ATTACHMENT A1

CATEGORY 1: ACUTE TREATMENT FACILITIES

RFSQ-BHS-FY23-0225: Behavioral Health Treatment Facility Continuum of Care Page 1 of 14 ATTACHMENT A1: Acute Psychiatric Hospital and Psychiatric Health Facility Scope of Work

CATEGORY 1 - ACUTE TREATMENT FACILITIES:

ACUTE PSYCHIATRIC HOSPITAL AND PSYCHIATRIC HEALTH FACILITY

Scope of Work

I. Purpose

A. The County of Santa Clara (County) Behavioral Health Services Department (BHSD) is seeking statements of qualifications from qualified Offerors interested in providing Acute Psychiatric Hospital and Psychiatric Health Facility units in Santa Clara County as part of the Behavioral Health Treatment Facility Continuum of Care.

B. This program encompasses the following two (2) programs:

1. Type 1: Acute Psychiatric Hospital Services: Acute in-client psychiatric units for clients, which shall include high-intensity (locked) services, treatment, and placement into appropriate aftercare. Services shall be available for all Santa Clara County clients with Medi-Cal. Services shall be available twenty-four (24) hours, seven (7) days a week.

2. Type 2: Psychiatric Health Facility (PHF) Services: Therapeutic and/or rehabilitative inpatient services. Offeror shall provide services to improve a client's ability to function in the community by addressing and ameliorating the client's acute needs through an acute stabilization treatment model focused on precipitating events.

C. Offeror shall provide services to improve a client's ability to function in the community by addressing and ameliorating the client's acute needs through an acute stabilization treatment model focused on precipitating events.

D. Offeror shall establish and maintain certification through the County to provide Medi- Cal reimbursable services before providing and billing for Medi-Cal services to clients.

Offeror shall not be reimbursed by County for any Medi-Cal services under this program until Offeror receives Medi-Cal Certification.

II. Background Information

A. This level of care shall provide therapeutic and/or rehabilitative in-client psychiatric services for County BHSD clients. This is an alternative to unnecessary in-client psychiatric admissions into the County’s client settings and thus shall reduce the overall cost for the County.

III. Target Population

A. Offeror shall provide acute in-client services to one or more of the following groups:

1. Adolescents (ages 14-17);

2. Transitional age youth (TAY [ages 18-21]); and

3. Adults and older adults (ages 18+).

B. Offeror shall serve adults (ages 18- 64) that are the responsibility of the County, have a

RFSQ-BHS-FY23-0225: Behavioral Health Treatment Facility Continuum of Care Page 2 of 14 primary diagnosis of severe mental illness (SMI), and meet requirements for subacute in-client psychiatric care.

IV. Program Goals and Objectives

A. The programs shall be aligned to achieve the following goals and objectives:

1. Goals shall include, but not be limited to:

a. Ensure services provided to a specific client at a given time are costeffective, clinically and culturally appropriate, and least restrictive.

b. Provide a coordinated system of care for clients whose level of impairment requires evaluation and treatment in an acute in-client unit operated by the Offeror. The programs shall operate under Lanterman-Petris-Short Act regulations (LPS).

c. Stabilize the client to prepare them for successful discharge.

d. The primary goal of rehabilitation services is to restore, establish and maintain optimum levels of social, vocational, and physical functioning, and to minimize residual disabilities.

2. Objectives shall be achieved by:

a. Comprehensive assessment;

b. Multidisciplinary treatment plans incorporating the principles of wellness and recovery;

c. Individual, family, and group therapy;

d. Acute symptom stabilization; family involvement; and

e. Timely discharge planning to appropriate aftercare.

V. Reporting and Data Collection Requirements

A. Offeror is responsible for collecting and managing data in a manner to be determined by Department of Health Care Services and/or the BHSD.

B. Offeror shall monitor and evaluate client/family satisfaction and culturally responsive services/practices to continually improve service quality. Data shall be used to improve program satisfaction.

