Attachment A4.docx

ATTACHMENT A4

CATEGORY 1: PREVENTION AND EARLY INTERVENTION SERVICES

ELDERS’ STORYTELLING

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 providing Prevention and Early Intervention (PEI) Elders’ Storytelling Program (hereafter referred to as “the program”) for culturally isolated older adults with mild to moderate depression and are residents of Santa Clara County.

Offeror shall provide a culturally proficient technique of life review and storytelling (Reminiscence), which incorporates innovative service components to help reduce the elderly client’s depressive symptoms and restore their position of social connectedness within their family, friends, caregivers, and community.

Older adults served in this program may be open to traditional outpatient mental health services and may benefit from this adjunct treatment. Clients who are not currently assigned to traditional outpatient mental health services may also be referred to the program through other Older Adult Programs.

I. Background Information A. The program is funded under the PEI component of the Mental Health Services Act (MHSA). Offeror shall implement the program in accordance with the California Welfare and Institutions Code (WIC) Section 5840.

Target Population A. Offeror shall serve culturally isolated older adults (age 60 and over), who may have experienced trauma and may have mild to moderate depression.

B. Offeror shall serve underserved older adults and shall demonstrate knowledge of specialized ethnic and cultural populations and regions to be served. Knowledge shall be gained through extensive experience in working with these specific populations and through the lived experiences of staff providing services to these specific communities.

C. Offeror shall serve clients who are open to traditional behavioral health services and are subject to all Medi-Cal and Medicare record requirements, as well as clients who are seen through the Older Adult Outreach Programs Prevention (OAOPP).

D. The clients referred to this program shall be from different areas throughout Santa Clara County and represent multiple ethnic and linguistic groups.

E. Older Adults who may be receiving outpatient services would be deemed appropriate to participate in this program as an adjunct modality.

Program Goals and Objectives A. Offeror shall be aligned to achieve the following goals with respect to the client:

1. Reduce depressive symptoms;

2. Decrease isolation;

3. Restore social connectedness with their family, friends, caregivers, and community;

4. Strengthen recovery;

5. Increase self-sufficiency;

6. Promote participation in meaningful activities;

7. Develop, increase, and strengthen natural networks of supportive relationships; and

8. Conduct outreach contacts with older adults interested in participating in the Storytelling activity.

B. Offeror shall achieve the following objectives:

1. Serve older adults who have a history of trauma by processing feelings through Reminiscence and positive support networks; and

2. Provide ongoing education and supports to assist clients and their families gain insight and understanding into mental illness.

II. Reporting and Data Collection Requirements A. MHSA Reporting and Data Collection Requirements are required for non-billable services for clients who are not open to traditional services or for whom Elders’ Storytelling is used as a non-billable adjunct therapy. Specific testing materials are required for this group and are included in the Evaluations, Transitional Planning, and Discharges.

B. Offeror shall submit a PEI Data Report in a BHSD MHSA template that includes demographics, implementation challenges, successes, and lessons learned. Both Offeror Report and PEI Data Report shall be submitted to the BHSD Program Monitor on a quarterly and annual schedule.

C. Offeror shall complete the MHSA reporting template which shall summarize and describe the following data elements, on a quarterly and annual basis:

1. Number of unduplicated clients served;

2. Number of clients at risk;

3. Number of clients with early onset;

4. Number of client family members;

5. Number of clients with Severe Mental Illness (SMI) referred to treatment;

6. Type of treatment referred to;

7. Number of individuals referred clients who followed through on referral and engaged in treatment;

8. Average duration of untreated mental illness for each client;

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

10. Number of referrals to an Early Intervention Program or Prevention Program;

11. Number of referrals to treatment beyond early onset; and

12. Description of the ways the County encouraged access to services and follow-through on referrals.

D. Offeror’s staff shall attend meetings as scheduled by the BHSD to report on activities to date for comparison with contract deliverables and to receive technical assistance or other support. Offeror’s staff shall be informed about any trainings and/or informational sessions related to PEI data regulations and shall attend these trainings and/or sessions as determined by the BHSD Program Monitor.

E. Offeror shall be required to submit additional deliverables or reports requested by County financial or program monitors that may be required by the MHSA and related regulations and requirements. Offeror shall comply with the reporting requirements of County, State, or Federal agencies, and applicable law and regulations, as a condition of funding. The BHSD shall provide timelines in advance for requests of additional deliverables or reports.

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

1. 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 achieve the following client outcomes:

1. Decrease suffering from traumatic events;

2. Decrease depressive symptoms and improve quality of life;

3. Support a positive client service experience;

4. Connect clients to community or county-based programs and services; and

5. Successful discharge.

B. Offeror shall use the following outcome measurement methods:

1. Offeror shall comply with all requests regarding local, state, and federal performance outcomes measurement requirements and participate in the outcomes measurement processes as requested.

