Attachment A3b.doc

ATTACHMENT A3b

CATEGORY 3: ADULT RESIDENTIAL TREATMENT FACILITIES

CATEGORY 3 - ADULT RESIDENTIAL TREATMENT FACILITIES:

ADULT CRISIS RESIDENTIAL SERVICES WITH MEDICATION SUPPORT SERVICES

Scope of Work

Purpose A. The County of Santa Clara (County) Behavioral Health Services Department (BHSD) is seeking statements of qualifications from qualified Offerors interested in providing Adult Crisis Residential Services with Medication Support (the program) in Santa Clara County as part of the Behavioral Health Treatment Facility Continuum of Care. The program shall provide short-term, voluntary, structured, less restrictive, and therapeutic residential services for clients at risk of experiencing a mental health crisis. These clients often require support beyond the resources available in the community.

B. The program shall serve adults (ages 18-59) and older adults (ages 60 and older) throughout the county as an alternative to hospitalization for clients presenting sub-acute psychiatric symptoms and possible co-occurring disorders (mental health and substance use) in the least restrictive environment possible to reduce involuntary (re)hospitalizations, institutional placements (e.g., incarceration[s]), and homelessness.

C. The program shall be a community-based and lower-cost treatment option in a home-like setting that offers safe, trauma-informed alternatives to psychiatric inpatient hospitalization or other locked facilities. Services shall follow a social rehabilitation model that integrates aspects of emergency psychiatric care, psychosocial rehab, milieu therapy, case management, and practical social work.

D. Offeror shall provide evidence-based, culturally competent, and linguistically proficient Crisis Residential Treatment Services, which include assessment, medication support (oral and injectable), plan development, case management/brokerage, rehabilitation, consultation/collateral services, outreach and engagement, and crisis intervention.

E. This program encompasses the following two (2) residential treatment programs:

1. Type 1: Forensic, Diversion, & Reintegration (FDR) Crisis Residential with Medication Support Services; and

2. Type 2: Adult and Older Adult (AOA) Crisis Residential with Medication Support Services.

Background Information A. California Welfare and Institution Codes (WIC) 5670-5676.5 delineate the intent of the California Legislature to develop a system of residential treatment programs in every county to provide a range of alternatives to institutional care based on principles of residential and community-based treatment. These regulations further outline the criteria for community residential treatment programs and indicate that the primary focus includes the following:

1. De-escalation of client crisis;

2. Stabilization;

3. Diagnostic evaluations;

4. Assessment of each client’s existing support system; and

5. Design, development, and support relating to each client’s discharge plan.

B. The BHSD recognizes the importance of partnering with County-Contracted Providers (CCPs) to make behavioral health services accessible to clients with Severe Mental Illness (SMI) and co-occurring disorders (mental health and substance use) treatment needs.

Target Population A. The program shall serve adults (ages 18 to 59) and older adults (age 60 and older) residents of Santa Clara County who may also be high-risk and/or justice involved. Clients shall have full-scope Medi-Cal benefits based in Santa Clara County (County 43) or be uninsured.

B. Clients served shall meet medical necessity criteria in accordance with all laws and regulations governing Medi-Cal and Medicare programs mandated by Federal, State, and Local statutes, including, but not limited to:

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

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

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

C. Clients served in the program shall meet the following prerequisites, including, but are not limited to:

1. Diagnosed with an SMI and co-occurring disorder (mental health and substance use);

2. Requiring stabilization following an acute psychiatric episode(s);

3. Referred from either the BHSD FDR or AOA 24-Hour Care teams;

4. Involved in the justice system; and/or

5. May also include Track I, Track II and Track III Incompetent to Stand Trial (IST) clients served per Assembly Bill [AB] 1810, who are diverted from State Hospitals and Penal Code 1001.35 & 1001.36, Diversion Statutes which amends Penal Code 1370 & 1370.01 Incompetent to Stand Trial (IST) Statutes, and Welfare & Institutions Code 4361 Department of State Hospitals (DSH) Diversion funding.