C. Offeror shall provide consistent documentation across all disciplines. Medical necessity documentation shall include a description of supporting evidence to justify the statement. Daily notes on each shift shall describe a description of the service provided.

The BHSD shall deny a service day when a physician or psychologist's daily note is consistently the only discipline documenting medical necessity.

D. Offeror shall detail the organization’s ability to use their current electronic health record (EHR) system (including the capability to exchange data with County systems) and/or the ability to implement a new EHR system as listed in Appendix H, Offeror’s Electronic

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Health Record (EHR) Status. Offeror shall indicate current and future County EHR system needs in Appendix H, using one (1) of the following myAvatar implementation types:

1. Provider Connect Enterprise (PCE) with 837 billing;

2. Provider Connect NX (PCNX) with 837 billing;

3. PCNX non-837 billing with fast service entry claims submission; or

4. Solely client information without billing, if no EHR billing is needed for the particular program/contract.

VI. Outcomes and Measurements

A. Offeror shall achieve the following outcomes:

1. Offeror shall use culturally and developmentally appropriate Evidence-Based Treatment (EBT) and shall flexibly adopt and implement modifications to treatment according to the needs of each client.

2. Clinicians practicing within these programs shall employ EBT, and that the Offeror shall employ treatments, which show promise in decreasing multiple symptoms of served clients, including adoption of Cognitive Behavioral Therapy principles and practices, and wellness and recovery principles.

VII. Program Description

A. Purchase of dedicated beds (if applicable) shall be upon successful contract negotiations and mutual agreement between the BHSD and Offeror.

B. Type 1: Acute Psychiatric Hospital Services

1. Offeror shall provide therapeutic and/or rehabilitative inpatient services. The program shall provide services to improve a client's ability to function in the community by addressing and ameliorating the client's acute needs through an acute stabilization treatment model focused on precipitating events. Concurrently, the inpatient program shall coordinate services with the BHSD Outpatient Service Team client to assist in a seamless discharge to the least restrictive level of care that can successfully meet the client's needs.

2. The acute inpatient psychiatric unit shall provide care to clients needing acute inpatient treatment with an anticipated average length of stay between 5-7 days.

3. Offeror shall provide therapeutic and/or rehabilitative inpatient services and documentation of services in accordance with regulatory requirements and guidelines as set forth in the County's policies and procedures.

4. Once the BHSD presents a client for placement, Offeror must respond within two (2) hours. Extenuating circumstances requiring a response time of more than two (2) hours shall be considered on a case-by-case basis.

5. Offeror shall establish written standardized policies and procedures for assessing clients who are served by this program. Offeror shall ensure completion of the

RFSQ-BHS-FY23-0225: Behavioral Health Treatment Facility Continuum of Care Page 4 of 14 following:

a. The program design must be flexible to meet the changing needs of the client population.

b. The assessment program shall encompass all client life domains and shall extend beyond a symptom-based approach.

c. Information gathered from multiple informants must be an integral part of the assessment process.

d. Both a Diagnostic Statistical Manual of Mental Disorders-Fifth Edition diagnosis and a bio-psychosocial formulation shall be established for every evaluation.

e. The treatment plan developed must be conducted under the clinical supervision of a board-certified psychiatrist, who is to be retained by the Offeror.

f. Program components must meet requirements of the California Code of Regulations, Title 9, including compliance with staffing, services and administration provisions, and all other pertinent federal and state regulations.

g. Offeror must demonstrate the active welcoming, engagement and inclusion of family/conservators/caregivers and any natural resources as requested in all aspects of assessment, treatment planning and aftercare planning. For TAY, the natural resources shall include those as identified by the client.

h. Program components must include:

1) Psychiatric assessment, including medication evaluation, biopsychosocial evaluation, nursing, recreational/leisure, substance use and nutrition;

2) Individualized treatment planning;

