Attachment A16.pdf

ATTACHMENT A16

CATEGORY 6: Residential

RFSQ-BHS-FY25-0066: Children, Youth, and Family System of Care Services Page 1 of 13 ATTACHMENT A16: Short-Term Residential Therapeutic Program Scope of Work CATEGORY #6: Residential

SHORT-TERM RESIDENTIAL THERAPEUTIC PROGRAM

SCOPE OF WORK

In addition to Attachment B – Standardized Scope of Work Language, the following applies:

I. Purpose

A. The County of Santa Clara Behavioral Health Services Department (BHSD) seeks to identify and pre-qualify Offerors capable of providing services through a Short-Term Residential Therapeutic Program (STRTP).

B. STRTP programs (hereafter referred to as "the program") are designed to deliver comprehensive, trauma-informed, and culturally responsive mental health services for Medi-Cal youth.

C. The program aims to stabilize behavioral health needs and support youth transitions to less restrictive environments through residential therapeutic care. BHSD is also seeking Offerors capable of implementing an Enhanced Short-Term Residential Therapeutic Program (E-STRTP) model within the scope of STRTP services. The E-STRTP model provides highly individualized care by tailoring services to meet the specific needs of 1-2 youth at a time, requiring specialized supports such as increased staffing ratios, specialized interventions, and clinical oversight.

D. Offeror(s) shall deliver services aligned with the program's structure while ensuring interventions address clinical, behavioral, and cultural needs to promote stabilization, recovery, and transitions.

II. Facility and Licensing Requirements

A. Licensing and Certification Requirements

1. Offeror shall ensure that their facilities are licensed by the California Department of Social Services (CDSS) as a STRTP.

2. Facilities shall comply with the following standards:

a. Interim Licensing Standards for STRTPs, available at:

https://www.cdss.ca.gov/inforesources/continuum-of-care-reform/short-term-residential-therapeutic-program;

b. Community Care Licensing (CCL) and Department of Health Care Services (DHCS) regulations;

c. CCR Title 9, Title 19, Title 22, and Medi-Cal regulations;

d. Facilities shall ensure alignment with all relevant federal regulations concerning accessibility and inclusion;

e. State Department of Mental Health Certification Standards, accessible at:

www.dmh.ca.gov; and

f. State Department of Social Services Licensing Standards, accessible at:

www.cdss.ca.gov.

https://www.cdss.ca.gov/inforesources/continuum-of-care-reform/short-term-residential-therapeutic-program https://www.cdss.ca.gov/inforesources/continuum-of-care-reform/short-term-residential-therapeutic-program http://www.dmh.ca.gov/ http://www.cdss.ca.gov/

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B. Proximity Requirements

1. Facilities shall be located in Santa Clara County or within a 90-mile radius. Offers may also propose to provide services in Santa Clara County using a County-owned or leased property.

C. Facility Standards

2. Facilities shall comply with all state and local building, safety, and fire regulations

3. Facilities shall create an environment promoting a sense of safety, belonging, and healing, with clear consideration for trauma-informed design.

D. Licensing Timeline for New Providers

1. Offerors who are not currently licensed as an STRTP shall provide a detailed plan and timeline for obtaining licensure, including milestones.

2. Provisional licensure shall be obtained within a timeframe approved by BHSD upon submission of the plan.

II. Background Information

A. The Continuum of Care Reform (CCR) enacted pursuant to Assembly Bill (AB) 403 in 2015 and expanded by AB 404 in 2017, drew together existing and new reforms to child welfare services programs. Established through CCR, the State developed STRTPs to provide children and youth intensive Specialty Mental Health Services (SMHS) within a residential therapeutic setting. The STRTP relies on integrated, trauma-informed care to assist in building resiliency and achieving permanency outcomes for youth.

B. The System of Care principles outlined in the Integrated Core Practice Model (ICPM) guide (ICPM Guide and ACIN 1-21-18) strive to meet the prioritized needs identified by the child/youth and their and family/caregivers, to increase and strengthen the family’s natural supports, improve the youth’s level of self-efficacy within their family system, and integrate the work of system partners and service providers.

C. The STRTP service model allows for the provision of short-term, intensive, highly coordinated, trauma informed and individualized SMHS using a Child and Family Team (CFT) process to develop and guide the planning and service delivery. The services provided shall align with integrated, values-driven care as described in the ICPM.

