Addendum No. 1 RFP 25 134 Q and A FINAL.pdf

Request For Proposals for Substance Use Disorder and

Recovery Services Withdrawal Management and Residential

Treatment Services

ADDENDUM NO. 1 to RFP DBH 25-134 ePro Bid ID # DBHE26-ADMN- 6449

I. QUESTIONS AND ANSWERS

1. Question: So we are trying to submit for Bid# DBHE26-ADMN-6449 and I am completely confused. I was wondering if you had any kind of examples or instructions on how to fill it out? We watched the videos and we are still lost, this is my 1st time doing this and I just want to do it right?

Answer: The County does not provide examples, and proposers are to follow instructions in the RFP.

2. Question: Will the selected contractor be responsible for all routine facility maintenance, repairs, and preventive maintenance, or will San Bernardino County retain responsibility for building maintenance?

Answer: No, the County retains the responsibility for building maintenance.

3. Question: Which party is responsible for major capital repairs, including HVAC systems, plumbing, roofing, electrical systems, and structural repairs?

Answer: The County retains the responsibility for building maintenance.

4. Question: Is there a dollar threshold that distinguishes contractor maintenance responsibilities from County capital improvements?

Answer: No, the County retains the responsibility for building maintenance.

5. Question: Will the County provide a current Facility Condition Assessment or list of known deferred maintenance items before contract award?

Answer: Yes. The facility and the furnishing will be new.

6. Question: Are furniture, fixtures, and equipment (FF&E) currently available at the facility, or will the contractor be responsible for furnishing the residence?

Answer: The County will provide furniture and fixtures.

7. Question: Which equipment will remain County-owned and which items will become the contractor's responsibility to replace if damaged or worn?

Answer: All furniture and equipment provided by the County will remain County-owned.

Responsibility for the replacement of items that are damaged or worn will be determined by the final contract language established by SUDRS program administration.

8. Question: Will the County provide an inventory of existing assets that will transfer with facility operations?

Answer: Yes.

9. Question: Will DBH give preference to RFP proposals that offer a broader range of services within the residential level of care, or will proposals primarily be evaluated on the required scope of services outlined in the RFP?

Answer: We evaluate what is asked in the RFP. It is beneficial to explain your plan for services.

10. Question: Will DBH provide interpreter or translation services for contracted providers, or is the provider expected to secure these services independently?

Answer: The contractor is expected to have their own contracts in place for language services.

11. Question: Will DBH require providers to use a standardized assessment or outcome measurement tool for tracking client outcomes and completing the quarterly reports referenced in the RFP?

Answer: Yes, once DBH receives required measurements/outcomes from DHCS.

12. Question: Does the contractor need to select both male and female population?

Answer: Yes, for the Highland Creek Housing and Wellness Campus and for all other regions in the County.

13. Question: What is the expected max or minimum of detox beds?

Answer: At least two detox beds at Highland Creek Housing and Wellness Campus, no specific bed requirement for detox for the Countywide procurement just that the provider is required to offer current ASAM 3.2WM services.

14. Question: When will contractors be allowed to tour the grounds for ideas on the layout?

Answer: Contractors will be allowed to tour the grounds. The timeline is unknown at this time.

15. Question: Does the contractor have autonomy in the program expectations and program planning?

Answer: Yes, as outlined in the RFP.

16. Question: What is the expected scope of Recovery Services?

Answer: The components of Recovery Services are:

• Assessment;

• Care Coordination;

• Counseling (individual and group);

• Family Therapy;

• Recovery Monitoring, which includes recovery coaching and monitoring designed for the maximum reduction of the client’s SUD; and

• Relapse Prevention, which includes interventions designed to teach clients with SUD how to anticipate and cope with the potential for relapse for the maximum reduction of the client’s SUD

Recovery Services are services designed to support and/or enhance recovery.

These can include outpatient counseling, recovery monitoring, education and job skills and ancillary services, among others.

Residential, Withdrawal Management, and Recovery Services are provided to non-perinatal and perinatal beneficiaries.

17. Question: What is the anticipated date for the secondary RFP to come out for the additional residential beds, and will the awarded contractor have first priority to said beds?