3) Family involvement;

4) Conservator/caregiver involvement;

5) Outside agency/provider involvement, including outside therapists, psychiatrists, child welfare, probation, and educational staff;

6) Capacity to assess medical needs and a process for attaining lab and imaging tests;

7) Treatment issues needing further services are identified and coordinated with the referring agency and other providers as needed and in accordance with Aftercare service requirements;

8) Individual, family, and group therapy;

9) Intensive daily schedule of treatment services to augment individualized services;

10) Capacity to provide recreational/leisure activities;

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11) Capacity to manage aggressive and assaultive behavior; and

12) Provision of skills-based groups with focus of regulation of mood and emotions.

i. Offeror shall provide a plan that:

1) Describes how the Offeror shall work with other Behavioral Health Services Department (BHSD) programs.

2) Provides for access to physician services on a 24/7 basis for the acute inpatient programs.

3) Indicates how the following services shall be provided or arranged, specifying the use of off-site resources as appropriate:

a) Complete physical health assessment with medical history and physical examination within twenty-four (24) hours of admission to the unit;

b) Ongoing primary health care for inpatients;

c) HIV or other sexually transmitted diseases care;

d) Infectious disease care;

e) Nutrition services;

f) Pharmacy services;

g) Laboratory services;

h) Diagnostic imaging services;

i) Electroencephalogram and Electrocardiogram services;

j) Psychological and neuropsychological screening and testing services;

k) Social work services;

l) Rehabilitation and occupational therapy services;

m) Spiritual and/or pastoral care; and

n) Wellness and recovery resources.

j. Offeror shall be a full-service provider that operates the client services programs described herein, including all required client food service, housekeeping, facilities support/maintenance, and program administrative services necessary to operate a psychiatric acute inpatient unit.

k. Offeror’s facility shall be always open to inspection upon demand by representatives of the County. Offeror shall ensure compliance with all staffing requirements mandated by state and federal regulations for the acute inpatient unit.

l. Offeror shall ensure that all LPS proceedings, such as Probable Cause Hearings, RFSQ-BHS-FY23-0225: Behavioral Health Treatment Facility Continuum of Care Page 6 of 14 are conducted and coordinated with County-contracted agencies providing patients' rights advocacy services and certification hearing representation.

m. Offeror shall ensure that all evaluation and treatment services are accomplished in a setting conducive to client privacy and confidentiality. Care shall not be provided in common waiting areas for any client.

C. Type 2: PHF

1. Offeror shall manage an acute stabilization treatment model which provides an Individualized Treatment System based on the following premises:

a. The primary treatment goal is to establish written standardized policies and procedures for assessing clients who are served by this program.

b. Psychiatric nursing and other services shall include monitoring and evaluation of the quality and appropriateness of care and resolving identified problems.

c. Social services shall be designed to meet the objective of each client's Interdisciplinary Treatment Team (IDT) plan.

d. Length of stay shall be determined by medical necessity.

e. Discharge planning is an on-going process that begins upon admission. Through the Daily Treatment Focus (DTF) or IDT process, the client served is involved in the decision-making process.

f. Services of the program shall be flexible to meet the changing needs of the client population.

2. The acute stabilization model provides an individualized intensive daily schedule of treatment services in addition to individualized treatment. Clients shall be prompted to participate and be placed in programmed services as quickly as possible. Programmed or individualized components may include, but are not limited to, the following:

a. Scheduled and collaborative meetings to assist in the treatment and placement/discharge planning needs of the client (DTF or IDT);

b. Pharmacotherapy;

c. Group therapy;

d. Individual therapy;

e. Family services;

f. Psycho-education services;

g. Crisis intervention;

h. Assessment and evaluation;

i. Social and Individual, family, and group therapy;

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j. Behavioral programming and plans; and

k. Therapeutic treatment milieu.

