251233 RFR Opioid Treatment Programs1~3.docx

The Commonwealth of Massachusetts Department of Public Health Bureau of Substance Addiction Services

Address: 250 Washington Street 3rd Floor Boston, MA 02108

Contact Name: Ryan Naismith

Email: Ryan.H.Naismith@mass.gov

Request for Response (RFR)

Document Title: Opioid Treatment Programs

DPH RFR Document Number: 251233

COMMBUYS BID Number: BD-24-1031-BSAS0-BSA01-98497

January 15, 2024

Key RFR Information All potential bidders must read.

COMMBUYS REGISTRATION

It is the responsibility of the prospective Bidder and awarded Contractor to maintain an active registration in COMMBUYS and to keep current the email address of the Bidder’s contact person and prospective contract manager, if awarded a contract, and to monitor that email inbox for communications from the Purchasing Department, including requests for clarification. The Purchasing Department and the Commonwealth assume no responsibility if a prospective Bidder’s/awarded Contractor’s designated email address is not current, or if technical problems, including those with the prospective Bidder’s/awarded Contractor’s computer, network or internet service provider (ISP) cause email communications sent to/from the prospective Bidder/Awarded contractor and the Purchasing Department to be lost or rejected by any means including email or spam filtering. To register review the COMMBUYS Job Aide COMMBUYS Vendor Registration and/or go to www.COMMBUYS.com.

QUOTE SUBMISSION

This BID requires the submission of electronic quotes. All Bidders are advised to allow adequate time for submission of their quotes by considering potential online impediments like Internet traffic, Internet connection speed, file size, and file volume. DPH is not responsible for delays encountered by Bidders or their agents, or for a Bidder’s local hardware failures, such as computers or related networks, associated with bid compilation or submission. Bids submitted via COMMBUYS are time stamped by the COMMBUYS system clock which is considered the official time of record.

If you plan to submit a quote to this RFR “No Bid” should not be checked anywhere in your quote in COMMBUYS. This includes on the General Screen and the Items tab. Checking No Bid sends your quote to a different location in COMMBUYS than the rest of the quotes for that Bid and you run the risk of the Department not receiving your response. The department will not guarantee that a bid received with a “No Bid” checked will be reviewed.

Section A: Procurement Overview

A1: Procurement Description and Purpose

Research indicates that for many individuals with Opioid Use Disorder (OUD), treatment with Medication for Opioid Use Disorder (MOUD) at an Opioid Treatment Program (OTP) can reduce the illicit use of opioids, retain people in the recovery continuum of care, improve general health and functioning, and reduce the risk of opioid overdose death. Additionally, medication usually produces better treatment outcomes than outpatient treatment without medication (SAMHSA Treatment Improvement Protocol 63). The core elements of an OTP include provision of FDA-approved medication for opioid use disorder (MOUD); counseling; vocational, educational, and other assessments; case management; and direct referrals for recovery-related and social-service–related needs. OTPs are licensed by the Bureau of Substance Addiction Services (BSAS) at Massachusetts Department of Public Health (DPH) and are federally certified as Substance Abuse and Mental Health Services Administration (SAMHSA) Opioid Treatment Programs.

With this Request for Responses (RFR), BSAS seeks proposals for OTPs statewide, to be contracted with BSAS as payer of last resort for the delivery of OTP services. New vendors or program sites not previously contracted with BSAS are eligible to apply, but no start-up costs will be considered for funding at this time.

BSAS anticipates future amendments to this RFR to solicit proposals for innovative OTP service delivery models to expand access to methadone treatment in areas of demonstrated high need. Provisions for support of start-up costs may be included in those future amendments.

To receive and maintain an OTP facility license programs must be in compliance with DPH Regulations found in 105 CMR 164.000 - (Licensure of Substance Addiction Treatment Programs) in addition to meeting all state and federal certification and registration requirements. BSAS expects OTPs to have policies that operationalize an efficient, seamless direct admission process from 24-Hour Diversionary Services, emergency departments, and correctional facilities in addition to expediting direct admissions for priority populations such as pregnant and parenting women, injection drug users and individuals who have been recently released from incarceration. Updated BSAS Regulations fully align with Federal OTP Regulations (42 CFR Part 8), allowing for increased take-homes and individualized treatment approach.

Community-based OTP providers who are currently contracted with BSAS must respond to this RFR in order to continue contracting with BSAS beyond the end of state fiscal year 2024. Responses from ongoing vendors must be received by April 1st, 2023 at 4pm in order to guarantee contract continuation on July 1, 2024 with no break in service.

This is a rolling RFR. Bidders may submit proposals during the entire contract period. Applications will be reviewed as they are received.

