21. 2017 Respite Master Service Agreement RFA 6.5.17~1.docx

Department of Mental Health Respite Services – Master Agreement Request For Applications

DMH # 2017-DMH-3048-03

June, 2017

The Commonwealth of Massachusetts Executive Office of Health and Human Services Department of Mental Health

COMMBUYS Bid#: BD-17-1022-DMH08-8220A-18593

DMH Document Number: RFA # 2017-DMH-3048-03

DATE:

Contact Name: Jerome Collins, Assistant Director Contract Administration, Audit and Systems

Address: Department of Mental Health Central Office 25 Staniford Street Boston, Ma 02114 Fax: (617) 626-8014

Email: Jerome.Collins@state.ma.us

TABLE OF CONTENTS

Application Requirements Application Cover Sheet Authorized Signatory Listing Authorization for Electronic Funds Payment Commonwealth Terms and Conditions for Health and Human Services Commonwealth of Massachusetts Standard Contract Form and Instructions DMH Business Associate Terms and Conditions Executive Office of Health and Human Services Siting Guidelines and Operational Procedures for siting group living environments EOHHS New Group Home Request Form False Claims Memorandum List of Permitted Application Attachments MA Form W-9 OSD Instructions for Filing a Quote on COMMBUYS OSD RFR- Required Specifications for POS Services RFA Evaluation Tool Worksheet Supplier Diversity Plan Form for POS WTO Government Procurement Agreement Link

Attachments

Department of Mental Health Respite Services – Master Agreement Request For Applications

DMH # 2017-DMH-3048-03

June, 2017

DEPARTMENT OF MENTAL HEALTH

RESPITE SERVICES REQUEST FOR APPLICATIONS

DMH # 2017-DMH-3048-03

June, 2017

SECTION 1 INTRODUCTION AND GENERAL DESCRIPTION

1.1 Issuing Entity/COMMBUYS

Issuing Entity: Department of Mental Health

DMH RFA File Number: 2017-DMH-3048-03

Contact Person: Jerome Collins Assistant Director of Contract Administration, Audit and Systems Address: Department of Mental Health 25 Staniford Street Boston, MA 02114

This Bid has been released on COMMBUYS. COMMBUYS is the official source of information for this Bid and is publicly accessible at no charge at COMMBUYS. For more information on COMMBUYS, see the OSD RFR - Required Specifications included in this Bid’s COMMBUYS File. In COMMBUYS, a “Bid” refers to the solicitation, Request for APPLICATIONS (RFA) or procurement. All Attachments to this RFA are included in the Bid’s COMMBUYS File.

Applicants may not alter (manually or electronically) the Bid language or any Bid component files, except as directed in the RFA. Modifications to the body of the Bid, specifications, terms and conditions, or which change the intent of this Bid are prohibited and may disqualify an APPLICATION.

Capitalized terms not otherwise defined herein shall have the meaning ascribed to them in Attachment A of the RFA. All attachments to this RFA are in included in the Bid’s COMMBUYS file. A list of all attachments that were included when this RFA was issued is set forth at the end of the Table of Contents.

1.2 Description of Procurement

The Massachusetts Department of Mental Health (DMH), through this RFA, is seeking to establish a pool of qualified providers from which DMH Areas can purchase Site-Based Respite (also referred to as “Site Only”) and/or Mobile Respite Services (also refered to as “Mobile Only”) on an as needed basis. DMH will enter into a Master Agreement (MA) with all qualified providers. If and when a DMH Area determines that it needs to purchase Respite Services from a provider with a MA, it will enter into a Purchase Agreement with the provider. The Purchase Agreement will specify the Respite Services being purchased (i.e., individual(s) to be served; type of respite to be provided; number of units beingpurchased; maximum number of units that can be billed under the Purchase Agreement; and the DMH Office responsible for oversight of the Purchase Agreement; etc.).

An Applicant may elect to provide both or just one of the two types of Respite Services. An Applicant must submit a separate application for each type of Respite Services it wants to provide. A provider of Site-Based Respite will be qualified by On-Site location(s), meaning that a provider is being qualified to provide On-Site Respite at specific locations selected by the provider and approved by DMH. A provider of Mobile Respite Services will be qualified by DMH Site Office, meaning a provider is being qualified to provide services only in those communites covered by specific DMH Site Offices selected by the provider and approved by DMH. It is preferred that a provider be able to to serve all communities served by the applicable DMH Site Office(s) for which an Applicant is seeking to be qualified to serve, but this is not a requirement. Included in this bid’s COMMBUY file, as Attachment B, is a list of DMH Site Offices and the communities they serve. See Subsection 9.1 for more information regarding the filing of Applications.