3. Participation in the programmed or individualized components of the intensive daily schedule of treatment services shall be strongly encouraged on a daily basis.

4. Offeror shall accept clients requiring wheelchairs and/or walkers who are independently mobile.

5. Offeror shall assess clients for co-occurring, chronic medical conditions.

6. Offeror shall train staff in Early Periodic Screening Diagnosis and Treatment (EPSDT) and Therapeutic Behavioral Services (TBS). Offeror shall provide EPDST and TBS literature at discharge to all clients served who may qualify for these services.

7. Staff shall:

a. Assist to contact the Department of Health Care Services to initiate the Medi- Cal application. Offeror shall provide documentation substantiating contact.

b. Complete an accurate financial review form for each client served at the time of intake regardless of funding or benefits.

c. Verify benefit coverage.

d. Identify medical problems and/or abnormal laboratory results and address them through consultation and follow-up appointments as appropriate.

e. Include interdisciplinary treatment plan review and modifications as frequently as the client's condition warrants.

f. Document current outpatient medications or reasonable attempts to obtain such documentation to include in the PHF record. PHF and BHSD Outpatient Service Team staff are expected to work in conjunction with each other to ensure continuity of care.

g. Formulate and conduct internal monitoring and utilization review activities that shall be included in the IDT plan meeting or psychiatric nursing services processes. These processes shall be observable and in collaboration with the Offeror's internal departments and other service providers approved by the County. These processes shall be reviewed during facility audits and shall require a plan of correction if deficiencies are found.

h. Monitor practices and procedures to assure that all staff from all disciplines evaluate and document with consistent standards, so the treatment team has consistent information with which to plan treatment in a culturally competent fashion.

i. Document reasonable continued efforts to involve the client served in daily program participation when the client served refuses to attend services provided in the program.

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j. Document all efforts to obtain medication consent in a good faith effort to begin medication therapy to avoid a delay in treatment.

k. Offeror shall maintain a maximum ratio of clients: physician (psychiatrist) equal to 16:1.

l. Offeror shall provide therapeutic and/or rehabilitative in-client services and documentation of services in accordance with regulatory requirements and guidelines as set forth in the County's policies and procedures.

m. Offeror shall treat and document according to medical necessity guidelines and discharge clients appropriately.

n. If Offeror requests consultation from the BHSD Outpatient Service Team, Offeror shall provide access to mental health record information in a timely manner so services shall be completed within the necessary timeline.

o. If the client served refuses medical procedures, refusal shall be documented in the client's chart. Payment shall not be denied if the client served refuses procedure.

p. The Offeror shall implement a medication management system that promotes the safe and effective use of medications in clients. This management system shall identify how the Offeror shall evaluate its medication management system for risk points and identify procedures to improve client safety.

q. The Offeror shall indicate the process for obtaining medications on a 24/7 basis in order to respond to urgent or emergent conditions.

G. Staffing Requirements

1. Staff shall include board-certified psychiatrists, internal medicine doctors, psychiatric nurses, licensed or license-eligible social workers or marriage and family therapists, recreation/leisure therapists, nutritionists, pharmacists, and therapists qualified to assess and treat substance use.

2. Offeror’s organization shall maintain practices related to recruiting, hiring, and promoting multi-lingual staff and/or a culturally or ethnically diverse workforce.

Offeror’s organization shall have training requirements related to diversity, equity, and/or inclusion (e.g., Lesbian, Gay, Bisexual, Transgender, Queer, Questioning + [LGBTQ+], cultural and linguistic capacity, racial equity).

H. Cultural Competency

1. Offeror’s organization shall be inclusive of promoting behaviors and practices towards a more equitable, diverse, and inclusive organizational mindset. Offeror shall have a leadership model inclusivity and tools and support to improve their organization’s ability to identify and mitigate bias, respect differences, build empathetic relationships, and manage conflict.

