Attachment A16.docx

ATTACHMENT A16

CATEGORY 3: FULL SERVICE PARTNERSHIP SERVICES

ASSERTIVE COMMUNITY TREATMENT

Scope of Work

Purpose The County of Santa Clara (County) Behavioral Health Services Department (BHSD) is seeking statements of qualifications from qualified Offerors interested in operating an Assertive Community Treatment (ACT) program (hereafter referred to as “the program”) for eligible County residents. ACT is an evidence-based behavioral health program for clients with a serious mental illness who are at risk, would otherwise be served in institutional settings (e.g., hospitals, jails/prisons), or experience homelessness.

The Program shall be Dual Diagnosis Capable (DDC) and provide the highest level of outpatient services with the intent of promoting recovery, reintegrating clients into the community, and reducing incarceration and/or hospitalization. Services shall include, but are not limited to, the following:

Mental health services;

Medication support;

Case management;

Crisis intervention;

Outreach and engagement;

Housing support;

Substance use treatment for clients with co-occurring disorders[footnoteRef:2]; [2: Clients require both mental health and substance use treatment services.]

Educational and vocational services; and Rehabilitative services.

Medi-Cal Certification Offeror shall have current Medi-Cal certification or become Medi-Cal certified to provide Medi-Cal reimbursable services on or before the contract start date.

Target Population The Program shall serve adults (ages 18 through 59) and older adults (age 60 and over) with severe and persistent mental health and/or co-occurring conditions that result in substantial functional impairments or symptoms. Due to the recalcitrant nature of their symptoms, these clients are more likely to experience a high utilization and repetitive cycle of incarceration, homelessness, substance use, crisis, and/or hospitalization.

Clients served must meet Medi-Cal medical necessity criteria in accordance with all laws and regulations governing Medi-Cal and Medicare Programs mandated by federal, state, and local statutes. Clients served must have Medi-Cal benefits designated to County 43 (Santa Clara County) or be uninsured. Program staff shall assist any uninsured clients with applying for Medi-Cal benefits and gaining access to an income source (e.g., General Assistance [GA], Supplemental Security Income [SSI], etc.).

Clients may present with the following:

A primary psychiatric diagnosis of Schizophrenia; Schizoaffective Disorder; Bipolar Disorder; or Major Depressive Disorder with Psychotic Features;

Significant functional impairment(s) demonstrated by at least one (1) or more of the following:

Inability to consistently perform practical activities of daily living required for basic adult functioning in the community without significant support or assistance from others;

Inability to be consistently employed at a self-sustaining level;

Inability to maintain a safe living situation due to multiple evictions or loss of housing; or High service needs with no indication that other available community-based services can equally or more effectively meet the client’s needs, demonstrated by two (2) or more of the following:

i. Difficulty in participating or succeeding in traditional, office-based outpatient services; and/or

ii. High use of acute psychiatric hospitals (five [5] to six [6] hospitalizations per year, or sixty [60] days of inpatient hospital days).

Persistent severe symptoms, such as psychosis, suicidality, or significant impulse control issues resulting in high-risk and frequent utilization of emergency psychiatric services, emergency departments, urgent care, or jails;

Co-occurring mental health and substance use disorders with a minimum duration of six (6) months;

Residing in a locked institution, such as a State Hospital or Institute of Mental Disease (IMD), but clinically assessed to be able to live in a more independent setting if intensive community services are provided;

Currently living independently but clinically assessed to be in need of a more restrictive living situation, such as a community residence, psychiatric hospital, or IMD if intensive community services were not available;

Current conditions cannot be safely, efficiently, and effectively assessed and/or treated in a less intensive level of care; and/or Have low illness management and recovery skills, including poor adherence to medication, and at increased risk of premature death resulting from suicide or physical illness.

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

Goals shall include, but are not limited to, the following:

Decrease symptoms of mental illness and co-occurring substance use;

Increase access to primary health care services;

Meet basic needs and enhance quality of life in daily living activities;

Improve socialization and development of natural supports;

Reduce incarceration, acute inpatient hospitalization, homelessness, and institutionalized care;

Reduce experiences of crisis, violence, and victimization;

Strengthen recovery, self-sufficiency, and other psychosocial outcomes, including housing, education, employment/income, and access to entitlement benefits; and Increase reintegration into community life with a focus on stability, particularly in the area of symptom management and reduction of harmful behaviors and suicide.

