Addendum No. 2 RFP 25-187 - Questions and Answers.pdf

Request for Proposals for High Fidelity Wraparound Services

RFP DBH #25-187

ePro Bid #DBHE26-ADMN-6310

ADDENDUM NO. 2 to RFP DBH # 25-187

Answers to questions submitted prior to the 12:00 p.m. deadline on October 1, 2026

1. Question: Between Section 1. Description of Services to be Provided ending on page 64/123 (PDF page 67/162) and Section 3. Administrative Requirements starting on page 64/123 (PDF page 67/162), there is no Section 2. Is Section 2 missing or is this a numbering error?

Answer: The numbering error is on page 49 of the RFP – there should be no “1.” before “Description of Services to be Provided”.

2. Question: The RFP references the ASC as one of the oversight bodies, however our understanding from county communication is that the ASC will no longer exist. Could the County clarify the oversight bodies that will receive and monitor documentation? Will the HFW Committee replace the ASC?

Answer: The HFW Community Leadership Team will serve as the primary administrative oversight body for HFW contractors and will assume functions previously performed by the Administrative Sub-Committee (ASC). The Community Leadership Team operates under the authority of the Interagency Leadership Team (ILT) and includes DBH, Children & Family Services, Probation, Tribal representatives, HFW providers, and other system partners responsible for HFW oversight.

3. Question: Who is the interagency team (ILT)?

Answer: The ILT is the Interagency Leadership Team established under AB 2083. It is the cross-system leadership structure through which county behavioral health, child welfare, probation, education, regional center, and other required partners coordinate services for children and youth with complex needs. The HFW Community Leadership Team operates under the ILT's authority.

4. Question: Page 47 Indicates collaborative and oversite of flex funds. Who governs this, the CBO or County and what is the tracking process?

Answer: Flex funds are governed through a shared County/provider process rather than solely by the CBO. The HFW Community Leadership Team is expected to review access to and use of flex funds, while each provider must maintain written procedures for requesting, approving, tracking, and managing the funds, including an expedited process for emergencies. Flex funds are non-Medi-Cal dollars used for individualized needs identified in the youth's Plan of Care.

5. Question: For placement services, please clarify the responsibilities of the CBO in this process?

Answer: The HFW provider's role in placement-related activities is supportive and care-coordination focused. The provider may assist with identifying and coordinating an appropriate living arrangement, preparing the youth and family for a move, facilitating pre-placement visits, coordinating with system partners, and providing follow-up support.

San Bernardino County Department of Behavioral Health

Request for Proposals High Fidelity Wraparound Services

RFP No. DBH #25-187

This may include participating in child and family team meetings and multi-disciplinary team meetings to better coordinate and collaborate. The placing agency retains its statutory placement authority and responsibility.

6. Question: How is the CBO involved in determining HFW eligibility for children/youth placed in an

STRTP?

Answer: DHCS has not yet issued final versions of the HFW BHIN or HFW Policy Manual. The current draft guidance indicates that for youth age six and older, a completed CANS is used by a qualified licensed mental health professional to apply the HFW Decision Support Criteria and determine whether HFW is medically necessary and clinically appropriate. For youth in an STRTP, the HFW provider may assist by confirming or updating the CANS, participating in the assessment and CFT process, and coordinating the transition and aftercare plan. The placing agency and behavioral health plan retain their respective statutory and clinical responsibilities.

7. Question: What is the referral process for the program?

Answer: Referrals may originate from multiple sources, including child welfare, probation, behavioral health, FURS, and other system partners. The final County referral and assignment workflow will be established with the awarded providers and the HFW Community Leadership Team. Once referred, families must be engaged timely and eligibility must be determined in a manner that promotes equitable access and avoids unnecessary delays.

8. Question: Page 46/123 (PDF page 49/162), Section 8.8.3. Cost Savings are Reinvested: San

Bernardino County has not historically requested reinvestment from its contractors, and it is not a typical process under the CalAIM model. County the County clarify what this process will entail?

Answer: The RFP requires HFW savings, defined as total annual revenue in excess of total expenditures, to be reinvested to expand or enhance services/resources for youth and families. This is consistent with the UC Davis HFW certification requirements. To be clear the HFW Agency will be reinvesting into their own program. The requirements of reporting this process will be developed with the awarded CBOs.

9. Question: Page 50/123 (PDF page 53/162), Section 1.i. Monthly High Fidelity Wraparound (HFW)

Rate: Please confirm whether the Monthly HFW Rate is bundled or individual/per service, and if bundled, what is the rate?

Answer: $4,290 - The Monthly HFW Rate is a monthly bundled rate covering specified core HFW activities; it does not cover all required activities in the HFW Service Package. The RFP does not state the dollar amount of the Monthly HFW Rate, but this was provided at the Proposer’s Conference and is hard coded into the fiscal schedules.

10. Question: Staffing requirements in the RFP are for a psychiatrist. Can a Psychiatric Mental Health

Nurse Practitioner with required consultation by a psychiatrist be used instead?

Answer: No, the RFP specifically defines the Psychiatrist position as a licensed physician with a psychiatric specialty. Although Medication Support Services may be subcontracted, the RFP does not identify a Psychiatric Mental Health Nurse Practitioner as a substitute for the required psychiatrist position.