A2: Program Background Information

· The effectiveness of MOUD in stabilizing individuals and enabling them to build a recovery-based lifestyle is well documented. Research and experience provide an increasingly comprehensive understanding of the physiological changes that accompany or result from substance use. For example, we understand a great deal about substance-related changes in metabolism and brain activities such as increased or decreased neurotransmitter production. This expanding field of knowledge is accompanied by increased availability of effective treatments using medications which target those physiological effects, for example by disrupting metabolism of the substances, or modifying substance-related brain activity. BSAS requires the use of proven, effective MOUD in a variety of settings.

Section B: Procurement Information

Executive Branch Goods and Services

B1: Applicable Procurement Law

B2: Whether Single or Multiple Contractors Are Required For Contract(s)

Check One (“X”):

B3: Calendar Rule Type

B4: Acquisition Method: Fee for Service:

B5: Use of a Procurement by a Single or Multiple Departments

· Identify additional Eligible Entities by name or type.

The Purchasing Department reserves the right to add or remove additional authorized users during the contract term.

B6: Expected Duration of Contract

month(s)

B7: Anticipated Expenditures, Funding Or Compensation For Expected Duration

Dollar Amount

Estimated annualized procurement amount $8,500,000

Check One (“X”):

Notice concerning rates of payment – implementation of Chapter 257 of the Acts of 2008: An Act Relative to Rates for Human and Social Service programs, provides that the Secretary of Health and Human Services has the sole responsibility for established rates of payment for social service programs purchased by governmental units of the Executive Office. Contracted vendors will be reimbursed based on rates established by EOHHS regulation, 101 CMR 346, 101 CMR 444, and other applicable rate regulations as may be amended from time to time during the duration of the Contract. As a result of Chapter 257, during the life of the Contract, rates of payment and reimbursement structures may change.

Will Federal Funds be used to fund any part of Contract(s)?

*Additional information for contracts with Federal Dollars:

Sub-Recipient: Providers receiving federal grant funds will be considered sub-recipients for federal grant purposes and will be required to comply with applicable federal requirements, including but not limited to sub-recipient audit requirements under OMB Circular A-133.

Unique Entity Identifier: On April 4, 2022, the unique entity identifier used across the federal government changed from the DUNS Number to the Unique Entity ID also known as UEI or SAMS number. Any entity that wants to apply for federal contracts or wants to receive federal funds must register with SAM. Entities that use SAM include for profit businesses, nonprofits, government contractors or subcontractors, as well as state and local governments.

Registering with SAM.gov is free and is required for your organization to receive federal funds. Your organization can submit an application to this RFR without being registered on SAM, however if awarded your organization will need to have an active SAM account prior to contract execution.

Unspent Funds: Any funds from Capital, Trust and/or Federal Accounts designated in the budget that are unspent in any fiscal year will not be available for expenditure in the subsequent fiscal year.

Section C: Performance and Contract Specifications

C1: Eligibility This RFR is for direct services under the Office of the Comptroller’s object code classification MM3 or M03. To be considered eligible to apply for this RFR a bidder must be considered an organization. Individuals are not eligible to apply.

All BSAS-licensed ambulatory OTPs must apply for this RFR in order to be eligible to bill the BSAS OTP master agreement contract. Providers of OTP must obtain all required federal and state licenses, certifications, and registrations for the operation of an OTP facility and be in good licensure standing with the Bureau of Substance Addiction Services. Providers cannot be contracted under the OTP master agreement contract until they fulfill all these licensure, certification, and registration requirements. A license in good standing is considered such when a licensee is in compliance with all applicable DPH regulations as found in 105 CMR 164.000 – Licensure of Substance Addiction Treatment Programs. A licensee with outstanding deficiency correction orders may be considered in good standing if there is no history of repeat unresolved deficiency correction orders and/or the deficiencies are not a threat to the health and safety of residents.

Licensure and Certification To receive and maintain OTP facility license programs must be in compliance with the DPH Regulations found in 105 CMR 164.000 Licensure of Substance Addiction Treatment Programs.

OTP providers proposing services as part of this RFR are also required to comply with SAMSHA certification and accreditation as an OTP as detailed in 105 CMR 164.300 and 42 CFR Part 8.

To become OTP certified by the SAMHSA Center for Substance Abuse Treatment (CSAT) refer to the CSAT website for step-by-step instructions. SAMHSA OTP certification includes application to and accreditation by a SAMHSA-approved accrediting body.

· See: https://www.samhsa.gov/medication-assisted-treatment/become-accredited-opioid-treatment-program

· See TIP 63 Medications for Opioid Use Disorder: https://store.samhsa.gov/sites/default/files/pep21-02-01-002.pdf

In addition, applicants must apply concurrently with DEA and Massachusetts DPH Drug Control Program (DCP) registrations for controlled substances. The applications can be found online. Both the DEA and DPH DCP require inspections as part of their application process.

