Attachment A3.docx

ATTACHMENT A3

CATEGORY 1: PREVENTION AND EARLY INTERVENTION SERVICES

PROMOTORES

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 serving the community through Promotores where services are provided by Community Health Workers.

Promotores de salud is a Spanish term for “community health workers.” Promotores are individuals that live in the communities where they work, share similar life experiences as the clients they are trying to reach, and create relationships based on trust. Clients are cross-generational individuals who live in hard-to reach populations, and other unserved and underserved communities. Promotores serve as the bridge between community-based organizations, health care agencies, schools, and their respective communities with focus on increasing access to care through outreach, enrollment, engagement, referral, and promotion in behavioral health services and preventive care services. Promotores establish a source of care and improve self-efficacy within the target population.

The Promotores program (hereafter referred to as “the program”) is part of the approved Mental Health Services Act (MHSA) Prevention and Early Intervention (PEI) Access and Linkage to Treatment.

The program shall focus on reducing disparities by utilizing a non-clinical networking model among service providers to exchange information about activities and resources that promote economic stability, educational success, access to healthcare, housing, and legal services for families. Events and activities for families, youth, and young adults are promoted through free cultural events, family literacy events, and healthcare screenings.

The program shall provide culturally relevant community health education, promotional efforts, and referral efforts by disseminating information to the community and targeting engagement challenges that face the community stemming from behavioral health stigma. The program shall provide training programs, builds relationships among community groups, and bi-directionally refer clients to/from clinics.

The program shall operate with an open-door policy whereby individuals who are not diagnosed with behavioral health-related disorders may receive services.

I. Background Information A. Staff play an important role in providing culturally relevant health education, promotion, and referral efforts. Utilization of the program improves information dissemination to the community, specifically targeting engagement challenges that arise due to behavioral health stigma. Numerous studies have demonstrated the effectiveness and cost efficiency of programs that have improved health outcomes and addressed health disparities across the community.

B. The BHSD’s Family and Children (F&C) Services Division serve clients with severe mental illness (SMI) that are 18 years and under and represent the ethnic and racial diversity of the County.

C. The BHSD’s Adult and Older Adult (AOA) Services Division serve clients with SMI that are 18 years and over and represent the ethnic and racial diversity of the County.

D. The AOA System of Care consists of a variety of behavioral health programs, including Emergency and Crisis Services, Residential Services, and Outpatient Services. There is also a collection of community education and prevention services, housing, and specialty services.

Target Population A. The program shall serve County residents within the following populations:

Transitional Aged Youth (TAY), ages 16 through 24;

Adults, ages 24 through 59; and Older Adults, ages sixty (60) and over.

B. The program shall serve County residents located throughout the four (4) County regions:

1. North County (Cupertino, Los Altos, Mountain View, Palo Alto, and Sunnyvale);

East County (Downtown San Jose);

South County (Gilroy, Morgan Hill, and San Martin); and Central County (Campbell, Los Gatos, Milpitas, Monte Sereno, San Jose, Santa Clara, and Saratoga).

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

1. Building capacity for behavioral health prevention and early intervention services at sites of clients’ routine activities;

1. Ensuring early access to behavioral and health services to nearby clinics, to lower behavioral health illness and suicide rates, enhance wellness and resilience, and reduce barriers to health education/services, behavioral health stigma, and discrimination that are common for native-born and immigrant communities;

1. Implementing strategies to empower traditionally underserved/unserved communities to engage in services prior to the development of SMI or serious emotional disturbances; and

1. Increasing the strength and capacity of culturally relevant community programs in the County to be a viable and sustainable organization that provides a unique service and support to the target population.

B. Objectives shall be achieved by:

1. Increasing the awareness of behavioral health stressors and protective factors, reducing substance abuse, and reducing delinquent behavior;

1. Increasing family management skills, including anger management skills, refusal and problem-solving skills, child education skills, and the ability to assist their children with academic success;

1. Working to create positive neighborhoods, schools, and community environments;

1. Referring/linking clients and family members to needed services in support of their children;

1. Fostering tolerance and understanding of diversity in communities; and

1. Identifying problems early on and intervening quickly.

II. Reporting and Data Collection Requirements A. Offeror shall submit a program report that details the applicable tracking measures that describes Offeror’s progress in achieving the contract deliverables and requirements.

B. Offeror shall submit a PEI Data Report in the BHSD MHSA-provided template that includes demographics, implementation challenges, successes, and lessons learned.