2. Offeror’s organization shall have a plan to address barriers when they do not have

RFSQ-BHS-FY23-0225: Behavioral Health Treatment Facility Continuum of Care Page 9 of 14 staff available to meet the seven (7) Santa Clara County threshold languages (Spanish, Vietnamese, Mandarin, Cantonese, Tagalog, Farsi, and Russian) and a plan for actions and changes to ensure diversity and inclusion in service delivery.

I. Referrals and Admissions

1. Type 1: Acute Psychiatric Hospital

a. Offeror shall accept referrals and admit clients being held according to:

1) California Welfare and Institutions Code (WIC) Section 5150; and

2) WIC Section 5250 who have not had a hearing on a case-by-case basis based on time of the referral and availability of Offeror's onsite medical doctor to complete required legal procedures.

b. Appropriate referrals per established guidelines shall include all medically cleared clients deemed by emergency psychiatric services to be stable for transfer to inpatient psychiatric care, including, but not limited to:

1) Clients who are pregnant;

2) Clients who are hearing impaired and mute;

3) Clients who require use of an interpreter;

4) Clients who refuse lab tests (e.g., urine toxicity and pregnancy testing); and

5) Clients with known behavioral problems.

2. Type 2: PHF

a. If a client served is admitted to the Psychiatric Health Facility (PHF) and is identified as open to an BHSD Outpatient Service Team, the service team shall be contacted within twenty-four (24) hours of admission. If the client served has no current outpatient service team, the Offeror shall call the Mental Health Call Center for assignment of an outpatient service team and for aftercare plans prior to discharge.

b. Once BHSD presents a client for placement, Offeror must respond within two

(2) hours. Extenuating circumstances requiring a response time of more than two (2) hours shall be considered on a case-by-case basis.

c. Offeror shall accept referrals and admit clients being held according to:

1) California WIC Section 5150;

2) WIC Section 5250 who have not had a hearing on a case-by-case basis based on time of the referral and availability of Offeror's onsite medical doctor to complete required legal procedures; and/or

3) Voluntary clients.

d. Appropriate referrals per established guidelines shall include all medically-

RFSQ-BHS-FY23-0225: Behavioral Health Treatment Facility Continuum of Care Page 10 of 14 cleared clients deemed by emergency psychiatric services to be stable for transfer to inpatient psychiatric care including the following:

1) Clients who are pregnant;

2) Clients who are hearing-impaired and/or mute;

3) Clients who refuse lab tests such as urine toxicity and pregnancy testing;

4) Clients who require the use of an interpreter; and

5) Clients with known behavioral problems.

e. Offeror is not required to accept clients who are on dialysis, require isolation, have dangerously high blood pressure, or other medical conditions that require immediate emergency interventions from a facility with an attached medical hospital.

f. Offeror is not required to admit and treat clients with a primary diagnosis of eating disorder as defined in Section 1254.5(b) of the California Health and Safety Code.

g. Offeror is not required to admit and treat clients with a primary diagnosis of chemical dependency, chemical intoxication, or chemical withdrawal. Clients with major mental disorders shall not be admitted if their treatment requires interventions beyond the level appropriate to a psychiatric care facility, including, but not limited to:

1) Detoxification from substance use; and/or

2) Treatment for substance-induced delirium.

h. If Offeror fails to accept an appropriate referral, or states that there are no beds available on a specified date for placement but during the reconciliation process it is determined that there was in fact bed capacity, County shall not be responsible to reimburse Offeror for an empty dedicated bed for that service date. County shall provide appropriate documentation (date, client, County staff making inquiry, Offeror staff responding to inquiry) before taking any credits for unused bed guarantees.

J. Care Coordination

1. Type 1: Acute Psychiatric Hospital

a. Offeror shall serve as part of the County of Santa Clara’s continuum of care services for clients. The program shall be expected to set and achieve fixed-term goals for their clients and to then link the client to other Offerors for necessary aftercare services.