· See: https://www.deadiversion.usdoj.gov/GDP/(DEA-DC-056)(EO-DEA169)_NTP_manual_Final.pdf

· See: https://www.mass.gov/how-to/apply-for-renew-or-amend-information-for-your-facility-mcsr

To become licensed by the Bureau of Substance Addiction Services, an application must be submitted to the DPH Bureau of Substance Addiction Services (BSAS). The application process involves an on-site inspection.

· See: https://www.mass.gov/info-details/information-for-licensed-substance-use-disorder-treatment-programs#suitability-.

· See New Applicant Licensing Workflow: https://www.mass.gov/doc/opioid-treatment-licensing-workflow-pdf/download

· See BSAS Licensing Information: https://www.mass.gov/info-details/information-for-licensed-substance-use-disorder-treatment-programs

Site Control Respondents proposing new OTP programs that are not currently licensed to operate must demonstrate a timeline and specific plan for gaining site control of the proposed program site. Site control includes documentation detailing ownership, intent to purchase, intent to lease, and/or lease agreement. Proposed sites must be conducive for the program operations using criteria from the Specifications section of the RFR, meet all federal and state licensure requirements, and be compliant with the American with Disabilities Act. (See Section G- Other Requirements Pertaining to this RFR.). A federally certified OTP may establish a mobile, medication unit or units to administer or dispense MOUD and is intended to facilitate access to MOUD treatment for patients who would otherwise have to travel great distances (See 42 CFR 8.11 (i)(1)). Programs must adhere to any applicable state/local building and occupancy codes. Compliance with these standards also applies if an alternate facility is secured by the provider at any time during the life of the OTP contract. BSAS may make site visits to proposed facilities before the technical review occurs and/or part of the ongoing review process and reserves the right for final approval of any site. If the site is determined to be inappropriate for the target population and service, the proposal may be excluded from further review.

Providers will be required to have all required federal and state licenses, certifications, and registrations for the operation of an OTP facility including Medication Units and Mobile Components.

Service Population Bidders awarded a contract under this RFR must demonstrate the ability to provide clinically appropriate, high quality opioid treatment to the diverse population of opioid addicted persons. Services must prioritize pregnant and parenting women, injection drug users who are at high risk for HIV/AIDS/HCV, and criminal justice population recently released from a correctional setting.

Eligible applicants must:

· Demonstrate service models that will help reduce the spread of HIV/AIDS and HCV infection among this population and others who may be at risk due to sexual contact or shared needle use.

· Demonstrate the ability to respond to and prioritize special populations, including young adults (18 to 25), veterans, pregnant and postpartum women and parenting individuals, homeless individuals, criminal-justice–involved individuals especially those who have recently been released from incarceration, as well as injection drug users.

· Demonstrate ability to provide service supports that help reduce the risk of overdose.

· Provide simultaneous treatment for alcohol and/or drug abuse/dependency to assist polysubstance using individuals to enter treatment and sustain recovery.

· Provide services that combine medical and pharmacological intervention with counseling, education, case management, and referral services to meet the complex needs of the opioid dependent population. Referrals may include other OTPs, Office-Based Opioid Treatment (OBOT) programs, Office-Based Addiction Treatment (OBAT) programs, 24-Hour Diversionary services, and other community-based primary care services for the delivery of substance use disorder treatment.

· Provide services in an environment conducive to rehabilitation, and that conveys a sense of dignity and trust between the program and persons in treatment in the context of a culture of recovery.

· Bidders must demonstrate the ability to provide services to the range of individuals described throughout the RFR and at a minimum have trained all program staff in the provision of culturally responsive, gender responsive and accessible services.

C1a: Provider Qualification Requirements

To be considered eligible and prior to entering into a contract with DPH a bidder must demonstrate that it meets minimum administrative and fiscal standards established through the Executive Office of Health and Human Services (EOHHS) provider qualification policy. Your provider qualification status will be considered in making award decisions.

Provider qualification is the process used to evaluate a provider’s administrative and financial condition. The main objectives of the provider qualification process are to determine whether the provider has (a) the capabilities to comply with the numerous federal and state administrative requirements that surround the expenditures of public funds and (b) sufficient fiscal and administrative capacity to fulfill its contractual obligations.

· New Providers of Purchased Human and Social Services to Clients Bidders who do not have current contracts with the Commonwealth of Massachusetts to provide human and social services for clients must submit completed provider qualification application materials as part of the response to this RFR. The Contracting Qualification Forms and instructions can be found in the Provider Qualification Folder (QUALIFICATION) in the attachments section of COMMBUYS for this RFR.

· Current Providers of Purchased Human and Social Services to Clients Bidders with current human and social services contracts (MM3/M03 contracts) must have filed their Uniform Financial Statements and Independent Auditor's Report (UFR) with the Operational Services Division via the internet using the UFR eFiling application for the most recently completed fiscal year before a contract can be executed and services may begin unless considered exempt from filing. Other contractor qualification/risk management reporting requirements and non-filing consequences promulgated by Secretariats or Departments pursuant to 808 CMR 1.04(3) may also apply. If you have questions about your UFR contact the UFR Help Desk at ufrefilehelp@mass.gov.