Objectives shall be achieved by:

Identifying issues including, but not limited to mental health, co-occurring, and physical conditions/disabilities;

Increasing mental health and/or substance use treatment retention through outreach and engagement efforts;

Decreasing service fragmentation;

Utilizing results of client satisfaction surveys;

Identifying and assisting clients with housing needs;

Providing access to peer support staff who shall assist clients in modeling personal recovery;

Increasing educational and employment opportunities;

Identifying suicide risk and impact of trauma;

Identifying the risk to re-offend; and Providing culturally and linguistically proficient client-centered services that integrate the full range of treatment and rehabilitation modalities, which are key to the ACT Model and shall assist clients in their recovery process.

Reporting and Data Collection Requirements The Program 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.

Mental Health Service Act regulations require counties to collect outcome data per CCR Title 9 § 3620.10 and submit it to the State within ninety (90) days per CCR Title 9 § 3530.30. Counties submit data for three (3) different types of assessments into the state Data Collection and Reporting (DCR) system through an online interface:

The Partnership Assessment Form (PAF);

The Key Event Tracking (KET); and The Quarterly Assessment (3M).

The Program shall develop a process to systematically monitor, analyze, and improve the performance of the program which shall support clients in achieving treatment outcomes.

The data collection process shall provide information relevant to specific treatment outcomes which may include, but not be limited to:

Number of clients referred;

Number of clients who were successfully outreached/engaged into treatment;

Number of clients enrolled who were retained in services and for what duration;

Number of clients who obtained medical benefits;

Number of clients who obtained a steady source of income;

Number of clients who maintained stable housing;

Number of clients enrolled in educational/vocational Programs;

Number of clients who graduated to less intensive services;

Number of clients not re-incarcerated; and Other categories as deemed necessary by the BHSD.

As part of the data collection process, the program shall complete forms provided by the BHSD for a baseline assessment. Forms shall be completed begin within thirty (30) days of admission and updated in six (6) month intervals. These forms shall be part of the program’s regular assessment and service planning process.

The Program shall analyze data to identify trends, verify goal achievement and service quality, and the impact of corrective actions at six (6) month intervals (consistent with the required assessment and service planning process). The analysis shall also be used as a bench measure for the program to review client progress in achieving outcomes and to make decisions regarding organizational performance improvement.

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 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:

Provider Connect Enterprise (PCE) with 837 billing;

Provider Connect NX (PCNX) with 837 billing;

PCNX non-837 billing with fast service entry claims submission; or Solely client information without billing, if no EHR billing is needed for the particular Program/contract.

Outcomes and Measurements Offeror shall achieve the following outcomes:

Improved adult stability and decreased incarceration and psychiatric hospitalization.

Improved Milestones of Recovery Scale (MORS) and/or Daily Living Activities Functional Assessment (DLA-20) scores for all clients.

Demonstration of a positive client service experience.

Offeror shall achieve the following outcome measurement methods:

The Program shall evaluate client/family satisfaction as it pertains to quality of care/services, and use data collected to continually improve services.

Reports shall be utilized to collect and track each client’s progress. The Program shall have electronic health record capabilities that meet the County's standards prior to the start of service delivery and provide monthly, quarterly, and annual reports from the following data sources:

Client and Service Information (CSI) system;

County Data System (myAvatar);

DCR system (PAF, KET, and 3M data);

Vulnerability Index-Service Prioritization Decision Assistance Tool (VI-SPDAT);

MORS or DLA-20; and Other data reporting requirements as requested by BHSD.

Program Description Program Operations The Program shall provide services in accordance with fidelity as defined by the Dartmouth Assertive Community Treatment Scale (DACTS).

The Program shall utilize a multidisciplinary team (Team) approach by which clients are the responsibility of the collective Team, and all members shall be expected to know and work with all ACT clients.

Although the physical Program location shall be considered the home base for Program staff, it shall be expected that eighty through ninety percent (80%-90%) of outreach and services be delivered in the community (e.g., jail, school, home, homeless shelter, etc.).