Respite Services provide temporary short-term, community-based clinical and rehabilitative services that enable an individual to live in the community as fully and independently as possible. Persons Served benefit from choosing enrollment in Respite Services which:

· Assist transition from an inpatient facility, including a state hospital, with the need for a transitional living situation and/or additional support services before returning to and/or entering a stable living situation;

· Provide interventions and support to remain clinically stable;

· Develop or create solutions to help individuals increase functionality in their current living environment. Through Individualized Action Plans (IAPs) individuals are empowered to make informed treatment decisions and to develop goals to manage their wellness;

· Bridge services when an individual moves from one service to another, or from one situation to another, such as from homelessness to DMH Community Based Flexible Support services; and incorporates supportive strategies that will enhance the individual’s chances for success; and

· Provides further clinical assessments including, but not limited to, functional and/or risk assessments.

Site-Based Respite Services requires Contractors to provide temporary supportive services and short-term community based living arrangements in a distinct location, away from an individual’s current living situation. Applicants submitting Applications for Site-Based Respite Services must specify the physical location(s) where Site-Based Respite Services will be provided and the number of potential beds it has available at such location(s) for purposes of providing Site-Based Respite under a Purchase Agreement with DMH.

Mobile Respite Services requires Contractors to provide temporary supportive services to individuals in their current locations. Applicants submitting Applications for Mobile Respite Services must specify the DMH Site Office(s) they are willing and able to provide Mobile Respite Services and the number of individuals they will be able to serve at one time under a Purchase Agreement with DMH.

Both types of Respite Services will be paid on a unit rate basis. The rate for Site-Based Respite is different from Mobile Respite. For more information regarding the unit rates is see Subsections 1.5.4. and 7.1.

DMH makes no guarantee that any Respite Services will be purchased from a provider as a result of the provider entering into a MA. Again, if it is necessary to purchase Respite Services from a provider with a MA, the applicable DMH Area will enter into Purchase Agreement with the provider. A provider may have more than one Puchase Agreement with a DMH Area and/or with one or more DMH Area.

Service Class Information:

1.3 Respite Services Principles

Providers of both Site-Based Respite and/or Mobile Respite Services must fully integrate the following principles into their service delivery structure:

· An understanding that growth and recovery is possible for each Person Served.

· An understanding that reasonable risks are necessary for growth and those reasonable risks can be mitigated by providing supports.

· The opportunity for peer to peer support is readily available and utilized to offer opportunities to discuss shared experiences.

· Collaborative working relationships with current DMH and other mental health providers, other relevant community organizations, and natural supports are established and maintained to help facilitate Persons Served to lead full lives in the community with the support networks of their choosing.

Services are:

· Strength Based and Person Centered.

· Trauma Informed. This includes an understanding of an individual’s symptoms in the context of the individual’s life experiences, current experiences and environment, history, social identity, and culture.

· Culturally and Linguistically Competent, and are sensitive and responsive to cultural, ethnic, linguistic, sexual orientation, gender identity, parental status, and other individual needs of the Persons Served; age and developmentally appropriate, including services for transitional age youth and elders.

· Fully accessible regardless of physical disability, auditory or visual impairment.

1.4 Service Goals

Respite Services provide intensive clinical and supportive interventions that are intended to:

· Be temporary and time limited.

· Assess service needs and facilitate transition to community based services.

· Enable a Person Served to remain in or transition back to a stable living situation.

· Divert or transition a Person Served from acute or continuing care hospitalization.

1.5 Procurement Information

1.5.1 Applicable Procurement Law. This Bid is issued under the following law(s): MGL c. 29, § 29B, st.1993 c.110, S.274 as amended; MGL c. 7, § 22; 801 CMR 21.00; 808 CMR 1.00; 815 CMR 3.00; Federal Single Audit Act, OMB A-133; the American Reinvestment and Recovery Act of 2009 (ARRA).

1.5.2 Single or Multiple Contractors

____ Single Contractor __X__ Multiple Contractors

1.5.3 Eligible Entities.

· Executive Office of Health and Human Service Agencies The Purchasing Department reserves the right to add or remove additional authorized users during the contract term.

1.5.4 Acquisition Method. The acquisition method to acquire services from this Bid is fee for service, based on prescribed Unit Rates (described in more detail in Subsection 7.1).

The Unit Rates covers all services required to be delivered by Contractors. MAs will not have a Maximum Obligation Amount; however, Purchase Agreements will specify the maximum number of units that can be bill DMH under them.