D. Clients served in the program must be at risk of being in at least one (1) of the following:

1. Locked psychiatric treatment facility;

2. Emergency Psychiatric Services (EPS);

3. Correctional/detention facility; and/or

4. An Institution for Mental Disease (IMD).

E. Clients served may:

1. Qualify as an immediate risk for hospitalization but do not meet California WIC, Section 5150 (Lanterman-Petris-Short Act [LPS]) criteria;

2. Qualify as PC 1370(a)(1)(B) If the defendant is found mentally incompetent, the trial, the hearing on the alleged violation, or the judgment shall be suspended until the person becomes mentally competent.

a. If, at any time after the court finds that the defendant is mentally incompetent and before the defendant is transported to a facility pursuant to this section, the court is provided with any information that the defendant may benefit from diversion pursuant to Chapter 2.8A (commencing with Section 1001.35) of Title 6, the court may make a finding that the defendant is an appropriate candidate for diversion.

3. Possess a history of assaultive behavior;

4. Have established patterns of relying on emergency and institutional care;

5. Utilize various services without improved outcomes; and/or

6. Experience cognitive difficulties or medical co-morbidities.

F. Clients served shall not require nursing care services and must be ambulatory and free of communicable diseases.

G. Type 1: FDR program. Clients simultaneously receiving FDR Outpatient Services through other CCPs, who are temporarily in need of crisis residential services to prevent inpatient hospitalization or incarceration, may also be eligible for the program.

1. Mental Health Diversion eligibility requirements shall include all of the following:

a. Diagnosed DSM 5 disorder;

b. Disorder played significant role in charged offense;

c. Disorder would respond to treatment;

d. Waives speedy trial rights and consents to diversion (unless IST);

e. Agrees to comply with treatment; and

f. No unreasonable risk of danger if treated in community.

Program Goals and Objectives A. The program shall be a co-ed crisis residential facility for individuals with an SMI and co-occurring disorder (mental health and substance use).

B. The program shall be aligned to achieve the following goals and objectives.

Goals shall include, but are not limited to:

Serve as an alternative to acute inpatient hospitalizations (e.g., EPS, Barbara Arons Pavilion, Emergency Department [ED], and community hospitals) and other locked facilities.

Assess for co-occurring disorders (mental health and substance use) in adults and older adults who may be justice-involved, requiring specialized services due to complex risk factors (e.g., abuse/violence, homelessness, substance use, psychological trauma, and/or intergenerational impacts of incarceration).

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

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

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.

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.

Facilitate transitions to a less intensive level of care that include assisting clients in reintegrating back into the community, including transition from a carceral setting.

Offeror shall 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.

Increase the number of IST defendants diverted by the court from a State Hospital to crisis residential and other community treatment programs by the court.

i. Increase the number of IST patients treated in the least-restrictive setting appropriate to their clinical needs and violence risk.

ii. Increase diversion opportunities and community-based treatment options for IST clients.

iii. Prioritize CRT beds for IST patients in need of the highest levels of care based on DSH dedicated funding.

Objectives shall be achieved by the following:

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

b. Engage and encourage individuals 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 ED encounters.

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

d. Improve client access to medical and dental healthcare.

e. 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. Successfully step-down clients into appropriate behavioral health outpatient programs prior to discharging from Crisis Residential Treatment Services. This includes facilitating ongoing collaboration and a warm hand off with the clients’ assigned outpatient treatment providers.

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

1. California WIC, Divisions 1 and 5; and

2. CCR Title 9 (State Department of Mental Health Social Rehabilitation and Medi-Cal Rehabilitation Option), Title 19 (Public Safety), and Title 22 (Community Care Licensing).

3. DSH data requirements on Track I, Track II, and Track III clients served.

B. Offeror shall track extension requests on spreadsheets and provide justifications to BHSD on the clinical need for each extension request which may also be utilized to assist in determining areas of service improvements.