11. Question: What were the total maximum contract amounts for 2025-2026 for each of the 6 Target

Areas?

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Answer: The RFP does not provide the 2025-2026 maximum contract amounts by geographic area. It provides only the projected HFW allocation of approximately $108,302,281 annually/$541,511,405 over five years and prospective geographic service information in Attachment O. The maximum amount for each region will be proportional based on the estimated unduplicated client count.

12. Question: What were the average number of clients served at one time for 2025-2026 for each of the 6 Target Areas?

Answer: HFW is a new program, serving a broader population than historically serviced through

SB 163 Wraparound, so we do not have this information.

13. Question: What were the total unduplicated clients served during 2025-2026 for each of the 6

Target Areas?

Answer: HFW is a new program, serving a broader population than historically serviced through

SB 163 Wraparound, so we do not have this information.

14. Question: As in past solicitations, 5 years of budgets are requested however the total funding available per year is unchanged at $541,511,405. Under Fee For Service reimbursement, DHCS has been and can be expected to continue providing annual rate increases based on inflation. Providers will need to have maximum contract increases to cover inflation. Can increasing amounts be budgeted across the 5 years? How will the County account for this is its annual amount of available funding is unchanged over the 5 years?

Answer: The submitted fiscal schedules should be for the same amount for each fiscal year;

however, it is recognized that CalAIM FFS rates will likely increase. Should a provider require an increased allocation in future fiscal years, this will be navigated at that time.

15. Question: County / External Systems: Can the County confirm which HFW data must be entered directly into Objective Arts, the County billing/transactional system including myAvatar, and the WFI database, and whether any of these requirements may be satisfied through an approved interface, batch/FTP process, or other automated data exchange rather than separate manual entry?

Answer: The question includes three different data systems. MyAvatar requires direct data entry to register a client and maintain some critical information, but service data does not require direct entry. CANS/ACE/PSC-35 data must be entered directly into Objective Arts. Specifics regarding entry of HFW data (e.g., WFI) are not decided by DBH.

16. Question: EMR: Can the County clarify whether the required Mental Health Chart, Safety Plan, ICFP, SMHS care/treatment plan, discharge summary, CFT documentation, and other required clinical documentation may be maintained in the contractor’s EHR, or whether any must also be separately maintained or submitted in a County-designated system or format?

Answer: Contractors may maintain the clinical record in their own compliant EHR, provided the record contains all required HFW and SMHS documentation and the contractor also completes any County-required forms, submissions, data entry, or system uploads.

County-standardized forms or data systems must be used when the County specifically requires them. Information (e.g., ICFP) needs to be shared and provided to others involved in the care of the participant (e.g., CFS).

17. Question: Business Analytics / Data: Can the County provide the outcome-data specifications expected at implementation, reporting templates/file formats, submission methods, and

Behavioral Health

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Answer: The RFP identifies the principal outcome tools and minimum reporting cadence: outcome reports no less than quarterly; ACE/CANS-SB/PSC-35 entry within specified timelines;

and a yearly provider outcome report. It also states that future DHCS/HFW Center of Excellence requirements may add or refine metrics; specific future templates/file formats are not known at this time.

18. Question: Artificial Intelligence Approval: What are SBC’s current requirements for approval of artificial intelligence (AI) software, and what is the process for obtaining approval to use specific AI tools under this contract?

Answer: At this time there is no “AI approval” process for contractors, however use of AI must adhere to existing confidentiality, privacy and security standards in accordance with state and federal laws (including HIPAA Privacy and Security Rules). Additionally, contractors must ensure adherence to County Policy 09-08, as applicable.

19. Question: If we have a contracted psychiatrist who supports Medication Supportive Services, is that considered to be a subcontract and does Attachment 5, section 7 need to be completed?

Answer: Yes. A psychiatrist engaged under a separate contractual arrangement to provide Medication Support Services is a subcontractor. The subcontract must be disclosed and approved in accordance with the subcontracting requirements, and the required subcontractor documentation and MOU must be included.

20. Question: Can optional attachment be included?

Answer: Yes, in addition to the Proposal requirements outlined in the RFP, respondents are free to submit additional attachments/addenda as needed.

21. Question: Are electronic signatures acceptable?

Answer: Electronic signatures for Proposals submitted to ePro are required. Hard copy submission of Proposals require original signatures.

22. Question: The staffing question 5 on page 112 of the RFP asks us to “Differentiate between the

HFW team and other professionals.” Pages 73-75 of the RFP list 12 “specific positions within the HFW Programs.” Are we to assume that any position outside of the 12 staff classifications on pages 73-75 are “other professionals”? Or do you intend to differentiate between direct service staff and indirect staff? Please clarify.

Answer: The distinction is between HFW team roles and other professionals who may participate in the Child and Family Team or provide additional services. The HFW staffing model includes both direct-service roles (such as Facilitator, Parent/Caregiver Peer Partner, Family Specialist, and Youth Peer Partner) and indirect support roles (such as Supervisor, Clinical Supervisor/Clinician, Fidelity Coach, and Community Developer).

