Att F- Technical Proposal CRMNF.docx

RFP 26-87928 Comprehensive Rehabilitative Management Needs Facility (CRMNF)

TECHNICAL PROPOSAL

ATTACHMENT F

INSTRUCTIONS

· Please supply requested information in the blue-shaded areas and indicate any attachments that have been included.

· Document all attachments with which section and question they pertain to.

Mandatory Requirements Comment by Vanwicklin, John: Will each of these sections be further broken down into subsections? i.e. A) The respondent must provide description regarding familiarity with Indiana’s service system, BDS expectations and ICF/IID level supports. B) Respondent will include it’s organizational history, etc...

Company Background: The Respondent must provide a description regarding how it will meet and address the requirement to demonstrate familiarity with Indiana’s service system, BDS expectations, and ICF/IID‑level support needs.

Organizational Overview What is your organization’s history serving individuals with intellectual and developmental disabilities?

Please include:

· What experience does your organization have operating ICF/IID or similar residential or treatment models?

· How has your organization collaborated with government partners (such as FSSA, BDS, IDOH, OMPP) and community stakeholders?

· What experience does your organization have following ICF/IID residential rules, CMS requirements, and IDOH expectations?

Technical Proposal Questions

1. General Expectations: The Respondent must provide a description regarding how it will meet the general operational expectations for CRMNF Services. Please include:

A. How will you scale staffing and resources to support up to twenty (20) individuals as needed?

B. How will you support individuals with varying levels of ability, behavioral, medical, and psychiatric needs?

C. How will you implement person-centered planning and ensure individuals are supported in the least restrictive environment appropriate to meet their needs?

D. How will you maintain contingency plans for staffing shortages, emergencies, or technology outages, and other disruptions to ensure continuity of care?

E. How will you collect, track, analyze, and report required data—including incidents, outcomes, staffing metrics, and discharge progress—in formats required by BDS or IDOH?

F. How will you maintain foundational knowledge and compliance with

· IDOH survey expectations, including Life Safety Code and emergency preparedness requirements?

· Applicable Indiana Administrative Code (IAC 405, 410, 560)

· CMS regulated to ICF/IID certification and service delivery

· Myers and Stauffer rate methodologies and cost-reporting requirements?

2. Regulatory Compliance: The Respondent must describe how it will meet all Medicaid, CMS, IDOH, BDS, and state regulatory requirements for CRMNF operations Comment by Vanwicklin, John: Add questions about how they will provide ongoing comprehensive quality assurance within their plan of corrections.

A. How will you obtain and maintain Medicaid certification in accordance with all applicable CMS ICF/IID regulations?

B. How will you ensure readiness and successful completion of IDOH annual surveys and complaint investigations?

C. How will you respond to survey findings and maintain ongoing compliance?

D. How will you develop, submit, and implement Plans of Correction for citations issued by IDOH, BDS, or other regulatory agencies?

E. How will you ensure corrective actions are effective, prevent recurrence, and address root causes?

F. How will you incorporate ongoing, comprehensive quality assurance into your PoCs to ensure sustained compliance?

G. How will you maintain knowledge of and adhere to all relevant federal and state policies, rules, and regulations?

3. Staffing, Supervision, & Training: The Respondent must provide a description regarding how it will meet staffing, supervision and training requirements for CRMNF operations. Comment by Vanwicklin, John: Need to add a question about how they will provide appropriate staffing based on current capacity of the CRMNF including the need to start with a few individuals and potential to increase staffing when maximum capacity is reached? Comment by Kimmel, Kira D: I added a question I think addresses that under the general expectations.

A. How will you ensure sufficient, qualified staffing levels that meet the behavioral, medical and active-treatment needs of all individuals?

· How will you prepare for increasing capacity at the facility starting with a few and potentially increasing to the maximum capacity?

B. How will you maintain 24-hour awake staff coverage and appropriate supervision?

C. How will you address performance issues promptly?

D. How will supervisory staff remain knowledgeable and engaged in day-to-day facility operations?

E. How will you implement structured onboarding and ongoing training covering behavioral supports, medical needs, crisis intervention, documentation, trauma-informed practice, and CRMNF-specific expectations?

F. How will you ensure staff demonstrate competency in all required areas?

G. How will staff collaborate and communicate effectively with individuals, team members, guardians, and families?

H. How will a QIDP oversee, coordinate, and monitor each individual’s active treatment program?

4. Communication Requirements: The Respondent must describe how it will meet communication expectations for individuals, guardians (when applicable), family members, staff, and IDT members.

A. How will you maintain clear, effective, and accessible communication processes for individuals, guardians, families, employees, BDS staff, and case managers?

B. How will you ensure an accessible phone system is available at the facility with 24/7 support?

C. How will you ensure communication about each individual includes all members of the IDT?

D. How will you promptly notify guardians, parents, or other authorized persons of significant incidents or changes in condition (e.g. illness, injury, abuse, etc.)?

E. How will you ensure communication regarding discharge goals and planning that begins at admission and continues regularly throughout the individual’s placement?

