Attachment A12.docx

ATTACHMENT A12

CATEGORY 2: OUTPATIENT SERVICES

ADULT AND OLDER ADULT OUTPATIENT CONTINUUM SERVICES - JUSTICE INVOLVED

Scope of Work Purpose A. The County of Santa Clara (County) Behavioral Health Services Department (BHSD) is seeking statements of qualifications from qualified Offerors interested in providing Adult and Older Adult Outpatient Continuum Services for Justice Involved eligible County residents (hereafter referred to as “the program”).

B. The program shall serve justice involved adults (ages 18 through 59) and older adults (ages 60 and above) diagnosed with co-occurring[footnoteRef:2] substance use disorders and require co-occurring outpatient services to remain in the community. [2: Clients require both mental health and substance use treatment services.]

C. The program shall provide comprehensive behavioral health services for clients that combine components of recovery-oriented, evidence-based practices (EBPs), promising practices (PPs), and trauma-informed practices.

D. The program shall promote recovery and shall increase client quality of life, community connections, self-reliance, and shall decrease negative outcomes, such as hospitalization, isolation, abuse, incarceration, and homelessness.

E. Services shall be culturally appropriate and trauma-informed to promote the recovery, stability, and resilience of all clients. Services shall be designed to improve emotional/behavioral functioning and enhance the clients’ ability to participate in meaningful activities such as recreational, school, employment, and independent living activities. The program shall build and nurture supports that help clients remain in their respective communities as emotionally healthy and productive members.

F. Offeror shall work collaboratively with community navigators, community providers, other mental health agencies, substance use treatment services providers, physical health service providers, educational systems, other groups that provide supportive services, and justice partners including, but not limited to, probation officers, courts of law, district attorneys, and public defenders.

G. Offeror shall have experience providing services funded by grants, including, but not limited to:

1. Adapting flexibly to changing caseloads;

2. Providing unusual or frequent data requests; and

3. Planning for program closure, if funding were to cease.

H. Services shall strategically be situated within the identified County catchment areas. The four (4) primary regions of focus for program services are North, Central, East, and South County regions:

1. North County: Palo Alto, Los Altos and Los Altos Hills, Mountain View, and Sunnyvale;

2. Central County: San Jose, Cupertino, Santa Clara, Los Gatos, Monte Sereno, Saratoga, and Campbell;

3. East County: San Jose (Foothills, Berryessa) and Northeast San Jose/Milpitas areas; and

4. South County: Gilroy, Morgan Hill, and the unincorporated area of San Martin.

I. Offeror shall strategically operate a Medi-Cal and Medicare certified service delivery site within the identified County catchment areas. The site shall be considered home base for Offeror’s staff. In addition, services shall be offered in the community or wherever the clients are (e.g., work, school, home, homeless shelter, jails, courts, etc.), if appropriate.

J. Offeror shall have current Medi-Cal certification, for both mental health and Drug Medi-Cal, or become certified to provide Medi-Cal reimbursable services on or before the contract start date. In addition, Offeror shall have Medicare certification on or become certified to provide Medicare reimbursable services on or before the contract start date.

K. The program shall maximize Drug Medi-Cal eligible services where appropriate and conform to the Drug Medi-Cal Organized Delivery System Model that has been developed for Santa Clara County.

L. Offeror shall be Dual Diagnosis Capable to address the relationship between the mental health and substance-related disorders and its effect on the client’s readiness to change, as well as relapse and recovery environmental issues, through individual and group program content.

I. Background Information

1. Research studies have indicated that high percentages of individuals who are incarcerated suffer from mental health and co-occurring conditions. According to a report from the American Psychological Association, “64% of jail inmates, 54% of state prisoners, and 45% of federal prisoners reported mental health concerns. Substance abuse is also rampant and often co-occurring” (2014). These individuals often encounter an array of psychosocial problems, including increased risk of incarceration, hospitalization, homelessness, lack of gainful employment, lack of family and social supports, and lack of financial support. These psychosocial problems make it difficult for individuals to re-integrate into their communities.