Teams shall be expected to be persistent and utilize a variety of methods to engage clients who may initially refuse or be reluctant to receiving services. Clients referred to the program shall receive outreach services for a period not to exceed ninety (90) days in order to assess their desire and readiness to enter into a partnership with the program. For clients in restricted/locked facilities, outreach and engagement shall be facilitated as part of discharge planning and engagement should begin no more than thirty (30) days prior to the anticipated discharge date.

Clients accepted into the program shall be eligible to receive services on a no time limit basis that is available 24-hours per day, seven (7) days per week and 365-days per year. Service intensity is dependent on need and can vary from once weekly to several contacts per day. On average, clients shall receive four (4) weekly contacts with two (2) of those contacts being face-to-face. This flexibility allows the Team to quickly ramp up service provision when a client exhibits signs of decompensation prior to a crisis occurring.

Teams shall have the ability to demonstrate basic core competencies in designated areas of practice, including ACT core processes, integrated mental health and substance abuse treatment, supported education employment, family psychoeducation, and wellness self-management.

Program Services Offeror shall provide Program services in accordance with the ordinances and resolutions of the County Board of Supervisors and the applicable policies, procedures, directives, 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 BHSD policies and procedures.

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

Medical necessity criteria;

Documentation redesigns;

Co-occurring treatment;

Standardized screening and transition tools;

Behavioral health CPT coding transition; and Payment reform.

In accordance with CalAIM implementation, a Problem List shall be used to guide integrated, client-centric care. The development of the Problem List shall include input from the client and all members of the Team as appropriate for their scope of practice.

Program services shall include the use of Evidence-Based Practices (EBPs), Promising Practices (PPs), and Trauma-Informed Practices. EBPs that are expected to be effective for the target population may include, but not limited to:

Cognitive Behavioral Therapy (CBT);

Trauma-Focused CBT (TF-CBT);

Family Therapy, Motivational Enhancement Therapy (MET); or Motivational Interviewing; and Wellness and Recovery Action Plan (WRAP).

Integrated services shall be evidence-based and include, but not limited to:

Mental health treatment (including comprehensive and client-centric assessments and care/treatment plans, client and group therapy, and psychiatric services);

Chemical dependency/substance abuse treatment (client and group treatment), including 12-step Programs;

Medication management and education;

Twenty-four (24)-hour crisis intervention services and immediate support;

Assertive community-based outreach and engagement services;

Support and advocacy while incarcerated or hospitalized;

Self-management and skills training (includes symptom management);

Physical health screenings and care coordination for other medical needs;

Immediate linkage to necessary basic needs, such as food and clothing;

Immediate assistance with securing appropriate supported housing arrangements, including linking to safe and permanent housing upon graduation from ACT;

Assistance with applying and gaining access to Medi-Cal and an income source (i.e., GA, SSI, etc.);

Vocational/educational support and linkages (e.g., community colleges, technical/trade schools, universities, etc.) that shall contribute to long-term employment and community stability;

Community integration through social activities and outings that shall assist in building pro-social skills;

Peer support services;

Assistance with transportation and accessing transportation benefits;

Assistance in obtaining personal identification and Social Security cards;

Assistance with activities of daily living and linkage to natural support networks, including family;

Transition planning beginning at assessment with step down planning as part of the client’s overall plan; and Housing support:

i. The Team shall have access to client support and housing flex funds to be used only for clients once a determination has been made that assistance with housing costs, medication costs, food, and other needs identified in the recovery planning process and the client’s client-centric treatment plan, are necessary to assist the client in achieving successful treatment outcomes. As such, the use of flex funds should be directly tied to the client’s care plan. Flex funds are not to be used for staff expenditures (i.e., food, gas, supplies, entertainment events, etc.).

Staffing Requirements Staff shall address the relationship between the client’s mental health and substance-related conditions, readiness to change, and relapse/recovery environmental issues through client and group Program content.

Staffing shall be maintained to assure a low staff-to-client ratio, as outlined in Table 1, and must be in place prior to the start of the program.

The Team shall comprise of staff who are appropriately trained and meet the qualifications as Licensed Professionals of the Healing Arts, as well as their respective discipline requirements. Minimally, staff must meet the licensing requirements as set forth in Title 9, Title 19, and Title 22 of the Medi-Cal Regulations. Additionally, all Team members must have a valid driver’s license.