Other professionals may include the youth's therapist, teacher, physician, social worker, probation officer, or other providers who are not serving in an assigned HFW team role.

23. Question: Regarding the Facilitator, the RFP lists HFW Facilitator as a team title on page 71, but it is not in the list on pages 73-75. Please clarify.

Answer: The HFW Facilitator is a required direct-service role and the central coordinator of the

HFW process. The Facilitator works with the youth and family to identify team members, leads development and implementation of the Plan of Care, coordinates the CFT/HFW team process, and monitors progress and transitions.

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24. Question: How are you defining the difference between ICC Coordinator and Facilitator? Can this be fulfilled by the same staff member?

Answer: The Facilitator is the HFW role that leads the Wraparound process and coordinates development and implementation of the Plan of Care. 'ICC Coordinator' describes the care-coordination function of ensuring services and plans across systems are integrated.

The same staff member may perform both functions when appropriately qualified; in HFW, the Facilitator will commonly perform the ICC/care-coordination function.

25. Question: Are agencies providing HFW to take referrals from FURS and open HFW cases, as opposed to asking the County to authorize and make the referrals to our HFW program?

Answer: For FURS, the initial request continues to come through the established CFS FURS structure. CFS will contact the HFW provider responsible for the geographic coverage/rotation, and the provider will deliver the required urgent or non-urgent response and follow-up. Whether the youth is subsequently enrolled in ongoing HFW will depend on the eligibility and clinical determination process.

26. Question: Should an organizational chart for our proposed HFW program be included as an attachment?

Answer: While an organization chart is not a Proposal requirement outlined in the RFP, respondents are free to submit additional attachments/addenda as needed.

27. Question: When will the County provide responses to all questions submitted by the October 1 deadline?

Answer: Responses to all questions submitted by the 12:00PM PST deadline of Thursday, October 1, 2026 will be posted as an addendum to ePro by Thursday, October 8, 2026.

28. Question: The Family Specialist services are included in the bundled rate, however MHRS is listed as a SMHS service that can be billed outside of the monthly rate. What would be an example of a billable MHRS service?

Answer: Family Specialist activities are part of the bundled rate. However, an agency is allowed to staff a MHRS to provide the SMHS which are not part of the monthly bundled rate (e.g., IHBS).

29. Question: Is a clinician able to bill ICC if they attend a CFT Meeting as a member of the CFT? Or if not, what service can they claim?

Answer: While we do not have a final version of the BHIN, the draft version indicates an outpatient

LMHP outside the HFW team (for example, the youth's therapist) who joins CFT/HFW meetings bills that time as H2000 with the HK modifier, not as ICC or TCM.

30. Question: My understanding is that crisis services can be billed outside of the monthly rate if they are provided by an individual outside of the assigned HFW team. For example, an on-call clinician. Can you please clarify?

Answer: While we do not have a final version of the BHIN, the draft version indicates that crisis services not provided by the HFW team, such as mobile crisis, crisis stabilization, or crisis intervention may be billed. Telephonic crisis support stays with the HFW team.

31. Question: It appears that Provider Certification may take longer than when you want to award contracts and this program design in in flux by the State. So, is this RFP intended to identify Providers who are interested in a contract and that you will contract with any qualified providers?

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Answer: No. The RFP is a competitive best-value procurement; it does not state that every qualified proposer will receive a contract. The County may reject proposals, does not commit to award a contract, and will award based on the proposal(s) that best meet County needs, subject to final award authority. However, it is understood that agencies may not have a finalized HFW certification.

32. Question: Is HFW designed to be provided to our current STRTP clients or are we expected to provide HFW services to clients who reside outside of our STRTP while simultaneously providing our regular SMHS services to our clients who reside in our STRTP?

Answer: This RFP is for the development of a HFW program targeting children and youth residing in a community area. A HFW Program contract will not be awarded to an agency solely for the delivery of HFW to youth in an STRTP. It is understood that the forthcoming Tiered Rate Structure (TRS) is dramatically altering the funding structure for youth residing in an STRTP. The Immediate Needs portion of the TRS may be designated for the provision of HFW to youth in the STRTP, but this has not been finalized. Should CDSS and DHCS clarify the purpose of the Immediate Needs portion of the TRS to be for an STRTP agency to provide HFW to youth in placement, then DBH will address this by incorporating the HFW Bundled rate within the Children’s Residential Intensive Services (ChRIS) program thereby allowing qualified STRTPs to provide HFW.

33. Question: Is the requirement for in-person response to FURS calls restricted to the geographic area a provider serves or does a provider need to provide county wide response under this requirement?

Answer: Restricted to the geographical area a provider serves.

34. Question: Is the Regional FURS On-Call center provided by the county or expected to be provided by the Provider? If by the Provider, can multiple Providers collaborate to operate a regional call center?

Answer: The FURS phone line is maintained by Children and Family Services (CFS). The HFW providers maintain a response ability if they are contacted by CFS. The response requirements will be shared by multiple providers on a FURS rotation schedule.

35. Question: Regarding FURS funding, the RFP states: “If the immediate need or circumstances are such that the service may not be billed to Medi-Cal, then the costs of these services will be reimbursed without billing Medi-Cal.” How are these services funded and/or billed?