Answer: Unknown at this time. We do not have the date, and it is unknown if the additional beds will have to go out for procurement.

18. Question: Who is considered to require the BAA in addition to the contractor?

Answer: The County’s relationship is with the Contractor. It is up to the Contractor to determine compliance on its end as County has no contractual relationship with the subcontractors.

19. Question: Which operating expenses remain the responsibility of the County and which are the contractor's responsibility?

Specifically:

• Electricity

• Maintenance

• Natural gas

• Water

• Sewer

• Trash

• Internet

• Telephone

• Security systems

• Pest control

• Landscaping

• Housekeeping supplies

Answer: The County will provide electricity, maintenance, natural gas, water, sewer, trash service, security systems, pest control, and landscaping. The contracted service provider will be responsible for internet, telephone service, and housekeeping supplies.

20. Question: If the contractor wishes to make improvements to better support treatment services, what approval process is required?

Answer: Any improvements proposed by the contracted service provider will require prior County approval. See contract language for the applicable approval process and requirements.

21. Question: Are contractors permitted to purchase improvements using grant funds if approved by the County?

Answer: The use of grant funds for improvements may be permitted but will require prior County approval. See contract language for the applicable approval process and requirements.

22. Question: Will the facility already possess all required DHCS residential licensing and DMC certification, or will the selected contractor be responsible for licensing under its own organization? Is there going to be a designated IMS office space in place?

Answer: Provider is responsible for DMC and AOD licensing.

Provider will have IMS space.

23. Question: If new licensure or certification is required, when will access to the facility be provided to allow inspections before the contract start date?

Answer: For the Highland Creek Housing and Wellness Campus, access will be given after contract start date.

24. Question: Does the County anticipate minimum staffing ratios beyond Title 22 and DMC-ODS requirements?

No, for either procurement.

25. Question: Will County personnel be co-located at the facility?

Answer: No, for either procurement.

26. Question: Will County security personnel be assigned to the campus?

Answer: County will provide security to campus.

27. Question: What are the staffing budget requirements?

Answer: Contract is Fee-for-Service, budgets for staffing is based on staffing requirements per DHCS and ASAM required staffing per Level of Care.

28. Question: Will the contractor utilize its existing Electronic Health Record system, or will documentation be required in a County-designated EHR?

Answer: You can use your own Electronic Health Record, but billing must be through the county Electronic Health Record system (myAvatar). County will provide limited access to system for billing.

29. Question: If County systems are required, what training and implementation support will be provided?

Answer: The County provides training and implementation support.

30. Question: Will referrals be centralized through DBH Access Unit, or may other County departments refer directly?

Answer: Referrals will come from the SARC unit.

31. Question: Does the County anticipate operating the facility at full census throughout the contract?

Answer: Yes.

32. Question: What percentage of referrals are anticipated to come from justice-involved populations?

Answer: Unknown.

33. Question: Will startup funds be paid in advance, reimbursement-based, or milestone-based?

Answer: Startup costs will be reimbursement-based. Provider will invoice for allowable startup costs and DBH will reimburse based on the startup cost allowable budget.

34. Question: Which startup costs are allowable and non-allowable?

Answer: Licensing, Accreditation & Legal

Facility Lease & Build-Out

Furniture, Fixtures & Equipment

Clinical & Administrative Staffing (Pre-Opening)

Electronic Health Records (EHR) & IT

Insurance & Risk Management

Clinical Supplies & Testing

Marketing & Community Outreach

Policies, Training & Compliance

Working Capital & Contingency

35. Question: Are the provided rates in the budget worksheet fixed or are they negotiable?

Answer: Provider rates are fixed but based off current DHCS rates.

36. Question: Will startup funding be provided separately from service reimbursement?

Answer: Startup & service reimbursements will be invoiced and reimbursed separately.

Startup and service reimbursement funding will be paid based on monthly claims submitted by the Provider for previous month’s services provided and for previous month’s startup costs paid.

37. Question: Who assumes liability for incidents related to facility infrastructure failures?

Answer: Responsibility will depend on the circumstances of the incident and the applicable contract provisions. The Contractor is responsible for its acts and omissions, and the indemnification and insurance requirements in the RFP will determine the responsibilities of the Contractor and the County.