2. Offeror shall utilize the Quarterly and Annual PEI Report Template and shall submit a quarterly report demonstrating performance in the above metrics.

3. Offeror shall create and review run charts that demonstrate monthly performance in the above metrics from the start date of the contracted services and shall include discussion of methods of improving activities related to the targeted performance.

IV. Program Description A. Service Description

1. Offeror’s staff shall participate in older adult community outreach events, including but not limited to: community fairs, faith-based or cultural community events, social events, senior nutrition centers, County-contracted providers (CCPs), and orientation and psychoeducation groups where older adults congregate.

2. Offeror shall part take in a referral system to engage clients who are part of the traditional mental health system.

3. Offeror shall provide culturally and linguistically proficient techniques of Reminiscence and incorporate other service components to help restore participating clients to a position of social connectedness with family, friends, caregivers, and community.

4. Offeror’s staff shall explore, identify, and utilize artistic methods to document the older client’s oral stories and keepsakes for sharing with family, friends, and the community.

5. Offeror’s staff shall conduct weekly home visits to facilitate the client’s storytelling.

6. Offeror’s staff shall conduct support groups to facilitate the client’s storytelling to promote socialization and reduce isolation.

7. Storytelling intervention shall include family members when appropriate to help improve family relationships.

8. Offeror shall conclude storytelling sessions with an event where the participants share their story or related art pieces with family and/or members of their community.

9. 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.

10. 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[footnoteRef:2] treatment; [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 designee must approve the plan and any changes prior to implementation.

2. Offeror shall conduct storytelling intervention in the client’s language to engage and support the client.

3. Offeror shall be trained to deliver the storytelling practice.

4. Offeror shall be trained and have specific expertise in working with the elderly population.

5. Offeror shall have a valid State Elder Abuse Reporting Certificate.

6. Offeror shall be trained in Mental Health 101 or equivalent.

7. Offeror’s staff shall participate in weekly staff meetings and/or check-in meetings.

8. Offeror staff shall possess skills that include experience with Elder Storytelling and working with Older Adults who are culturally isolated.

9. Offeror’s staff shall possess education and experience in mental health/co-occurring disorders and have specialized experience working with Older Adults in behavioral health services, issues of aging, and substance use issues. Staff shall have crisis and conflict management training.

10. Offeror’s staff shall attend regularly scheduled meetings, training sessions, seminars, or other meetings as scheduled by the BHSD, including Adult and OA System of Care meetings.

11. 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.

12. 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.

13. 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.

D. Referrals and Admissions

1. Offeror shall refer clients as determined by County’s policies, procedures, directives, and guidelines that are within its resources.

2. Offeror shall accept referrals from other contracted agencies and OA outreach programs. The clients referred shall meet the diagnostic and functioning levels stated herein. All referrals shall be screened for consistency with the BHSD inclusionary criteria, as determined by guidelines developed with community and provider input and approved by the BHSD Director.

3. Offeror shall have sufficient resources to redirect a referral to other resources when the need is deemed outside of the service provided.

E. Care Coordination

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

a. To facilitate care coordination, Offeror shall request Health Insurance Portability and Accountability Act (HIPPA) and California law-compliant client authorization to share client information with all other providers involved in the client’s care, in satisfaction of state, and federal privacy laws and regulations.

b. Offeror shall engage in care coordination activities beginning at client intake and throughout the treatment and discharge planning processes.

c. Offeror shall discuss in their proposal evaluation criteria for clients needing additional mental health services and other resources, including how they would assist in transitioning the client.

d. Clients who are open to receiving traditional mental health services shall, as part of their acceptance into this program, sign appropriate Consents for Release of Information so that program staff have authorization to share client information with their primary mental health providers.

e. Offeror shall describe their organization’s willingness, experience, and ability to collaborate with multiple County systems and services.

F. Program Hours of Operations

1. Offeror shall be open for services Monday through Friday, from 8:00 a.m. - 6:00 p.m., and shall have services available during evening hours and on weekends as needed to meet clients’ needs.

2. Offeror shall provide an updated agency plan for administrative coverage or Program-related changes to the BHSD Division Director or their designee at the beginning of each new fiscal year and whenever any changes to this plan occur for approval prior to implementation.

G. Evaluations, Transitional Planning, and Discharge

1. Offeror shall use the following measures to establish baseline data and collect post-intervention measures on clients: Demographic data on clients; the PHQ-9; the Geriatric Depression Scale (GDS-15) the Short Scale (SWLS); Treatment Satisfaction (post-test only).

2. Offeror shall evaluate upon completion of this program whether, unless already part of the traditional mental health services, the client shall be linked to a Medi-Cal Home, Health, and Wellness Program and/or Primary Care Behavioral Health (PCBH) or other related health care program for continued care, if required.

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 B4 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;

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 1 of 9 ATTACHMENT A4: Elders’ Storytelling Scope of Work CATEGORY 1: Prevention and Early Intervention Services