5. Abuse, Neglect, & Incident Management: The Respondent must describe how it will prevent, report, investigate, and manage incidents of abuse, neglect, exploitation, and mistreatment.

A. How will you develop and implement policies that prohibit mistreatment, neglect, abuse, and/or exploitation of individuals?

B. How will you ensure all allegations of mistreatment, neglect, abuse, or injuries of unknown origin are reported immediately to administrators and required officials?

C. How will you ensure investigations are thorough, prevent further potential abuse during investigations, and meet the 5-working-day reporting requirements?

D. How will you implement corrective actions when allegations are substantiated?

E. How will you comply with all BDS incident reporting and follow-up requirements to ensure ongoing health and welfare?

6. Active Treatment & Habilitation: The Respondent must describe how it will deliver individualized active treatment and habilitation services that prepare individuals for transition to less restrictive settings.

A. How will you ensure active treatment and habilitation services are designed to prepare individuals for discharge to a less restrictive community setting?

B. How will you ensure opportunities for socialization and inclusion in community activities?

C. How will you ensure active treatment is individualized and aligned with each person’s preferences?

D. How will you coordinate ISP development to meet individuals’ social, health, and emotional needs?

E. How will you maintain and post an accessible activity or active treatment calendar for individuals and staff?

F. How will you ensure sufficient trained support staff are available to assist with ADLs, and skill development?

G. How will a QIDP integrate, coordinate, and monitor each individual’s active treatment program?

7. Behavioral Services: The Respondent must describe how it will meet all behavioral service requirements, inducing timely plan development, data tracking, staff training and trauma-informed practices.

A. How will you ensure BSPs are developed by a qualified Behavioral Clinician (BC) within thirty (30) days of admission and based on a completed FBA?

B. How will you provide 24‑hour BC availability and at least fifteen (15) hours per week of onsite behavioral services including monitoring, assessment, intervention, and staff training?

C. How will you ensure BSP implementation, documentation, communication, and reporting meet all required timelines and procedures?

D. How will you ensure BSP revisions include participation from the individual and the IDT whenever possible?

E. How will you ensure staff are trained on any plan updates prior to implementation?

F. How will you track and review restrictions frequently to ensure timely removal, efficacy, and reduction?

G. How will you ensure BSPs are monitored for least restrictive practices?

H. How will you complete monthly behavior tracking and share reports with the team?

I. How will you incorporate trauma‑informed care principles into all behavioral plans and interventions?

8. Health Services & Medical Management: The Respondent must describe how it will deliver comprehensive medical support, nursing oversight, and medication management for individuals served.

A. How will you coordinate and attend medical appointments as needed?

B. How will you implement, monitor, and track physician recommendations?

C. How will you follow and update dining plans and food restrictions?

D. How will you ensure availability, proper use, and maintenance of adaptive equipment?

E. How will you manage all aspects of medication delivery, storage, packaging, documentation, and regimen review?

F. How will you ensure timely access to prescribed and over-the-counter medications, including refills?

G. How will you communicate appointment information, results, changes in condition, or medical incidents to families, guardians, and physicians?

H. How will you ensure qualified nursing staff are available to meet ongoing medical needs?

9. Discharge Planning & Transitions: The Respondent must describe how it will meet all discharge planning and transition requirements to ensure timely, coordinated movement to less restrictive settings.

A. How will you develop a person-centered discharge plan withing 90 days of admission?

B. How will you ensure the discharge plan is reviewed and updated quarterly – or more frequently as needed?

C. How will you ensure behavioral and medical discharge criteria are established, documented, and monitored?

D. How will you help facilitate individuals transitioning within six (6) months once discharge criteria is met?

E. How will you conduct monthly transition meetings once criteria are met, including participation from the CMO with applicable?

F. How will you prepare both the individual and the receiving provider/staff for a smooth and successful transition?

G. How will you identify, document, and address barriers to discharge – including those caused by guardians?

10. Admissions: The Respondent must describe how it will meet referral, admission, and pre-admission requirements for CRMNF placement.

A. How will you ensure referral packets are reviewed within five (5) business days and recommendations or decisions are provided within ten (10) business days?

B. How will you address potential denials and ensure consultation with BDS before any denial decision?

C. How will you conduct required transition meetings involving the individual, guardian/family (if applicable), BDS staff, previous provider (if applicable), and the CRMNF team?

D. How will you ensure all required documents are submitted to BDS prior to admission?

E. How will you provide a staffing schedule that demonstrates capacity to meet the needs of the individual?

F. How will you ensure all staff receive training on high‑risk plans, behavior plans, and individual‑specific requirements before admission?

11. Environmental Safety and Facility Maintenance: The respondent must describe how it will maintain a safe, sanitary, and fully complaint facility environment.

A. How will you ensure the facility remains clean, sanitary, odor‑free, and in good repair?

B. How will kitchen areas be kept clean with properly stored and dated food?

C. How will you ensure sleeping accommodations and furnishings meet CMS certification standards and promote comfort, dignity, and safety?