All paraprofessional and professional practitioners shall have a minimum of the following three (3) core co-occurring standard skills: co-occurring informed, co-occurring capable, and co-occurring enhanced.

Program staff with clinical expertise shall assist in the cross-training of other staff.

Additional Program staff experience, training, and skills, that are required for this Program shall include knowledge of Medi-Cal regulations; knowledge of confidentiality laws; knowledge of crisis assessment and intervention; knowledge of local community resources available to clients; knowledge of the justice system and its impact on clients; understanding of the behavioral health system of care; knowledge of grievance and complaint policies and procedures; knowledge of informed consent to medication and treatment; capacity to collaborate and coordinate with local health and human service agencies.

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, plus [LGBTQ+], cultural and linguistic capacity, racial equity).

Table 1:

Team Leader (1 FTE)

The team leader shall direct and supervise staff activities, lead the team in organizational and service planning meetings, provide clinical direction to staff regarding client cases, conduct side-by-side contacts with staff, and regularly conduct client supervision meetings. The team leader shall be responsible for direct consumer services as a member of the clinical staff (50% of work allocation shall be providing direct services to clients), as well as providing administration and leadership of the team. Minimum qualifications: A master’s degree or higher in social work, psychology, rehabilitation counseling, or related field. Licensed or registered nurses are expected to be of a master’s level or nurse practitioner with experience on a multi-disciplinary team and must be licensed in State of California

Psychiatrist/Psychiatric prescriber (1 FTE) minimum of 16 hours for 50 clients Staff to client ratio of 1:100 The psychiatrist, in conjunction with the team leader, shall have overall clinical responsibility for monitoring consumer treatment and staff delivery of clinical services. The psychiatrist shall provide psychiatric, medical assessment and treatment, clinical supervision; as well as the development of medical treatment and procedures. Community-based services shall include an initial assessment visit to the client in the community, and quarterly community visits thereafter. Minimum qualifications: Currently licensed as a physician, or eligible to be certified by the American Board of Psychiatry and Neurology, and other health care practitioners who are permitted by State law to prescribe psychiatric medications.

Psychiatric Nurse Staff to client ratio of 1:50 The registered nurse is responsible for conducting psychiatric assessments; assessing physical health needs; making appropriate referrals to community physicians; providing management and administration of medication in conjunction with the psychiatrist; providing a range of treatment, rehabilitation, and support services. Minimum qualifications: a master’s, bachelor’s, or associate degree in nursing with California licensure.

Clinicians Low client to staff ratio This group of staff are qualified by credentials, education, and/or experience to provide clinical supervision and/or direct services related to the treatment of serious mental illness. Minimum qualification: a master’s and licensure in the State of California, which may include, but is not specific to, a Social Work Clinician, Marriage and Family Therapist, Psychologist, or Mental Health Counselor.

Paraprofessional Low client to staff ratio This group of staff are qualified through experience obtained working in the mental health field and shall be capable of all mental health treatment functions under clinical supervision. Duties may include rehabilitation and support functions; assistance in treatment; providing substance abuse services; providing education, support, and consultation to families; and providing crisis intervention services. This staff may have a bachelor’s degree and 2 years of experience, or high school with 4-6 years of experience working with consumers who have severe and persistent mental illness and co-occurring substance use disorder.

Substance Abuse Specialist Staff to client ratio of 1:50

This is a clinical staff member, who in addition to performing routine Team duties, has lead responsibility for integrating dual-recovery treatment with the tasks of other team members. Competency must be demonstrated by at least 1 year of training and/or experience in integrated mental health and substance abuse assessment and treatment, motivational interviewing techniques, and stage-wise treatment. Must also be a Certified Alcohol Drug Counselor.

Employment/Vocational Specialist Staff to client ratio of 1:50

This is a clinical staff member, who in addition to performing routine Team duties, has lead responsibility for integrating vocational goals and services with the tasks of all team members. This staff member provides needed assistance through all phases of the vocational service. Competency must be demonstrated by at least 2-3 years of training and/or experience in vocational assessment, job exploration, and skills development in employment counseling or vocational rehabilitation.