Federal funds _X__ MAY be used to fund part/all of Contract(s) Federal funds __ WILL NOT be used to fund part/all of Contract(s)

1.5.5 MA Duration. The duration of an MA awarded as a result of this RFA may potentially be for 9 years and 9 months. The duration will depend on when a particular MA is awarded. The duration of a MA issued under this RFA will be from its Effective Date (as defined in Subsection 11.4) up to the termination date of the RFA, June 30, 2027. The duration of any Purchase Agreement entered into by DMH to purchase services from a provider with a MA will be negotiated at the time of execution; provided, however, that the duration of a Purchase Agreement cannot extend beyond June 30, 2027, the termination date of the RFA.

All MAs and Purchase Agreements made as a result of this RFA are subject to appropriations and the performance of the Contractor on an on-going basis.

1.5.6 Ownership of Submitted Applications. All materials submitted by Applicants become the property of the Commonwealth of Massachusetts and will not be returned to the Applicants. DMH shall be under no obligation to return any Applications or materials submitted by an Applicant in response to this Bid. The Commonwealth reserves the right to use any ideas, concepts, or configurations that are presented in an Application, whether or not the Application is deemed qualified for the MA.

Applications stored on COMMBUYS in the encrypted lock-box are the file of record. Applicants retain access to a read-only copy of this submission via COMMBUYS, as long as their account is active. Applicants may also retain a traditional paper copy or electronic copy on a separate computer or network drive or separate media, such as CD or DVD, as a backup.

1.5.7 Prohibitions. Applicants are prohibited from communicating directly with any employee of DMH regarding this RFA except as specified in this RFA, and no other individual Commonwealth employee or representative is authorized to provide any information or respond to any question or inquiry concerning this RFA. Applicants may contact the contact person using the contact information provided in the Header Information of this RFA in the event that this RFA is incomplete or information is missing. (See Subsection 1.1 for DMH contact information). Applicants experiencing technical problems accessing information or attachments stored on COMMBUYS should email the COMMBUYS Helpdesk at COMMBUYS@state.ma.us or call during normal business hours (8AM – 5PM Monday – Friday) at 1-888-627-8283 or 617-720-3197.

In addition to the certifications found in the Commonwealth’s Standard Contract Form, by submitting an Application, the Applicant certifies that the Application has been arrived at independently and has been submitted without any communication, collaboration, or without any agreement, understanding or planned common course of action with, any other Applicant of the services described in the RFA.

SECTION 2 ESTIMATED PROCUREMENT TIMETABLE

2.1 Procurement Calendar

Physical Applicant’s’ Conference There will be one Physical Applicants’ Conference

June 12, 2017

2:00 p.m. to 3 p.m.

Location:

Worcester Recovery Center and Hospital K 2 Conference Room 305 Belmont Street Worcester, MA 01604

Questions submitted after June 19, 2017 will be responded to as is appropriate and necessary. DMH expects to review questions at a minimum every 90 days.

Questions may be submitted up to March 31, 2027, 4 p.m.

There after questions will be responded to every fiscal quarter, starting September 1, 2017, if necessary.

Times are Eastern Standard/Daylight Savings (US), as displayed on the COMMBUYS system clock displayed to Applicants after logging in. If there is a conflict between the dates in this Procurement Calendar and dates in the Bid’s Header, the dates in the Bid’s Header on COMMBUYS shall prevail. Applicants are responsible for checking the Bid record, including Bid Q&A, on COMMBUYS for Procurement Calendar updates.

*Applications will be reviewed within ninety (90) days of receipt (or sooner). Provider names will be added to the Master Agreement List posted on COMMBUYS as MAs are executed. Purchase Agreements will be negotiated and executed as needed.

2.2 Written Questions Via the Bid Q&A on COMMBUYS

The “Bid Q&A” provides the opportunity for Applicants to ask written questions and receive written answers from DMH regarding this Bid. All Applicants’ questions must be submitted through the Bid Q&A found on COMMBUYS (see below for instructions). Questions may be asked as specified in Subsection 2.1. DMH reserves the right not to respond to any questions asked. It is the Applicant’s responsibility to verify receipt of questions.

Please note that any questions submitted to DMH using any other medium (including those that are sent by mail, fax, email or voicemail) will not be answered. To reduce the number of redundant or duplicate questions, Applicants are asked to review all questions previously submitted to determine whether the Applicant’s question has already been posted.

Applicants are responsible for entering content suitable for public viewing, since all of the questions are accessible to the public. Applicants must not include any information that could be considered personal, security sensitive, inflammatory, incorrect, collusory, or otherwise objectionable, including information about the Applicant’s company or other companies. DMH reserves the right to edit or delete any submitted questions that raise any of these issues or that are not in the best interest of the Commonwealth or this Bid.