Answer: The RFP states that qualifying FURS activities may be billed as Crisis Intervention and/or Assessment. If the immediate need/circumstances cannot be billed to Medi-Cal, the costs will be reimbursed without billing Medi-Cal by using specific service codes.

36. Question: For clarification, is the total contract amount per provider?

Answer: No. The $541,511,405 figure is the projected total five-year allocation for the entire program, not a stated amount per provider. The RFP does not guarantee any minimum or maximum referrals/enrollments or a fixed award amount to an individual contractor.

37. Question: P.13 of RFP notes that IP-CANS is integrated in CANS-SB. Pease confirm we will continue to use CANS-SB only?

Answer: Yes. CANS-SB will continue to be the County tool. CANS-SB includes the items required for both the CANS-50 and IP-CANS, supporting alignment across behavioral health and placing agencies.

38. Question: What is the methodology for assigning FURS calls requiring response from providers?

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Answer: A rotating schedule of providers covering different regions will be maintained.

39. Question: On page 68, when the minimum number of encounters are not met to be able to bill HFW bundled rate, do we bill Med-Cal for each service under the 8 encounters?

Answer: We do not have a final BHIN, however the draft BHIN indicates that only one qualifying contact is required for the monthly billing. DHCS may provide additional information that would prohibit the submission of the bundled rate. Should that occur, we expect that individual SMHS may be billed.

40. Question: Will the Monthly HFW Rate be released before 4:00 pm, 10/15/2026?

Answer: Yes, the Monthly HFW Rate of $4,290 was provided at the Proposer’s Conference.

41. Question: Currently referrals are reviewed and approved by ASC and assigned to providers. Will this process be similar, knowing it will not be ASC, will there another referral process?

Answer: The RFP replaces ASC oversight with the HFW Community Leadership Team for specified functions, but it does not set out a complete replacement referral-assignment workflow because it is not yet established. The functions that are part of ASC will need to be maintained, but additional aspects of the referral process need to be developed.

42. Question: Please define and differentiate between the following positions: 1) Parent Partner vs

Family Partner and 2) Family Specialist vs Youth Partner.

Answer: 'Family Partner' and 'Parent Partner' refer to the caregiver peer-support role. This role is grounded in lived experience as a parent/caregiver who has navigated child-serving systems and focuses on peer support, advocacy, system navigation, and strengthening caregiver voice. The Family Specialist is a behavioral support/skill-building role focused on the youth and family, while the Youth Partner is a peer role for the youth that relies on lived experience and focuses on emotional support, advocacy, engagement, and youth voice and choice.

43. Question: On Page 52, Placement services. Can you provide clarity to the responsibilities? The

RFP indicates HFW will assist in locating and securing an appropriate living environment, locating and securing funding, pre-placement visit, negotiation of housing or placement contracts, placement and follow-up. The activities have not traditionally been the providers responsibility. Is the CBO HFW, responsible for these activities?

Answer: While the HFW provider is not responsible for locating a youth’s residence the team may be helpful in facilitating a successful move via pre-placement visits and follow-up. These activities may not be separately claimed when the Monthly HFW Rate is claimed.

44. Question: The RFP indicates HFW staff to assist with the determination of HFW eligibility for children/youth placed in the STRTP. How do you see HFW assistance?

Answer: While the draft BHIN includes some information, the final requirements related to qualifying for HFW are not published. It is expected that HFW will be part of this process.

Potentially by assessing a youth or processing a referral and ensuring qualifications are met.

45. Question: Will referrals for HFW include AB1299 & SB785?

Answer: Yes, youth subject to AB 1299 presumptive transfer or SB 785 may be referred to HFW when they otherwise meet HFW eligibility requirements. The applicable inter-county responsibility, authorization, and payment rules will continue to apply.

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46. Question: Will HFW providers service Mode 60?

Answer: Yes, the reimbursement section includes non-billable Modes 60 on a cost-reimbursement basis, subject to the contract maximum and all eligibility/allowability requirements. (RFP pp. 83-86)

47. Question: Respite Care is defined on p.26 but not mentioned anywhere else in the RFP. Please expand on providers' responsibility regarding respite care, if any.

Answer: DHCS has indicated that Respite Care for youth receiving HFW should be coordinated with the appropriate Managed Care Plan though a community supports program. It is expected that a HFW agency would facilitate accessing this program and potentially utilize flex funds to cover aspects of the respite care as appropriate.

48. Question: Can Schedule A be provided on a non password protected version so we can properly check everything?

Answer: No, an unlocked version of the budget schedules will not be made available. If a

Proposer has any questions regarding the budget schedules they will be addressed accordingly.

49. Question: The budget worksheet does not seem to allow for calculating ramping up services. Is there a way that can be done?

Answer: No, the budget worksheet cannot be modified at this time.

50. Question: Will the ICFP be required for all youth in the program or only for foster youth?

Answer: The individualized HFW Plan of Care/ICFP is required for all youth enrolled in HFW, not only foster youth. The plan is individualized to the youth and family and should incorporate the youth's needs, strengths, goals, safety/crisis planning, and responsibilities of team members.