III. Target Population A. Population Served

1. Age Range: Youth aged ten (10) through seventeen (17) years old.

2. Eligibility: Youth must be beneficiaries of Santa Clara County Medi-Cal or referred by a placing agency such as Child Welfare or Juvenile Justice.

3. Demographics and Characteristics:

a. Youth requiring 24/7 care and supervision within a structured therapeutic milieu to stabilize behavioral health needs and transition to less restrictive settings; and/or

b. Youth who may identify as Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ+) or belong to underserved cultural or ethnic communities.

https://www.cdss.ca.gov/Portals/9/ACIN/2018/I-21_18.pdf

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B. Behavioral and Emotional Needs:

1. Youth often present with:

a. Severe behavioral challenges, such as emotional dysregulation, verbal and physical aggression, suicidal ideation, and self-harm behaviors;

b. Youth with complex trauma histories, including those who have experienced sexual exploitation, victimization, or significant neglect or abuse;

c. Youth with co-occurring conditions, such as mental health disorders, substance use disorders, trauma-related disorders, or developmental challenges; and/or

d. Functional impairments affecting relationships, academic performance, and daily living.

C. Referral Sources:

1. Youth are primarily:

a. Youth adjudicated as Wards or Dependents of the Juvenile Court, including Dually Involved Youth (DIY);

b. Youth referred by the Interagency Placement Committee (IPC) or social workers from the Adoption Assistance Program (AAP); and/or

c. Youth placed voluntarily through the Voluntary Family Reunification process.

D. Typical Characteristics:

1. Functional Impairment: Youth require intensive external support to manage significant difficulties in family relationships, peer interactions, and academic or vocational settings.

2. Educational Support Needs: Due to disrupted educational experiences, youth may need coordination with school systems, such as Individualized Education Plans (IEPs), to address developmental delays and re-engage in learning.

3. Complex Needs: Diagnoses often include trauma-related disorders, mood disorders, psychosis, and co-occurring conditions such as developmental challenges or substance use.

4. Crisis Support Needs: Youth frequently experience crises requiring 24/7 access to trauma-informed crisis intervention to stabilize behavioral and emotional challenges.

5. Care Coordination: Collaboration with Multi-Disciplinary Teams (MDTs), Child Family Team Meetings (CFTMs), and other support systems is critical to ensuring care plans reflect evolving youth needs.

6. Cultural and Identity-Specific Considerations: Youth may identify as part of underserved cultural, ethnic, or LGBTQ+ communities, requiring inclusive and culturally responsive services tailored to their unique identities and experiences.

IV. Program Goals and Objectives

A. Program Goals

1. The program shall aim to:

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a. Provide services to youth whose level of functioning, symptoms, and psychiatric history require residential treatment prior to transitioning to family-based settings;

b. Promote long-term success in community settings by assisting youth in achieving mutually agreed-upon outcomes and fostering empowerment and self-confidence; and

c. Enhance youths’ functional outcomes and prepare them for successful transitions to community living environments.

B. Program Objectives

1. The program shall achieve its goals by:

a. Maintaining a structured and supportive residential environment to stabilize mental health symptoms, develop coping skills, fosters personal growth, and prepare youth for transitions to less restrictive settings;

b. Facilitating coordination and collaboration with child-serving agencies and institutions to ensure comprehensive, consistent care.

c. Demonstrating the values and principles of the ICPM in service delivery to youth and families;

d. Engaging underserved children, youth, and families who face barriers to accessing traditional outpatient mental health services due to factors such as substance use, community violence, family violence, neglect, or trauma;

e. Partnering with placing agencies to support permanency and reintegration into family living situations. This includes offering therapeutic services and CFT processes to enhance relationships and facilitate reunification and permanency planning; and

f. Integrating culturally responsive and linguistically appropriate approaches in all treatment plans and interventions.

V. Reporting and Data Collection Requirements

A. Staffing and Training Records

1. Offeror shall maintain comprehensive staffing and trainings records to demonstrate compliance with contractual and CCL requirements.