C. The program report and PEI Data Report shall be submitted to the BHSD Program Manager on a quarterly basis.

D. Quarterly, Offeror shall complete a MHSA reporting template which shall summarize and describe the following:

1. Number of unduplicated client (UDC) clients served;

Number of clients with SMI referred to treatment;

Type of treatment referred to;

Number of referred clients who engaged in treatment;

Average duration of untreated mental illness for each client;

Average time between referral and participation in treatment for each client;

Number of referrals to a prevention program;

Number of referrals to an early intervention program;

Number of referrals to treatment beyond early onset; and Description of the ways the BHSD encouraged access to services and follow-through on referrals.

E. Offeror shall be required to attend meetings scheduled by the BHSD to report on activities to date/contract deliverables and to receive technical assistance or other support.

F. Offeror shall remain informed about County trainings and/or informational sessions related to PEI data regulations and shall be required to attend these trainings and/or sessions as determined by the BHSD Program Monitor.

G. Offeror shall submit additional deliverables or reports requested by the BHSD that may be required by the MHSA and/or related regulations and requirements. Offeror shall comply with County, State, and Federal agency reporting requirements, and applicable law and regulations.

H. Offeror's organization shall describe the organization’s ability to use their current electronic health record (EHR) system (including the capability to exchange data with County systems) and/or the ability to implement a new EHR system as listed in Appendix H. Offeror shall provide details on how their organization shall use the County’s myAvatar system using one (1) of the following implementation types:

1. PCE with 837 billing;

2. PCNX with 837 billing;

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

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

III. Outcomes and Measurements A. Offeror shall reduce risk factors to improve mental, emotional, and relational functioning in clients.

B. Offeror shall measure the program’s impact on client with one or more of the following positive outcomes listed in the MHSA plan:

1. Improved mental functioning;

2. Improved emotional functioning;

3. Improved relational functioning; and/or

4. Improved health, mental health, and well-being of families and children.

C. Offeror shall enhance client and staff knowledge of mental health resources and treatment in following areas:

1. Improved website with mental health information;

2. Improved website with multi-language capacity, where appropriate;

3. Increased knowledge of mental health resources within the County’s ethnic groups;

4. Increased knowledge and ability of mental health service providers to engage and serve the identified target population;

5. Increased capacity of service providers to provide support to the target population; and/or

6. Increased community awareness of behavioral health issues and resources.

D. Offeror shall measure the program’s impact on clients with one or more of the following negative outcomes listed in the MHSA plan:

1. Suicide;

2. Incarcerations;

3. School failure or dropout;

4. Unemployment;

5. Homelessness; and/or

6. Removal of children from their homes.

IV. Program Description A. Service Description

1. The program shall be persistent and utilize a variety of methods to engage communities that may initially refuse or be reluctant to receive behavioral health services. Clients referred to the program shall receive outreach services in order to assess their desire and readiness to enter into a partnership with an identified behavioral health program.

2. The program shall use an evidence-based psychosocial intervention model delivered by Community Health Workers to provide behavioral health education in the community and serve as connections between clients and providers to promote behavioral health services among underserved or underrepresented populations.

3. The program shall reduce disparities by focusing on support and assistance to community members as they navigate the behavioral health system and access resources.

4. Offeror shall utilize a networking model among community service providers to exchange information about activities and resources that promote economic stability, educational success, access to healthcare, housing, and legal services for families. Events and activities for TAY shall be promoted through free cultural events, family literacy events, healthcare screenings, and other related events.

5. Offeror shall publish an electronic newsletter and website with behavioral health information, notice of opportunities for family recreation activities, information that promotes mental health resiliency in the community, and other information that supports and strengthens the target population and their families.

6. The electronic newsletter shall include information regarding training opportunities for service providers and County community members.

7. Offeror shall conduct monthly meetings with various behavioral health providers where providers share information about available services and resources.

8. Offeror shall work to establish partnerships with National Alliance on Mental Illness (NAMI), Mental Health Coalition (MHC), and other community service providers that provide outreach and education to the target population.

9. Offeror shall collaborate with the BHSD Ethnic/Cultural Communities Advisory Committee (ECCAC) to ensure the website includes behavioral health information and resources posted in County threshold languages and any additional languages where appropriate.

10. Offeror shall promote the BHSD as an expert resource for behavioral health service providers that aim to improve working with the community, including ethnic communities.

11. Offeror shall develop collaborative relationships with behavioral health service providers, criminal justice service providers, and other community organizations to increase the availability/quality of information and technical assistance regarding cultural competency issues within the community.