1. Transitional Housing Units (THUs), intensive outpatient services assist criminal justice involved individuals as they are released from correctional and inpatient settings will provide the needed resources to promote successful reintegration into Santa Clara County communities. As a result, risk factors are decreased through linkage to housing, behavioral health, primary care, benefits assistance, and peer support services who will model successful re-integration into the community.

1. Proposition 47 was passed on November 4, 2014 by California voters to address overcrowding in the State’s prison systems. The initiative allowed for reclassification of certain non-violent crimes, such as petty theft under $950 and simple drug possessions, from felonies to misdemeanors. The savings generated from Proposition 47 are placed in the Safe Neighborhoods and Schools Fund, which allows the Board of State and Community Corrections (BSCC) to issue grants to expand mental health treatment, substance use treatment, housing-related assistance and other community-based services for justice-involved individuals.

1. The intent of the program is to provide co-occurring services to justice-involved individuals with serious mental health and co-occurring (mental health and substance abuse) conditions. The program shall include mental health services; case management; medication support services; crisis intervention; outreach; and other appropriate services to reintegrate clients into the community and reduce recidivism.

1. The County is considered linguistically more diverse with proportionally more local County residents speaking a language other than English. The BHSD seeks to identify interested applicants with ethnically and linguistically diverse staff to provide outpatient mental health services within diverse communities to increase outreach and access to those families who may be unaware of available services and treatment options.

1. The current grant the BHSD has with the Board of State and Community Corrections (BSCC) as a funding source is slated to end June 1, 2026.

II. Target Population A. The program shall serve justice-involved adults (ages 18 through 59) and older adults (ages 60 and above) who:

1. Have been arrested, charged with, or convicted of a criminal offense and have a history of mental health or substance use disorders;

2. Are diagnosed with severe and persistent mental health and co-occurring conditions that result in functional impairments or symptoms, and without treatment, would be at imminent risk of decompensation, resulting in hospitalizations and/or incarceration;

3. Come from underserved cultural populations;

4. Are trauma-exposed and/or are in distressed families;

5. Identify with Lesbian, Gay, Bisexual, Transgender, Queer, Questioning + (LGBTQ+) communities;

6. Are at risk for suicide, homelessness, incarceration, or hospitalization;

7. Adherence poorly to treatment with medication management; and/or

8. Require public assistance services or benefits due to mental functioning impairments and circumstances.

B. Clients served are residents of County that may be uninsured, have full-scope Medi-Cal, Medicare, or both Medi-Cal and Medicare (Medi-Medi).

C. All individuals served through these programs must meet Medi-Cal medical necessity criteria pursuant to Title 9, California Code of Regulations (CCR), Chapter 11, Sections 1820.205, 1830.205, and 1830.210 to receive Medi-Cal specialty mental health services.

Program Goals and Objectives A. The program shall be aligned to achieve the following goals and objectives:

Goals shall include, but not be limited to:

Reduce subjective suffering from mental illness and/or co-occurring conditions;

Reduce the number of people with mental illness and/or co-occurring conditions who are booked into correctional facilities;

Decrease incarceration rates among justice-involved adults and older adults;

Reduce experiences of homelessness, crisis, hospitalization, substance use, violence, and victimization;

Strengthen recovery, self-sufficiency, and other psychosocial outcomes; and Promote adults and older adult clients’ active participation in their recovery and self-monitoring of milestones and goals towards self-determination, family, vocational, and recreational services.

