Attachment 1 - Comprehensive Mental Health Group Programming.pdf

ATTACHMENT 1:

Comprehensive Mental Health Group Programming

The Government anticipates the transference of the services covered under Attachment 1-Comprehensive Mental Health Group Programming, to the ICE Health Services Corps in September 2022. Therefore, the Government reserves the right to terminate the Comprehensive Mental Health Group Programming portion of this contract provided the Contractor is given at least ninety (90) days written notice.

Objective

The objective of this attachment is to obtain comprehensive mental health group programming services for the detainee population housed in the facility. The U.S. Department of Homeland Security (DHS), Immigration and Customs Enforcement (ICE) seeks to provide behavioral health group programming services to detainees with mental health conditions and who have experienced traumatic events. Comprehensive mental health group programming is in addition to, and complements, the existing behavior health and clinical services at the facility. For the purpose of this program, comprehensive behavioral health group therapy programming encompasses a variety of evidence-based, trauma-focused group therapeutic interventions, to include, cognitive-behavioral therapy interventions, substance abuse recovery and treatment, music and art therapy, as well as social, and recovery skills. The contractor shall create individualized treatment plans for each participating detainee. These individualized treatment plans must be tailored to each detainee’s needs and group programming is integrated into individual treatment plans.

Group programming services will be available to all detainees at the facility, both female and male population, regardless of custody level or type of housing (e.g. Segregation, General Population, and Medical).

Scope of Work

1. Operational Capacity

This attachment does not change the level of care provided at the facility. Rather, it is an addendum to the current care received which augments existing behavioral health resources by adding group mental health programming. Behavioral health therapeutic group programming will supplement current services for detainees with mental illness detained by ICE at the facility.

Scheduled group mental health programming shall be provided Monday through Friday for a minimum of six hours a day. The specific scheduling may be determined by the Contractor, but the programming should occur within the hours of 8 a.m. and 7p.m. Detainee enrollment in group programming will be considered on a case-by-case basis based on a need for services, as determined by behavioral health staff, and a desire and willingness to participate. Behavioral health therapeutic group programming shall not take precedence over immigration court appearances, medical appointments, or any other interview/activity related to their immigration court proceedings.

The Contractor shall provide structured (Monday-Friday) evidence-based behavioral health therapeutic programming for the female and male population through a range of group services.

It is anticipated that a minimum of 15% of the detainees at the facility have mental health concerns. The Contractor shall provide the capacity to assist this population with daily programming at any one time. Group programming should be scheduled so as not to comingle classifications or genders, per the facility’s security protocol. However, the program will be available to all classifications. Group sizes shall ultimately be determined by the behavioral health staff, in consultation with ICE Health Services Corps (IHSC). However, for best results group sizes should be limited to a maximum of 10-12 detainees if language line services are required.

Behavioral health therapeutic group programming shall be conducted in designated and/or multipurpose rooms within the facility. The Contractor must use facility space for Programming that will be separate space from housing units. If a separate space isn’t available within the facility, trailers or modular units can be used within a secured area. The contractor must ensure that the designated programming space provides adequate sound confidentiality and promotes the safety of both detainees and staff. The contractor is encouraged to promote a therapeutic environment in the delivery of group programming. A therapeutic environment may include, for example, therapeutic colors for wall paint, artwork, music, and comfortable seating.

2. Participation in Mental Health Group Programming

Based on ICE’s analysis of data provided of the detained population, the current facility’s mental health caseload is typically 15% of the overall population, many of whom will benefit from behavioral health therapeutic group programming. However, any detainee at the facility may be referred to mental health group programming services by the contract health care staff, Contracting Officer’s Representative (COR) or Alternate Contracting Officer’s Representative (ACOR), or IHSC. Detainees at the facility will also have the ability to request enrollment in mental health group programming, with enrollment subject to approval by the behavioral health staffing. In general, referrals/requests will be routed to identified behavioral health staff who will prioritize and refer detainees to specific therapy sessions based on their clinical assessment.

3. Mental Health Group Programming

The Contractor shall use an evidenced and trauma-informed approach, led by a dedicated contracted Behavioral Health Program Manager, to implement mental health group programming. The core goal is to promote a holistic approach to mental health treatment and identify areas for individual change across the social, psychological, and emotional spectrum.

Group programming will also be culturally appropriate to the ICE population at the facility.

The following are core aspects of structured evidence-based group programming:

• A variety of group methods, including music and art therapy;

• Trauma-focused group programming;

• Substance Abuse groups, including for dual diagnosis populations;

• Domestic violence group programming, including for both male and female populations;

• Mindfulness and meditation programming with a focus on acceptance and commitment;

• Illness Management and Recovery (IMR) mental health programming;

• Facilitated peer support and process groups;

• Dialectal Behavioral Therapy Skills Training;

• Mood Management Group Programming; and

• Cognitive-based Therapy or Distress Tolerance Skills Training.

The Contractor shall create a Program Plan that includes a Program Schedule detailing the types and frequency of programming. This Program Plan must be approved by the government. The Contractor shall utilize evidence-based group therapy treatment modalities.

Group programming shall consist of multiple sessions, with interactivity and verbal discussions, and include various written materials as appropriate. These sessions shall be tailored to suit detainees with mental illness and individuals with past trauma, as well as other special vulnerabilities. Moreover, group programming will be offered in a language and manner the detainee can understand. The Contractor shall use bilingual Spanish speaking staff and appropriate contracted language access services for other languages spoken by detainees - see Program Staffing section. The Contractor shall ensure effective communications, including through the use of auxiliary aids and services, with detainees with special needs, including disabilities.