C. When applicable, Offeror shall administer assessment tools as part of the County’s program requirements.

D. The following data shall be entered into the County’s electronic health record (EHR) system for outcomes data reporting:

1. Treatment and service data;

2. Individual demographic information;

3. Direct and outreach services;

4. DSH required data on IST clients served; and

5. Other appropriate data as requested by the BHSD.

E. When applicable, Offeror shall initiate other data collection methods, which may include, but shall not be limited to, entering data into a database as specified by the County and electronic submission of data to the County using other formats such as Microsoft Excel.

F. Offeror shall detail the organization’s ability to use their current EHR system (including the capability to exchange data with County systems) and/or the ability to implement a new EHR system listed in Appendix H, Offeror’s EHR Status. Offeror shall describe how their organization shall use the County’s myAvatar system for the following tasks:

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.

G. All client demographic information, service, and other appropriate data shall be entered into the County’s EHR system.

H. Offeror shall provide data showing the number of clients referred for crisis services and received crisis services, type of services provided, number and type of linkage referrals, and other resources provided.

1. Offeror shall follow the County’s data reporting requirements. Methods may include the following data reporting collection:

a. Track the monthly number of referrals received from services and interventions (such as EPS);

b. Track the number of crisis services and interventions (EPS, etc.) received by clients;

c. Track the quarterly number of crisis diversions from County partners to either the BHSD FDR or AOA 24-Hour Care teams, or alternative resources;

d. Track the quarterly number and type of clients served by region;

e. Track Milestones of Recovery Scale (MORS) for target population (applies only to Type 2, AOA services);

f. Track all extension requests and justifications using spreadsheets through a template provided by the BHSD;

g. Track the number of readmissions within thirty (30) days of discharge from program using spreadsheet;

h. Track the rate of readmission and cost-savings from non-emergency settings and non-psychiatric hospitalization for clients served; and/or

i. Track the number of FDR Track I, Track II/IST (AB1810) and Track III Diversion clients in order to obtain reimbursement from the Department of State Hospital (DSH).

2. Offeror shall describe available data reporting methods and experience with providing monthly and annual reviews from the following data sources:

a. Client Services Information (CSI) system;

b. Data Collection and Reporting (DCR) data; and

c. County EHR data.

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

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

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

3. Track client service experiences;

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

5. Reduce the percentage of enrolled clients receiving inpatient services who are readmitted within thirty (30) days to no more than fifteen percent (15%); and

6. Reduce length of stay (LOS) in locked facilities (psychiatric inpatient, IMDs, correctional settings, and other related facilities), resulting in decreased County costs and better long-term community stability.

7. Type 1: FDR program. In addition to general outcomes described above, sixty percent (60%) of clients shall successfully complete the program and be transitioned to lower levels of care within the average LOS.

8. Type 2: AOA program. In addition to general outcomes described above Offeror shall achieve the following outcomes:

a. Eighty percent (80%) of clients shall successfully complete the program and be transitioned to lower levels of care within the average LOS; and

b. Improve functioning as defined through MORS score.

B. Offeror shall achieve the following outcome measurement methods:

1. Assess performance targets, metrics, and improvement objectives and address needed improvements in the Quality Improvement Plan (QIP) as set forth by the BHSD; and

2. Submit a report demonstrating program performance. The report shall include run charts, demonstrating monthly performance and discussion of improvement activities related to the targeted performance category.

3. Type 1: FDR program. In addition to general outcome measurement methods described above, Offeror shall provide data required by the Department of State Hospitals on Track I, Track II and Track III clients served, in order to maintain and ensure reimbursement of DSH Funding.

4. Type 2: AOA program. In addition to general outcome measurement methods described above, Offeror shall collaborate with the BHSD to develop a well-defined referral and coordination procedure to determine which data to share for evaluation purposes.

Program Description A. Service Description

1. Purchase of dedicated beds (if applicable) shall be upon successful contract negotiations and mutual agreement between the BHSD and Offeror.

