Appendix B14.docx

APPENDIX B14

CATEGORY 5: BEHAVIORAL HEALTH PLACEMENT SUPPORT SERVICES

THERAPEUTIC BEHAVIORAL SERVICES

EVALUATION CRITERIA AND QUALIFICATIONS

Instructions:

When completing the evaluation criteria and qualifications below, please refer to the applicable Scope of Work (SOW) and Attachment (if applicable) of the RFSQ packet for detailed program requirements, objectives, target populations, service delivery expectations and compliance criteria:

· SOW Reference: B14 - Therapeutic Behavioral Services

· Attachment Reference: N/A Ensure that the responses align with the expectation outlined in the SOW and Attachment (if applicable). These documents provide essential context and guidelines for the submission.

Responses for Section 1 Responses for Section 1 should include direct entries and/or completion of applicable checkboxes to affirm experience. Supporting documentation must be provided in the Miscellaneous Supporting Documents section. Reference specific page numbers where relevant information is located.

Indicate experience and ability to provide supplemental short-term SMH services through intensive, home-based or placement-based, 1:1 behavioral intervention. Select all that apply:

Target Populations ☐ Children (ages birth-5) ☐ Youth (ages 6-15) ☐ Transitional Aged Youth (TAY) (ages 16-20)

Geographic Locations Select where services would be provided.

☐ North County (Palo Alto, Los Altos and Los Altos Hills, Mountain View, and Sunnyvale) ☐ Central County (San Jose, Cupertino, Santa Clara, Los Gatos, Monte Sereno, Saratoga, and Campbell) ☐ East County (San Jose [Foothills, Berryessa] and Northeast San Jose/Milpitas areas) ☐ South County (Gilroy, Morgan Hill, and the unincorporated area of San Martin) Supporting Documentation: Insert Miscellaneous Supporting Document Page Number

Confirm ability to meet the following requirements and provide supporting information:

☐ Medi-Cal Certification ☐ Documentation ☐ Billing requirements ☐ CalAIM behavioral health requirements (medical necessity criteria, documentation re-designs, co-occurring treatment, standardized screening and transition tools, Behavioral Health Current Procedural Terminology [CPT] coding transitions, payment reform, etc.)

Supporting Documentation: Insert Miscellaneous Supporting Document Page Number

Indicate the applicable staff titles that make up the treatment team to deliver services.

☐ Paraprofessional Staff: [Specify] ☐ Licensed or Waivered Practitioner of the Healing Arts (LPHA): [LMFT, LCSW, ASW, AMFT, Ph.D., etc.] ☐ Mental Health Rehab Specialist (MHRS): [Rehab Counselor, TBS Coach, etc.] ☐ Other: [Specify.] Supporting Documentation: Insert Miscellaneous Supporting Document Page Number

Select the Evidence-Based Practices (EBPs), Community Defined Evidence-Based Practices (CDEPs), and Promising Practices (PPs) used in training and treating the target population.

☐ Cognitive Behavior Therapy ☐ Behavior Therapy ☐ Motivational Interviewing ☐ Other: [Specify] Supporting Documentation: Insert Miscellaneous Supporting Document Page Number

Select the applicable items below to confirm the organization’s capacity for data collection, reporting, and CQI.

· Organization’s Capacity and Data Collection Process ☐ Capacity and processes are in place to administer and collect the required outcome evaluation data, including the assessment/outcome tools and performance measures including but not limited to:

· Functional Behavior Analysis

· TBS Treatment Plan

· TBS Progress Summary ☐ Data results are used to inform clinical practices, service quality, and CQI.

· Data Monitoring and Evaluation ☐ Staff regularly monitors and evaluates data, including client/family satisfaction surveys, pre-/post-service tests, and the implementation of culturally responsive services and practices.

☐ Program reports, CQI projects or processes, and data collection methods demonstrate commitment to ongoing evaluation and outcome improvement.

· Ongoing Evaluation and Outcome Improvement ☐ Plan in place for ongoing evaluation of program effectiveness, including data collection, analysis, and strategies for continuous improvement.

☐ Provision of quarterly staffing reports to the Behavioral Health Services Department (BHSD) using County-provided or other tools.

· Data-Driven Practice and Service Quality ☐ Data results are regularly used to inform and improve clinical practices and service quality.

