2-Appendix D-workplan-Nutrition.docx

APPENDIX D- VENDOR WORK PLAN TEMPLATE

BEHAVIORAL HEALTH NUTRITION SERVICES

Name of VENDOR is a bidder for RFP HSS-26-NNN, Behavioral Health Nutrition Services to perform the service functions required to successfully implement and maintain the scope of services required for Behavioral Health Nutrition Services.

Parts of RFP HSS-26-NNN Appendix B-Scope of Work and Technical Requirements are restated for vendor completion of this Work Plan Template.

Nutrition plays a critical role in behavioral health recovery. Individuals with SMI and substance use disorders often face elevated risks of malnutrition, food insecurity, and chronic diseases that can exacerbate psychiatric symptoms and hinder treatment engagement. Integrating nutrition services into behavioral health care is essential for promoting holistic wellness, reducing health disparities, and improving long-term recovery outcomes. Benefits of nutrition services for those with behavioral health conditions are outlined below:

• Reduces depression and anxiety symptoms: Research shows improved mood and reduced symptoms from diets rich in fruits, vegetables, and omega-3 fatty acids.

• Stabilizes mood swings: By balancing blood sugar, proper nutrition prevents the crashes that can cause irritability and mood instability.

Depression, anxiety, bipolar disorder, ADHD, schizophrenia

• Manages stress: Stress can deplete key nutrients. Nutrition services help replenish these resources, improving the body's ability to manage stress.

• Combats oxidative stress and inflammation: Diets rich in antioxidants and anti-inflammatory nutrients reduce the damage associated with mental health disorders like schizophrenia.

ADHD, chronic stress, schizophrenia, dementia

• Reduces cravings: Proper nutrition can stabilize the brain's chemistry, which helps to reduce substance cravings.

• Aids detoxification: Certain nutrients assist organs like the liver in flushing toxins out of the body.

Substance use disorders

• Improves gut health: The gut-brain axis connects the digestive system and the brain. A healthy diet supports a balanced gut microbiome, which influences mood and emotional regulation.

• Empowers long-term wellness: Nutrition counseling provides individuals with the knowledge and skills to make empowered food choices that support their mental and physical health long after treatment.

All behavioral health populations

• Addresses comorbidities: RDNs provide guidance to manage co-occurring conditions, such as diabetes or heart disease, that are common in people with behavioral health issues.

• Provides personalized care: A registered dietitian nutritionist (RDN) creates personalized plans based on an individual’s specific needs, preferences, and lifestyle.

All behavioral health populations

This initiative seeks to:

· Break the cycle of poor nutrition and behavioral health challenges

· Improve access to nutrition education and counseling

· Identify and address food insecurity and malnutrition

· Support management of nutrition-related chronic conditions

· Enhance coordination between nutrition and behavioral health services

BRIEF VENDOR DESCRIPTION

Directions: In the box below, Vendor shall provide the name of their organization, the organization mission, the address where the Vendor is based, the location(s) of intended service delivery, how the vendor shall facilitate accommodation needs for the target population, and a description of how hours will be scheduled for the project.

Name of Vendor

State Mission of Organization

Address where Vendor is Based

Location of Behavioral Health Nutrition Services (may be more than one location to be able to serve all functions at designated Recovery Community Center (Horizon House) and a proposed location for Medical Nutrition Services for participants of DSAMH’s Transitional Case Management services)

Describe how vendor may accommodate needs of high-risk target population (such as linguistic services, virtual access due to mobility challenges)

Describe how hours/days of service operation will be scheduled for service functions

Client Target Population

Name of VENDOR agrees to serve adults (age 18 and over) primarily diagnosed with a serious persistent mental illness with a co-occurring substance use disorder receiving recovery support services at a DSAMH contracted Recovery Community Center (presently at Horizon House, Inc.-Wilmington, DE) and case management services through DSAMH’s Transitional Case Management program (Newark, DE and surrounding New Castle County).