All answers are final when posted. Any subsequent revisions to previously provided answers will be dated.

It is the responsibility of the prospective Applicant/Contractor to maintain an active registration in COMMBUYS and to keep current the email address of the prospective Applicant’s contact person and prospective contract manager, if awarded a MA, and to monitor that email inbox for communications from the DMH or if applicable, other Purchasing Department(s), including requests for clarification. The Purchasing Department and the Commonwealth assume no responsibility if a prospective Applicant/Contractor’s designated email address is not current, or if technical problems, including those with the prospective Applicant/Contractor’s computer, network or internet service provider (ISP) cause email communications sent to/from the prospective Applicant/Contractor and the Purchasing Department to be lost or rejected by any means including email or spam filtering.

Locating Bid Q&A:

Log into COMMBUYS, locate the Bid, acknowledge receipt of the Bid, and scroll down to the bottom of the Bid Header page. The “Bid Q&A” button allows Applicants access to the Bid Q&A page.

Note: Generally any other communications with DMH about the Bid are prohibited. See OSD RFR - Required Specifications, “Applicant Communications,” for more information. The OSD Required Specifications are included in the COMMBUYS file for this Bid.

2.3 Physical Applicants’ Conference (in person)

The one Applicants’ Conference being offered is a physical conference conducted by the DMH for the purpose of informing prospective Applicants about general Bid information and answering questions from prospective Applicants. Attendance is optional. The current place and date for the Applicants’ Conference is set forth in Subsection 2.1. Please refer to the COMMBUYS for any updated information. Please note that this Conference will be held in conjunction with the DMH’s Bidders’ Conference that has been scheduled for DMH’s Respite Services Request for Response, that was issued on COMMBUYS at about the same time as this RFR (DMH Document Number: RFR # 2017-DMH-3048-01).

2.4 Bid Amendments, Withdrawal, Cancellation

DMH reserves the right to make amendments to the RFA after initial publication. It is each Applicant’s responsibility to check COMMBUYS for any amendments, addenda or modifications to this Bid, and any Bid Q&A records related to this RFA. DMH and the Commonwealth accepts no responsibility and will provide no accommodation to Applicants who submit an Application based on an out-of-date Bid or on information received from a source other than COMMBUYS.

This RFA does not commit DMH to enter into a Master Agreement or to pay any costs incurred in the preparation of an Application. DMH reserves the right to accept or reject any and all Applications received as a result of this RFA, to negotiate with any or all qualified Applicants and to cancel in part or in its entirety the RFA if it is in the best interest of DMH to do so.

SECTION 3 DMH MISSION STATEMENT

Contractors will be responsible for ensuring that the mission and values of DMH, the Respite Services Standards, and when applicable DMH policies, directives, procedures, and initiatives, are integrated and adhered to in all contract activities and by all staff members. DMH’s vision and mission statements are as follows:

Vision

Mental health is an essential part of health care. The Massachusetts Department of Mental Health, as the State Mental Health Authority, promotes mental health through early intervention, treatment, education, policy, and regulation so that all residents of the Commonwealth may live full and productive lives.

Mission Statement

The Department of Mental Health, as the State Mental Health Authority, assures and provides access to services and supports to meet the mental health needs of individuals of all ages, enabling them to live, work, and participate in their communities. The Department establishes standards to ensure effective and culturally competent care to promote Recovery. The DMH sets policy, promotes self-determination, protects human rights, and supports mental health training and research. This critical mission is accomplished by working in partnership with other state agencies, individuals, families, providers, and communities.

SECTION 4 RESPITE SERVICES DESCRIPTION

Respite Services deliver short term, clinically indicated community based treatment services which provide the opportunity for stabilization. Respite Services must be delivered by an integrated, multi-disciplinary team. Respite Services must be culturally and linguistically competent. The goal of this Service is to assist Persons Served to remain in or transition back to community settings, including permanent or other stable living situations, and community based mental health services.

Individuals who are referred will often times be in locations such as hospital emergency departments and acute inpatient services. In these instances the rapid response that is required of Respite Services is vital to engage the Person Served to address immediate needs and to divert him/her from more intensive, longer term services.

Respite Services may also be used to conduct clinical and/or functional assessments to inform DMH of the Person’s Served service needs pending a final DMH Service Authorization decision. Also, Respite Services provide supportive interventions to help facilitate a Person’s Served successful transition to a new service or living situation.