2. These records shall be reviewed quarterly in a format approved by BHSD.

3. Training record shall include:

a. Names of trainings completed;

b. Dates of trainings;

c. Certifications obtained; and

d. Documentation of specialized trauma-informed care training completed by staff.

4. Staffing records shall include:

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a. Employee’s name and date of hire;

b. Job title and language capacity;

c. Qualifications and certifications; and

d. Notation of vacancies in staffing.

B. Compliance with Data Requests

1. Offeror shall comply with data requests from the following agencies, in accordance with Protected Health Information (PHI) regulations:

a. Santa Clara County Department of Family and Children's Services (DFCS);

b. Juvenile Probation Department (JPD);

c. BHSD; and/or

d. Other related agencies, as required.

2. Data collection shall also include youth-level outcomes, such as improvements in educational engagement, step-down to family settings, behavioral health metrics, and reduction in crisis interventions.

VI. Outcomes and Measurements

A. Offeror shall achieve the following outcome:

1. CFT Model

a. The program shall use the CFT model to assess, monitor, and adapt services based on the youth’s progress.

b. A successful outcome is achieved when:

i. The CFT determines that the youth’s primary goals have been met; or

ii. The youth no longer meets medical necessity criteria for program services.

c. The youth may then:

i. Graduate treatment; or

ii. Transition to a lower level of care in a less restrictive setting.

d. Outcome measures shall also evaluate caregiver engagement and satisfaction with services provided.

VII. Program Description

A. Program Overview

1. Offeror shall operate a program that meets all licensing and operational requirements outlined in the Facility and Licensing Requirements section (Section II).

2. The program shall align with state and local regulations, including compliance

RFSQ-BHS-FY25-0066: Children, Youth, and Family System of Care Services Page 6 of 13 with all Community Care Licensing (CCL) and the Department of Health Care Services (DHCS) standards.

B. Therapeutic Environment

1. The program shall ensure the facility provides a warm, inviting, and engaging environment that supports healing and growth, as well as a sense of safety and security, by:

a. Providing personalized bedrooms with comfortable beds and space for personal belongings;

b. Designing common areas that foster social interaction and relaxation, featuring games, books, art supplies, and comfortable seating;

c. Ensuring therapy rooms are private and calming, designed to support trauma-informed care;

d. Celebrating diversity and promote inclusivity through the overall design; and

e. Designing outdoor spaces to facilitate physical activity and recreational therapy.

C. Program Services

1. Behavioral Health Services: Offeror shall provide services tailored to treat behavioral health symptoms, substance use disorders, and co-occurring conditions while improving the youth’s functional outcomes.

2. SMHS: Services may include:

a. Individual, group, and family therapy;

b. Crisis intervention and safety planning in collaboration with youth and their caregivers;

c. Rehabilitation and skills-building services tailored to youth needs; and/or

d. Development and implementation of strategies to support educational achievement and engagement.

3. Trauma-Informed Approach: Deliver services in residential, school, and community settings through a trauma-informed and healing-oriented model.

4. Care Coordination and Communication: Ensure effective coordination with system partners, including child welfare, juvenile justice agencies, schools, medical providers, the San Andreas Regional Center, and other child-serving systems as need to comprehensively address the complex needs of youth.

D. Treatment Methods

1. Core Treatment Services

a. Offeror shall provide treatment methods that include intensive integrated/co-occurring mental health services, medication evaluation and support services, crisis intervention, individual, group, collateral, and family therapy; Intensive Home-Based Services (IHBS)/rehabilitation; and Intensive Care Coordination (ICC)/targeted case management/brokerage services.

Services shall be available to every youth according to their specific needs and prescribed in a manner consistent with their treatment plans.

i. Services shall be provided in a variety of settings, including within the

STRTP setting, school, and community as needed.

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ii. Services shall be strength-based, individualized, and shall consider each youth’s age, maturational level, culture, family values and structure, educational functioning level, and physical health.

2. Trauma-Informed Evidence-Based Practices (EBPs)

a. Trauma-Informed Care shall be at the core of EBPs and may include, but are not limited to:

i. Motivational Interviewing (MI);

ii. Seven Challenges;

iii. Relapse Prevention;

iv. Cognitive Behavioral Therapy (CBT);

v. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT);

vi. The Neurosequential Model of Therapeutics (NMT);

vii. Dialectical Behavioral Therapy (DBT); and/or

viii. Various family therapy models.