C2: Scope of Services In accordance and in addition to service elements mandated by state and federal regulations, OTP bidders must provide the following:

Admission/Orientation

· Design effective admissions systems and referral networks to manage and ultimately reduce waitlists with a goal of same day admissions.

· Coordinate with 24 Hour Divisionary Services, Clinical Stabilization Services (CSS), emergency departments, Correctional Facilities, inpatient hospital services, inpatient psychiatric treatment, and residential rehabilitation for adult treatment programs to expedite OTP admissions to support a person’s continued recovery.

· Screen persons admitted for and provide education on TB in accordance with DPH Policy for Tuberculosis Control in Substance Abuse Treatment Centers.

· Provide individual orientation initially that is documented in the medical record. This orientation must include all topics covered in the patient handbook, including education on the nature of addictive disorders, medication interactions and information about the range of treatment options, including all forms of FDA approved opioid use disorder medication as well as the risk and benefits of medication for opioid use disorder, and the risks and benefits of not receiving treatment.

· Ensure that an initial and an annual orientation includes education on harm/risk reduction topics, such HIV/AIDS, TB, HCV, use of Naloxone for overdose reversal, signs and symptoms of overdose and when to seek emergency assistance.

· Provide information about family support services including family or group therapy or social or educational services for family members.

Treatment

· Determine through a comprehensive individualized assessment the appropriate FDA approved medication for the treatment of opioid use disorder for each patient (methadone, buprenorphine, naltrexone). The decision should be a shared decision with the patient ensuring that the patient is making informed decisions regarding their treatment. OTPs must inform all patients of their OUD diagnosis and the nature of the disorder including the risks and benefits of methadone and other OUD medications and risks and benefits of non-medication treatments.

· Coordinate the delivery of services that supports seamless treatment services for individuals involved in two or more service levels such as opioid treatment, 24 Hour Diversionary Services), Correctional Facilities, Clinical Stabilization Services (CSS) and all residential treatment, mental health outpatient services and recovery support services.

· Ensure policies and protocols for submission of exception requests through SAMHSA Extra-net for patients who are receiving residential treatment services, in order to provide efficiencies and collaborative care.

· Ensure the delivery of appropriate treatment interventions for individuals who are being readmitted or who are transferring from another OTP through review of previous treatment episodes.

· Coordinate primary counseling services, case management, and transportation services with other social service and substance use providers, especially for high-risk individuals such as pregnant and postpartum women, parenting individuals, those recently released from incarceration, persons with mental health diagnoses, homeless individuals, other disabilities, veterans, and individuals with limited English-speaking abilities, to engage and to increase retention in treatment.

· For pregnant women assure and assist with prenatal care linkages, educate on pregnancy, MOUD, breastfeeding, preparing for labor and delivery, the potential effects of MOUD on newborn such as neonatal abstinence syndrome (NAS), rooming-in if infant is experiencing NAS and birthing hospital allows rooming in, and preparation for potential DCF involvement including developing a portfolio of supporting documentation to bring to hospital, and support to develop and coordinate their “Plan of Safe Care”, a new legislative mandate for all families with a child born with substance exposure. (See Institute for Health and Recovery website: http://www.healthrecovery.org/safecare/ for resources on Plan of Safe Care and the Massachusetts Health Promotion Clearinghouse resources: https://massclearinghouse.ehs.state.ma.us/mm5/merchant.mvc?Screen=PROD&Product_Code=SA3588 and the BSAS website for pregnant and parenting women called the Journey Recovery Project https://journeyrecoveryproject.com/ for information for pregnant and postpartum mothers with substance use disorders.) Utilize the BSAS Practice Guidance: Treatment Services for Pregnant and Parenting Women and Partnerships with DCF for guidance in developing policies and practices

· For postpartum women provide linkages and follow up to early intervention (all infants with NAS diagnosis are automatically eligible for EI), parenting support groups, provide follow-up and support on their Plan of Safe Care, and provide relapse prevention support and postpartum depression screening and referral as needed. Referral to recovery coaching and other peer recovery supports is encouraged.

· Ensure that all pregnant individuals with concurrent HIV and/or HCV infection are informed of currently recommended practices to reduce transmission and that they are provided with appropriate referrals and case management for this treatment

· Provide gender-specific trauma informed treatment in accordance with best practices.

· Individualize counseling services using evidence-based practices to provide the appropriate balance of individual and group counseling based upon factors such as on-going illicit drug use, readiness to change, medical and/or psychiatric conditions, living and social environment, acute life stressors.