51. Question: Will Flex funds be available at the same level for foster youth vs non-foster youth?

Answer: Yes.

52. Question: Please clarify the anticipated funding and reimbursement methodology for High Fidelity

Wraparound (HFW) services under this RFP. Specifically, what rate or payment methodology will DBH use to reimburse contracted HFW providers, including the HFW Monthly Rate referenced in the RFP? For foster youth who would historically have received services through SB 163 Wraparound, please also clarify what funding will support HFW services from January 1, 2027 through implementation of the Foster Care Tiered Rate Structure (TRS) and Wraparound Immediate Needs (WIN) Program, currently anticipated for July 1, 2027, and how TRS/WIN funding is expected to interact with Medi-Cal HFW reimbursement once implemented. If specific HFW, TRS, or WIN rates have not yet been established, please describe the assumptions proposers should use in developing their budgets and anticipated cost per participant.

Answer: The Monthly HFW Bundled Rate is $4,290 for all youth served. There is no differentiation between system involved and non-system involved youth. The specifics of TRS/WIN are not finalized, but we do not expect them to impact the rate used in this program.

53. Question: Upon implementation of the new HFW contracts on January 1, 2027, how does DBH anticipate transitioning youth and families currently enrolled in SB 163 Wraparound and Success First/Early Wrap? Will existing participants be assigned or transferred to awarded HFW providers based on geographic service area, participant/family choice, Behavioral Health

Request for Proposals High Fidelity Wraparound Services existing provider relationships, or another methodology? Please also clarify whether awarded providers should anticipate receiving an existing caseload at contract implementation in addition to new referrals.

Answer: Clients being served by SB 163 Wraparound or Success First/Early Wrap will require a collaborative transition to the appropriate level of care. This process will respect the participant/family choice while adhering to the HFW requirements. All participants will not automatically qualify for HFW. If they do not qualify, then a transition to appropriate services will be managed.

54. Question: For children and youth approved for HFW who are not Medi-Cal beneficiaries, what funding source and reimbursement methodology will DBH use to reimburse the HFW provider, and should proposers include an assumed percentage of non-Medi-Cal participants in their budgets?

Answer: The fiscal schedules include a Medi-Cal mix percentage of 95%, so we anticipate no more than 5% of services will be provided that cannot be billed to Medi-Cal.

55. Question: For purposes of the proposal's anticipated cost-per-participant calculation and financial evaluation, please clarify whether DBH expects proposers to include the total cost of the HFW Service Package, including separately claimable SMHS, FURS activities, flex funds, and other non-Medi-Cal-funded activities, or only costs associated with activities covered by the Monthly HFW Rate?

Answer: The fiscal schedules combine all activities to create the estimated cost per participant.

56. Question: Recognizing that the allocation for the first fiscal year 26 for 27 in San Bernardino is

$75,000, what is the other Funding mechanism for youth when this allocation is depleted or utilized, expended?

Answer: The allocation is not $75,000.

57. Question: Please clarify the reimbursement methodology for FURS services required under this

HFW contract. Will HFW contractors receive a portion of the County's FURS allocation or other non-Medi-Cal funding to support the required 24/7 FURS response capacity and responses for youth not already enrolled in HFW? Please also clarify which services provided by the HFW team in response to a FURS referral are expected to be covered by the HFW Monthly Rate, which may be separately claimed as SMHS, and what reimbursement applies prior to the youth's enrollment in HFW.

Answer: For FURS, qualifying activities may be billed as Assessment and/or Crisis Intervention.

When the circumstances are not billable to Medi-Cal, then specific service codes will be used. These will result in payments at the same level as the SMHS without billing Medi- Cal.

58. Question: The local preference policy has 11 areas of criteria to meet for the vendor preference.

Does a vendor have to meet all 11?

Answer: Yes, for the purposes of the application of the Local Preference Policy (County Policy

11-10), a vendor must meet all 11 requirements outlined in the Local Preference Policy.

59. Question: Pg 17 says case load for facilitator will be 1:8; but pg. 71 says Fac case load is 1:10 which is correct?

Answer: The ratio is not fixed. The average will be 1:10.

60. Question: Are flex funds dollars part of the contract amount or are they separate?

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Answer: The flex funds are part of the contract amount. While the implementation of the Tiered Rate Structure (TRS) may impact this for foster youth, flex funds for non-system involved youth will continue to be part of this contract.

61. Question: Will the bundled wraparound rate cap be different than the cap for specialty mental health services?

Answer: The Monthly HFW Bundled rate is $4,290. The rate for SMHS Outpatient Services is

75% of funds from DHCS.

62. Question: Are total available funds inclusive of SMHS outside of the bundled rate?

Answer: Yes.

63. Question: When will the PowerPoint from the pre-bid presentation be available?

Answer: Yes, the PowerPoint from the Proposer’s Conference (pre-bid presentation) was uploaded to ePro on Wednesday, September 30, 2026.

64. Question: The RFP identifies an HFW Facilitator ratio of 1:8 on page 17 and 1:10 on page 71. Page

17 also specifies a bachelor's degree in a social-service field plus two years of experience. Please clarify the controlling Facilitator caseload ratio and minimum qualifications proposers should use for staffing and budgeting.