Service Functions

The primary functions of Behavioral Health Nutrition Services for the target population include:

a. Nutrition Screen and Risk Identification: Conducting screenings for:

· Food insecurity using validated tools (such as USDA Food Security Survey, Malnutrition Screening Tool, Nutrition Literacy Assessment Instrument)

· Malnutrition risk via clinical indicators, dietary intake, and anthropometric measures

· History of nutrition-related chronic diseases, including diabetes, hypertension, cardiovascular disease, and gastrointestinal disorders

b. Medical Nutrition Therapy: Nutrition counseling will be individualized to meet the unique needs of each participant, with the focus being on screening and facilitating maximal participation in supplemental food and nutrition programs, and referrals to Registered Dietitian Nutritionists (RDNs) licensed in the State of Delaware when counseling needs are more complex and need more in-depth medical management. One-on one counseling sessions shall address:

· Personalized dietary needs and preferences

· Nutritional strategies to support behavioral health recovery

· Management of chronic conditions through nutrition

· Develop individualized nutrition care plans and monitor progress

· Coordinate with behavioral health providers to ensure integrated care delivery

c. Group-Based Nutrition Education: Vendor shall deliver a structured group-based nutrition education curriculum. Vendor shall develop and implement a structured, evidence-informed curriculum tailored to behavioral health populations. Curriculum must address:

· The role of nutrition in mental health and substance use recovery

· Basic principles of healthy eating

· Budget-conscious meal planning and preparation

· Food access and navigating food environments

*Group Nutrition Education is not applicable to participants of DSAMH’s Transitional Case Management Program

VENDOR RESPONSE TO SERVICE FUNCTIONS

Name of VENDOR agrees to conduct the primary functions of Behavioral Health Nutrition Services for the target population as outlined.

Name of VENDOR shall submit any policies, processes, screening tools, and nutrition education curriculum in place that support the operation of the intended service functions identified as requested by the Division as part of its contract monitoring process.

Staffing Requirements The Vendor must employ or subcontract:

· Registered Dietitian Nutritionists (RDNs) or Licensed Nutritionists with experience in behavioral health settings.

· Support staff trained in screening protocols and group facilitation.

· Staff must demonstrate competency in trauma-informed care, and motivational interviewing.

VENDOR RESPONSE TO STAFFING REQUIREMENTS

Name of VENDOR agrees to comply with the staffing requirements.

VENDOR IMPLEMENTATION PLAN

Directions: In the chart below, Vendor shall identify the intended Implementation Plan in chart format with key activities (shade the appropriate contract month (1-12) for the start and completion time frame, as seen in monthly invoice line). The plan must cover start up through implementation of activities, including recruitment, hiring and orientation of key staff.

Recruitment and hiring

Orientation of staff

Implementation of project

ENTER OTHER ACTIVITIES THAT SUPPORT Behavioral Health Nutrition Services IMPLEMENTATION AND SERVICE FUNCTION COMPLETION (such as screening/referral process development, training, etc) can insert additional rows as needed

Monthly performance reports

Monthly provider/DSAMH meetings

Monthly invoices

Directions: Vendor can add any additional content, in the box below, that supports the implementation of the project:

Adherence to Policies and Procedures Vendors are required to adhere to all federal, state and DSAMH policies, processes, procedures, requirements, rules, laws, and regulations, including, but not limited to, those listed under RFP# HSS-26-NNN, Behavioral Health Nutrition Services.

Name of VENDOR agrees to adhere to the following requirements:

· DSAMH026 – Client Complaint and Grievance

· Criminal Background Check

· DSAMH011 – Trauma Informed Care

· DSAMH012 – Provision of Culturally and Linguistically Appropriate Services

· Human Subjects Review Board

· Inclusion

· The Drug-Free Workplace Act of 1988.

· The Americans with Disabilities Act (PL 101-336).

· State of Delaware, Office of Management and Budget, Budget and Accounting Manual. https://budget.delaware.gov/accounting-manual/index.shtml.

VENDOR RESPONSE TO ADHERENCE TO POLICIES AND PROCEDURES

Name of VENDOR shall submit any policies in place that support the agreeance of identified policies, processes, and regulations as requested by the Division as part of its contract monitoring process.

Name of VENDOR acknowledges that the Division reserves the right to modify, replace, or add to these policies with 60 days’ written notice to Name of VENDOR. In the event of a policy modification or addition of new policy, Name of VENDOR agrees to formulate a plan, in writing, regarding its compliance strategy with the modified or new policy.

Evaluation and Performance Measures The following content establishes sustainable systems to understand the program and its outcomes as simply as possible, integrating data collection into current systems wherever possible. DSAMH has the right to conduct any onsite evaluation and monitoring of the Vendor’s activity at any time.

The extension of the service period of the contract is based on, but not limited to, the past performance of the Vendor. The determination shall be based on, but not limited to, considerations of the following factors:

VENDOR RESPONSE TO EVALUATION AND PERFORMANCE MEASURES

Name of VENDOR agrees to the following responsibilities as outlined for Evaluation and Performance Measures:

· Participate in all meetings (as appropriately scheduled) related to program/project management and contractual administrative functions.

