is requested in this document. Technical quotations submitted in another format or forms created by the Quoter will not be evaluated.

1. Staffing Requirement – Key Personnel: The Quoter must have key personnel to meet the solicitation requirements. The Quoter must ensure all personnel providing clinical services to Bureau offenders meet the experiential, educational, and appropriate licensure/certification as required by the state authority where the services will be rendered. [SOW 5.1]

a. Submit the Technical Personnel document that identifies the position and responsibility of all personnel proposed to meet the minimum staffing requirements of key personnel identified in the Decisional Rule Criteria (2.1 of SF 1449). [SOW 5.2]

0. All key personnel and administrative positions must be identified in this document. All key personnel, authorized negotiator(s), and administrative positions must be identified and listed on this document.

0. Listing only one key personnel to provide all required counseling services in the solicitation is not acceptable and does not meet the requirements of this subfactor.

0. Note: Key personnel listed in a separate document created by the Quoter is not acceptable and does not meet the requirements of this subfactor.

RESPONSE: Attach completed Technical Personnel List identifying clinical personnel, authorized negotiator(s), and administrative staff. For clinical personnel, check only the boxes that pertain to the type of services (counseling or medication) and method of delivery (in-person or telehealth) that key personnel will deliver and are licensed to provide. ☐

· Counseling services include substance use disorder, mental health, co-occurring, and sex offender treatment. Proposed key personnel identified must meet the licensing requirements to provide any counseling services.

· Medication services include psychiatric treatment and medication monitoring services. Proposed key personnel identified must meet the licensing requirements to provide any medication services.

• Do not check the box under a service if proposed key personnel are not licensed to provide that type of service.

b. Submit copies of current and valid professional licenses for key personnel who will provide direct clinical services (counseling or medication) to Bureau offenders. Clinical licenses submitted for counseling services must be listed in the Decisional Rule Criteria (2.1 of SF 1449) and must correspond to the respective clinical duties performed. All copies of professional licenses and license verification sheets must clearly show the applicable state licensing board and the expiration date on the submitted document. [SOW 5.4]

i. Staff licenses for medical staff (e.g., medical doctor, physician assistant, nurse practitioner) must meet the standards of practice established by the applicable state’s professional regulatory board in the state where services will be rendered.

ii. If submitting a non-medical license that is not listed in the Decisional Rule Criteria (2.1 of SF 1449), complete the Mental Health/Behavioral Health Professionals Scope of Practice Summary. Any licenses other than those listed in the Decisional Rule Criteria (2.1 of SF 1449) will be reviewed on a case-by-case basis.

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

RESPONSE: Attach copies of professional licenses or certifications for all clinical staff listed as key personnel who will be providing either counseling or medication services on 1a. ☐

· If providing a license verification sheet, it must show the applicable state board which issued the license.

· If only providing a license verification sheet, submit a current government-issued photo identification card for each key personnel.

c. Submit resumes for key personnel listed on the Technical Personnel document proposed to provide direct clinical services for counseling services only. Resumes must show documented experience working with a criminal justice population providing substance use disorder, mental health, or sex offender treatment services. Documented experience on a resume must include brief descriptions of the type of clinical services provided working with a criminal justice population. [SOW 5.3]

RESPONSE: Attach resumes for all key personnel listed on the Technical Personnel document for 1a who will be providing direct clinical services (COUNSELING SERVICES ONLY). ☐

· Documented experience working with a criminal justice population must be included on a resume or it will be found unacceptable.

· Counseling services include substance use disorder, mental health, and sex offender treatment.

· Resumes submitted for any non-counseling key personnel will not be evaluated.

d. Submit the Clinical Experience document for all key personnel who will be providing direct clinical services for counseling services only and list total clinical experience working with a criminal justice population providing substance use disorder, mental health, or sex offender treatment services. The Clinical Experience document must correspond to information submitted in the resumes, as to the type and number of years’ experience working with a criminal justice population.

RESPONSE: Attach completed Clinical Experience List for all key personnel on 1a who will be providing direct clinical services (COUNSELING SERVICES ONLY). ☐

· The Clinical Experience document and the Technical Personnel List must match in experience in the type of service with the proposed services to be provided by key personnel.

· Counseling services include substance use disorder, mental health, co-occurring, and sex offender treatment.

· Any non-counseling key personnel listed on the Clinical Experience document will not be evaluated.

e. 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, medication monitoring, and follow-up services. [SOW 5.4.5]

RESPONSE: Attach DEA certificates for qualified practitioners listed on 1a. ☐

2. 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 2.2]

a. Submit two (2) cognitive behavioral methods or techniques that will be used with Bureau inmates in the delivery of Community Treatment Services (CTS). Limit response to listing the methods or techniques that will be used; do not provide explanations or descriptions of the methods or techniques, unless not a widely known form of treatment. [SOW 2.2.1]

RESPONSE 1: Click or tap here to enter text.

RESPONSE 2: Click or tap here to enter text.