2. The program is an acute hospital alternative treatment for clients, including justice-involved individuals experiencing a psychiatric episode or mental health crisis. Program services shall follow a social rehabilitation model that integrates psychosocial rehabilitation, milieu therapy, and case management.

3. Services shall increase each client’s level of functioning by addressing any deficiencies that affect their ability to function at their optimal level and allow them to reside in the community with stability.

4. The BHSD requires services provided to use a person-centered care and treatment planning approach, such as transformational care planning. Person-centered care refers to an understanding of each client’s strengths, abilities, needs, and challenges and incorporates these into a personal recovery vision.

5. Offeror shall provide services in accordance with the ordinances and resolutions of the County Board of Supervisors and applicable policies, procedures, directives, and guidelines of the County, BHSD, and County of Santa Clara Health System, including, but not limited to the BHSD Provider Manual.

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

a. Medical necessity criteria;

b. Documentation redesigns;

c. Co-occurring disorder treatment;

d. Standardized screening and transition tools;

e. Behavioral Health Current Procedure Terminology (CPT) coding transition; and

f. Payment reform.

7. Offeror shall provide inclusive, individualized behavioral health treatment services to clients, including individuals with charges such as assault, arson, and California Penal Code § 290.

8. The facility shall maintain awareness of staffing and caseload ratios to avoid overloading clients and staff.

B. Service Delivery

1. Offeror shall establish and maintain State certification to provide Medi-Cal reimbursable services, including CCL Licensing, in Santa Clara County before rendering and billing for Medi-Cal services to clients.

2. Service activities shall include outreach and engagement in and out of a carceral setting, assessments, medication support, evaluations, plan development, individual and group therapy, rehabilitation, collateral intervention, crisis intervention, consultation, collaboration with justice partners including supervising officers and the courts, discharge planning including warm hand offs to lower levels of care programs, and referrals to other community resources. Services shall be based on client needs, presenting issues, and identified wellness and recovery goals. Offeror shall be responsible for arranging emergency services for clients as needed.

3. Offeror shall create a residential community/setting that places an expectation on clients to participate in their day-to-day activities.

4. Offeror shall involve clients in creating their treatment plans, defining their immediate and long-term goals, and deciding how those goals shall be met. Program staff shall assist clients in defining tangible and realistic steps to build necessary client skills, overcome personal fears in meeting their goals within a specific timeframe, and begin to build increments of success over time.

5. Type 1: FDR program. In addition to service delivery and treatment requirements described above, this also includes the following:

a. Structured, all-inclusive services shall be provided within the average LOS of twenty-one (21) days and have an active, structured schedule based on 15-16 hours a day with the understanding that additional time may be needed in special circumstances.

b. Staff shall provide a Client Status Report (CSR) to BHSD FDR Division for justice-involved clients who have been released into the community: 1) on a monthly basis, 2) immediately after an unusual incident occurs, which shall in no event be more than forty-eight (48) hours after the incident; and 3) within seventy-two (72) hours from when additional client information is requested by the Court, the clients’ supervising officer, and/or BHSD FDR Division. Offeror’s staff shall conduct client outreach within twenty-four (24) hours of any client being remanded into custody in order to re-engage the client into treatment, in instances of flash incarcerations.

c. Program staff shall be responsible for transporting clients. Locations include, but are not limited to:

i. From a custodial or inpatient setting to the FDR Crisis Residential Services facility;

ii. Scheduled client appointments (e.g., behavioral health, medical, Social Security, etc.); and/or

iii. Scheduled court-ordered appearances.

iv. Staff shall provide BHSD FDR Division a weekly client status report of individuals who are pending release from jail into the community.

6. Type 2: AOA program. This level of care includes all service delivery and treatment requirements described above and below:

a. Structured, all-inclusive services shall be provided within the average LOS thirty (30) days as determined by Evidence-based practices (EBPs) or Promising Practices (PPs) with the understanding that additional time may be needed in special circumstances.

b. Offeror shall utilize approaches, such as the Wellness Management and Recovery Services, Copeland’s Wellness Recovery Action Plan, Adams and Grieder's Person-Centered Care and Planning, and other methods as appropriate for client needs.