· Coordinate and communicate work product efforts in conjunction with the Division’s Project Lead.

· Submit a Continuity of Operations (COOP) Plan annually as part of the Division’s contract monitoring process. COOP Plans are intended to guide the Vendor as whole in the continued provisions of essential operations and the re-establishment of critical business functions during and after a disaster occurs.

· Comply with performance objectives and all contractual requirements outlined in contract.

· Prominently display on all materials related to and developed for this project the following wording “Funding for this project has been provided by Delaware Health and Social Services’ Division of Substance Abuse and Mental Health through state general funds.”

Quality Improvement Vendor shall implement a method for identifying, evaluating, and correcting deficiencies in the quality and quantity of services to be provided under any resulting contract arising out of this RFP. The quality assurance plan shall include the proposed indicators essential to assess the Vendor’s performance and the overall adequacy of services being provided to individuals in the target population. Specifically, within the quality assurance plan, identify expected individual and system outcomes and benefits, and how client satisfaction and stakeholder satisfaction will be assessed.

1. Vendor must comply with HIPAA and 42 CFR, Part 2.

2. Vendor must comply with regular program and service reporting Presently, the Vendor shall submit monthly program reports to DSAMH_housing@delaware.gov by the 10th of each month for the preceding month of service. DSAMH shall establish the content and format structure of the report.

As DSAMH reviews its various reporting mechanisms for the purpose of standardization across its behavioral health ecosystem, DSAMH reserves the right to shift the mechanism of how monthly program information is submitted which may include submission via a state contracted cloud-based survey platform. DSAMH shall provide the Vendor 60 days’ notice of any report submission changes in writing.

VENDOR RESPONSE TO QUALITY IMPROVEMENT

Name of VENDOR agrees to submit an updated quality assurance plan annually as part of the Division’s contract monitoring process.

This plan should include a description of how the fidelity of the services provided will be sustained (i.e. methodology, reporting mechanisms used, etc.). This plan shall include performance targets and how these will be evaluated, tracked, and reported. Additionally, this plan shall include how client satisfaction and stakeholder satisfaction will be assessed.

Measurement and Key Outcome Indicators Presently, the Vendor shall submit monthly program reports to DSAMH_housing@delaware.gov by the 10th of each month for the preceding month of service. DSAMH shall establish the content and format structure of the report. As DSAMH reviews its various reporting mechanisms for the purpose of standardization across its behavioral health ecosystem, DSAMH reserves the right to shift the mechanism of how monthly program information is submitted which may include submission via a state contracted cloud-based survey platform. DSAMH shall provide the vendor 60 days’ notice of any report submission changes in writing.

The Vendor will be required to establish a monthly reporting process at the time of contracting and on an ongoing basis to monitor project milestones. Additional reporting measures may be asked of the Vendor ad hoc by DSAMH as needed. Below are the category measures that the Vendor shall be asked to collect:

· Screening Information-Tracks aggregate number of client screenings conducted at designated Recovery Community Center and for DSAMH Transitional Case Management, including basic client demographics (gender, age (Young People (18-24); Young Adults (25-35); Older Adults (36-60); Seniors 60+), race and ethnicity). Of those screened, percentage of those positive for food insecurity, percentage at risk for malnutrition; percentage at risk for prediabetes; percentage of persons screened enrolled in the Supplemental Nutrition Assistance Program.

· Medical Nutrition Therapy Statistics- Tracks aggregate number of client referrals to Medical Nutrition Therapy at designated Recovery Community Center and for DSAMH Transitional Case Management. This includes the number of sessions held per client (new and follow-up) and any pre and post screening outcomes. Client HIPAA de-identified success stories or challenge narratives may also be requested as qualitative analysis based on direct client experience provides a complete understanding of the service’s importance.

· Group Nutrition Education Evidence-Aggregate metrics related to group nutrition education classes held. This includes number of classes presented, number of attendees per session, and topics presented. An additional metric includes a description regarding changes to participant knowledge and practice due to Group Nutrition and resources provided.

As part of the quality improvement plan, the monthly program report must also highlight issues raised either by the vendor as continuous improvement objectives along with recommendations to address these objectives.

DSAMH reserves the right to claw back or hold funds for program reports not submitted.

VENDOR RESPONSE TO MEASUREMENT AND KEY OUTCOME INDICATORS

Name of VENDOR agrees to submit the requested metrics as outlined. Name of VENDOR acknowledges that the Division reserves the right to shift the mechanism of how monthly program information is submitted provided Name of VENDOR receive 60 days’ notice of any report submission changes in writing.