Offeror shall achieve the following objectives:

a. Provide services that meet timeliness requirements set forth by the BHSD;

b. Incorporate the principles of “wellness and recovery,” in which all services are client-centered, strength-based, and promote recovery and resiliency;

c. Decrease the percentage of open client no-shows;

d. Increase the percentage of successful discharges;

e. Decrease the number of clients receiving inpatient hospital services who are readmitted;

f. Increase the number of referrals subsequently enrolled into and complete treatment;

g. Provide housing services for clients with an identified need for housing.

h. Assist justice-involved individuals in developing life skills that will improve their ability to live and thrive in the community following incarceration;

i. Provide behavioral health and co-occurring substance use services for clients through care coordination and utilization of EBPs, PPs, and trauma informed practices;

j. Help clients address substance/alcohol use and related risky behaviors (e.g., unsafe sex, criminal behaviors) as applicable;

k. Link clients to mental health, medical, and dental healthcare, and to other relevant services, as applicable;

l. Enhance client understanding of medication adherence and its effectiveness, if appropriate;

m. Engage clients to actively participate in their recovery and self-monitor their milestones and goals toward self-determination, family, education, vocational education, and recreational services;

n. Provide time-limited[footnoteRef:3] services through the Care Coordinator as the single point of responsibility for services; [3: Time frame shall be based on clinical care and treatment needs on a case-by-case basis per client.]

o. Improve client’s self-sufficiency through the development of a recovery plan that secures housing, food, clothing, and a stable income; and

p. Provide culturally- and linguistically-aware services for the full range of treatment and rehabilitation services and resources to meet the needs of clients and their families during the clients’ recovery process.

III. Reporting and Data Collection Requirements A. Offeror shall comply with the reporting requirements reflected in Division 5 of the California Welfare and Institutions Code, Division 1, and Title 9 of the California Code of Regulations.

B. Offeror shall complete the following requirements:

1. Provide a weekly report to the BHSD that includes recent referrals, current enrollment, and recent discharges;

2. Enter client demographic information, direct and outreach services information, and other appropriate data into the BHSD’s data information system;:

3. Collect Sexual Orientation and Gender Identity and Expression (SOGIE) information;

4. Enter client data into the State Client and Service Information (CSI) system;

5. Collect treatment and service data for outcomes data reporting;

6. Collect and track client Milestones of Recovery Scales scores to determine treatment effectiveness;

7. Collect, document, track, and report data related to community outreach, education, and training services;

8. Measure client outcomes for justice-involved clients to determine areas needing of improvement;

9. When applicable, administer assessment tool(s)[footnoteRef:4] to collect and report on assessment tool data, including, but not limited to: [4: The BHSD shall offer training through the Learning Partnership Division, as needed.]

a. Functional Assessment Scale (FAS[footnoteRef:5]); and [5: Given CalAIM Department of Health Care Services (DHCS) integrated oversight, administration, and payment of specialty mental health and substance use disorder services into one contract between DHCS and counties. Through CalAIM, DHCS is going to make it possible for patients to receive multiple services in one coordinated location or during one visit. FAS & ASAM 6 Dimension scale have been added as a billable code.

b. American Society for Addiction Medicine (ASAM1) Six-Dimension Scale.

10. Utilize the Diagnostic and Statistical Manuel of Mental Disorders, Fifth Edition (DSM-5) and/or the International Classification of Diseases, Tenth Edition (ICD-10) for diagnoses and coding purposes.

C. Offeror shall provide time-sensitive data to showcase effectiveness of services as required by any grant funding that the BHSD receives.

D. Data Submission

1. Offeror shall collect and report data including the following as appropriate for the program:

a. Active Caseload/Length of Stay (LOS);

b. Units of Service (UOS) report;

c. Client to staff ratio;

d. Report on client readmission to the program;

e. Post-discharge placement/service(s) type, frequency, etc. report;

f. Outreach and Engagement Process report; and

g. Number of clients stepping down within the three phases of co-occurring treatment;

h. Number of clients who have successfully graduated from the program;

i. Number of clients who have obtained County/State benefits;

j. Number of clients who were linked to a primary care physician;

k. Number of clients who enrolled in educational/vocational programs;

l. Number of clients who became employed;

m. Number of clients who were not re-incarcerated; and

n. Other data reporting requirements as requested by the BHSD.

E. Offeror shall describe 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 shall provide details on how their organization shall use the County’s myAvatar system using one (1) of the following implementation types:

1. PCE with 837 billing;

2. 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 need for the particular program/contract.