· Include in treatment plans the justification for the group and individual counseling services provided, based upon factors such as on-going illicit drug use, readiness to change, medical and/or psychiatric conditions, living and social environment and acute life stressors. Treatment plans must be collaborative and include each patient’s individual circumstances including the frequency to attend counseling.

· Provide services that focus on the needs of priority populations, including offering service and resources in languages common to the community, offering specialized groups, and recruiting staff representative of these groups.

· Utilize individualized care in the management of individuals who are taking other medications, such as benzodiazepines, and other opiate potentiating drugs and provide continuous education and monitoring to individuals who are taking multiple medications and ensure ongoing care coordination with external providers.

· Ensure that the program meets regulatory requirements for individuals who are homebound, such as counseling, drug testing, and ongoing assessment and evaluation.

· Ensure collaboration with skilled nursing and long-term care facilities to ensure patients receive continued OTP treatment while receiving rehabilitative treatment.

· Provide psychosocial and counseling services for current or previous individuals who are receiving “0” dose levels.

· Provide appropriate measures to identify and address other individual problems, including case management to ensure that individuals receive access to ancillary services. This shall include strategies to assist with food, shelter, income support, transportation, childcare, and vocational services.

· Offer on-site education and training for all parenting individuals and offer referral sources for individuals who are appropriate for additional parenting skill services.

· Develop and implement a plan for educating individuals about HIV/AIDS and HCV, including testing procedures, confidentiality, reporting, and follow-up care, education on safer sex, social responsibilities, sharing of intravenous equipment, and community-based resources.

· Develop strategies and increase efforts to retain individuals throughout treatment that have persistent symptoms of the disease of addiction, especially relapse or on-going illicit drug use. Coordinate referrals to higher levels of care as needed and facilitate seamless OTP treatment during the transition between services.

· Educate and collaborate with family members and/or significant others to promote their support of the individual’s treatment and an understanding addiction and the recovery process.

· Ensure access and direct referrals to medical, mental health, addiction counseling, smoking cessation and recovery support services throughout treatment.

Aftercare and Recovery Support

· Ensure that the discharge plan includes direct referrals which maximize the likelihood of continuity of care.

· Develop specific guidelines or policies for individuals who are being discharged, especially a pregnant patient, either emergency discharge or administrative discharge, including case management supports especially if the individual needs a higher service setting.

· Provide comprehensive specific resources that support ongoing recovery such as recovery coaching and recovery support centers, mental health counseling, alternative methods for recovery with consideration of special populations.

· Provide overdose prevention resources upon leaving treatment such as the use of Naloxone, signs and symptoms of overdose and when to seek emergency assistance. Also, include other medication for opioid use disorder such as buprenorphine and injectable naltrexone as treatment options.

Administrative Elements

· Policy and Procedure Manuals must be in compliance with state and regulatory requirements including Substance Use Disorder Patient Records (42 CFR Part 2).

· Policies and procedures must demonstrate linkages, responsiveness, and collaboration with other levels of substance use treatment, mental health and medical services, DCF, criminal justice, and other community based social supports.

· Establish policies and procedures for Interim Methadone Maintenance Treatment including obtaining the state and federal approvals.

· Establish policies and procedures on Guest Dosing, including lengths of stay and payments.

· Develop a policy to ensure that the prescription monitoring program, Massachusetts Prescription Awareness Tool (MassPAT) is being utilized in a consistent and clinically appropriate manner to guide treatment and to ensure that decisions to discharge are not based solely on the MassPAT.

· Establish and implement policies and procedures to ensure appropriate service coordination and follow-up for pregnant and parenting women and infants for their Plan of Safe Care, including DCF communication, primary health care for mother and infant, parenting support, early intervention services and family planning support and referral.

· Ensure that all staff will receive training in the specific characteristics and needs of individuals participating in opioid treatment, including a focus on current, effective strategies for treating alcohol, cocaine, and other drug use.

· Ensure compliance with Fair Hearing Procedures for Involuntary Terminations per BSAS regulations.

· Participate in Methadone Treatment Quality Assurance System (MTQAS) on a monthly basis and submit all admission and discharge data to BSAS.

· Comply with all BSAS requests for data within the timelines set forth.

· Provide appropriate measures to identify and address other individual problems, including case management services to assure that individuals receive access to ancillary services.

· Report all billing information to include all third-party income and the individual fees collected by the program, on a monthly basis to the Bureau.

· Establish and use linkages with community 24 Hour Diversionary programs, OBOTs (Office Based Opioid Treatment), OBATs (Office Based Addiction Treatment), Clinical Stabilization Services (CSS), Transitional Support Services (TSS) programs, Residential, and Ambulatory programs, and recovery support services.

· Establish QSOAs and linkage agreements with community resources such as mental health providers, health care providers, long-term care and skilled nursing facilities, vocational and employment services as well as basic entitlement services.