12. Offeror shall provide outreach efforts to a minimum of one thousand (1,000) unduplicated residents annually, in a variety of settings in the community.

13. 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 the BHSD policies and procedures.

14. Offeror shall ensure that their organization’s 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[footnoteRef:2]; [2: Clients require both mental health and substance use treatment services.]

d. Standardized screening and transition tools;

e. Behavioral Health CPT coding transition; and

f. Payment reform.

B. Staffing Requirements

1. Offeror shall provide an updated agency plan for administrative coverage or program-related changes to the BHSD Division Director at the beginning of each new fiscal year, and whenever any changes to this plan occur. The BHSD Division Director and/or their designee must approve the plan and any changes prior to implementation.

2. Offeror’s staff shall demonstrate basic core competencies in designated areas of practice, including neighborhood and ethnic and cultural core processes, integrated behavioral health, substance abuse treatment, supported education employment, family psychoeducation, wellness self-management, and community resources.

3. Offeror’s staff shall provide emotional support to individuals and families and facilitate community support groups.

4. Offeror’s staff shall provide behavioral health education (e.g., self-help training) to address the mental health challenges that the client communities face.

5. Offeror’s staff shall offer unique expertise on a range of challenges faced by underserved clients in safety net systems. As members of the community, staff shall have a strong understanding of the communities that they serve, allowing them to facilitate access of services and improve the quality of service delivery in their communities.

6. Offeror shall describe the existing staff who shall be providing the services and program components described in this Request For Statement of Qualifications (RFSQ). Offeror shall include a staffing table and credentials for staff providing and supporting these services which indicate position title, linguistic and cultural skills, education, experience, licensure, and certifications, including administrative, supervisory, and direct service.

7. Offeror shall describe their plan to recruit and maintain appropriate staffing to meet the diverse population of Santa Clara County. Offeror shall provide a personnel retention plan, which includes a current list of staff at the organization, their credentials, bilingual language capacity, and the length of time the employee has worked with the organization.

8. Offeror shall provide the approximate percentage turnover of the direct service staff over the past three (3) years. Offeror shall also describe how the organization shall provide continuity of care for families during staff turnover.

9. Offeror’s staff shall attend regularly scheduled meetings, training sessions, seminars and/or other meetings as scheduled by the BHSD Director and/or their designee. Meetings shall include but are not limited to: Adult/Older Adult System of Care meetings, and Quality Improvement (QI) meetings.

10. Offeror shall maintain adequate staffing for the program, including the following as follows:

11. Offeror’s staff shall be qualified, trained, and provide documentation in accordance with the requirements and other applicable regulations for the program.

12. Offeror shall ensure that staff are trained and proficient in the following background and topics:

a. Principles of psychosocial rehabilitation and recovery processes;

b. Confidentiality;

c. Psychopathology and physical health issues within the context of the clients’ ages and cultures;

d. Clients’ cultural and language needs;

e. Awareness of clients’ language and cultural influences;

f. Local community resources available to the client population, including self-help centers and ethnic community resources; and

g. Ability to collaborate and coordinate with local providers of health and human services.

13. Offeror shall plan and implement continuous staff training on quality improvement related to cultural and linguistic responsiveness.

14. Offeror’s organization shall maintain practices related to recruiting, hiring, and promoting multi-lingual staff and/or a culturally or ethnically diverse workforce. Offeror’s organization shall have training requirements related to diversity, equity, and/or inclusion (e.g., Lesbian, Gay, Bisexual, Transgender, Queer, Questioning + [LGBTQ+], cultural and linguistic capacity, racial equity).

C. Cultural Competency

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

2. Offeror 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.

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

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

D. Care Coordination

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

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

b. Offeror shall establish collaborative working relationships with the client’s family and identify natural supports/individuals to enlist involvement in ongoing planning and service evaluations.

c. Offeror shall establish collaborative working relationships with law enforcement and other service providers involved in service delivery to the target population (e.g., faith communities, drop-in centers, shelters, health clinics, local emergency rooms, and Crisis Responders (CRs), behavioral health professionals, etc.).

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

e. Offeror shall collaborate with the BHSD Learning Partnership to determine and execute Promotores training, including necessary trainings to the community.

E. Program Hours of Operations

1. The program shall be open for services Monday through Friday, 9:00 am - 6:00 pm and optionally be available to the community for outreach in the evenings and weekends.

V. 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 B3 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 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 2 of 10 ATTACHMENT A3: Promotores Scope of Work CATEGORY 1: Prevention and Early Intervention Services