Housing Specialist Low client to staff ratio This is a clinical staff member, who in addition to performing routine Team duties, has lead responsibility for integrating housing goals and services with the tasks of all team members. This staff member provides needed assistance through all phases of the housing service. Competency must be demonstrated by two (2) or more years of experience in providing housing need assessment, search, and skills development in choosing, obtaining, and maintaining housing permanence and rehabilitation. Must also have knowledge of community resources and low-cost and subsidized housing.

Peer Support Specialist

These are staff members with lived experiences of behavioral health issues. Peer specialists are in a unique position to serve as role models, educate consumers about self-help techniques and self-help group processes, teach effective coping strategies based on personal experience, teach symptom management skills, assist in clarifying rehabilitation and recovery goals, and assist in the development of community support systems and networks.

Cultural Competency 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 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.

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

The Program shall be composed of staff who are proficient in the six (6) Santa Clara County threshold languages (Spanish, Vietnamese, Mandarin, Cantonese, Tagalog, and Farsi). Offeror’s organization shall have a plan to address barriers when they do not have staff available to meet the County threshold languages and a plan for actions and changes to ensure diversity and inclusion in service delivery.

Offeror’s organization shall provide outreach activities focused on reaching underserved, underrepresented, and/or multicultural populations.

Referrals and Admissions Based on the severity of mental illness and functional impairment of clients who qualify for services, the final decision to admit a referral shall rest with the BHSD and Program provider.

Program referrals shall be managed through the BHSD call center, inpatient hospital liaison staff, 24-Hour care state hospital staff, behavioral health outpatient staff, families, and/or the client.

An admission decision by Program must be made within five (5) consecutive days of the receipt of the initial referral, unless otherwise indicated by BHSD.

Upon the decision to accept a referral into the program, a screening assessment shall be performed that includes: a justification that shows the client meets medical necessity for this level of care. Screening should include the following elements: reasons for the referral; immediate clinical needs and other service needs; and diagnoses.

When a decision is made to deny the referral, the program shall be expected to notify to the referring party and contract monitor. The Program is also expected to document the following: (a) the reason(s) for denial; (b) the disposition of the case; and (c) any other referrals or recommendations made to the referring agency, as appropriate. Please note the client’s decision not to take medication shall not be a sufficient reason for denying admission to the program.

Clients are expected to have access to medication evaluations and support services in a timely manner once enrolled in services. Any client in pre-open outreach state of services (if applicable) shall continue to receive services (including medications) from the referring agency until enrollment is established or completed by Offeror.

Annual evaluations shall be conducted to determine the effectiveness of EBP utilization.

At intake, staff shall conduct a housing stability assessment with each client to:

Assess the extent to which housing subsidies are needed to sustain the client in housing; and Link each client to housing as it becomes available.

The Vulnerability Index – Service Prioritization Decision Assistance Tool (VI-SPDAT) utilized to determine the risk and prioritization assistance to clients who are at risk for homelessness and/or homeless. Upon making a determination that the client has a history of chronic homelessness, staff shall complete the VI-SPDAT.

The Program shall serve clients as determined by County policies, procedures, directives, and guidelines within the program resources.

Care Coordination Offeror shall adhere to the following care coordination guidelines:

Offeror shall provide outreach and engagement services during episodes of incarceration and inpatient hospitalization to ensure that teams maintain rapport with clients and are involved in the clients’ transition back into the community.

Offeror shall establish collaborative working relationships with families and identify natural supports and clients to enlist their involvement in the ongoing planning and evaluation of services.

Offeror shall establish collaborative working relationships with law enforcement, community-based organizations involved in service delivery to the target population, including faith communities, drop-in centers, meal Programs, shelters, health clinics, and other similar organizations, as well as the local emergency rooms, and Crisis Responders and/or Mental Health Professionals.

Offeror shall develop and maintain productive working relationships with housing providers and mainstream education and employment services.

Program Hours of Operations Offeror shall be open for services twenty-four (24) hours a day, seven (7) days a week, and shall provide a plan for flexible coverage hours that address a variety of client needs.

Evaluations, Transitional Planning, and Discharge Although long-term services may be provided, it shall be expected that clients be assisted in attaining recovery goals, which enable the transition to less intensive community services.