· Establish linkages and communication/collaboration agreements with state agencies such as Department of Children and Families (DCF), Department of Mental Health (DMH) and Penal facilities.

· Medical Director, Program Director and/or Senior Management staff hired (unless otherwise specified) shall participate in all BSAS required meetings.

· Program Directors or Senior Management staff should represent organization at DPH BSAS Provider Meetings.

· Program must have a plan that demonstrates the ability to comply with HIPAA and 42 CFR Part 2 with regard to the privacy of patient records and the sharing of patient information as appropriately requested when in receipt of a compliant consent form forwarded to the program and must be able to store such regards, regardless of if paper or electronic, for seven years including if the organization dissolves.

· Program must always maintain valid and current registrations, certifications, licenses, and insurance policies.

· Program must submit timely Required Notifications and must have an internal investigation process to address incidents.

· Have an established mechanism to incorporate the individual’s and staff feedback into operational aspects of the program. (See www.niatx.net)

Staffing, Supervision and Minimum Requirements

· Each program must have a designated Medical Director (164.005: Definitions), who is the primary physician assessing, admitting and treating individuals at the individual OTP and is ultimately responsible for all treatment decisions. The Medical Director must have expertise in medications for opioid use disorder, especially methadone, buprenorphine, and extended-release injectable naltrexone.

· Each OTP shall have a Program Director, a Clinical Supervisor and a Nursing Supervisor at each individual licensed site.

· Bidders will meet staffing requirements called for in Federal Opioid Treatment Regulations 42 CFR part 8 and in 105 CMR 164.000.

· Supervision policy and protocols must at a minimum meet the requirements of 164.000, must ensure that all staff has the proper supervision to provide quality care, and such supervision is documented.

· All staff, including Medical Director, must have documentation that they have been evaluated annually.

· Professional Liability Insurance for professionals must be current, valid and adequate.

Operations

· Location and facilities must meet the health, safety, and privacy needs of the people served and staff providing the services.

· Hours of operation must meet the needs of the individuals served.

· Dosing and counseling hours must allow individuals to meet employment, educational, and parenting responsibilities.

· Programs must establish written policy and procedures for ensuring continuation of operations due to and type of emergency conditions (e.g., severe weather, cyber-attack) including protocols for continued dispensing or provision of medications. The policy shall be approved by both the Program Director and Medical Director and shall include the following method for notifying patients of the licensee’s plan for ensuring continued availability of medications.

· All programs must have a 24-Hour dose verification system to respond to non–community-based OTPs where patients are seeking treatment.

· All programs must abide by current policies, regulations, guidelines set forth by state and federal regulatory bodies, as well as any that may be subsequently released.

Education/Treatment for Use of Tobacco Products and other Nicotine Delivery Systems:

All staff should review the BSAS Practice Guidance, Integration of Tobacco and Nicotine into Substance Use Treatment Services which summarizes information from regulations and Standards of Care. Each program is required to have a Tobacco Education Coordinator who attends TA and Training from the statewide capacity building vendor on Tobacco Education and Cessation. In addition to their ability to adhere to the Guidance, all programs should provide or support access to nicotine replacement therapy or other medications for quit attempts. Post discharge planning should also include continuity of care for tobacco treatment.

BSAS will require compliance with all BSAS Standards of Care.

Trauma-Informed Services Trauma-informed care is an approach to delivery of behavioral health services. Given the prevalence of trauma among persons with substance related disorders, and the benefits of trauma-informed approaches, BSAS requires vendors to establish trauma-informed treatment environments and provide trauma informed care, as evidenced by:

· Stated commitment to trauma-informed care, with emphasis on individual choice and decision making.

· Inclusion of trauma screening in all assessments, and periodic reassessments and facilitated referral if indicated.

· Collaborative systems which provide access to trauma specific services.

· Recognition that children of individuals served have experienced trauma and that they and their parents may require support and assistance in obtaining effective trauma treatment.

Commitment to Opioid Overdose Prevention Vendors are required to support Massachusetts’ efforts to prevent and reduce opioid overdose, as evidenced by:

· A stated commitment to prevent and reduce opioid overdose.

· Up-to-date knowledge of overdose prevention and response resources in their communities, including identification of pharmacies stocking naloxone and/or having standing orders for naloxone.

· Establishing an on-site overdose emergency response plan and ensuring all staff are trained in preventing, recognizing and responding to overdose, including having access to naloxone on site.

· Including review of overdose history (including witnessing overdose) in treatment assessments.

· Educating individuals served about opioid overdose prevention, recognition and response.

· Allowing individuals served to retain possession of naloxone rescue kits while in the treatment program.

· Including opioid overdose risk reduction in treatment and discharge plans.