38. Question: Is the contractor responsible for insuring County-owned buildings or only its operations and professional liability?

Answer: The Contractor is not required to insure the County-owned building itself as property. However, the Contractor must maintain the insurance required by the RFP for its operations and services at the facility and may be responsible for damage to County property arising from its acts or omissions, as provided under the Contract.

39. Question: Are commercial kitchen equipment and food storage systems already in place? Will

Answer: Yes, for the Highland Creek Housing and Wellness Campus. However, the Countywide procurement requires Contractor to have food services/equipment on their own.

40. Question: What security infrastructure currently exists at the facility?

• Cameras

• Badge access

• Security personnel

• Alarm systems

Answer: All of the above will be in place by contract start date.

41. Question: Is security expected to be provided by the contractor?

Answer: The County will provide security.

42. Question: Does the County anticipate any future expansion of residential treatment capacity or additional services at the Highland Creek Housing and Wellness Campus during the contract term that the selected contractor should consider in its proposal?

Answer: Yes, there will be additional expansions at the site but not to be considered in this proposal.

43. Question: Will the selected contractor have exclusive operational control over the residential treatment facility, including day-to-day decisions regarding admissions, staffing, programming, schedules, visitation, and facility operations, or will certain operational decisions require prior County approval?

Answer: DBH will make admission decisions, and the Provider will make all daily operations regarding implementation for SUD residential site.

44. Question: Please provide clarification regarding the Onboarding Start-Up Budget listed on page 22. The text indicates that this budget is ONLY applicable to the Highland Creek Housing and Wellness Campus (Pacific Village). Is the Residential and Withdrawal Management Building subject to this budget as well, or should it be considered excluded?

Answer: Start-up budget specific to the Highland Creek Housing and Wellness Campus facility.

45. Question: Are we leasing a building? If yes, how much is the rent?

Answer: Yes, unknown at this time.

46. Question: How many square feet is the facility? What is the ratio of space usage for treatment, room and board, and others?

Answer: The facility is approximately 13,000 square feet. Approximately 50% of the facility is dedicated to room and board, 30% to treatment space, and 20% to office space.

47. Question: Are we required to offer treatment to women with custody of young children?

Answer: No, the procurement does not require the proposer to operate as a site with programing for mothers/fathers with custody of small children.

48. Question: Could you please clarify the following Note that is posted on page 33 of the RFP?

(Note: The facility utilized for Residential Treatment and Withdrawal Management is an integral component of the proposed services. Floor Plans, pictures, maps, or any other items that will assist the Proposer(s) in describing the facility in detail are encouraged to be provided with the proposal.) We do not see the plans posted on ePro and are wondering whether they will be provided.

Answer: These will be posted to ePro as an addendum.

49. Question: Can we please get a copy of the building/floor plan?

Answer: These will be posted to ePro as an addendum.

50. Question: Will the residential program be completely furnished by the county, or are we required to furnish it?

Answer: The Highland Creek Housing and Wellness Campus is furnished by the County.

51. Question: The budget template has the contracted rates pre-filled out. Does it mean that we have to use these rates? Can it be higher or lower?

Answer: Yes, these are the DBH rates for residential services under the current ASAM 3.

Residential providers are also allowed to provide stand-alone services as outlined by DHCS and those are paid at the DBH outpatient rate per unit.

52. Question: RFP page 1 states that the County is seeking a provider for "Substance Use Disorder and Recovery Services Withdrawal Management and Residential Treatment at Highland Creek Housing and Wellness Campus...along with all regions within the County." Could the County please clarify: 1. If this RFP is only for the Wellness Campus? 2. If this RFP is a general call to find qualified providers for residential SUD services including the services to be provided at the Wellness Campus?

Answer: RFP is seeking providers for the Highland Creek Housing and Wellness Campus as well as additional providers to provide services in other regions.

53. Question: RFP page # indicates the Highland Creek residential facility will have 16 beds.

Could the County please clarify: 1. If the County would consider proposals for only

15 beds to better align with the 1:15 staff-to-client ratio indicated on page #? 2. Will there be an opportunity to add additional beds?

Answer: 16 beds are expected with at least two beds for detox.

There is not an opportunity to add additional beds at this time.