IV. Outcomes and Measurements A. Offeror shall achieve the following outcome measurement methods:

1. Offeror shall provide monthly, quarterly, and annual reviews from the following data sources:

a. Client and Service Information (CSI) system;

b. County data system; and

c. Network Adequacy Certification Tool (NACT); and

d. Any outcome tools as identified and communicated by the BHSD.

B. Offeror shall administer the client feedback tool bi-annually (Client Satisfaction Survey).

C. Offeror shall initiate any other monthly, quarterly, and annual measurement tools and documents, which may include, but shall not be limited to Microsoft Excel and other formats as requested by the BHSD.

D. Offeror shall have a current behavioral health electronic health record (EHR) system with capability that meets the County’s standards or shall have a behavioral health EHR system in place upon start of contract. Offeror shall utilize the County-operated EHR for billing/reimbursement purposes.

E. Offeror shall provide a weekly status report on CAPS clients who have been released into the community to the BHSD Forensic, Diversion, and Reintegration (FDR) Division, as well as immediately following the occurrence of an incident and when additional client information is needed by the BHSD.

V. Program Description A. Service Description

1. The program shall provide the following services:

a. Care/treatment plan;

b. Individual, family, and group therapy;

c. Rehabilitation services (vocational readiness, education, and skills for activities of daily living);

d. Collateral services;

e. Medication support services;

f. Housing services;

g. Crisis intervention services;

h. Outreach services; and

i. Other applicable services.

2. Offeror shall collaborate with clients to formulate individualized treatment plans.

3. Offeror shall visit potential clients in custody to screen and determine the appropriateness of referral, engage the client in mental health treatment, and develop a therapeutic relationship.

4. Provide evidence-based services such as:

a. Cognitive Behavioral Therapy (CBT);

b. Trauma-Focused (TF-CBT);

c. Solution-Focused Brief Therapy;

d. Dialectical Behavior Therapy; and

e. Motivational Interviewing.

5. Provide treatment based on one of the following models specialized for justice-involved population:

a. Criminal Thinking;

b. Thinking for a Change;

c. Moral Reconation Therapy; and

d. Risk and Responsivity.

6. Offeror shall coordinate and secure safe housing for clients released from custody. Designated staff shall transport clients to safe community placements upon client release from custody.

7. Offeror shall assist clients in completing a Tuberculosis test for the purpose of timely access to housing placements.

8. Offeror shall transporting clients to and from medical, social security, and other appointments.

9. Offeror shall be present for clients who require additional support during scheduled court hearings to provide treatment updates/recommendations and gather information from the court on client’s justice status.

10. Offeror shall attend weekly Community Awaiting Placement Supervision (CAPS) Meetings in which clients are scheduled for release from custody.

11. Offeror shall ensure that clients have access to their psychotropic and physical health medications immediately upon release from custody.

12. Offeror shall conduct outreach to the client within twenty-four (24) hours of being remanded into custody to re-engage the client into treatment.

13. Offeror shall immediately submit an incident report to the BHSD when an event that causes or has the capacity to cause physical or psychological injury or has the potential for a claim or litigation to occur. When submitting incident reports, Offeror shall abide by BHSD Policy and Procedure #412-122: Outpatient Behavioral Health Services Department Incident Reports for Contract Operated Programs.

14. Offeror shall immediately notify the BHSD FDR Division when an incident involving a client occurs.

15. Offeror’s services shall abide by the Client Status Report (CSR) Policy and Procedure established by the BHSD.

B. Service Expectations

1. Offeror shall provide program services in accordance with the ordinances and resolutions of the County Board of Supervisors and the applicable policies, procedures, directors, and guidelines of the County, BHSD, and the County of Santa Clara Health System (“Health System”), including, but not limited to the BHSD Provider Manual and/or the BHSD policies and procedures.

2. Offeror shall ensure that Network Adequacy standards are met by ensuring that each of the outpatient services under the program shall be available within fifteen (15) miles or thirty (30) minutes from the clients’ established residency. Clients may opt to receive services from another provider outside the specified distance and time restrictions upon providing the BHSD with written authorization.