2. Type 2: PHF

a. All Offerors shall contact the Notification Hotline or submit a Notification of Hospitalization Form to Point of Authorization via fax within twenty-four (24)

RFSQ-BHS-FY23-0225: Behavioral Health Treatment Facility Continuum of Care Page 11 of 14 hours of admission to the inpatient unit. The following information shall be included:

1) Client name;

2) Date of birth;

3) Facility name;

4) Phone number;

5) Date of admission;

6) Insurance status; and

7) Contact person.

b. A representative from BHSD Point of Authorization Department shall contact Offerors facility on the next scheduled business day for any additional information required.

c. Offeror shall participate in active and continuous collaboration with County-contracted Providers (CCP) support services. Served clients shall be linked, as appropriate, within the network of available CCP support services to meet their extended needs. For all Medi-Cal clients, the BHSD Hospital Liaison shall assist the Offeror social service staff with this linkage and coordination of services.

d. Treatment issues needing further services are identified and coordinated with the BHSD Outpatient Service Team coordinator and other involved representatives, including the BHSD 24-Hour Care Unit staff, in accordance with aftercare services requirements.

K. Quality Assurance

1. Offeror shall have a fully operational quality improvement program, with a written quality improvement plan, consistent with National Council on Quality Assurance standards. Offeror participation in the BHSD Quality Improvement and Compliance Programs and adherence to all BHSD performance requirements is mandatory.

L. Program Hours of Operations

1. Offeror shall be available twenty-four (24) hours, seven (7) days a week, 365 days a year to address any client emergency needs.

M. Evaluations, Transitional Planning, and Discharge

1. Type 1: Acute Psychiatric Hospital

a. The length of stay for the acute inpatient program is anticipated to be no greater than seven (7) days.

b. Discharge planning by the Offeror shall begin immediately upon admission. Each client admitted shall be reviewed daily for progress made towards discharge.

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c. Upon achieving clinical stabilization, the client shall be transitioned to the appropriate aftercare in the community.

d. Clients identified as ready for discharge (e.g., who no longer present a danger to themselves or others, or who are not gravely disabled and no longer meet medical necessity for treatment in an acute inpatient setting), shall be released per the discharge plan as soon as possible.

e. The program shall participate in active and continuous collaboration with CCP support services. Served clients shall be linked, as appropriate, within the network of available CCP support services to meet their extended needs. For all Medi-Cal clients, the BHSD Hospital Liaison shall assist the Offeror social service staff with this linkage and coordination of services.

f. Offeror shall actively engage and involve the client’s family and/or caregivers with the permission and request of the client and any conservators in addressing the acute psychiatric crisis and preparing the client for successful discharge.

2. Type 2: PHF

a. Evaluations for therapeutic and/or rehabilitative shall address acute needs related to life functioning deficits and must explain the circumstances that led to the need for services. Offeror intake assessments must also define proposed goals for services. Offeror is responsible to assure that this information is included in the client's medical record and is available through the subsequent DFT or IDT plan to assist in the aftercare placement/discharge planning process.

b. Clients shall receive a face-to-face evaluation by a psychiatrist or psychologist within twenty-four (24) hours of admission. Medical necessity, in accordance with CCR Title 9, must be established for any client admitted for therapeutic and/or rehabilitative in-client services. To substantiate medical necessity, the psychiatrist's evaluation must include: a mental status exam, onset of illness, chief complaint, and circumstances that led to the services.

c. Within twenty-four (24) hours of admission and each day thereafter, the attending physician or psychologist shall note in client charts the following information:

1) Explanation of continuing medical necessity; and

2) The means used to decrease the medical necessity (e.g., current symptoms, response(s) to treatment, and rationale for modifications or no modifications of the course of treatment or treatment plan).

d. Daily documentation concerning medical necessity must include a description of supporting evidence to justify the medical necessity statement. Any day without this information written in the medical record by the attending physician or psychologist shall be denied. When the psychiatric evaluation includes the

