9-DHHS26105 Attachment D Facility Service Selection Template 6.26.docx

This is a Facility Service Selection Template for the Utah Department of Health and Human Services (DHHS) residential treatment services contract opportunity 9-DHHS26105. The document serves as an attachment requiring offerors to provide facility and service information to participate in the bidding process. Offerors must submit their organization name and address, identify the specific facility location and licensed bed capacity, and select the client population and risk/need level their facility will serve from ten designated service categories. These categories include high-level youth with problematic sexual behaviors (ages 16-18 and 12-15), moderate-level youth with problematic sexual behaviors (adjudicated and non-adjudicated), substance-dependent youth, and mental and behavioral health services at both high and moderate levels, with designations for DCFS and JJYS populations.

The template requires offerors to specify the gender of clients to be served at their facility, selecting either female or male populations. The template does not address pricing terms, funding requirements, contract duration, or renewal options within its scope. As a selection and qualification document, it functions primarily to establish facility eligibility and service capacity alignment with DHHS program needs, enabling the state to match available residential treatment resources with appropriate client populations and risk levels across its behavioral health and youth services programs.