3. Offeror shall ensure that clients move through three (3) phases while in treatment. Offeror shall transition clients between the three phases based on their level of treatment need. These three phases of treatment are as follows:

a. Discovery & Engagement: intensive services due to clients’ low functioning, high risk status.

b. Building & Mastery: emphasis on wellness and recovery through peer support and psychoeducation.

c. Active Recovery: clients independently manage their medication and build their social connections.

4. Offeror shall ensure that their organization’s service plan shall meet Medi-Cal/CalAIM behavioral health requirements, including but not limited to:

a. Medical necessity criteria;

b. Documentation redesigns;

c. Co-occurring treatment;

d. Standardized screening and transition tools;

e. Behavioral health CPT coding transition; and

f. Payment reform.

C. Staffing Requirements

1. Staffing shall include a multidisciplinary team, including the following as appropriate for the program:

a. Psychiatrist;

b. Direct service staff, such as:

i. Licensed or associate social workers;

ii. Licensed Professional Clinical Counselors;

iii. Marriage and family therapists and interns;

iv. Social workers;

v. California Association of Alcoholism and Drug Abuse Counselor (CAADAC)

vi. Peer mentors;

vii. Rehabilitation counselors; and

viii. Other direct service staff, as appropriate.

b. Nursing staff and/or psychiatric nurse; and

c. Quality assurance staff.

2. Offeror shall ensure that the psychiatric and clinical staff required by the program are in place prior to the start of the program and shall remain available to provide services to the clients on an ongoing basis.

3. Offeror shall have staff who are appropriate trained and meet the qualifications of Licensed Practitioner of the Healing Arts (LPHA) as well as meet specific discipline requirements.

4. Offeror’s staff shall at least meet the licensing requirements as set forth in Title 9, Title 19, Title 22, and Medi-Cal Regulations. All staff working directly with clients shall follow State DCHS credentialing requirements.

5. Staff shall be specialized and experienced in working with justice involved clients.

6. Offeror’s staff shall meet the BHSD Co-Occurring Standards. The BHSD Co-Occurring Standards expect all paraprofessional and professional practitioners to have the minimal core skills and be trained according to the following three-core skill levels:

a. Co-Occurring Informed: This level of practice identifies the core skills needed to support treatment. The identified domains for this level are screening, engagement, readiness and retention, education, advocacy, and collaboration.

b. Co-Occurring Capable: This level of practice identifies the core skills needed to provide an integrated assessment and provide treatment to clients and families facing mild to moderate co-occurring disorders. The identified domains for this level are screening, assessment, diagnosis, and co-occurring capable treatment.

c. Co-Occurring Enhanced: This level of practice identifies the expertise needed to provide fully integrated treatment to clients and families challenged with moderate to severe co-occurring disorders. The identified domains are assessment, diagnosis, and integrated treatment.

7. Offeror’s staff shall participate in the Sexual Orientation and Gender Identify and Expression (SOGIE) 101 Training.

8. Offeror shall ensure that appropriate staff attend all system wide BHSD trainings and shall participate in all required trainings specific to the needs of the program.

9. Offeror shall document that all staff are qualified and trained in accordance with the licensing requirements and applicable regulations for this program.

10. Staff shall be trained and proficient in the following:

a. Principles of psychosocial rehabilitation and recovery processes;

b. Confidentiality;

c. Crisis intervention;

d. Knowledge of community resources, including self-help centers and ethnic community resources;

e. Sensitivity and awareness of language and cultural influences on the individual;

f. Understanding of the behavioral health system of care;

g. Understanding of the justice system;

h. Capacity to collaborate and coordinate with local providers of health and human services; and

i. Understanding of psychopathology and physical health problems within the context of clients’ culture.

11. Staffing shall be appropriate for the caseload, complexity, and scope of service.

12. Staffing shall be required to obtain jail clearance to conduct outreach to clients who are in custody.

13. Offeror shall provide quarterly staffing reports to notify the FDR Contract Monitor and FDR Division Director of staffing changes.