Applicants should note that referrals may include individuals who face open criminal charges, CORI issues and have SORI requirements, and require court-ordered evaluation, but who have been deemed by the court suitable for release to the community while undergoing a criminal court process. The need for the court-ordered evaluation will not be the reason why a Person Served is referred to Respite Services, and the forensic evaluation will not be done by the Respite Services Contractor.

Respite Services are not intended to be used as a substitute for the intensive level of evaluation, observation and treatment furnished by an acute crisis stabilization service when that level of service is clinically indicated.

Respite Services are delivered in one of two settings as outlined below. All Respite Services components and specifications must be delivered as appropriate regardless of the setting.

If and when a DMH Area determines that it needs to purchase Respite Services from a provider with a MA, it will enter into Purchase Agreement with the provider that specifies the Respite Services being purchased (individual(s) to be served, number of units to be purchased, etc.).

4.1 Site-Based

Site-Based Respite Services are provided to individuals in a short-term, community based living arrangement in a distinct physical site, away from an individual’s current living situation. Contractors must have a physical site that accommodates one or more individuals. The physical site must meet the specification set forth in Subsection 6.11. An Applicant must specify the specific location(s) of its physical site(s) and the capacity of such site(s) for providing Site-Based Respite Services under a Purchase Agreement. A MA for Site-Based Respite Services will be award to a Contractor specifying the physical site(s) where the Contractor has been determined qualified to provide services.

4.2 Mobile

Mobile Respite Services are provided to individuals who are in their current living situation (e.g., own apartment, group living environment, with family) or are in transition from other settings (e.g. hospital, shelter). An Applicant must specify the DMH Site Office(s) where it wants to and is able to provide Mobile Respite Services and the capacity for providing such services at any one time. A MA for Mobile Respite Services will be award to a Contractor specifying the DMH Site Office(s) to which the Contractor has been determined qualified to provide Mobile Respite Services.

4.3 Additional Physical Sites or DMH Area Offices

If a Contractor wants to add to the Physical Sites where it can provide Site-Based Respite or the DMH Site Offices to which it can provide Mobile Respite Services, it must file a new Application, that updates the material from its last application and which specifically addresses the new Physical Site(s) or DMH Site Office(s) for which it wants to qualify for Site-Based or Mobile Respite.

Respite Services must deliver the Service Components set forth in Section 5 that meet the Service Specifications and Standards set forth in Section 6.

SECTION 5 RESPITE SERVICES COMPONENTS

This Section sets forth the Respite Services service components. The components are applicable to both Site-Based and Mobile Respite. When Contractors are providing services pursuant to Purchase Agreements, the Contractors must provide the Service Components included by this Section 5 in accordance with the terms of the Purchase Agreements and the needs of the Persons Served. In doing so the Specifications and Standard set forth in Section 6 also must be met.

5.1 Consultations and Assessments

For each person referred to a Contractor, the Contractor must conduct and document consultation(s) and assessment(s) that may be required as a result of the reason(s) for the referral including, but not limited to, clinical, medication, functional skills, and/or risk. The consultation(s) and assessment(s) must be completed by staff appropriately trained to conduct such consultation(s) and assessment(s). The consultation(s) and assessment(s) will be used to inform DMH of the service needs of the individual referred, to assist in referral and transition to community based services.

5.2 Crisis Management

Contractors must have and implement written plans for 24 hours/day 7 days/per week support in the event of a psychiatric crisis. The Contractors must have the staff capacity to provide crisis intervention and stabilization support to meet the needs of a Person(s) Served. This shall include the availability of both face-to-face and telephone contact. When clinically appropriate, intervention and stabilization support should be provided prior to referral to a separate crisis stabilization or psychiatric emergency service.

5.3 Symptom Management

As to the Persons Served, Contractors must address their problems associated with their mental health conditions; assist them with symptom self-management skills in order to maximize recovery and reduce the risk of relapse.

In addition, Contractors must encourage each Person Served to use evidence based and best practice Recovery tools and techniques as well as self-management strategies. This is to be done by:

· Providing the Person Served with information and options about Recovery tools and techniques and self-management strategies.

· Providing the Person Served with support by staff, including peer staff and, when desired, assistance in developing a recovery plan.

· Incorporating Persons’ Served self-management plans and tools into his or her crisis plans.

· Incorporating family members, friends and other individuals as chosen by the Person Served, in the development of self-management plan(s) and the Recovery process.

5.4 Medication Education and Self-Management

Respite Services provide the necessary support and training for Persons Served to self-administer and monitor their own medication whenever possible. Persons Served are supported in developing self-advocacy and decision making skills regarding their medications. Contractors as part of the Assessment process (see Subsection 6.5) must complete and document the evaluation of the ability of Persons Served to self-administer medications. For Persons Served unable to self-administer medications, medication administration must be consistent with the regulations and policies of DMH and the Department of Public Health that currently allow only staff certified under the Medication Administration Program (MAP), or staff are appropriately licensed to administer medication.