D. How will you implement environmental adaptations for individuals with intensive needs?

E. How will you ensure fire and safety systems meet current IDOH Life Safety Code requirements?

F. How will you maintain routine housekeeping, building functionality, and safe/exterior grounds?

G. How will you maintain an emergency preparedness plan, including relocation procedures if necessary?

12. Quality Improvement: The Respondent must describe how it will implement strong internal quality assurance and performance-improvement processes.

A. How will you conduct routine internal audits to monitor service quality and regulatory compliance?

B. How will you develop and implement corrective action plans when issues are identified?

C. How will you regularly review and analyze:

· incident reports,

· service and outcome trends,

· admissions and discharges,

· staffing levels and gaps, and

· facility maintenance or repair needs?

D. How will you ensure continuous improvement through oversight processes that maintain compliance and support high‑quality service delivery?

13. Benefits Management & Financial Responsibilities: The Respondent must describe how it will manage Medicaid, Social Security benefits, and individual financial responsibilities when designated.

A. How will you apply for, maintain, and manage Social Security benefits (SSI and SSD) for individuals?

B. How will you ensure understanding of how SSI/SSD benefits and additional income impact financial liability?

C. How will you manage Medicaid eligibility, maintain benefits, and ensure individuals are enrolled in the correct Medicaid category?

D. How will you manage individuals’ personal funds in compliance with Medicaid, Social Security, and applicable state and federal rules?

14. Documentation Requirements: The Respondent must describe how it will meet all document management requirements and ensure accessibility, accuracy, and compliance.

A. How will you maintain all required documentation and ensure it is available for review upon request?

B. How will you ensure all relevant documentation is shared with the full IDT—including the individual, guardian (as applicable), family members, and BDS staff?

C. How will you maintain and make available all completed and current staff training records?

D. How will you maintain staff schedules and provide them as requested?

E. How will you document and make accessible Incident Reports (IRs) and related investigations?

F. How will you maintain current versions of all required plans and documents, including:

· ISP

· BSP

· High Risk Plans (HRPs)

· Discharge planning documents

· Medication administration reports/tracking

· Medical notes

· Daily progress notes

· Restriction tracking

· Any other documents required to support service delivery?

15. Per Diem/Daily Rate: The Respondent must acknowledge the Medicaid per diem payment structure and describe how it will manage all services covered by the daily rate.

A. How will you implement services under the Medicaid daily per diem rate?

B. How will you ensure all required services are provided within the all-inclusive per diem rate, including:

· Room and board (housing, dietary services, laundry)

· Nursing care and health oversight

· Medical and non‑medical supplies

· Durable Medical Equipment (DME) and repairs

· Mental health services (behavioral, psychiatric, psychological)

· Therapy services (PT, OT, speech, audiology)

· Transportation for necessary medical and habilitative needs

· Habilitation and active treatment services C. How will you maintain financial systems to ensure accurate tracking and delivery of all per-diem covered services?

D. How will you ensure compliance with Medicaid billing expectations?

16. Implementation Plan: The Respondent must describe how it will implement the proposed CRMNF facility within the designated timeframe and ensure all required leadership, clinical, and programmatic positions are fully established.

A. How will you implement the proposed facility within the required timeframe?

B. What steps will you take to ensure operational readiness before admissions begin?

C. How will you ensure all critical positions – Executive Director, Medical/Nursing Director, Activities Director, QIDPs, Psychiatric Provider, and Behavioral Clinician/Director – are hired and onboarded in alignment with state standards and organization needs?

D. How will you establish clinical, behavioral, medical, and habilitative structures during implementation?

E. How will you ensure all systems, protocols, and required operational processes are in place prior to opening?

F. How will you ensure state requirements, certification standards, and agency expectations are met throughout the implementation phase?

17. Status Updates & Reporting: The Respondent must describe how it will meet all quarterly and annual reporting requirements to support State oversight and proactive quality monitoring.

A. Quarterly Reporting

a. How will you report incident activity, including types, frequency, severity, timeliness of reporting, investigations, follow‑up actions, and identified trends requiring corrective action?

b. How will you collect and analyze trends and data related to behavioral outcomes, medication errors, health events, staffing ratios, and other quality metrics?

c. How will you track and report admissions and discharges, including referral decisions, admission timeliness, discharge progress, and barriers to transition?

d. How will you evaluate and report staffing adequacy, turnover, training completion, and competency?

e. How will you document environmental safety updates, including repairs, maintenance, environmental risks, and Life Safety Code compliance?

B. Annual Reporting:

a. How will you complete and report a Year‑End Quality Review summarizing major trends, corrective actions, and outcomes?

b. How will you prepare and report an annual staffing summary, including turnover, recruitment/retention, and training compliance?

c. How will you report annual program outcomes such as length of stay, discharge results, and system‑level barriers?

d. How will you prepare annual facility review reports, including maintenance, safety improvements, and emergency preparedness updates?