3. Additional Treatment Approaches

a. Treatment may include process groups, skill-building groups, and family sessions, as well as adjunctive therapies to develop effective problem-solving skills, assist in resolving behavioral, emotional, and substance use problems, and improve relationships. The goal is to facilitate recovery, improve overall functioning, and support youth in transitioning to their next living situation.

b. Programs are highly encouraged to consider promising practices that focus on somatic movement and sensory experiences as a holistic approach to therapy and well-being. Examples of these practices include somatic experiencing, art therapy, movement therapy, mindfulness-based approaches, sensory integration therapy, expressive arts therapy, trauma-informed yoga, and ecopsychology.

4. Service Delivery Model

a. All residential facilities shall provide an outpatient mental health service delivery model instead of the day treatment model. Utilizing this model allows for individualized services tailored to meet the best fit for treatment.

b. Rehabilitation services shall be provided in both the residential setting and within the youth’s home and community to support a smooth transition back into the community.

c. The focus of services shall be on supporting families/caretakers in meeting the youth’s needs, developing “portable” skills, and linking to community supports to maintain the youth in the community.

5. Child Psychiatry/Medication Management

a. Child psychiatry and medication management shall be provided as clinically indicated.

E. Individualized and Integrated Care

1. Services shall be individualized and strength-based, addressing the unique needs of each youth and their family.

2. The program shall integrate EBPs and innovative approaches such as somatic

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3. Engagement Strategies: The program shall include strategies to initiate and sustain youth and family/caregiver participation.

4. Focus on Family Systems: Services must address the youth needs within their family relationships, culture, language, and community.

5. STRTP-Specific Services: Services shall align with the Medi-Cal Manual for ICC, IHBS, and Therapeutic Foster Care (TFC).

6. Team-Based Approach: Services shall be provided using a multidisciplinary team, including facilitators, peer mentors, clinicians, and psychiatrists.

F. Education and Transition Support

1. Ensure reliable transportation for youth to and from school and coordinate with educational institutions to maintain academic progress.

2. Provide services focused on smooth transitions back into the community or less restrictive settings.

3. Transportation: Offeror shall provide reliable and safe transportation to and from school, ensuring it aligns with youth’s academic schedules.

4. Educational Coordination: Collaborate with local educational institutions to ensure youth receive consistent academic support during their treatment.

VIII. Service Parameters A. Length of Stay (LOS)

1. The average LOS shall be 6-months, or as determined by medical necessity criteria, to improve the youth’s level of functioning and ensure readiness for successful transition to home-based care.

B. Comprehensive Care Requirements

1. Offeror shall provide care and services under SMHS and contractual agreements, which include:

a. 24-hour Non-Medical Care: Supervision tailored to each youth’s specific needs;

b. Individualized Treatment Plans:

i. Develop plans addressing behavioral, emotional, and mental health needs with clear objectives informed by the youth and family.

ii. Regularly review and update based on youth progress and evolving needs.

iii. Collaborate with youth to include their personal goals and milestones in the treatment plan;

c. Evidence-Based Therapeutic Interventions: Utilize MI and other strategies to determine appropriate interventions and motivate change;

d. Collaboration: Work closely with placing agencies, health care providers, and educational institutions to coordinate comprehensive care;

e. Access to External Services: Facilitate youth access to additional support as needed;

f. Transition Planning: Develop and execute transition plans to ensure successful movement to less restrictive environments or family reunification;

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g. Post-Discharge Support: Provide continuity of care after discharge to maintain progress;

h. Regulatory Compliance: Adhere to all applicable California laws, regulations, and guidelines governing STRTP operations;

i. Audits and Inspections: Participate in regular compliance checks;

j. Care Planning: Coordinate efforts with child-serving to ensure comprehensive care;

k. Trauma-Focused Treatment: Treat behavioral health symptoms and improve functioning within the family and social systems;

l. Family Involvement: Place special emphasis on family engagement in treatment, especially for youths with complex trauma;

m. CFT Process: Use CFT meetings to identify team members, set goals, and plan for community transitions;

n. Care Coordination: Manage urgent or escalating situations with the expectation that all treatment interventions will be exhausted before escalating to higher care levels;

o. Accreditation: Obtain and maintain accreditation from recognized entities (e.g., Joint Commission [JC], Commission on Accreditation of Rehabilitation Facilities [CARF], or the Council on Accreditation [COA]); and

p. Qualified Staff: Employ licensed mental health professionals and other qualified staff to deliver therapeutic services and ensure ongoing training to meet youth needs.