5.5 Substance Use Services

Contractors must provide and/or coordinate with community based clinical, self-help and peer, medication assisted treatment, and psycho-educational services that address substance use treatment and related issues such as HIV/AIDS/Hep C and relapse prevention that reflects the need(s) of a Person Served as identified in the assessment(s) (see Subsection 5.1 and 6.5) and the Individual Action Plan (IAP) (see Subsection 6.6). These services may be provided through individual and group interventions, as well as medication assisted treatment as needed. Contractors must also maintain relationships with the full continuum of substance use treatment services.

5.6 Coordination and Communication with Healthcare System

Contractors must know when Persons Served are enrolled in healthcare coordination resources (e.g., Behavioral Health Community Partner, Accountable Care Organization, One Care) and must collaborate, to the extent authorized, with the resources to assure full access to identified treatment services. If Persons Served are not enrolled in healthcare coordination resources, Contractors must evaluate the individuals’ eligibility for third party resources for healthcare coordination and with authorization provide linkage as needed.

Until linkage is made with the healthcare coordination resource, Contractors must seek to obtain authorizations to communicate (and communicate) with individuals’ healthcare providers including psychiatric and general medical hospitals prior to discharge as part of the enrollment into Respite Services and other treatment providers as applicable.

5.7 Support Services

Contractors must provide Support Services as are appropriate to insure individuals to whom they are providing Respite Services have the following as needed:

· Medical and dental services.

· Safe, affordable housing.

· Health insurance and other entitlements and benefits.

· Psychiatric and other community mental health services.

· Community resources such as self-help, home care.

· Legal advocacy and representation.

· Transportation.

5.8 Skill Building Activities

Contractors must address the activities of daily living and community living skills needs of each Person Served as reflected in his or her assessment and IAP (see Subsections 6.5 and 6.6).

5.9 Peer Support Services

Contractors must provide peer counselling and support through Certified Peer Specialist staff. In addition, Contractors must make linkages to consumer self-help programs and advocacy organizations that promote Recovery (e.g., Recovery Learning Communities). The goal is to help Persons Served to actively participate in their own Recovery and develop strategies to combat stigma and discrimination associated with mental illness.

5.10 Community Inclusion and Social Connection

Contractors must assess each Person’s Served current social network to identify opportunities to strengthen access and utilization of natural supports. The goal is to expand and maintain positive social networks, reduce social isolation and promote community integration. Contractors must ensure each Person Served has reasonable access to family and/or other significant individuals of his or her choice to support meaningful connections and to encourage his or her participation in all stages of Respite Services.

SECTION 6 RESPITE SERVICES SPECIFICATIONS AND STANDARDS

This Section sets forth the Respite Services service specifications and standards.

6.1 Delivery of Services

Respite Services utilizes a multi- disciplinary team to deliver Services. Respite Services must be flexible to meet the needs of the persons served.

6.2 Enrollment Criteria for Respite Services

To be eligible for enrollment in Respite Services an individual must be 18 years of age or older and have been authorized for Respite Services through the DMH Service Authorization process. For the purposes of this RFA a Person Served may also be an individual who has not yet been authorized for DMH Services but has been authorized to receive Respite Services by the Area Director/Designee for the purposes of assisting DMH in determining a service authorization request by gathering information and assessing service needs.

6.3 Referral to Respite Services

All individuals referred to a Contractor, pursuant to a Purchase Agreement, will be authorized for Respite Services in accordance with Subsection 6.2. A Contractor must accept all referrals as agreed to in the applicable Purchase Agreement it holds with a DMH Area.

Referrals will be made using the standardized DMH Respite Referral Form and/or through the Purchase Agreement itself. Upon referral, a Contractor must review the Respite Referral Form and attachments or the Purchase Agreement and rapidly respond to enroll the individual or as soon as possible.

DMH reserves the right to modify the Referral Form in whole or in part and to modify the method by which it is sent to a Contractor.

6.4 Enrollment in Respite Services

6.4.1 Respite Services in a Site-Based Setting: Upon receiving a referral, a Contractor must rapidly respond by obtaining written consent from the individual to participate in Respite Services and make arrangement for the individual to take occupancy of the available bed on the same day the referral is received. Within twenty four (24) hours of an individual taking occupancy of the available bed, the Contractor shall notify the applicable DMH Area Office that the individual has agreed to participate in the service and the date he or she first occupied the bed. An individual shall be considered “enrolled” in Site-Based Respite as of the date he or she first occupied the bed and he/she shall remain enrolled until and including the day he/she is disenrolled pursuant to Subsection 6.9.