Answer: The ratio is not fixed. The average will be 1:10.

65. Question: Pages 48 and 71 indicate the HFW Supervisor/Manager does not require licensure, while page 77 describes the HFW Supervisor as a clinician with a master's or doctoral degree and an active California license. Please clarify the required minimum qualifications and licensure requirements for this position.

Answer: The RFP contains conflicting language. The Staffing Requirements table lists HFW Supervisor/Manager as license not required (1:40) and this is accurate. A master's degree or doctorate with an active California clinical license is not required.

66. Question: Please clarify the methodology used to calculate the 8-10 monthly HFW encounter average and the 2.5 weekly additional SMHS-hour average during the first three months (page 68), including whether each participant is individually expected to meet these figures.

Answer: Historical data from SB 163 Wraparound.

67. Question: What documentation will DBH accept as evidence that a proposer is "in the process of obtaining" UC Davis HFW Provider Certification at proposal submission (page 4)? For example, portal registration, submitted certification materials, a completed self-assessment, or correspondence from UC Davis.

Answer: Portal registration is sufficient.

68. Question: Page 61 states that FURS on-call coverage will be shared among awarded vendors on a rotating basis when possible. For proposal staffing and budgeting, should each proposer assume responsibility for full 24/7 FURS coverage unless and until a shared rotation is established, or budget based on an anticipated shared rotation? If shared, is there a minimum on-call coverage expectation per awarded provider?

Answer: For the purpose of the proposal, please assume full coverage for the proposed area.

69. Question: Can we get a copy of the pre-bid meeting recording?

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Answer: No, the recording of the Proposer’s Conference is not available; however, the PowerPoint from the Proposer’s Conference was uploaded to ePro on Wednesday, September 30, 2026.

70. Question: What evidence of certification readiness is required with the proposal?

Answer: Portal registration is sufficient.

71. Question: If applicant pursuing UC Davis HFW certification, what evidence of progress is required at submission, and must certification be completed by January 1, 2027?

Answer: Portal registration is sufficient.

72. Question: Would a signed MOU with a landlord for a specific office, contingent on award and DBH approval, satisfy the facility requirement?

Answer: Yes.

73. Question: May a vendor apply for one geographic region with a smaller initial caseload, and what is minimum capacity for smaller proposal?

Answer: Yes. A proposer may apply for a single geographic region or a defined portion of a region.

There is no separate minimum caseload stated for a partial-area proposal; the proposer should define the proposed service area clearly and demonstrate staffing, access, facility, and operational capacity appropriate to the number of participants it proposes to serve.

74. Question: Does Medication Support Services require direct psychiatrist involvement, or may a

California-licensed psych NP with prescribing authority provide these services through a nursing professional corporation?

Answer: Direct Psychiatrist involvement is required.

75. Question: Can Medication Support Services be delivered by telehealth? May the Nursing PC serve adolescents and young adults through age 24, with the lead agency arranging younger children’s medication care through a qualified San Bernardino pediatric or child psychiatry provider? Is any in-person or after-hours prescriber coverage required?

Answer: Medication Support Services may be delivered via telehealth, as appropriate. The contract does not allow for a Nurse Practitioner.

76. Question: Should we be budgeting a dollar amount for Flex Funds and for the WIN program, or is the county going to provide the dollar amount if awarded?

Answer: The TRS/WIN program is not finalized. Budget as you believe is appropriate.

77. Question: There are specific services that cannot be billed when the provider is claiming the monthly HFW (i.e. Crisis Interventions, ICC, psychosocial rehabilitation), does this mean that we cannot bill SMHS at all while they are receiving Wraparound Services?

Answer: DHCS has not yet issued final versions of the HFW BHIN or HFW Policy Manual. The current draft guidance indicates that the monthly HFW rate covers core HFW functions such as targeted case management/care coordination, psychosocial rehabilitation provided by the HFW team, caregiver/parent peer support, and HFW-team crisis support.

Other medically necessary SMHS may still be provided and claimed separately when they are outside the monthly-rate functions and are complementary rather than duplicative, including therapy, IHBS, TBS when criteria are met, and crisis services delivered outside the HFW team.

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78. Question: How will the activities related to FURS be billed? Bundled rate, Fee for Service, Cost reimbursement?

Answer: The RFP allows qualifying FURS activities to be billed as Assessment and/or Crisis

Intervention. If the circumstances are not billable to Medi-Cal, special service codes will be used.

79. Question: On page 46 of the RFP it states under the Cost Savings are Reinvested, that savings achieved by HFW (i.e., total annual revenues in excess of total expenditures) are reinvested to expand or enhance services and resources for youth and families. It further states that there is a process to track the use of reinvested funds that includes program description(s), budget(s) and reporting outcomes achieved. Is this only for the bundled rate cost savings? Or for SMHS?

Answer: This is requirement for UC Davis HFW certification, and some specifics have not been established. This will be part of our discussion prior to implementation. At this point we expect it to only be related to the Monthly HFW Bundled rate.

80. Question: Will all individual child and family service plans be approved by the HFW Leadership

Team?