3. Operational Requirement – Crisis Interventions: The Quoter must provide emergency crisis intervention assessments, when necessary. The Quoter must have the ability to provide a crisis intervention evaluation and submit a report, contract line item number (CLIN) 6000, within 24 hours of the request made by CTS staff. [SOW 4.3.9]

a. Identify on the Technical Personnel document which key personnel can conduct a comprehensive diagnostic interview and provide the written report within 24 hours of the referral for emergency crisis interventions.

RESPONSE: Attach completed Technical Personnel document listing and identifying the key personnel who will provide crisis intervention assessments. ☐

4. 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 7.1 & 7.2.1]

a. List addresses for all proposed performance sites, including subcontractors, where the required services will be provided within the solicitation’s restrictions in the Decisional Rule Criteria (2.1 of SF 1449).

RESPONSE: Click or tap here to enter text.

· The full address, including the office or suite number, if applicable, must be provided for each proposed performance site.

b. Submit a lease, option or intent to lease, an office service agreement or option, a deed, bill of sale, or option to buy, in the name of the Quoter, or subcontractor if applicable, for all addresses listed in 4a. Documents submitted for a lease, option or intent to lease or an office service agreement or option must meet the following requirements:

i. Acceptable proof of a lease, option or intent to lease, or an office service agreement or option, must address, at a minimum, the following provisions:

1. Names of the parties (landlord, management company, or provider and prospective tenant)

2. Proposed or current terms of lease or agreement, including termination terms, and desired or current start and end dates

3. Property details of the location for an option or intent to lease must include conditions of premises, i.e., space is being leased in “AS IS” condition or will require either party to build out the space

4. Property details for an office service agreement option must define the workspace via specific desk counts, private office numbers, or shared, non-exclusive areas, and any included services like internet, utilities, and reception

5. Signatures of both parties

ii. Month-to-month terms are not acceptable for a proposed performance site on a lease, or an option or intent to lease, or on an office service agreement or option.

iii. A lease, or option or intent to lease, or an office service agreement or option, on a one-year (12 months) term or less must also include an assurance statement, signed by the authorized negotiator and dated, which provides a contingency plan to secure a new location, without any interruption in services, if the need should arise.

iv. When the Quoter is using a subcontractor to deliver the required services at subcontractor’s proposed performance site, Quoter must submit a lease, option or intent to lease, an office service agreement or option, a deed, bill of sale, or option to buy in the name of the subcontractor for all addresses listed in 4a. The lease, option or intent to lease, office service agreement or option, deed, bill of sale, or option to buy must clearly show the subcontractor, by their signature on the document submitted, as the tenant, potential tenant, owner, or potential owner of the proposed performance site.

v. A service or lease agreement between the Quoter and the subcontractor is not acceptable when the subcontractor has a lease, option or intent to lease, office service agreement or option, with a third party, i.e., a landlord, management company, or provider.

vi. A service or lease agreement between the Quoter and the subcontractor will be acceptable when the subcontractor has a deed, bill of sale, or option to buy a proposed performance site. Quoter must then submit the deed, bill of sale, or option to buy proposed performance site in the name of the subcontractor as proof of ownership or potential ownership and a service or lease agreement or option which meets all elements in i, ii, and iii.

RESPONSE: Attach documents for all addresses listed in 4a. ☐

· Documents submitted must include essential pages to meet the subfactor requirements.

· Documents submitted must have signatures of both parties, including the date.

· If leasing or sharing office space, include the full address, suite/unit number.

· Documents must specify the exact duration of the terms of a lease or office service agreement, including any options to renew.

· Documents to show proof of a lease, option or intent to lease, or office service agreement or option, a deed, bill of sale, or option to buy must be in the name of the Quoter, or if applicable, the subcontractor, for a proposed performance site.

c. Provide the methods and means that will be used to ensure individual and group rooms are private and allow for confidentiality during treatment sessions. [SOW 7.1.1]

RESPONSE: Click or tap here to enter text.

d. Submit an office diagram (see attached example) for each proposed performance site listed in 4a. The diagram must identify all rooms that will be used as counseling space and services, i.e., individual, group, or psychiatric treatment rooms, as well as space used for a waiting, lobby, or reception area. The location of the restroom facilities should also be identified. [SOW 7.1.1]

i. Specify on the office diagram 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: Attach an office diagram for all addresses listed in 4a. ☐

e. Complete and submit the attached Americans with Disabilities Act (ADA) Checklist for each proposed performance site listed in 4a. [SOW 7.1.1] RESPONSE: Attach completed ADA Checklist for all addresses listed in 4a. ☐

f. Complete and submit the attached Office Service Agreement (OSA) Checklist for each proposed performance site listed in 4a which will be under an office service agreement. The document must assess risks primarily related to security, data protection, oversight, and contract compliance.

i. The OSA Checklist must include a plan to mitigate any risks identified at the proposed performance site (office workspace).

ii. Submit a listing, e.g., a directory, of all businesses located on the same floor as the proposed performance site (office workspace).