C. Medication Support Services

1. Offeror shall ensure that Psychiatrist(s) are part of the Programs treatment team(s) and are available to provide medication support services to clients in CR.

2. Offeror shall assist clients in understanding the role of medication in their recovery plan, explain the range of medication choices, and provide education on possible side effects and how to manage them.

3. Offeror shall obtain clients’ informed consent to take medication and address concerns and questions quickly and proactively to increase medication adherence.

4. Offeror shall ensure medication requirements are in accordance with, but not limited to, those described in the State of California Manual of Policies and Procedures, CCL Title 22, Division 6, Chapter 2.

5. The medical and psychiatric policies and practices of the program shall be in writing and shall include, but not be limited to:

a. Monitoring of medications;

b. Screening for medical conditions and/or complications;

c. Psychiatric medication education;

d. Documentation in clients’ case records; and

e. Provision for central storage of medications.

1. Type 1: FDR program. In addition to medication support requirements described above, this also includes the following:

a. Offeror’s staff shall ensure clients have access to their psychotropic and physical health medications immediately upon release from custody, community placements have been secured prior to the clients’ release, and immediate physical health needs have been met.

D. Staffing Requirements

1. 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).

2. Offeror shall recruit staff (including staff with lived experience or in recovery) that bring a wide range of experience and perspective, comfortable with clients in psychiatric distress, and can skillfully function in an open, rather than clinical, environment.

3. Psychiatrist(s) shall be onsite to provide medication support services to clients, including on-call availability to deal with emergencies 24/7.

4. Addiction Counselor(s) shall administer assessments addressing any substance use concerns for clients served through this program.

5. Addiction Counselor(s) working directly with clients shall be a Certified Advanced Alcohol and Drug Counselor (CAADC) II.

6. All staff shall abide by the following staffing requirements:

a. Have knowledge and skills in confidentiality and principles of psychosocial rehabilitation and recovery processes;

b. Understand psychopathology and physical health problems within the context of client age range, cultural influences, and language needs;

c. Serve specialized ethnic and cultural populations and regions based on County needs. Preference for qualification shall include Offerors indicating available program language capacity for the County’s seven (7) threshold languages with treatment and recovery staff designated as bilingual.

d. Demonstrate knowledge of local community resources available to the diverse population, including services available through self-help centers, ethnic community resources, social services, and housing services; and

e. Have the ability to collaborate and coordinate with local providers of health and human services, as well as justice partner organizations.

7. Staffing shall be provided at the minimum licensing requirements outlined in Title 9, Title 19, and Title 22 of Medi-Cal regulations.

8. Type 1: FDR program. In addition to staffing requirements described above, Offerors staff shall:

a. Obtain jail clearances to provide clients with in-custody outreach and engagement services;

b. Understand the intergenerational impacts of incarceration on clients and their families; and

c. Understand the justice system in order to support clients in navigating through the various legal requirements needed to successfully graduate from the justice system.

E. Cultural Competency

1. Offeror shall submit a complete and updated list of staff’s cultural, gender, and language-specific competencies, per Appendix G, Cultural Competence Form.

2. 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.

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

4. Offeror’s organization shall have a plan to address barriers when they do not have staff available to meet the seven (7) Santa Clara County threshold languages (Spanish, Vietnamese, Mandarin, Cantonese, Tagalog, Farsi, and Russian) and a plan for actions and changes to ensure diversity and inclusion in service delivery.

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

6. Type 1: FDR program. In addition to cultural competency requirements described above, Offeror shall provide outreach and engagement services to individuals in-custodial settings who have been referred to crisis residential services.