4. Program Objectives and Evaluation Plan

This attachment and the Quality Assurance Surveillance Plan (QASP) include program outcome and evaluation requirements, thus assisting ICE Enforcement and Removal Operations (ERO) with assessing the effectiveness and quality of the service provision model. Program evaluation and reporting will assist ICE ERO in determining the benefits of facility behavioral health at this facility. The Contractor shall develop an Evaluation Plan to assess the efficacy of the Group Mental Health Programming operations for review by the COR and IHSC.

The following program objectives should be incorporated in the Contractor’s evaluation of the program. The government shall receive quarterly program outcomes reports as well as ad hoc data reports upon request. The program reports will include quantitative and qualitative data on group programming has assisted with the following objectives:

• Decreased frequency of inpatient hospitalization;

• Decreased frequency of disciplinary incidents, segregation placements and lengths of stay in segregation;

• Improved mental health well-being;

• Decreased self-injury incidents and suicide attempts;

• Compliance with obligations to provide mental health treatment; and

• Effective and active participation in the detainees’ legal process and immigration court proceedings.

The contractor shall consider pre-screening data points for a comparative analysis and a post outcome survey after completion of the program.

5. Required Staffing

The following charts represents staff that is contractually required. The following resources shall be independent of other staffing needs.

Contracted Posit ion Male Side Female Side Total

Behavioral Health Program Manager 0.5 0.5 1

Behavioral Health Specialist 1 (Can be Psychologist or Licensed Clinical Social Worker) 2 2 4

Psychiatrist 0.5 0.5 1

Substance Abuse Counselor2 0.5 0.5 1

Security Personnel 3 3 6

Data Analyst 0.5 0.5 1

Total 14

Key Personnel

The Contracting Officer and/or the COR shall provide written approval before any employee is assigned as key personnel to perform duties under this contract. Any subsequent changes to key personnel must meet these criteria and be approved in writing by the Contracting Officer or the COR. The following are considered key personnel for the contract. The Contractor may use other titles.

a) Behavioral Health Program Manager. The Behavioral Health Program Manager will have appropriate credentials in Psychology or be a Licensed Clinical Social Worker (LCSW) and shall be responsible for developing, implementing, coordinating, and evaluating the specialty group programming and for coordinating and evaluating all activities within the specialty group program. The Program Manager shall be responsible for initiating group programming plan and for implementing, monitoring the program in compliance with this attachment and designing and implementing the evaluation and reporting requirements. In addition to clinical considerations, the Program Manager should demonstrate an on-going awareness of evidenced-based mental health treatment for comparable populations and modern correctional practice. Accountability for the total treatment effort is the prime concern of this position. The Behavioral Health Program Manager shall provide direction and oversight to the line behavioral health staff.

1 Licensed Professional Clinical Counselors (LPCCs) will not be considered as a substitute for Psychologists or LCSWs.

2 Certified Substance Abuse Counselor (CSAC)

b) Behavioral Health Specialists.

Given the nature of the services to be performed and the population housed at the facility, the contractor shall try to recruit bilingual (Spanish-speaking) staff to the maximum extent practicable. The Government has a preference for at least 67% (or two-thirds) of the behavioral health staff to be bilingual in Spanish (the top language spoken by ICE detainees), with multiple language capability3. Bilingual Spanish speaking staff must be tested for proficiency in any language other than English and meet a minimum score of S2 (Limited Working Proficiency) on the Interagency Language Roundtable (ILR) scale4, or an equivalent test, prior to use in this capacity. The Contractor shall provide copies of the language proficiency scores to the COR for review and verification. Staff will have professional work experience in a variety of treatment approaches, to include trauma-informed care service provision.

c) Dedicated Security Personnel. All security personnel will be trained in the goals of the group programming as outlined in the Objectives, including trauma-informed approaches and interacting with individuals with mental illness, and crisis intervention techniques to include de-escalation techniques.

1. The Contractor shall provide escorting and guarding detainees during group programming.

2. Dedicated Security Personnel are fixed posts. The following notes are applicable to the above posts:

a) All on call posts require at least one guard that is of the same sex as the detainee.

b) Additional officers for each post assignment may be required at the direction of the COR or Alternate COR when operationally necessary

d) Data Systems and Reporting Analyst. The Contractor shall be required to build, maintain, and utilize an appropriate and approved data system(s) for capturing and reporting data. This data is to include, but may not be limited to, demographic information, electronic health records, and programming data for detainees participating in group programming. The Contractor shall ensure that contracted staff provided timely and complete data extracts quarterly and upon ICE’s request.

6. Contract Compliance

3 The Contractor shall work with ICE ERO to determine the most relevant languages. As of 04/17/2019, the top five spoken languages by ICE detainees (for Fiscal Year 2019) were: Spanish, Hindi, English, Mandarin Chinese, and French.

4 The Interagency Language Roundtable (ILR) is an unfunded Federal interagency organization established for the coordination and sharing of information about language-related activities at the Federal level. It serves as the premier way for departments and agencies of the Federal government to keep abreast of the progress and implementation of techniques and technology for language learning, language use, language testing and other language related activities.

https://www.govtilr.org/

To assess the impact of the program, IHSC, in close coordination with the ERO Denver Field Office, will review progress toward the Program Outcomes. The implementation of the new requirements will be monitored closely by IHSC and the COR in collaboration with Denver Field Office leadership.

6. Contract Compliance