RESPONSE: Attach completed OSA Checklist for addresses listed in 4a which will be under an office service agreement. ☐ Check here if this subfactor does not apply. ☐

g. Complete and submit the attached Local Areas of Concern document for each proposed performance site listed in 4a. This document must identify the following areas of concern that are within 500 feet, which must also include the same space and/or same building, of each proposed performance site:

i. 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. [SOW 7.2.1]

ii. The LAC document must include a plan to mitigate risk to children and other vulnerable populations for each area of concern identified, as applicable.

iii. Submit evidence to show a review of the area around each proposed performance site was completed, e.g., a screenshot or pdf printout of each proposed performance site location pinned on a digital map which clearly shows the surrounding area within a 500 foot radius.

RESPONSE: Attach completed Local Area of Concern document, including evidence of review for all addresses listed in 4a. ☐

· Quoter must provide evidence that a review of the surrounding area of each proposed performance site was conducted by submitting a digital map.

5. 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 7.4]

a. Submit the required state facility license or certification to provide all treatment services at the proposed performance site(s) listed in 4a.

i. If in the process of obtaining a valid license or certification, submit the completed application, provisional license or certification, 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.

ii. Providing only the email for submitting the application is not acceptable and does not meet the requirements of this subfactor.

iii. Documentation, such as official email correspondence, must show the Quoter may begin services on, or by, the contract effective date.

iv. If a facility license or certification is not required, Quoter must submit official documents, e.g., recent email correspondence from the state regulatory board, or a copy of the current state licensing or certification regulations or statutes, as proof to clearly show that this factor does not apply.

v. Note: A business license does not meet the requirements for a facility license or certification.

RESPONSE: Attach facility license/certification, or other official documents, for all addresses listed in 4a. ☐

· If this factor is listed, and it does not apply, Quoter must submit documentation, as specified above, to show why it does not apply to Quoter. Not submitting any evidence is unacceptable.

Technical Personnel List – Table 1A 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.

Professional License and Number or Admin Position Title

License Expiration Date

USE ONLY

NTERV

☐ L ☐ PA

☐ L ☐ PA

☐ L ☐ PA

☐ L ☐ PA

☐ L ☐ PA

☐ L ☐ PA

☐ L ☐ PA

☐ L ☐ PA

☐ L ☐ PA

☐ L ☐ PA

*Required Key Personnel include Authorized Negotiator, all personnel proposed to provide services awarded to the contract, and administrative positions.

AN = AUTHORIZED NEGOTIATOR

SU = SUBSTANCE USE DISORDER TREATMENT, MH = MENTAL HEALTH TREATMENT, CO-OCC = CO-OCCURRING TREATMENT (COUNSELING SERVICES)

PSY = PSYCHIATRIC TREATMENT (MEDICATION SERVICES)

SO = SEX OFFENDER TREATMENT (COUNSELING SERVICES)

Professionals Scope of Practice Summary – Table 1B

License

Professionals Scope of Practice Summary ***EXAMPLE***

License

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

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

http://www.socialwork.state.sw.us/ Practices under supervision. May not engage in clinical practice.

Practice includes:

1. assessment

1. case management ‘

1. client-centered advocacy

1. client education and counseling

1. crisis intervention

1. referral

(S.W. 148D.050) Requires Supervision

Clinical Experience List – Table 1D (Information listed here must correspond to information submitted on resumes.)

List all required key personnel, as identified on the Technical Personnel document, who will be providing direct clinical services (COUNSELING SERVICES ONLY).

Total Clinical Experience providing the following services to a criminal justice population:

Disorder Treatment

Note: Key personnel identified on the Technical Personnel document and the proposed services to be provided by the individual must match experience in the same type of services on the Clinical Experience document.

Example Office Diagram – 4D

For each proposed performance site listed in 1a, submit an office diagram:

· Identify all rooms that will be used as counseling space.

· Include any areas used for a waiting, lobby, or reception area.

· Identify the location of the restroom facilities.

· Specify the number of people each group room can comfortably accommodate.

ADA Compliance Checklist – Table 4E

· 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

Site Address:

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

Click or tap here to enter text.

OSA Checklist – Table 4F (If Applicable)

· Submit the following checklist to assess risks primarily related to security, data protection, oversight, and contract compliance for each proposed performance site under an office service agreement.

Site Address:

· For any “YES responses, provide a plan to mitigate risks at the proposed performance site (office workspace):

Click or tap here to enter text.

Local Areas of Concern – Table 4G

· 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.

· Submit evidence to show a review of the area around each proposed performance site was completed. Provide a screenshot or pdf printout of each proposed performance site location pinned on a digital map which clearly shows the surrounding area within the restrictions of 2.1 of SF1449.

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

Site Address:

(name and location/address)

Technical Quotation Checklist

Check each response for correct and complete information submitted in technical quotation packet:

☐ Provide resumes for all key personnel providing clinical services

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