Appendix B5.docx

APPENDIX B5

CATEGORY 3: OUTPATIENT SERVICES

EARLY PSYCHOSIS INTERVENTION - RAISING EARLY AWARENESS AND CREATING HOPE

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: A5 - Early Psychosis Intervention - Raising Early Awareness and Creating Hope

· Attachment Reference: Attachment B – Standardized Scope of Work Language Ensure that your responses align with the expectation outlined in the SOW and Attachment (if applicable). These documents provide essential context and guidelines for your 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 your organization’s experience in providing early intervention services to clients showing early signs and symptoms of clinical high risk for psychosis (CHR-P) or experiencing a first episode of psychosis (FEP). Additionally, confirm your ability to serve the target populations across specified geographic locations and levels of care using a CSC model. Select all that may apply.

Target Populations ☐ Youth (ages 12- 17) ☐ Transitional Aged Youth (TAY) (ages 18- 25)

Target Population – Specialty ☐ Clients Experiencing Early Signs/Symptoms of CHR-P ☐ Clients Experiencing a First Episode of Psychosis (FEP)

Supporting Documentation: Insert Miscellaneous Supporting Document Page Number

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

☐ Medi-Cal Certification (at designated school site) ☐ 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 possessed licenses and certifications for team members as required by the Coordinated Specialty Care (CSC) model (Team Leader, Clinical Therapist, Supported Education and Employment Specialist (SEE), Case Manager, Family Advocate and/or Peer Support, Psychiatrist or Psychiatric Nurse Practitioner).

☐ Paraprofessional Staff: [Specify] ☐ Licensed or Waivered Practitioner of the Healing Arts (LPHA): [Specify] ☐ Mental Health Rehab Specialist (MHRS): [Specify] ☐ Medical Board-Certified: [Specify] ☐ 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 treating the target population, including programmatic models.

☐ Cognitive Behavior Therapy ☐ Cognitive Behavior Therapy for Psychosis ☐ Multi-Family Support Groups ☐ Individual Placement Support Model ☐ Coordinated Specialty Care Model ☐ Portland Identification and Early Referral (PIER) Model ☐ Trauma Informed Practices ☐ Other: [Specify] Supporting Documentation: Insert Miscellaneous Supporting Document Page Number

Select the applicable items below to confirm your organization’s staffing and organizational strategies.

· Staffing and Continuity of Care:

☐ Organizational strategies for ensuring continuity of staffing and care.

☐ 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 service delivery during a pandemic and/or emergency disasters, including cooperation with County-required COVID efforts.

Supporting Documentation: Insert Miscellaneous Supporting Document Page Number

Select the applicable items below to confirm your organization’s capacity for data collection, reporting, and continuous quality improvement.

· Organization’s Capacity and Data Collection Process ☐ Capacity and processes are in place to administer and collect the required outcome evaluation data, including utilizing outcome measures specific to the CSC model, such as:

☐ Structured Interview for Psychosis Risk Syndromes (SIPS) ☐ Mini SIPS ☐ Prodromal Questionnaire – Brief Version (PQ-B) ☐ Scale Of Prodromal Symptoms (SOPS) ☐ Global Assessment of Functioning (GAF) ☐ 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

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

Describe your 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 your organization’s leadership model of inclusivity, and what tools and support are provided to improve your organization’s ability to identify and mitigate bias, respect differences, build empathetic relationships, and manage conflict.

Describe your ability to provide and ensure cultural competency, targeted outreach, and engagement requirements are met:

· Capacity to provide culturally, ethnically, and linguistically appropriate services to the target population(s), including capacity for all County threshold languages.

· Address barriers when staff are not available to meet the County threshold languages.

· Current and future actions and changes to ensure diversity and inclusion in service delivery.

Describes your organization’s experience in serving youth and TAY who are experiencing early signs and symptoms of CHR-P or experiencing a FEP through a CSC model or Multi-Disciplinary Team (MDT) approach. Include your experience collaborating with Emergency Psychiatric Services (EPS), Crisis Stabilization Units, Psychiatric hospitals, and other relevant system partners. Additionally, describe your efforts in providing targeted community outreach and engaging youth, TAY, and their families.

Describe your organization’s experience in care coordination, including your ability to provide a warm handoff and train staff in these practices. Detail your agency’s capacity to step down or step up to an appropriate level of care to meet client needs. Additionally, explain the processes you have in place to ensure a feedback loop is maintained with all relevant parties to support continuous client care.

Describe your organization’s experience in training to, providing services in, and maintaining fidelity to Evidence-Based Practices (EBPs), Community Defined Evidence-Based Practices (CDEPs), and Promising Practices (PPs) used in treating the target population, including programmatic models such as Cognitive Behavior Therapy, Cognitive Behavior Therapy for Psychosis, Multi-Family Support Groups, Individual Placement Support Model, Coordinated Specialty Care Model, Portland Identification and Early Referral (PIER) Model, Trauma Informed Cognitive Behavior Therapy, Motivational Interviewing, and others, please specify)

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 B5: Early Psychosis Intervention - Raising Early Awareness and Creating Hope Program Evaluation Criteria and Qualifications CATEGORY 3: Outpatient Services