Supporting Documentation: Insert Miscellaneous Supporting Document Page Number

· Select the applicable items below to confirm the organization’s staffing and organizational strategies. Staffing and Continuity of Care:

☐ Organizational strategies for ensuring continuity of staffing and care are provided to the target population(s).

☐ Clinical supervision plans for professional and paraprofessional staff.

☐ Compliance with Medi-Cal standards.

· Staffing Details:

☐ Organizational chart detailing leadership, management, and reporting structure.

☐ Staffing chart including position titles, linguistic and cultural skills, education, experience, and certifications.

· Staff Training, Recruitment, and Retention:

☐ Practices for staff training, recruitment, and retention.

☐ Practices for recruiting, hiring, and promoting a multi-lingual and/or culturally or ethnically diverse workforce.

· Diversity, Equity, and Inclusion (DEI) Training:

☐ Training requirements related to DEI, including LGBTQ+ awareness, cultural and linguistic capacity, racial equity.

· Additional Required Plans ☐ Plans for delivering services 1) during a pandemic AND 2) during any emergency disaster(s), while ensuring safe protocols are followed to protect staff and clients during service delivery. Offeror indicated policies and practices in place for cooperation with County-required COVID efforts.

Supporting Documentation: Insert Miscellaneous Supporting Document Page Number

Responses for Section 2 require a ‘Written Response Submission’ for each criteria.

Describe the organization’s vision, mission, and/or values that are inclusive of promoting behaviors and practices towards a more equitable, diverse, and inclusive organizational mindset. Describe the organization’s leadership model of inclusivity, and what tools and support are provided to improve the organization’s ability to identify and mitigate bias, respect differences, build empathetic relationships, and manage conflict.

· Capacity to provide services to the target population(s) in a culturally, ethnically, and linguistically appropriate manner, including the ability to meet all County threshold languages.

· Strategies for addressing barriers when staff are unavailable to meet the County threshold languages.

· Current and future actions taken to ensure diversity and inclusion in the delivery of services.

· Capacity to provide outreach activities focused on reaching underserved, underrepresented, and/or multicultural populations, including outreach and engagement efforts targeting clients in carceral settings.

· Capacity to address and serve high-risk clients with co-occurring (mental health and substance use) treatment needs.

Describe the organization’s experience in delivering adjunct behavioral services to children, youth, and TAY with complex needs, including those whose level of functioning, symptoms, psychiatric history, and/or hospitalizations require TBS intervention.

Include details of how the organization has implemented EBPs, PPs, and CDEPs to address the needs of these populations in past programs similar to this one.

Describes the organization’s experience in gathering information about behaviors of concerns through a FBA. Include the organization’s ability to perform the following tasks, but not limited to:

· Data Collection: Ability to collect data through observation, behavioral checklists and questionnaires.

· Behavioral Analysis: Identify antecedents and consequences related to behaviors of concern.

· Treatment Planning: Develop treatment goals and create a behavior intervention plan based on the assessment.

· Intervention Implementation: Implement interventions to address behaviors of concern.

· Monitoring and Evaluation: Monitor and evaluate the effectiveness of the interventions through ongoing data collection.

Describes the organization’s experience in care coordination and its capabilities to provide a warm handoff for clients. Include the organization’s ability to train staff in these areas.

· Multi-Disciplinary Team (MDT) and Client Family Team (CFT) Meetings: Provide examples of participation in MDTs and CFT meetings, highlighting the role in coordinating care across various providers.

· Feedback Loop for Client Care: Describe the process used to ensure a feedback loop is maintained with all relevant parties, such as the ongoing primary Specialty Mental Health Services (SMHS) provider, to support continuity of care for clients.

Historical data analysis will be reviewed by BHSD Program Subject Matter Experts (SMEs) and rated according to the criteria outlined in this RFSQ.

Offeror’s electronic health record (EHR) system capacity and responses as listed in Appendix H will be reviewed by BHSD EHR Subject Matter Experts (SMEs) and rated according to the criteria laid out in this RFSQ.

Financial records will be reviewed by the Health System Finance Department and rated according to the criteria laid out in this RFSQ.

RFSQ-BHS-FY25-0066: Children, Youth, and Family System of Care Services Page 1 of 2 APPENDIX B14: Therapeutic Behavioral Services Evaluation Criteria and Qualifications CATEGORY 5: Behavioral Health Placement Support Services