14. Offeror shall maintain practices related to recruiting, hiring, and promoting bi/multi-lingual staff and/or a culturally or ethnically diverse workforce. Offeror shall have training requirements related to diversity, equity, and/or inclusion (e.g., LGBTQ+, cultural and linguistic capacity, racial equity).

D. Cultural Competency

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

3. Offeror shall have a plan to address barriers when they do not have staff available to meet the six (6) Santa Clara County threshold languages (Spanish, Vietnamese, Mandarin, Cantonese, Tagalog, and Farsi) and a plan for actions and changes to ensure diversity and inclusion in service delivery.

4. Offeror shall provide outreach activities focused on reaching underserved, underrepresented, and/or multicultural populations. The outreach process shall take place in custody settings, psychiatric hospitals, or in the community, as appropriate.

E. Clinical Supervision

1. Offeror shall meet reflective supervision, reflective practice, and clinical supervision requirements as follows:

a. Submit a clinical supervision plan centered around EBPs and/or PPs;

b. Provide a consistent schedule and structured weekly reflective supervision to serve their staff regardless of licensure;

c. Conduct a workflow that is manageable for supervisors and attending to the ratio of no more than one to eight (1:8) supervisors to supervisees; and

d. Provide clinical supervision activities for review during monthly or bi-monthly providers’ meetings.

F. Referrals and Admissions

1. Offeror shall accept referrals that are generated through the BHSD Collaborative Court Staff, BHSD Reentry Resource Center staff, and other FDR providers. These may include referrals that are a result of:

a. Step downs from a higher level of care;

b. Step ups from a lower level of care;

c. Screenings completed by the BHSD Collaborative Court and BHSD Reentry Resource Center staff of clients that require an assessment based on Title 9 medical necessity criteria;

d. Referrals from other Counties for clients that have benefits with Santa Clara County; and

e. Referrals from Adult Custody Health, the Probation Department, the Parole Department, the Pretrial Department, and other justice partners as determined appropriate by the BHSD FDR Division.

2. Offeror shall accept referrals five (5) days per week, during regular scheduled business hours.

3. Offeror shall ensure that referrals which fail to meet the criteria for behavioral health services or that need a different level of care, shall be directed and linked by the program to appropriate alternative resources or another provider.

4. Offeror, at the request of the client, shall initiate a transfer to a clinic of the client’s choosing as soon as there is availability at that clinic, per P&P 412-330.

5. If a client has or is suspected to have Autism Spectrum Disorder/Intellectual Developmental Disability but is not connected to San Andrea Regional Center (SARC), Offeror’s staff shall request collateral information from school, attorney, and/or doctor upon obtaining a signed Release of Information (ROI) to provide linkage to SARC and/or additional community resources.

6. Offeror shall provide status update(s) on particular clients to coordinate care and service linkages between County clinics, County-contracted providers, and other Health System resources, at the request of the BHSD. Offeror shall designate primary and alternate management positions to coordinate all referrals and discharges.

G. Care Coordination

1. Offeror shall adhere to the following care coordination guidelines:

a. Offeror shall utilize EBPs, PPs, and/or trauma informed practices whenever clinical indicated and based on each client’s diagnosis. EBPs and PPs recommended for FDR programs include, but are not limited to the following:

i. Motivational Interviewing;

ii. Cognitive Behavioral Therapy (CBT);

iii. Trauma-Focused CBT (TF-CBT);

iv. Solution-Focused Brief Therapy;

v. Dialectical Behavioral Therapy; and

vi. Integrated co-occurring disorder practices and peer supports such as Wellness Recovery Action Planning.

b. Offeror shall use following modalities for the justice-involved clients:

i. Thinking for a Change;

ii. Moral Reconation Therapy; or

iii. Risk and Responsivity.

c. Review each client’s status and progress towards planned goals annually to determine possible discharge planning and/or step down to a non-justice focused program. Offeror shall rewrite clients’ goals as necessary to match the level of care needed.

d. Provide client injection(s) and related medication management services as necessary in the outpatient clinics.

e. Link clients to community-based resources as well as primary care services.

f. Communicate with clients and their families to ensure comprehensive and consistent care, good communication with system partners and other serving agencies, and/or institutions involved in service delivery.

g. Co-Occurring substance use treatment shall be based on harm reduction principles. If Offeror is unable to provide this treatment specialty within their scope, a referral to appropriate services shall be facilitated and collaboration between Offeror and the new provider(s) shall address any co-occurring treatment needs.

H. Program Hours of Operations

1. Offeror shall be open for services during regular office hours Monday through Friday, and for forty (40) hours per week, with after-hours services available to accommodate clients requiring evening and weekend appointments as well as crisis outpatient services available twenty-four (24) hours a day, seven (7) days a week to address the emergency needs of clients under the program.

2. Offeror shall ensure that their 24-hour coverage plan shall be on file with the BSHD Division Director. Offeror shall provide an updated agency plan for 24-hour coverage to the BHSD Division Director and the BHSD Program Monitor for approval prior to implementation at the beginning of each new fiscal year and when any changes to this plan occur.

3. During holidays, Offeror shall maintain an minimum a skeleton crew that shall facilitate the processing of referrals coming from the BHSD Reentry Center or the Collaborative Courts, provide crisis coverage, and initiate Lanterman-Petris-Short (LPS) protocols.

I. Evaluations, Transitional Planning, and Discharge

1. Clients shall be discharged by Offeror when a client meets at least one (1) of the following criteria:

a. Upon successful graduation from the justice system, which shall include linkage to other levels of care when a referral to ongoing mental health services as needed;

b. Upon mutual agreement between the client and the treatment team that the treatment goals have been met;

c. Upon a good faith determination by Offeror that the individuals cannot be effectively served by the program and will be linked to other appropriate services that meet the needs of the individual;

d. Long-term incarceration;

e. Upon client unilateral decision to terminate treatment against medical advice;

f. Upon transfer to a lower level of care or another mental health provider;

g. Upon transfer to another County health program, in which Offeror shall comply with a Feedback Loop Process to ensure that referral sources are notified of the status of the referral, provided the appropriate sections of the assessment, and informed of outcomes and/or next steps;

h. Upon notification of client admission into an institutionalized setting (e.g., Institute of Mental Disorder [IMD], Mental Health Rehabilitation Center [MHRC], or locked Skilled Nursing Facility [SNF]) with the BHSD 24-hour Care Team re-assigning the client to outpatient services as appropriate;

i. When the client no longer meets Medi-Cal medical necessity criteria; and

j. When the client is not engaged and not responsive after thirty (30) days of persistent efforts to locate them and following all County policies and procedures.

2. Offeror shall transfer clients who have graduated from the program to lower-level care, such as non-justice focused programs or Primary Care Behavioral Health.

3. Offeror shall facilitate transitions to other agencies for additional or specialized support for clients requiring higher levels of care, such as Full Service Partnership (FSP) or Forensic Assertive Community Treatment (FACT).

4. Offeror shall take all reasonable steps to avoid unnecessary discharges.

5. All discharges shall be accompanied with a discharge summary.

VI. 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 B12 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;

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 relating to COVID-19.

1. If applicable, Offeror shall complete the Attachment E, Contractor Certification of Compliance with COVID-19 Vaccine Requirements (“Certification”) upon successful contract negotiations. For staff who routinely perform services for the County onsite and share airspace with or proximity to other people at a County facility as part of their services for the County, including but not limited to vaccination, as applicable and periodically updated, and available at https://procurement.sccgov.org/doing-business-county/contractor-vaccinations and incorporated herein by this reference.

RFSQ-BHS-FY23-0210: Adult and Older Adult System of Care Services Page 1 of 3 ATTACHMENT A12: Adult and Older Adult Outpatient Continuum Services - Justice Involved Scope of Work CATEGORY 2: Outpatient Services