54. Question: Could the County please specify the target population and what services and ASAM levels they expect providers to offer at the Highland Creek residential facility?

Answer: The target population includes Medi-Cal beneficiaries residing in San Bernardino County who have substance use disorder treatment needs, meet applicable DMC- ODS access criteria, and require medically necessary residential treatment based on an individualized assessment and ASAM level-of-care determination. Services shall be available to eligible adults and adolescents, as applicable, who require residential treatment at ASAM Levels 3.1, 3.2, 3.3, or 3.5 based on their clinical needs.

The target population may include individuals with co-occurring mental health conditions and other complex needs, including individuals who are pregnant or postpartum, justice-involved, experiencing homelessness or housing instability, or transitioning from withdrawal management, inpatient, or other levels of substance use disorder treatment.

55. Question: RFP page 1 states that the County is seeking a provider for "Substance Use Disorder and Recovery Services Withdrawal Management and Residential Treatment at Highland Creek Housing and Wellness Campus...along with all regions within the County." Could the County please clarify: 1. If this RFP is only for the Wellness Campus? 2. If this RFP is a general call to find qualified providers for residential SUD services including the services to be provided at the Wellness Campus?

Answer: The RFP is seeking a provider to provide services at the Highland Creek Housing and Wellness Campus for 16 beds.

The RFP is also seeking providers to provide residential services for county residents in all regions of the County.

56. Question: RFP page 22 indicates the Highland Creek residential facility will have 16 beds.

Could the County please clarify: 1. If the County would consider proposals for only 15 beds to better align with the 1:15 staff-to-client ratio indicated on page 40 for residential treatment and withdrawal management? 2. Will there be an opportunity to add additional beds?

Answer: 16 beds are expected with at least two beds for detox.

There is not an opportunity to add additional beds at this time.

57. Question: Could the County please specify the target population and what services and ASAM levels they expect providers to offer at the Highland Creek residential facility?

Answer: The target population includes Medi-Cal beneficiaries residing in San Bernardino County who have substance use disorder treatment needs, meet applicable DMC- ODS access criteria, and require medically necessary residential treatment based on an individualized assessment and ASAM level-of-care determination. Services shall be available to eligible adults and adolescents, as applicable, who require residential treatment at ASAM Levels 3.1, 3.2, 3.3, or 3.5 based on their clinical needs.

The target population may include individuals with co-occurring mental health conditions and other complex needs, including individuals who are pregnant or postpartum, justice-involved, experiencing homelessness or housing instability, or transitioning from withdrawal management, inpatient, or other levels of substance use disorder treatment.

58. Question: RFP page 1 states: "The County is seeking proposals to provide...Substance Use Disorder and Recovery Service Withdrawal Management and Residential Treatment at Highland Creek Housing and Wellness Campus...along with all regions within the county...The projected allocation for this (service/program) is approximately $19,087,102 for the 23-month period." Is the $19million budget for the 16-bed Highland Creek facility only?

Answer: The Highland Creek Housing and Wellness Campus budget is approximately $4,183,474.

59. Question: RFP page 22 states: "The Highland Creek...Campus...DBH is seeking proposals for a Provider to provide SUD services for the 16-bed residential treatment facility..."

Can the County please provide: 1. A floor plan of the new facility and/or more information about what is in the facility (number of group room, commercial kitchen, recreation spaces, offices, etc.). 2. More information about what services (i.e., janitorial, transportation, maintenance, food services) will be provided by the County, if any. 3. How much annual rent will be for the facility. 4. What utilities and security features will be in-place at the Highland residential facility when the provider gets access to the space.

Answer: Yes. The County will provide floor plans for the facility which will be posted into ePro as an addendum. The approximately 13,000-square-foot facility includes 16 residential treatment and withdrawal management beds, 14 office areas, one conference room, one family visiting room, two interview rooms, two group rooms, a large dining and living area, a hot box, and a staff break room. The facility also includes restroom and shower facilities and an approximately 3,081-square-foot courtyard with a large patio area to the north.

County-provided services:

Information regarding County-provided facility services will need to be confirmed by County Facilities Management (FM). FPM will coordinate with County FM on Program's behalf to obtain this information.