RFSQ-BHS-FY23-0225: Behavioral Health Treatment Facility Continuum of Care Page 13 of 14 components of a daily progress note, the need for a progress note for that day is eliminated.

e. Laboratory tests for therapeutic medication levels shall be ordered within standards and treatment adjusted accordingly without delay. Laboratory tests are to be ordered for those clients who are indigent and uninsured. Failure to order indicated testing shall result in denial for any delayed day. If the client served refuse testing, refusal shall be documented in the client's chart.

f. The psychosocial evaluation shall be completed within thirty-six (36) hours and the nursing evaluation shall be completed within eight (8) hours of admission, or as soon as reasonably possible, with the extenuating circumstances documented daily until completed. Because this information is required for the treatment planning process, failure to complete these evaluations within the required time frames shall result in denial of payment for the first day of the in-client stay and subsequent days wherein the evaluations are not completed.

g. A History and Physical (H&P) examination shall be completed within twenty-four

(24) hours of admission unless one has been completed within the previous thirty (30) days and is determined to be current, in accordance with CCR Title 22 regulatory requirements and shall include (but not limited to):

1) Systems review and list of all current medical conditions;

2) Complete blood count;

3) Urinalysis;

4) Urine drug screen;

5) Liver/Kidney function tests ;

6) Electrolytes;

7) Thyroid function test;

8) Pregnancy test (when indicated); and

9) Evidence of follow-up for medical problems for any client served with co-occurring medical problems.

h. Offeror shall publish the prearranged time slot for IDT meetings to discuss each client's condition, readiness for discharge, placement planning, and to update the treatment plan. The initial IDT shall be scheduled within seventy-two (72) hours of admission and shall be scheduled on at least a weekly basis thereafter.

Time slots shall be specific to each client served. The attending physician is to be present at IDTs.

i. The attending psychiatrist or psychologist shall write discharge summaries no later than fourteen (14) calendar days of discharge from the Psychiatric Health Facility.

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j. Offeror shall document evidence that client's support system has been involved, or has been invited to be involved, in the treatment process as consented to by the client served. Offeror shall collaborate with Hospital Liaison regarding discharge coordination and with the BHSD 24-Hour Care team for coordination of placement.

k. Offeror shall provide to the BHSD Outpatient Service Team the Aftercare Plan within twenty-four (24) hours of discharge and the Discharge Summary within fourteen (14) calendar days of discharge for continuity of care in accordance with County's Policies and Procedures.

l. Offeror shall obtain documentation of recent modification of outpatient treatment. If unable to obtain the outpatient treatment information, there must be evidence that ongoing attempts were made in an effort to increase continuity and appropriateness of care.

m. Offeror shall complete all documentation and include in client charts.

n. Offeror shall notify the BHSD Program Monitor of any client's admission, regardless of payor source when the client served. Telephone notification of the client-served Outpatient Service Team case manager or designee, according to County's policy and procedures, must occur (and daily fax notification thereafter) at the time of admission and confirmed at the first Daily Treatment Focus.

VIII. Public Health Emergency or Other Emergency Disaster Plan

A. Offeror shall have policies and procedures to address disaster preparedness during a Public Health Emergency or other emergency disaster. Offeror shall complete Appendix B1, Evaluation Criteria and Qualifications and submit the following supplemental information.

1. Emergency and disaster plan to deliver services during a Public Health Emergency or other emergency disaster that includes, at a minimum, evacuation procedures, training for workforce members, and quarterly emergency drills;

and

2. Emergency and disaster plan to deliver services during a pandemic such as the COVID-19 pandemic.

B. Offeror shall comply with all County requirements in effect relating to COVID-19 for persons who routinely perform services for County onsite and share airspace with or proximity to other people at a County facility as part of their services for County as set forth in a County Health Order (or similar directives).

2. Objectives shall be achieved by: