Attachment A14.docx

ATTACHMENT A14

CATEGORY 3: FULL SERVICE PARTNERSHIP SERVICES

CROSS SYSTEMS INITIATIVE FULL SERVICE PARTNERSHIP

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 designing and operating a Full Service Partnership (FSP) program (hereafter referred to as “the program”) for clients with severe mental illness (SMI) and co-occurring disorders[footnoteRef:2]. [2: Clients require both mental health and substance use treatment services.]

B. The program shall provide intensive, wraparound services that are recovery-orientated, client-driven, culturally and linguistically responsive, trauma-informed, and co-occurring capable. Services intend to be “full service” in that the program does “whatever it takes” to support a client in their recovery process twenty-four (24) hours per day, seven (7) days a week.

C. The program shall provide a full spectrum of community services necessary to attain the goals identified in each client’s Problem List and/or Personal Service Plan (PSP), as well as any services considered necessary through collaborative planning between the County, client, and/or client’s family to address unforeseen circumstances in the client’s life to include in their PSP, including crisis intervention. The PSP incorporates symptom and quality of life goals that reflect the clients’ cultural values, which may have living arrangements, social supports, education, and employment.

D. The program shall be a step-down level for clients that either complete the Assertive Community Treatment (ACT) or Assisted Outpatient Treatment (AOT) programs or require more structured and comprehensive care due to worsening psychiatric symptoms that cannot be treated using standard outpatient treatment models.

E. The FSP team shall have access to "flex" funds that can be used for personal needs to assist the clients who do not have funds for such services not provided or paid for by Medi-Cal in achieving successful outcomes of their PSP. The services program identified shall be low cost or no cost and directly tied to the clients’ Problem List and/or PSP.

F. The program shall provide comprehensive services for clients experiencing psychiatric problems managed by attending two (2) or more days a week of structured, supportive treatment that is flexible hours in duration. The services include but are not limited to client/group therapy, psychiatric evaluation and medication management, psychological/psychosocial assessment, and other services, including transportation, if necessary, with flex funds.

G. The program is funded through the Community Services and Supports (CSS) component of the Mental Health Services Act (MHSA).

II. Operational and Logistical Requirements A. Offeror shall have current Medi-Cal and Medicare certification or become Medi-Cal and Medicare certified to provide Medi-Cal reimbursable services on or before the contract start date.

III. Background Information A. The program originated from the Assembly Bill (AB) 2034 Model (Wraparound Program), which combines a recovery-oriented behavioral health services treatment approach with a harm reduction and housing support model.

IV. Target Population A. The program shall serve high-risk, unserved, and underserved adults (ages 26 through 59) and older adults (age 60 and above) who are residents of Santa Clara County. Clients shall meet the following prerequisites, including but not limited to:

1. Have full-scope Medi-Cal benefits based in Santa Clara County (County 43) or be uninsured;

2. Diagnosed 8A Main Jail Admissions” (County Main Jail Complex Mental Health, 8th Floor)

3. Possess a history of being hospitalized for mental health-related difficulties, but can function in the community with wraparound services upon discharge, for two (2) to four (4) times within the last twelve (12) months in an acute/long-term psychiatric facility, including but not limited to:

a. Emergency Psychiatric Services (EPS);

b. Institutions of Mental Disease (IMD);

c. Mental Health Urgent Care (MHUC); and/or

d. Psychiatric Inpatient Hospital County Contracted/Fee for Service (FFS) Hospital, where clients have had two (2) or more hospitalizations totaling at least twenty-five (25) days within twelve (12) months.

4. Have a major psychiatric condition and demonstrate a need for intensive case management services by virtue of their history and current level of functioning;

5. Difficulty to engage in services from acute and long-term institutional levels of care (e.g., locked facilities), but the ability to succeed in the community with sufficient structure and support;

6. At risk of out-of-home care;

7. Experience reductions in personal and/or community functioning;

8. Experience with unsuccessful community placement due to lack of engagement, lack of available intensive and comprehensive services, or utilization of various services without demonstrated improved outcomes;

9. Poor adherence to medication treatment, medical complications, patterns of substance and prescription drug use, co-occurring medical disorder and cognitive difficulties which would not hinder them from benefiting from psychiatric services; and/or

10. Meet medical necessity criteria in accordance with all laws and regulations governing Medi-Cal and Medicare programs mandated by Federal, State, and Local statues, including but not limited to:

a. California Code of Regulations (CCR) Title 9 and Social Security Act Title XXII Regulations;

b. State of California Department of Health Care Services (DHCS) Certification Standards - https://www.dhcs.ca.gov/provgovpart/Pages/MH-Licensing.aspx; and

c. State of California Department of Social Services (CDSS) Community Care Licensing (CCL) Standards - www.cdss.ca.gov.

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

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

a. Assess for co-occurring disorders (mental health and substance use) in clients requiring specialized services due to complex risk factors (e.g., abuse/violence, homelessness, substance use, psychological trauma, and intergenerational impacts of incarceration);

b. Improve psychological functioning of clients using a strengths-based recovery model to stabilize symptoms and return to community-based services;

c. Facilitate wellness and recovery services and reduce clients’ subjective suffering from mental illness and complex life stressors unique to them;

d. Facilitate the increase of meaningful use of clients’ time and capabilities in school, work, and age-appropriate activities to support a sense of connection and self-worth;

e. Educate clients, families, and significant others about mental health and co-occurring disorders (mental health and substance use) and how to manage/cope with their illness(es) using the principles of recovery and wellness;

f. Empower clients to take responsibility and accountability for their wellness and recovery to reduce unnecessary stays in psychiatric hospitals, emergency room visits, and jail settings while producing similar outcomes to those in institutional care;

g. Decrease negative outcomes such as mental health stigma, incarceration, hospitalization, and homelessness; and

h. Increase the use of psychotropic medication and other means of symptom reducing strategies by increasing education among clients/families.

2. Objectives shall be achieved by:

a. Offeror shall create and maintain a therapeutic community/setting that places an expectation on clients to participate in the day-to-day activities, such as social/interpersonal skills;

b. Offeror shall engage and encourage clients to participate in therapeutic activities, assessments, and/or linkage services that would facilitate a reduction in jail days/recidivism rates and/or psychiatric inpatient admissions, including EPS and Emergency Department (ED) encounters;

c. Offeror shall provide and facilitate psycho-educational sessions/groups to increase clients’ understanding of the importance of medication adherence and effectiveness;

d. Offeror shall improve client access to medical and dental healthcare;

e. Offeror shall encourage clients to actively participate in their recovery and self-monitor their milestones and goals toward self-determination, family, and vocational education, and recreation services;

f. Offeror shall administer culturally and linguistically proficient client-centered services that integrate or directly provide the full range of treatment modalities and rehabilitation services and resources to meet clients and their families need in their recovery process; and

g. Offeror shall successfully step-down clients into appropriate behavioral health outpatient programs to maintain ongoing recovery. This includes facilitating a warm hand-off with the clients’ assigned outpatient treatment providers.

VI. Reporting and Data Collection Requirements A. Offeror shall comply with all reporting requirements including, but not limited to:

1. California Welfare and Institutions Code (WIC), Divisions 1 and 5;

2. California Code of Regulations (CCR) Title 9 (State Department of Mental Health Social Rehabilitation and Medi-Cal Rehabilitation Option); and

3. California Department of Health Care Services (DHCS) Data Collection & Reporting System (DCR). The DCR allows for data and evaluation to be done regarding the effectiveness of FSP services being provided and the achievement of outcome measures. Offeror shall submit the following three (3) different types of Partner Assessments to the DHCS online interface through the FSP DCR system:

a. The Partnership Assessment Form (PAF) gathers baseline information about the client.

i. Upon initial admission to an FSP or re-establish FSP services if there has been more than one (1) year of discontinued FSP services; and

ii. No later than thirty (30) days upon client admission.

b. The Key Event Tracking (KET) records significant changes pertaining to education, living arrangements, legal issues, and emergency intervention.

i. PAF shall be completed before completing a KET; and

ii. Within five (5) days after a key event occurs during client treatment.

c. The Quarterly Assessment (3M) gathers follow-up information on the clients’ area of strength, need, and treatment focus.

i. PAF shall be completed before completing a 3M;

ii. 30 days before or after OR two (2) weeks before the due date and up to thirty (30) days after the due date; and

iii. Thirty (30) days prior or thirty (30) days after a client quarterly assessment is due.

B. Offeror shall ensure adherence to DCR policies and procedures established by BHSD.

C. Offeror shall be responsible for the completion and submission of data, including the following as appropriate for the program:

1. Client Perception/Satisfaction Surveys.

2. Data Required by County System.

3. DLA20/MORS data.

4. Client and Service Information (CSI) Data.

5. Capacity data for BHSD Adult and Older Adult Division.

6. Outreach and engagement services data; and

7. Other data reporting requirements as determined by BHSD.

D. 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. 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.

VII. Outcomes and Measurements A. Offeror shall achieve the following outcomes:

1. Demonstrate ability to successfully transition clients back into the community outpatient services or other lower levels of care;

2. Improve emotional and behavioral functioning and ability to participate in meaningful activities;

3. Increase number of clients maintaining housing stability to decrease homelessness;

4. Decrease number of psychiatric hospitalizations, emergencies, or crisis;

5. Decrease incarceration and jail contacts;

6. Improve access and engagement for clients from unserved or underserved communities who are experiencing their first mental health episode;

7. Increase number of clients engaged in educational and vocational activities;

8. Increase social relationships and natural support system; and

9. Increase positive client service experience.

B. Offeror shall achieve the following outcome measurement methods:

1. Develop a process to systematically monitor and analyze the performance of each targeted outcomes described in Section VI.A.1-9;

2. Use evidence-based assessments/tracking tools that monitor clients’ goals and recovery;

3. Track trends in EPS, ED, acute psychiatric inpatient and/or jail admissions; and

4. Track client service experience.

C. Offeror shall achieve data submission guidelines by following the County’s data reporting requirements described in Section VI above.

VIII. Program Description A. Service Description

1. Offeror shall be prepared to meet complex needs of clients, including providing intensive care coordination, crisis response, and case management. Offeror shall describe their plan to provide comprehensive and coordinated care to enhance the well-being of adult clients with severe mental illness, physical limitations, and co-occurring conditions.

2. Offeror shall provide direct home-based and community-based services, including crisis support, individual, family, group services, social skills building, independent living skills, school support, family environment support, advocacy, and ongoing service coordination/case management.

3. Offeror's site shall be considered the home base for FSP staff; though, most services shall be delivered in the community or meet the client wherever they are (e.g., school, home, homeless shelter, etc.) fifty through sixty percent (50-60%) of the time.

4. Offeror shall provide any client services qualified and appropriate for telehealth services, and necessary technology equipment (e.g., cellphone), including offering training as needed.

5. Offeror shall ensure clients have a psychiatric appointment and access to psychotropic and physical health medications as prescribed when discharging from inpatient or any other institution.

6. Offeror shall ensure clients Community placements are available before the discharge from inpatient or any other institution.

7. Offeror shall ensure the following services are provided, including but not limited to:

a. Engage clients twenty-four (24) hours, seven (7) days a week who have not benefitted from regular FSP services due to complex risk factors including substance use, community violence, interpersonal family violence, and exposure to psychosocial trauma;

b. A written plan on how the organization shall ensure clients obtain oral and/or injectable medications, including medication orders from the designated physician(s) providing psychiatric services and making arrangements with a local pharmacy;

c. Medication monitoring and screening for medical complications;

d. Client psychoeducation;

e. Enter services provided in the client case record;

f. Case management and housing flex funds; housing assistance may include rental subsidies, board and care home, rehabilitation program, and other as necessary to maintain stability;

g. Transportation supports for community placements and scheduled appointments (e.g., behavioral health, medical, dental, social security appointments, etc.); and

h. Participate in monthly or bi-monthly FSP provider network meetings facilitated by the BHSD Program Monitor (FSP team). The meeting format is to address FSP programming needs, referral issues, system challenges/successes, and/or consultation regarding any FSP quality improvement needs.

8. Offeror shall provide program services in accordance with the ordinances and resolutions of the County Board of Supervisors, applicable policies, procedures, directives, and guidelines of the County, BHSD, and the County of Santa Clara Health System.

9. Offeror shall ensure the organization service plan shall meets 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.

B. Older Adult Specific Services

1. Offeror shall provide services with consideration to age-related issues that compound psychiatric condition, resulting in low functioning, high-risk of hospitalization, and loss of independence such as:

a. Physical impairments that require home visits;

b. Cognitive dysfunction;

c. Linkages to medical services needed;

d. Stigma against using mental health services;

e. Effects of prescription drugs and substance use;

f. Self-neglect;

g. Potential physical, psychological, or fiduciary use; and

h. Isolation and inability to perform daily living activities.

C. Evidence Based Practices and Intervention Strategies

1. Offeror shall utilize Evidenced-Based Practices (EBPs), Promising Practices (PPs) and/or Community-Informed Practices, as clinically indicated to address each client identified behavioral health and psychosocial needs. Offeror shall describe the client age-specific EBPs, PPs, and trauma-informed practices utilized.

2. Offeror shall describe the organization’s capacity, including staff training, certifications, experience, and outcomes, in using EBPs including but not limited to:

a. Cognitive-Behavioral Therapy (CBT);

b. Dialectical Behavior Therapy (DBT);

c. Trauma-Informed Approaches;

d. Stages of Change;

e. Integrated Co-Occurring Disorder Practices; and

f. Motivational Interviewing (MI).

D. Staffing Requirements

1. FSP teams shall be available to clients twenty-four (24) hours a day, seven (7) days a week.

2. Offeror shall request for new staff training on the State Online DCR System to ensure a seamless transition and continuity of services. Training can be requested from the BHSD. Additionally, any State provided DCR trainings shall be attended by an agency representative.

3. Offeror shall ensure staff is trained in EBPs and can track the practice fidelity and client outcomes of all EBPs utilized in program services.

4. Offeror shall maintain adequate staffing for the program, including the following as appropriate for the program: licensed or license-eligible clinicians, Licensed Professional Clinical Counselors, psychiatrists/prescribers, personal service coordinators, case managers, rehabilitation counselors, housing specialists, employment specialists, substance use specialists, peer support staff, and nursing staff. The psychiatrist, clinical staff, and peer support staff are required positions for the program and shall be in place before startup and remain available at all times to provide services to the clients on an ongoing basis.

5. Offeror shall describe existing staff providing the services and program components described in this RFSQ.

6. Offeror shall provide a personnel retention plan for the program, which includes a current list of program staff within the organization, their credentials, bilingual language capacity, and the length of time the employee has been with the organization.

7. Offeror shall describe their plan to recruit and maintain appropriate staffing to meet the diverse population of Santa Clara County.

8. Offeror shall provide the approximate percentage turnover of the program’s direct service staff over the past three years. Offeror shall also describe how the organization shall provide continuity of care for families during staff turnover.

9. Offeror shall describe their ability to meet BHSD Co-occurring Standards and include a staffing table indicating each staff rate as to whether they would be co-occurring informed, co-occurring capable, or co-occurring enhanced. Offeror shall justify the rating (certifications/ training/ expertise, etc.). BHSD Co-Occurring Standards expects all paraprofessional and professional practitioners to have minimal core skills and be trained according to the following skill levels: co-occurring informed, co-occurring capable, and co-occurring enhanced.

10. Offeror shall have appropriately trained staff and meet the qualifications of Licensed Practitioner of the Healing Arts (LPHA) and specific discipline requirements necessary to provide services in this RFSQ. Staffing shall be provided at the minimum licensing requirements as outlined in Title 9, Title 19, and Title 22 of Medi-Cal Regulations.)

11. Offeror 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).

E. 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 of 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. The program shall be reflective of the ethnic, cultural, and linguistically diverse populations of the County and preferences of each client.

3. Offeror shall submit a Cultural Competency Plan to BHSD Program Monitor. Offeror shall provide in detail their organizational staff competency in working with the target population, trauma-exposed, and those who identify as LGBTQ+.

4. 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.

5. Offeror shall have a plan to address barriers when they do not have staff who are proficient in the six (6) Santa Clara County threshold languages: Spanish, Vietnamese, Mandarin, Cantonese, Tagalog, and Farsi.

6. Offeror shall have a plan for actions and changes to ensure diversity and inclusion in service delivery.

F. Referrals and Admissions

1. Referrals shall be generated through the BHSD Call Center using admission criteria or determined by the twenty-four (24)-Hour Care Liaison or BHSD Program Monitor. These may include referrals for:

a. Step-downs from acute care inpatient facilities or Institute of Mental Disease (IMD);

b. Referrals from mobile crisis teams, In-Home Outreach Teams, or other County-contracted providers;

c. Client mental disorder results in substantial functional impairments or symptoms or without treatment there is an imminent risk of decompensation with substantial impairments based on the client’s psychiatric history (e.g., client is likely to become so disabled and require public assistance, services, or entitlements);

d. Client is at risk of involuntary hospitalization or institutionalization or has experienced a first episode of severe mental illness;

e. Client is frequent user of hospital or emergency room services as the primary resource for mental health treatment;

f. Client is generally engaged at some level with the mental health system and natural supports but is minimally to moderately coping;

g. Client is underserved and at risk of one of the following:

i. Homelessness;

ii. Involvement in the justice system; or

iii. Institutionalization.

2. At the request of the client, all outpatient transfers shall be initiated by the County-contracted providers and coordinated with BHSD Call Center and/or other BHSD divisions such as Forensic, Diversion and Reintegration (FDR) Division, for screening and determination of appropriateness using admission criteria.

3. Level I referrals from the BHSD Call Center shall be initiated within twenty-four (24) hours of receipt; clients shall be seen within five (5) business days.

4. Level I referrals from the BHSD Call Center shall be exempt from the thirty (30) day outreach service as it shall be immediate and within five (5) business days.

5. Non-Level I referrals shall be initiated within twenty-four (24) hours and comply with BHSD guidelines for engagement within ten (10) days from clients’ initial request of services.

6. Referrals that do not meet the criteria for this level of care shall be redirected and linked to appropriate and alternative resources by the referring agency.

7. Offeror shall comply with a feedback loop process to ensure referral sources and BHSD Program Monitor are notified of the referral status and next step recommendations.

8. Offeror shall provide the BHSD Call Center a set weekly number of intake slots by entering the Google doc data system capacity no later than noon each Friday.

9. Offeror shall note when additional intake slots are required based on a review of the contracted number of caseloads, and/or units of service that fall below the contracted numbers and levels.

10. During an agency closure (e.g., holiday), Offeror shall identify a point of contact to receive referrals from the BHSD Call Center to meet all timely access requirements for clients.

11. Offeror and BHSD Program Monitor shall work closely together to monitor capacity and contracted caseloads. Based on trends and need for additional program capacity, Offeror may submit a program modification request for review and consideration.

G. Care Coordination

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

a. Due to client involvement in various systems, FSP teams shall work with these systems, including participating in multidisciplinary meetings to support this vulnerable population, address communication barriers between systems, and develop collaborative structures to make treatment more accessible.

b. Offeror shall provide continuity of care during inpatient episodes and incarcerations, if they occur, including acute care and after-care planning. Contacts and supports shall continue with FSP clients admitted to local hospitals or locked facilities to ensure the FSP teams maintain a connection to help their transition back to the community.

c. Offeror shall provide care coordination and help the target population transition from institutionalized care to another care level or other service providers. Offeror shall underscore the feedback loops that would occur to support care coordination for clients; a thorough assessment shall determine the client’s length of stay at IMD and jail for closure after ninety (90) days.

d. Crisis intervention is an essential aspect of the program that enhances clients' safety and wellness and reduces/prevents hospitalizations or institutionalized care. Being available by phone and other means is deemed clinically appropriate and a significant part of treatment. Offeror shall explain how their organization would provide the infrastructure and support necessary to support this service to meet 24/7 crisis needs, including medication support, to promptly mediate the crisis and indicate a plan to respond in-person when clinically appropriate.

H. Program Hours of Operations

1. Regular office hours shall be Monday through Friday, with a minimum of forty (40) hours per week.

2. Crisis services shall be available twenty-four (24) hours daily to address the emergency needs of the clients, with the professionals and psychiatric staff available to address the clinical needs of the clients as needed.

3. Offeror shall provide an updated agency plan for twenty-four (24) hour coverage to the BHSD Division Director for approval at the beginning of each new fiscal year and when any changes to this plan occur prior to implementation.

4. During holidays, Offeror shall maintain, at minimum, a skeleton crew that shall facilitate the processing of referrals coming from the BHSD Call Center, twenty-four (24)-Hour Care unit, crisis coverage, and the ability to initiate Lanterman-Petris-Short (LPS) protocols.

I. Evaluations, Transitional Planning, and Discharge

1. The FSP team shall review the clients’ status and progress towards planned goals annually to determine possible discharge planning/step down to less intensive services or re-write the clients’ intent to address an immediate need.

2. Offeror shall facilitate client transitions to other agencies for additional or more specialized support (e.g., higher care levels, such as Crisis Residential Services).

3. Offeror shall transfer clients who have graduated from the program to other appropriate services, such as Outpatient and Supportive Housing Services, based on the client’s level of care need.

4. Clients shall be discharged when they meet any of the following criteria:

a. Upon mutual agreement by the client and therapist for the successful completion of the program;

b. Upon good faith determination from Offeror the program cannot effectively serve the client;

c. Upon transfer to a lower level of care or other mental health provider;

d. Upon transfer to another BHSD division (e.g., FDR, AOA, etc.), Offeror shall follow the appropriate steps to link clients to other services;

e. Client no longer meets Medi-Cal medical necessity criteria; and/or

f. Client is not engaged and unresponsive to follow-up for more than three (3) months after persistent efforts to locate them, following all County policies and procedures.

J. Client Satisfaction Surveys

1. Offeror shall implement County-wide client satisfaction/perception surveys to improve services delivery process and operations. The BHSD Decision Support unit may be involved in overseeing the distribution, collection, and results in processing and distribution.

IX. 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 B14 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 will 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 A14: Cross Systems Initiative Full Service Partnership Scope of Work CATEGORY 3: Full Service Partnership Services