6.4.2 Respite Services in a Mobile Setting: Upon receiving a referral, a Contractor must rapidly respond by making contact with the referred individual within twenty four (24) hours of receipt of the referral, obtaining written consent from the individual to participate in Respite Services and begin providing services to the individual within the next twenty-four (24) hours. Within twenty four hours (24) of the Contractor starting to provide services to the individual, the Contractor shall notify the applicable DMH Area Office that the individual has agreed to participate in the service and the date he or she first received services from the Contractor. An individual shall be considered “enrolled” in Mobile Respite as of day he or she first started receiving services from the Contractor and he/she shall remain enrolled until and including the day he/she is disenrolled pursuant to Subsection 6.9.

6.4.3 Time limit For Making an Enrollment. If a Contractor is unable to Enroll an individual within forty-eight (48) hours from the date of the referral, the Contractor must notify the applicable DMH Area or Site Office so next steps can be determined. A Contractor must document all attempts to contact the Individual and the reason(s) why contact attempts failed.

6.4.4 30 Day Enrollment Limit and Waiver. The enrollment of a Person Served in Respite Services cannot exceed 30 days unless the Area Director, or designee, approves of such in writing. An approval may only be for a period of up to an additional 30 days; provided, however, that multiple approvals for additional days may be given. If an extension is approved, the IAP of the Person Served must be reviewed and modified as appropriate (see Subsection 6.6).

6.4.5 Orientation. Upon enrollment into Respite Services Persons Served are provided with an orientation to Respite Services. If a Contractor determines the Person Served cannot participate in the orientation the Contractor must document in the record of the Person Served its good faith efforts to provide such orientation and the reasons why the orientation was not provided (e.g., the individual refused, individual experiencing symptoms of mental illness) and the plan to provide the orientation at a later date. The written information, in the Person’s Served and LAR’s primary language, if feasible, is presented to and reviewed with the Person Served and LAR, if applicable. If the written information cannot be provided in the primary language of the Person Served or LAR, an interpreter must be used.

The written information must include:

· a description of Respite Services, including expected length of stay and expectations for involvement in active partnership in discharge planning,

· Hours of operation,

6.5 Assessment

Within 24 hours of enrollment, a Contractor must complete an assessment. The assessment must be completed by and/or reviewed and signed by a Respite Services clinical staff person and must include an assessment of the following areas as applicable based on the reason for referral:

· Immediate critical needs which impact the health and safety of the Person Served

· Mental status

· Risk factors

· Medical and psychiatric needs, symptom management

· Substance use/abuse

· Ability to self-administer medication

· Housing and benefits

· Need for financial and/or legal assistance

· Community resources available

· Family Involvement

· Discharge barriers

· Personal strengths and resources

· Cultural and ethnic needs

· Eligibility for third party resource(s) (e.g. Behavioral Health Community Partner, One Care, Accountable Care Organization)

· Need for language/communication assistance

The findings of the assessment are used when developing the IAP and will be updated and modified as the individual’s needs and circumstances change or additional information becomes available.

6.6 Individualized Action Plan (IAP)

A Contractor in partnership with the Person Served and the LAR of the Person Served, if any, must complete and document an IAP within 72 hours following the completion of the assessment. Using the information gathered through the assessment, the IAP must outline the plan to address the reason for referral, anticipated length of stay, barriers to discharge and any additional needs identified in the assessment. The IAP may also identify need areas which require further assessment. (See also Subsection 6.7 for discharge items to be included in the IAP.)

For Persons Served who have a DMH case manager, a Contractor must forward a copy of the IAP to the case manager. For all other Persons Served, DMH reserves the right to request that a Contractor submit a copy of a Person’s Served IAP to DMH. All IAP planning activities must comply with DMH regulation 104 CMR 29.00.

DMH reserves the right to have a standardized IAP form for Respite Services. If DMH makes this decision, a Contractor shall be required to utilize the standardized IAP or to submit its proposed IAP format to DMH for approval.

6.7 Discharge Planning

As Respite Services are transitional and time limited in nature, a Contractor with the Person Served must identify discharge criteria and develop and document a discharge plan, including an anticipated discharge date at the time the IAP is developed. Discharge criteria and plans must be practical, reflective of the time limited nature of Respite Services and take into account available resources. Discharge plans must be coordinated with the Person Served; LAR, if any; current and/or new service providers, to the extent authorized; and the applicable DMH Area Office (or DMH Site Office, as specified by the Area Office). Discharge from Respite Service requires the approval of the applicable DMH Area/Site office and a Contractor are required to inform DMH of any changes to the discharge plan, including changes to the anticipated discharge date and any barriers to discharge that arise. DMH reserves the right to request that a Contractor submit a copy of a discharge plan of a Person Served to DMH.