Answer: Yes. The individualized HFW Plan of Care/ICFP will be reviewed through the HFW team/CFT process and the County's HFW Community Leadership Team oversight structure at the required intervals. The County will provide the required format and implementation workflow.

81. Question: The RFP states on page 60, x., that clients will be transported for appointments or to access service as needed, can agencies budget for bus passes or Uber/Lyft?

Answer: Yes. Reasonable transportation costs such as bus passes or rideshare may be budgeted when they are necessary to help a participant access services and are allowable under the contract. Providers remain responsible for ensuring transportation expenditures are appropriate, documented, and consistent with County fiscal requirements.

82. Question: One section of the RFP references the ratio of Facilitator to Wraparound family being

1:8 and in another section it states the ratio of Facilitator to clients being 1:10; which is accurate?

Answer: The ratio is not fixed. The average will be 1:10.

83. Question: Are providers expected to budget for caregiver respite?

Answer: DHCS has indicated that Respite Care for youth receiving HFW should be coordinated with the appropriate Managed Care Plan though a community supports program. It is expected that a HFW agency would facilitate accessing this program and potentially utilize flex funds to cover aspects of the respite care as appropriate.

84. Question: Pg 14 mentions CCCP- how will these youth be incorporated into HFW?

Answer: CCCP youth may receive HFW when they meet HFW eligibility and clinical-appropriateness requirements. HFW should be coordinated with the youth's existing CFT and continuum-of-care partners so that there is one integrated team and plan rather than a separate parallel process.

85. Question: Will HFW service cover Mode 60 (not covered under Medi-Cal)? If we are no longer serving mode 60, will we have a transition plan/timeline to refer out all client's without Medi-Cal?

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86. Question: Will there be indigent funding to cover time of lapse in insurance?

more than 5% of services will be provided to clients without Medi-Cal. This could include lapses in insurance.

87. Question: Will all referrals go through the HFW Leadership Team or will referrals also come from other referral sources, including DBH directly?

Answer: The referral processes have not been established. There will be multiple sources of referrals.

88. Question: Please clearly state which positions are required to obtain "certified peer support specialists."

Answer: DHCS has not yet issued final versions of the HFW BHIN or HFW Policy Manual. The current draft guidance indicates that Caregiver/Parent Peer Partners and Youth Peer Partners may be either Certified Medi-Cal Peer Support Specialists or meet Medi-Cal requirements as Other Qualified Providers. A staff member must hold the Medi-Cal Peer Support Specialist certification when the provider is billing Certified Medi-Cal Peer Support Services under the peer-support billing codes. DHCS may revise these requirements in final guidance.

89. Question: Please differentiate between Youth Partner and Family Specialist (e.g., required education).

Answer: The Youth Partner is a peer role grounded in lived experience as a youth in child-serving systems and focuses on emotional support, engagement, advocacy, and youth voice and choice; no specific college degree is identified as essential to the role. The Family Specialist is a behavioral support and skill-building role that works with the youth and caregivers on coping, communication, stability, and community/school functioning; an associate or bachelor's degree and/or substantial relevant experience is appropriate for that role.

90. Question: On p. 13, CANS-SB was stated to have integrated IP-CANS items. Please confirm we will continue to use CANS-SB for this coming contract.

Answer: Yes. CANS-SB will continue to be used. It incorporates the core CANS requirements and the IP-CANS items needed to support aligned behavioral health and placing-agency practice.

91. Question: The RFP states two different FAC-to-Client ratios (1:8 ratio and 1:10). Please confirm ratio.

Answer: The ratio is not fixed. The average will be 1:10.

92. Question: Addendum No. 1 RFP 25-187 - HFW Attachment J Budget - discusses Schedule B. The workbook on the website does not have a Schedule B. Is this required to be completed?

If so, can you please provide?

Answer: The budget template worksheet is complete. Schedule B is referenced on the tabs labeled “HFW Bundled Rate Staff”, “Service Delivery Staff”, and “Srv Prok Modes 05,10 15”. No additional schedule is required.

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93. Question: Can there be a live walk through so we can understand how everything flows through the workbook?

Answer: No, a live walk through of the budget template workbook will not be conducted.

94. Question: We need a template for the short periods of Jan - Jun 2027 and for Jul - Dec 2032. On

Tab "Srv Proj Modes 05,10,15" - this needs to be updated for 6 month periods Answer: A six-month budget schedule template will be provided and uploaded to ePro as an

Addendum.

95. Question: Schedule A-Line 14 - the distributions can be changed - is there a view of acceptable ranges for these numbers?

Answer: The percentages provided are target percentages. You may alter them, but please explain why if your proposed percentages are very different.

96. Question: Line 25 - why is the split between Medi-Cal and BHSA non-match and non-Medi-Cal

50%, and then adjusted for a factor of 95%? How does this vary in terms of what the populations look like or is this split fixed?

Answer: Lines 9 and 10 (rows 25 & 29) show how the total funded amount of the specific column is funded between FFP and BHSA. The 95% mix indicates that we expect 95% of all HFW and other SMHS will be billed to Medi-Cal.

97. Question: Tab "Srv Proj Modes 05,10,15" - the months in cells B20-B31 don't change when you change the year - so the driver needs to be fixed Answer: An updated budget schedule template is being uploaded to ePro as an Addendum.