C. Capacity and Population

1. Offeror shall specify the ages served and the number of youths accommodated, particularly for high-acuity needs among youth aged 10-17.

D. Service Models

1. Offeror may propose one (1) or a mixture of the following models:

a. E-STRTP of 1;

b. E-STRTP of 2; and/or

c. Congregate Care STRTP (maximum of six [6] youth).

E. Staffing Requirements

1. Staff requirements include, but are not limited to:

a. Ability to work effectively as part of a multidisciplinary team;

b. Family Specialists/Partners and/or Peer Support Specialists are encouraged;

c. Knowledge of crisis management and use of defined practice models (e.g.

Therapeutic Crisis Intervention [TCI]);

d. Familiarity with ICPM principles and phases;

e. Capacity to deliver ICC and IHBS as outlined in the Medi-Cal Manual Third

Edition ADA;

f. Ability to provide individual, family, and group therapy by credentialed clinicians;

g. Compliance with CCL staffing regulations for STRTPs;

https://www.dhcs.ca.gov/Documents/ChildrensMHContentFlaggedForRemoval/Manuals/Medi-Cal_Manual_Third_Edition.pdf https://www.dhcs.ca.gov/Documents/ChildrensMHContentFlaggedForRemoval/Manuals/Medi-Cal_Manual_Third_Edition.pdf

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h. Knowledge of the juvenile justice system and the child welfare systems, including an understanding of court procedures, mandated reporting requirements, and the rights of children and families; basic knowledge of the developmental stages of children and how trauma, abuse, and neglect impact their emotional well-being; and/or

i. Strategies to support staff preventing burnout and secondary.

2. Key Roles:

a. ICC Coordinator:

i. A highly skilled facilitator with a strong clinical background who coordinates and develops the CFT;

ii. Serves as the single point of accountability for the care plan for each youth;

iii. Navigates complex team and family dynamics to ensure equity, psychological and physical safety, and full participation;

iv. Centers the child and family in care planning, ensuring their voices are heard;

v. Possesses advanced skills in team facilitation, setting clear expectations, reaching consensus, and mitigating barriers to care; and

vi. Maintains a distinct role, separate from individual treating clinicians or IHBS providers.

b. IHBS Worker:

i. Provides skill-based interventions to remediate behaviors or improve symptoms, such as implementing behavioral plans and modeling interventions for the youth’s family or caregivers;

ii. May include credentialed paraprofessionals, Mental Health Rehab Specialists, and other mental health professionals; and

iii. Distinct from the ICC Coordinator role.

c. Clinicians:

i. Licensed or waivered Practitioner of the Healing Arts (LPHA), including:

• Licensed or Associate Marriage and Family Therapist (LMFT/AMFT). Licensed or Associate Clinical Social Worker

(LCSW/ASW).

• Licensed or Associate Professional Clinical Counselors

(LPCC/APCC);

ii. Provide primary therapeutic interventions, including individual, family, and group therapy;

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iii. Focus on addressing behavioral, emotional, and mental health challenges, consistent with treatment plans; and

iv. Embedded within the CFT.

d. Psychiatrists/Prescribing Practitioners:

i. Evaluate the effectiveness and side effects of psychotropic medications;

ii. Obtain informed consent and provide education on medication risks benefits, and alternatives; and

iii. Responsible for prescribing, administering, dispensing, and monitoring psychiatric medications.

e. Parent/ Family Partners or Peer Support Specialists:

i. Assigned as part of the CFT when determined necessary;

ii. Provide direct support and advocacy to the youth or their caregivers, drawing from their lived experience;

iii. Contribute to fostering a family-centered philosophy and principles necessary to engage children, youth, and families; and

iv. Help families navigate child-serving systems (e.g., child welfare, juvenile probation, or mental health systems).

f. Direct Care Staff:

i. Responsible for 24-hour supervision and support within the residential setting;

ii. Meet staffing ratios as required by Community Care Licensing (CCL) for STRTPs; and

iii. Participate in ongoing training to support the delivery of trauma-informed care and address the complex needs of youth.

g. Support for Staff:

i. Develop and implement plans to prevent staff burnout and address secondary trauma through training, team-building activities, and access to wellness resources.