As applicable, discharge plans must include a list of follow-up appointments with DMH and non-DMH services and contact information, as well as any recommended community based services.

As agreed upon by the Contractor, Person Served, and DMH, a Contractor may also provide time limited phone calls or visits to the Person Served or his/her service provider(s) after discharge to ensure transition needs are met.

6.8 Dual Enrollments and Service Planning

There will be instances when Persons Served are dually enrolled in Respite Services and another DMH operated or funded service(s). Upon enrollment in Respite Services, a Contractor will work with other providers to insure the IAP developed by Respite Services is integrated with and complimentary to other IAPs the Person Served may have. The purpose is to ensure that all needed services are delivered in an efficient and coordinated manner. Additionally discharge planning (see Subsection 6.7) must be coordinated with other providers. Dual enrollments will be monitored by the applicable Area and/or Site Office to insure that each DMH funded or operated service is necessary to facilitate movement out of Respite Services.

6.9 Disenrollment from Respite Services

The applicable DMH Area/Site Office approval is required to disenroll a Person Served from Respite Services. A Contractor must notify the DMH Area/Site Office within 24 hours when any of the following conditions have occurred so that DMH can make a determination regarding disenrollment:

· Person Served meets his/her established goals for discharge (see Subsection 6.7).

· Person Served requests discharge from the service.

· Person Served has not received Respite Services within 48 hours of last contact.

· Person Served is hospitalized (medically or psychiatrically); referred to a skilled nursing facility; incarcerated; or admitted to some other institutional setting.

· The enrollment of the Person in Respite Services has exceeded 30 days and the Area Director, or designee, does not approve an extension.

Upon the death of a Person Served a Contractor must notify DMH. Upon notice, DMH will disenroll the Person Served from Respite Services as of the date of his/her death.

A Contractor is required to provide to DMH the disenrollment information to include whether the reason for referral was resolved and the disposition of the Person Served. This information will be provided on a form and in a manner prescribed by DMH (see Subsection 6.19).

6.10 Records

Contractors shall create and maintain a central record for all Persons Served and maintain records in a manner so that staff can readily access information. Records for Site-Based Respite must be located at the applicable site based setting for as long as the Person Served is located at the setting. Records at a minimum must include the following:

· Basic demographic information, including the information needed for reporting;

· Documentation of the consent of the Persons Served to participate (see Subsection 6.4);

· Initial and additional assessments/consultations, if any;

· Individualized Action Plans and modifications;

· Notes; and

· Other information important to the Persons Served and as required by the applicable Contractor’s policies and procedures.

In addition the records must meet the following requirements:

· Person Served records must reflect the implementation of the Peron’s Served IAP and must document outcomes. For Persons Served who receive Site-Based Respite Services, progress toward Respite Services goals and objectives must be documented daily and when there is any collateral contact with other parties involved with the Person Served. For Persons Served who receive Mobile Respite, progress toward Respite Services goals and objectives must be documented whenever there is contact with the Person Served and/or when there is collateral contact with other parties involved with the Person Served.

· Person Served records include information that is sufficiently detailed to prove that Persons Served are receiving services that are appropriate to their needs and that achieve desired outcomes.

· Person Served records include information that is sufficiently detailed to enable DMH to monitor and evaluate services.

· Person Served records are maintained and preserved in accordance with 104 CMR 28.09 and the DMH Respite Services Business Associate Terms and Conditions included in this Bid’s COMMBUYS file and the Commonwealth Terms and Conditions for Health and Human Services.

DMH and its agents may review such records at any reasonable time for purposes including, but not limited to, the following:

· to ensure continuity of care of Persons Served;

· to assure that services are being provided as specified in the MA and applicable Purchase Agreement;

· to evaluate the quality and effectiveness of those services;

· for utilization management;

· to investigate critical incidents or complaints pursuant to DMH regulations and policy;

· to monitor the maintenance of such files;

· to ensure compliance with financial reporting, record keeping, and service delivery standards;

· to collect data to plan or assess systems of service delivery; and

· for those purposes more generally expressed in the Commonwealth Terms and Conditions for Human and Social Services.

6.11 Physical Site – Site-Based Settings Only

The physical site provided by a Site-Based Contractor for Respite Services must be licensed by DMH in accordance with 104 CMR 28.13. (See DMH Regulations/Licensing).