Culturally and Linguistically Appropriate Services (CLAS):

· Vendors must have demonstrated ability to provide culturally and linguistically competent services, including be able to provide services to individuals whose primary language is not English, to individuals with disabilities especially the deaf and hard of hearing, to veterans, and to individuals who identify as GLBT.

· All staff must be trained in Cultural and Linguistically Appropriate Services.

· Vendor must have policies and procedures for and MOUs with interpreter and translation services.

· Patient manuals, patient rights and other critical documents for patients must be available in their primary language.

· Vendors must demonstrate efforts to hire staff that have representation from such identity groups.

Right Care at the Right Time Providers awarded a contract must be in compliance with requirements of “105 CMR 164.070: Referrals and Admissions” and agree to have and follow required written policies and procedures for monitoring all requests for admission and placement lists. BSAS federal funding requirements call for detailed procedures for follow-up steps and referral protocols to be followed by OTP services when capacity is reached. Providers agree to work with BSAS to establish/maintain a mechanism to track and monitor placement disposition regarding referrals provided should an individual not receive services at the OTP.

Additionally, OTP programs will be responsible for having such program policies and procedures in place and describe how they will assist patients in accessing other treatment programs and/or other appropriate services. OTP must establish policies which document reasons that individuals were denied treatment. Denial of treatment based on a co-occurring disorder is prohibited and documentation of a patient assessment based on ASAM Criteria that clearly dictates patient inappropriateness for OTP must be available. Providers are expected to attach these program policies, procedures and forms to their response to this RFR.

Massachusetts Regulation 105 CMR 164.000 requires that each program shall establish written eligibility criteria and procedures for admissions and denials of an individual from a program. Per the regulation, if a program denies an individual patient admission, the following steps must be taken:

· The licensee must document the reason the individual was not appropriate for that particular level of care.

· The licensee must document that the individual was referred to an appropriate service, program, agency or court.

A program may not deny treatment for an individual with a substance use disorder based on the following:

· The individual uses medication prescribed by a practitioner outside the Licensed or Approved Provider’s service or facility

· Solely, because the person

(1) withdrew from treatment against clinical advice on a prior occasion.

(2) relapsed from earlier treatment; or

(3) filed a grievance regarding an action or decision of the Licensed or Approved Provider.

Anyone seeking treatment shall have an individualized assessment to determine appropriateness for admission. If the licensee’s level of care is not appropriate, it is the responsibility of the OTP to ensure that the individual obtains a safe disposition to the appropriate level of care.

C2a: DPH Racial and Health Equity Commitment

DPH is committed to improving health outcomes for all Commonwealth residents while eliminating the marginalization and health inequities that disproportionately threaten of the ability for communities of color to reach their full potential of health. Applicants will be expected to design activities through a racial equity lens incorporating the principles for Racial Equity developed by DPH. (See Principles for Promoting Racial Equity in Attachments for this RFR on COMMBUYS). Applicants will also we expected to describe how the current or planned operations of their organization support racial equity. Each prospective applicant should demonstrate how they will incorporate racial equity into their service design. The social marginalization and inequities that racism cultivates in housing, education, employment, the built and social environments, and health care are felt across generations, most acutely in communities of color. DPH reviewers will be required to consider an applicant’s ability to reflect on racial equity and how it is incorporated into the agency operations and program design as they score proposals.

Culturally and Linguistically Appropriate Services (CLAS) can be used as an additional tool to help achieve Health and Racial Equity. The National CLAS standards[footnoteRef:2] incorporate several principles, including but not limited to (1) collecting and analyzing data to better understand structural root causes of racial inequities; (2) building community partnerships to engage those who are most impacted in planning, implementing and evaluating programs; (3) fostering cultural competence to ensure staff understand and reflect the community served; and (4) ensuring language access services to increase quality of services to all communities. Applicants are expected to demonstrate the ability to provide culturally and linguistically competent services, including the ability to provide services to individuals whose primary language is not English, to individuals with disabilities especially the deaf and hard of hearing, to veterans, and to individuals who identify as GLBTQ. For further guidance visit www.mass.gov/dph/healthequity including The Making CLAS Happen Manual, a user’s guide to providing culturally and linguistically appropriate services in a variety of public health settings and the CLAS standards at https://www.mass.gov/lists/making-clas-happen-six-areas-for-action. [2: Adapted from National CLAS Standards and racial equity data roadmap

C2b: Supplier Diversity Program (SDP)

Pursuant to Executive Order 599, the Commonwealth’s Supplier Diversity Program (SDP) promotes business-to-business relationships between awarded Vendors, including health and human service providers, and diverse businesses and non-profit organizations (“SDP Partners”) certified or recognized by the Supplier Diversity Office (SDO).