98. Question: Tab "Srv Proj Modes 05,10,15" - Please widen the columns - otherwise can't see all the numbers in line 32 Answer: An updated budget schedule template is being uploaded to ePro as an Addendum.

99. Question: On p71 of the RFP - referring to the Supervisor / Manager - this says license is not required (but conflicts with p77) Answer: The RFP contains conflicting language. The Staffing Requirements table lists HFW

Supervisor/Manager as license not required (1:40) and this is accurate. A master's degree or doctorate with an active California clinical license is not required.

100. Question: RFP says these ratios are "not firm" and actual ratios should fall "within a range that is clinically appropriate" - any further guidance on this?

Answer: No.

101. Question: Are the 24/7 staffing and the 1-3 hour FURS response expected within these ratios? Or need to budget separately?

Answer: The ratios only apply to the HFW bundled rate staff.

102. Question: "If the child/youth is not a Medi-Cal beneficiary, the HFW agency shall evaluate insurance options, including applying for Medi-Cal. If this is not viable, a small portion of children/youth may still be served without Medi-Cal. The HFW agency must submit a request to serve such children/youth to the HFW Community Leadership Team." On the budget - Schedule A - there's the line "BHSA Match & Non-M/C" - so is this the source of funding for non Medi-Cal youth? What is a "small portion"? Should these kids be counted in the census for staffing ratios?

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Answer: Yes, that line is accounting for services that cannot be billed to Medi-Cal. The fiscal schedules include a Medi-Cal mix percentage of 95%, so we anticipate no more than 5% of services will be provided to clients without Medi-Cal. Yes, include all participants in census.

103. Question: What percentage of kids can be non Medi-Cal eligible?

more than 5% of services will be provided to clients without Medi-Cal.

104. Question: Can assessment and transition-of-care services for youth later found ineligible be billed as SMHS under no-wrong-door? Or does it mean the County won't pay for them?

Answer: Yes, these services could be billed as SMHS.

105. Question: How should we estimate the share of referrals that end up ineligible? Is there data from the current Wrap and FSP programs?

Answer: This is not known at this time.

106. Question: Does transition of care to the MCP use the DHCS transition-of-care tool, and is that time billable?

Answer: Yes, the transition of care to the MCP uses the DHCS transition of care tool. A portion of this activity may be billed, but not all of it.

107. Question: If a youth is found ineligible for SMHS partway through a month, can the Monthly HFW

Rate still be claimed for that month?

Answer: The BHIN on HFW is not finalized. The final version will hopefully clarify this.

108. Question: Section 19 is largely cost reimbursement language and makes reference to MHSA language. Is this going to be revised - although noting there is FFS language in p86-7 Answer: The Mode 60 portion of the contract is cost reimbursement.

109. Question: On flex funds - the budget template has 10% - is this fixed / finalized?

Answer: It is the suggested percentage. You may modify it, but please provide an explanation if changed by a substantial amount.

110. Question: The RFP states that SB 163 Wraparound and Success First/Early Wrap will conclude upon HFW award (pp. 1, 34), and Section IV.k.xxiv (p. 61) requires transition of "children and families currently being served in the Wraparound program." Does this include youth currently served through the separate AAP program?

Answer: Children and youth with AAP Medi-Cal may be served in the new HFW program.

111. Question: Will the AAP program continue as a separate contract and funding stream after HFW award, or will AAP youth be referred to HFW?

Answer: Children and youth with AAP Medi-Cal may be served in the new HFW program.

112. Question: If AAP youth may be served in HFW, are they included in the Attachment O client counts, and does the HFW allocation include AAP funding?

Answer: All qualifying children and youth with San Bernardino County Medi-Cal may be served in the new HFW program, including those with AAP. All participants are included in the ranges provided in Attachment O. None of the funds supporting this HFW program are designated as from AAP.

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113. Question: How many agencies are currently contracted to provide these services?

Answer: This is a new program. No providers currently have a HFW contract.

114. Question: The ratio stated for the HFW Supervisor is 1:40. If Facilitators are holding caseloads at a 1:10 ratio, this means each Supervisor would only supervise 4 Facilitators. This supervisor to staff ratio will make it difficult for CBOs to control costs on their program.

The 25% deviation from the ratio discussed on the bidder's conference would only raise the supervisor to staff ratio to 1:5. Does the county find it allowable to raise this ratio to a more standard 1:8 supervisor to staff ratio?

Answer: The ratios were provided by DHCS in consultation with UC Davis. Modifying this to 1:8 is a large change. If you wish to propose that, please provide information as to why you believe DHCS and UC Davis would support this new ratio.

115. Question: What percentage of Wraparound youth does the county expect to be dependents vs non-dependents?

Answer: This is not known.

116. Question: How is a "portion" of an area defined, and will partial-area awards be considered?

Answer: A 'portion' of a geographic area means a clearly defined subset of the listed service area for which the proposer is offering full HFW coverage. Partial-area proposals are permitted; the proposal should identify the exact cities/ZIP codes or other boundaries included and demonstrate sufficient capacity and access for that defined area.

117. Question: For a partial bid, should the…