Annual rent:

Any costs associated with the facility will be based on Program's approved budget. Program will need to provide the applicable budget information.

Utilities and security features:

Utility responsibilities are addressed elsewhere in this Addendum. Security features will include a Genetec-based access control and camera system. The County will provide the necessary access cards for the facility.

The County will provide basic janitorial and landscaping services. The contracted service provider will be responsible for routine interior and operational maintenance. The County will remain responsible for major structural components and County-owned building systems. Specific maintenance responsibilities and associated costs will be governed by the final contract.

60. Question: RFP page 22 indicates there is a start-up budget and onboarding period for the Highland Creek Housing and Wellness Campus provider. Can the County please clarify: 1. When the facility will be completed and prepared for the provider to move in? 2. When are services expected to begin? 3. Will the County consider a ramp-up period as part of the proposed implementation timeline?

Answer: The facility is expected to be completed by February 2027.

Services are expected to begin approximately six months from the contract start date.

Yes, the “ramp-up period” will be approximately six months.

61. Question: Will all referrals for the Highland Creek Housing and Wellness Campus come from the County? Can the County please share any information about demand for services and/or expected utilization of the 16 beds during the 23-month contract period?

Answer: Referrals will come from DBH SARC. DBH expects provider to maintain full capacity in addition to providing the full spectrum of standalone services as outlined by DHCS.

62. Question: RFP page 22 states that housing units and recuperative care units will be available at the Highland Creek Wellness Campus. What other services will be available on sight after the campus is completed?

Answer: The items listed within page 22 of the RFP are the complete list.

63. Question: What are the County's required incident, sentinel event, death, grievance, privacy/security, and suspected fraud/waste/abuse reporting timelines and forms?

Answer: If Contractor identifies an issue or receives notification of a complaint concerning an incident of possible fraud, waste, or abuse, Contractor shall immediately notify DBH; conduct an internal investigation to determine the validity of the issue/complaint; and develop and implement corrective action if needed.

If Contractor’s internal investigation concludes that fraud or abuse has occurred or is suspected, the issue is egregious, or beyond the scope of the Contractor’s ability to pursue, the Contractor shall immediately report to the DBH Office of Compliance for investigation, review and/or disposition.

Contractor shall immediately report to DBH any overpayments identified or recovered, specifying the overpayments due to potential fraud.

Contractor shall immediately report any information about changes in a beneficiary's circumstances that may affect the beneficiary's eligibility, including changes in the beneficiary's residence or the death of the beneficiary.

Should Contractor identify improper procedures, actions or circumstances, including fraud/waste/abuse and/or systemic issue(s), Contractor shall take prompt steps to correct said problem(s). Contractor shall report to DBH Office of Compliance and Fiscal Administration any overpayments discovered as a result of such problems no later than five (5) business days from the date of discovery, with the appropriate documentation, and a thorough explanation of the reason for the overpayment. Prompt mitigation, corrective action and reporting shall be in accordance with the DBH Overpayment Policy (COM0954), which has been provided or will be provided to Contractor at its request.

64. Question: What County system will be used for billing/CDI entry, CalOMS, prior authorization, incident reporting, and outcomes reporting? Will training and test access be available before service start at Highland Creek?

Answer: Provider system for tracking, and county system for billing (myAvatar). Training will be provided before start date.

65. Question: Will the Highland Creek/Pacific Village continue to expand? If yes, will the provider selected for this 16-bed contract have priority consideration for any additional beds/residential SUD programs?

Answer: It is unknown at this time if the additional beds will require a separate procurement.

66. Question: Will the provider be responsible for: 1. Food service, onsite meal preparation 2.

Drivers/vehicles 3. Security 4. Maintenance and facility repairs?

Answer: Yes, provider responsible for Food and meal prep, drivers, vehicles. The County will provide facility repairs and maintenance.

67. Question: Given the extensive list of clarification questions for the Highland Creek/Pacific Village facility, would the County please consider extending the due date for this

RFP?

Answer: No.

68. Question: If a provider has available residential SUD treatment beds in a neighboring county, would the County consider contracting for services at facilities located outside of the County for this RFP?

Answer: Yes, we would consider contracting if appropriate.