All Bidders responding to this solicitation are required to make a significant annual financial commitment (“SDP Commitment”) to partnering with one or more SDO-certified or recognized diverse business enterprise(s) or non-profit organization(s). Providers that are issued a contract from this procurement (Bid) will be required to submit an annual “Supplier Diversity Program (SDP) Plan Form for Purchase of Service (POS)” with their Uniform Financial Report (UFR) through the Operational Services Division’s (OSD) eFiling site.

No contract shall be awarded to a Provider without an SDP Commitment that meets the requirements. This requirement extends to all Providers regardless of their own supplier diversity certification.

SDP Program Resources and Assistance: Additional information about the SDP policy can be found in the Attachments section of this RFR on COMMBUYS. Bidders seeking assistance in the development of their SDP Plans or identification of potential SDP Partners may visit the SDP webpage, www.mass.gov/sdp, or contact the SDP Help Desk at sdp@mass.gov.

C3: Performance Requirements and Contract Monitoring

Results and measures each medical provider is expected to develop and implement strategies that will achieve the following results. Baselines for each measure will be made available with the contract packages that funded vendors receive from the Bureau.

Result: Complete and submit MTQAS data on all individuals.

Measure: 100% compliance with MTQAS monthly submissions.

Result: Complete and submit all required data requests per DPH BSAS.

Measure: 100% compliance with submissions.

Result: The individual’s retention, during the first six months of treatment, will increase.

Measure: The rate of the individual’s retention in the first six months of treatment will increase annually over the prior yea

Result: All uninsured individuals will be enrolled in insurance plans through the Affordable Care Act.

Measure: 100% of all eligible individuals will be enrolled in an insurance plan.

Result: All Service Elements will be achieved within each Fiscal Year of funding.

Measure: Programs will maintain appropriate documentation for each service element and submit reports as requested.

Program Monitoring and Evaluation In accordance with the Department’s Payer of Last Resort Policy, providers are to reassess each patient’s indigent status every 90 days.

BSAS resources to support indigence may be utilized for up to 2 years per patient. The goal is for programs to have established healthcare resources for the patient, or for the individual to have achieved self-sufficiency. Providers can submit requests for extensions to this requirement to their regional manager.

· Providers will work with BSAS to develop standardized sliding fee scales, so that there is fee consistency to avoid “program shopping” by individuals.

· Providers will work with BSAS to develop a consensus on service elements/requirements with other major purchases of opioid treatment services.

· Providers will collaborate with the Bureau in the implementation of any additional tools and measures developed over the course of the contract period.

C4: Contract Invoicing Select at least one of the following types of contracts:

· DPH billing procedures through the EIM/ESM system require that contracted providers submit an invoice, on a monthly basis, for all services provided in the previous month.

· DPH requires that this invoice be authorized in EIM-ESM no later than the 14th day of the month, following service delivery. This includes a zero invoice if no services were provided.

· The only exceptions will be when the Bureau has been previously notified of extenuating circumstances and the request has been approved by the bureau contract manager. If corrections need to be made to previously submitted invoices, supplemental invoices must be submitted for the month in which the billing was originally submitted.

· All offsets must be reported for each UFR on the Invoice.

· Refer to the Provider Billing Booklet Reimbursement Policies and Billing in EIM at for detailed invoicing requirements.

1. Providers using the EIM-ESM manual billing process are required to submit a Service Delivery Report (SDR), on a monthly basis, for all services provided in the previous month.

· DPH requires that this SDR be authorized in EIM-ESM no later than the 14th day of the month, following service delivery. This includes a zero invoice if no services were provided.

· DPH requires that all services delivered to clients and paid by a third party be reported on the SDR as fully offset.

· Providers using the HIPAA electronic billing process are required to submit an all claims for the services provided in the previous month no later than the 14th day of the month, following service delivery.

· DPH requires that all delivered services paid by a third party be reported on an 837 HIPAA “encounter”.

· Program service delivery is paid through accommodation rates that are monthly rates developed to cover core services.

· Reports may be required for generation of payment.

Payment through Electronic Funds Transfer (EFT) is required for any contract awarded through this solicitation. If awarded a contract bidders not already enrolled will be required to sign up for EFT as a contract requirement by completing the Authorization for Electronic Funds Transfer Form. Additional information will be sent at the time of the contract.

Section D: RFR Evaluation

D1: Evaluation Criteria

All proposals will be scored on the following criteria:

· Ability to deliver OTP service elements mandated by state and federal regulations.

· Ability to deliver equitable, culturally competent and linguistically appropriate services

· Demonstrated commitment to Racial Equity

· Supplier Diversity Program (SDP)

· Provider Qualification Status

· Plan for coordinated and expedited admissions process, including immediate direct referrals.

· Services, policies, and procedures for population-specific care, specifically including pregnant, postpartum, and parenting participants.

· New patient orientation and engagement processes

· Ability to meet state and federal data requirements.

· Submission of required payment policy and sliding fee scale.

· Completeness of responses D2: Review Process

Proposals will undergo multiple levels of…