The Team may utilize the following scales to determine when a client is ready to transition from the ACT Program into other BHSD Programs:

ACT Transition Readiness Scale; and/or ACT Transition Assessment Scale.

The Program shall conduct regular needs assessments and evaluate clients to determine the effectiveness of EBPs utilized. The need for continued stay shall be documented by the agency:

Documentation should reference back to the reason for admission and goal achievement; and Documentation should occur for each client a minimum of every twelve (12) months.

The Program shall utilize the guidelines below for discharging clients and transitioning them into the community or into a new Program:

Discussion with the clients and their families about possible challenges;

Review of strategies, skills, and supports;

Use of additional supports, such as family, peers, parent mentor, etc.; and Provide clients and their families with a written transition plan which includes the elements above (a-c).

Additional requirements below shall apply if transitioning to a new Program:

i. Coordination with the new provider to ensure understanding of client’s needs, goals, strengths, and support system;

ii. Provide copies of Care Plan, Narrative Summary, and Assessment information to the new provider; and

iii. Arrange a visit to the new Program location with the current provider to meet the new provider(s) and tour the facility.

Considerations for discharge include:

Clients who do not meet Medi-Cal medical necessity criteria;

Clients who demonstrate, over a period of time, an ability to function in major life roles (e.g., work, social, self-care) and can continue to succeed with less intensive service;

Clients who move outside the geographic area of the program’s service area. The Program must arrange for the transfer of mental health service responsibilities to an appropriate provider and maintain contact with the recipient until the provider and the recipient are engaged in this new service arrangement;

Clients who need a medical nursing home placement, as determined by a physician;

Clients who are hospitalized or locally incarcerated for three (3) months or longer should be closed. However, an appropriate provision must be made for these clients to return to the ACT Program upon their release from the hospital or jail;

Clients who request discharge, despite the Team’s best, repeated efforts to engage them in service planning. Special care must be taken in this situation to arrange alternative treatment when the client has a history of suicide, assault, or jail involvement; and/or Clients who are not engaged and not responsive to follow-up for a period greater than three (3) months after persistent efforts to locate them, including following all County policies and procedures related to reporting clients as non-compliant, and/or AWOL from treatment.

Additional Program requirements:

Staff shall participate in the planning and collaboration of the local continuum of care by attending quarterly, bi-monthly, or monthly meetings as determined by the BHSD.

Staff shall 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.

The Program shall maintain a workflow that is manageable for supervisors by attending to the ratio of supervisors to supervisees. Clinical supervision shall include the following:

i. Reflective supervision shall be provided by a licensed clinician who has met the requirements for clinical supervision and has completed the two-day training on Reflective Practice provided by the BHSD. This requirement also applies to paraprofessionals or other practitioners who are not on a licensure or certification track;

ii. Unlicensed staff on the licensure track shall receive supervision in accordance with their licensure board requirements;

iii. Licensed staff receives one unit of supervision two (2) times per month;

iv. Paraprofessionals and other practitioners receive one (1) unit of supervision weekly. One (1) unit of supervision = one (1) hour of client or two (2) hours of group supervision;

v. Ensuring the number of supervisees assigned to a supervisor shall be in compliance with relevant licensure regulations, and appropriate in terms of the level of expertise and experience, years of professional practice, comfort level, complexity and intensity of services, qualifications, etc.; and

vi. Offeror shall be prepared to provide clinical supervision activities for review during the monthly or bi-monthly provider meetings.

The Program shall conduct a self-administration of the DACTS annually to ensure fidelity to the ACT model and utilize an external review group to administer the DACTS assessment of the ACT fidelity scale.

The Program shall submit to the BHSD Division Director and Program Monitor, a copy of the annual external review within thirty (30) days of completion.

Public Health Emergency or Other Emergency Disaster Plan Offeror shall have policies and procedures to address disaster preparedness during a Public Health Emergency or other emergency disaster. Offeror shall complete Appendix B16 and submit the following supplemental information:

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

Offeror is required to comply with all County requirements relating to COVID-19.

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 A16: Assertive Community Treatment Scope of Work CATEGORY 3: Full Service Partnership Services