F. Referrals and Admissions

1. Offeror shall serve youth as determined by County policies, procedures, directives, and guidelines, and that are within the Offeror’s resources. Offeror shall only accept referrals, which are screened by the County IPC Team, per BHSD guidelines and within their capacity.

2. Referrals shall include an assessment by the County Qualified Individual (QI), unless it is an emergency placement, in which case a QI will be provided within

RFSQ-BHS-FY25-0066: Children, Youth, and Family System of Care Services Page 12 of 13 thirty (30) days.

3. Additional slots may be requested based on Offeror utilization and capacity reviews.

4. Offeror shall comply with a Feedback Loop Process, providing updates to referral sources on status and outcomes.

5. Offeror shall outline a policy and our practices to ensure that youth are not rejected from admission or face early discharge due to challenges they may face.

Any exceptions to the policy should be identified, which would include the planning and transition to a higher level of care. Youth should not be turned away without consultation and mutual agreement from BHSD.

G. Care Coordination

1. Offeror shall collaborate with other agencies, providers, and institutions to ensure comprehensive holistic care.

2. Offeror shall report any critical incidents requiring a higher level of care, such as medical or psychiatric hospitalization, behavioral incidents, or elopement from the facility to BHSD's designated staff and the placing agency within twenty-four

(24) hours.

3. Offeror shall ensure regular CFTM at least every thirty (30) days, and as often as needed, to provide updates and guide care planning, and as specified in the ICPM manual. Care coordination is an important component of the Program, which involves various professionals (providers) such as therapists, social workers, Primary Care Providers, public health nurses, school staff, and family members. This is further specified in the ICPM manual.

H. Hours of Operations

1. The program shall operate a 24/7 residential program. Program services will be offered daily (7) days per week and consistent with the Medi-Cal Rehabilitation Option requirements. Staff will be available twenty-four (24) hours daily to provide supervision and structured therapeutic milieu, including the care and supervision and emergency needs of the client.

I. Evaluations, Transitional Planning, and Discharge

1. When treatment is nearing completion, Offeror shall:

a. Discuss potential challenges with youth/family;

b. Review of strategies, skills, and supports for success;

c. Provide written transition plans to all stakeholders;

d. Facilitate post-discharge follow-ups to ensure continuity of care and stabilization; and

e. All evaluations, transition planning, and discharge planning shall happen in

RFSQ-BHS-FY25-0066: Children, Youth, and Family System of Care Services Page 13 of 13 the context of the CFT and CFT meetings. Achievements should be acknowledged and celebrated.

2. For program transfers, coordinate with new providers to ensure a seamless transition and share all relevant documentation.

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

IX. Funding and Reimbursement Structure

A. To ensure program sustainability, the following payment terms apply:

1. Reimbursement from BHSD:

a. Offeror shall receive reimbursement from BHSD through a cost-based model, offset by a fee-for-services model under the SMHS Short-Doyle contract; and

b. Reimbursement rates and billing procedures shall adhere to the SMHS Short- Doyle contract, including submission of claims, documentation requirements, and payment schedules.

2. Monthly Placement Rate:

a. Offeror shall receive a monthly the program placement rate through the DFCS or the JPD via direct contract;

b. The placement rate is determined by the state and may be subject to adjustments. Current rates are available at CDSS Rate Schedule:

https://www.cdss.ca.gov/Portals/9/Child-Welfare-Programs/Foster- Care/RateSchedule1.pdf?ver=2024-03-22-154916-413.; and

c. Additional funding beyond the placement rate to support the youth’s success in the program is subject to approval by the placing agency.

https://www.cdss.ca.gov/Portals/9/Child-Welfare-Programs/Foster-Care/RateSchedule1.pdf?ver=2024-03-22-154916-413.

https://www.cdss.ca.gov/Portals/9/Child-Welfare-Programs/Foster-Care/RateSchedule1.pdf?ver=2024-03-22-154916-413.