F. Referrals and Admissions

1. Offeror shall accept referrals generated either through BHSD FDR or AOA 24-Hour Care teams, including, but not limited to:

a. Priority access shall be given to clients whose immediate admission shall prevent inpatient hospitalization;

b. All clients authorized for the program shall be informed by their case manager the service is time-limited and based on service needs as determined by the treatment team and authorized by BHSD; and/or

2. Client referrals may result from any of the following:

a. Discharge from an acute inpatient care facility, IMD, or EPS;

b. Referrals from other CCPs for clients requiring a higher level of care;

c. Referrals from other counties for clients whose benefits are associated with County 43.

3. Offeror shall abide by Level of Care Policy and Procedure #412-330, which indicates either the BHSD FDR or AOA 24-Hour Care teams may refer clients regardless of language and cultural focus in instances where the need for this specific language or cultural focus is required.

4. All clients placed within the program shall be authorized by either the BHSD FDR or AOA 24-Hour Care teams before placement occurs.

5. Type 1: FDR program. Referrals of justice-involved clients may result from general referrals described above, including the following:

a. Referral from BHSD FDR Division, which include the BHSD Collaborative Court Clinicians and BHSD Clinicians located at the Re-Entry Resource Center. These referrals may be initiated by:

i. Correctional/detention facilities; and/or

ii. Screenings by the Integrated Urgent Care Center or EPS for justice-involved Medi-Cal beneficiaries.

6. Type 2: AOA program. Client referrals may result from general referrals described above, including the following:

a. Outpatient services; and/or

b. BHSD Call Center.

G. Care Coordination

1. Offeror shall work collaboratively, as necessary, with the courts, supervising officer(s), other justice partners, conservators, family members, and other providers to help clients transition from the program as soon as feasible.

H. Program Hours of Operations

1. Offeror shall be available twenty-four (24) hours, seven (7) days a week, to address any emergent client needs.

2. Offeror shall provide an updated agency plan for 24/7 coverage at the beginning of each new fiscal year and when any changes to this plan occur prior to implementation, approval shall be obtained from:

a. Type 1: FDR program. FDR Division Director, Senior Manager, and Program Monitor.

b. Type 2: AOA program. AOA Division Director and BHSD Program Monitor.

I. Evaluations, Transitional Planning, and Discharge

1. Client Evaluations

a. Offeror shall maintain certification as a short-term crisis residential program by the California DHCS. Consistent with Section 532 of Title 9, CCR. Individuals admitted to Crisis Residential Treatment Services must receive an initial assessment within three (3) days prior to or after admission, which includes:

i. Mental health assessment;

ii. Psychiatric medication evaluation;

iii. Physical assessment; and

iv. Screening for medical complications that may contribute to any disability.

b. Offeror shall complete a client assessment and plan development of all client referrals within twenty-four (24) hours of admission. Based on assessment results, clients shall be supported in building on the strengths of recovery in partnership with the treatment team, family, and/or other supports.

2. Discharge

a. Offeror shall discharge clients according to BHSD Utilization Management (UM) discharge criteria for this level of care.

b. Offeror shall discharge clients upon improvement of symptoms and level of functioning and/or graduation from the justice system to enable them to progress to a less restrictive community-based outpatient service and/or other levels of care.

3. Client Transition Plan

a. Offeror shall ensure appropriate follow-up or other service linkages and placements are made prior to discharging the client from the program.

b. Offeror shall coordinate with new service provider to assure an understanding of clients’ strengths, needs, supports, and goals.

c. Offeror shall provide copies of the care plan, narrative summary, assessment information, psychiatric assessment, and medication orders to the new service provider.

d. Offeror shall arrange a visit to the new program location with the current service provider to meet, tour the facility, and provide a warm hand-off.

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 B3b, Evaluation Criteria and Qualifications 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 in effect relating to COVID-19 for persons who routinely perform services for County onsite and share airspace with or proximity to other people at a County facility as part of their services for County as set forth in a County Health Order (or similar directives).

RFSQ-BHS-FY23-0225: Behavioral Health Treatment Facility Continuum of Care Page 1 of 3 ATTACHMENT A3b: Adult Crisis Residential and Medication Support Services Scope of Work