Attachment A5.docx

ATTACHMENT A5

CATEGORY 1: PREVENTION AND EARLY INTERVENTION SERVICES

ETHNIC AND CULTURE SPECIFIC WELLNESS CENTERS

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 services for the Ethnic and Culture Specific Wellness Center (hereafter named “the program”). The program shall provide wellness-centered mental health services to the general population of adult and older adult residents of Santa Clara County by providing structured and unstructured wellness and recovery-focused groups, activities, and counseling support groups.

Offeror shall submit proposals for one or both centers located in the regions as specified in Section III.B.

This program shall provide direct activities to reduce negative feelings, attitudes, beliefs, perceptions, stereotypes and/or stigma and discrimination related to being diagnosed with a mental illness, having a mental illness, and/or seeking mental health services.

Background Information A. The BHSD’s Adult and Older Adult Services Division serves clients with severe mental illness (SMI) who are eighteen (18) years of age or older and represent the ethnic and racial diversity of the County.

B. In the fall of 2016, the BHSD collaborated with a consultant to assess the effectiveness, structure, quality, and impact of Mental Health Services Act (MHSA)-funded Continuum of Care in the County. The goals of the collaboration were to conduct a retrospective exploration to determine what had been accomplished regarding MHSA implementation, document the current landscape of MHSA-funded services, and identify what additional needs remain in order to target future efforts. As a result of this collaboration, it has been recommended that a series of Wellness Centers (which have a variety of wellness and recovery-related direct services) be beneficial to County residents. Moreover, clients taking part in the services of the Wellness Centers would be welcome to attend their choice of activities and services without limit.

Target Population A. The program shall serve County residents in the following age groups, regardless of their mental health status:

Adults (ages 18 through 59); and Older Adults (age 60 and over).

B. The program shall provide services in four (4) primary County regions:

1. North County: Palo Alto, Los Altos and Los Altos Hills, Mountain View, and Sunnyvale;

Central County: San Jose, Cupertino, Santa Clara, Los Gatos, Monte Sereno, Saratoga, and Campbell;

East County: San Jose (Foothills, Berryessa) and Northeast San Jose/Milpitas areas; and South County: Gilroy, Morgan Hill, and the unincorporated area of San Martin.

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

1. The overarching goal of this outreach program is to reduce stigma related to mental illness and increase public awareness of available resources so that individuals can get the help they need when they need it. With these goals and objectives, we aim to create a more informed and supportive community for those affected by mental health issues.

Goals shall include, but not be limited to:

a. Increase public awareness and understanding of mental health issues;

b. Reduce stigma associated with having a mental illness or seeking mental health services;

c. Increase program participation; and

d. Foster healthy living and positive interactions by building and maintaining a compassionate and supportive interpersonal environment that teaches, exemplifies, and reinforces wellness and recovery values including:

i. Improving self-advocacy;

ii. Enhancing community involvement; ands

iii. Reducing stigma and discrimination.

Objectives shall be achieved by:

a. Developing and delivering awareness campaigns to educate the public on mental health issues and reduce stigma associated with mental illness;

b. Establishing a network of resources to support individuals seeking help for mental illness and their families, friends, and those providing support for them;

c. Organizing local activities to promote positive mental health messages and create a supportive environment for those living with mental health issues;

d. Creating and distributing educational materials on available resources, diagnosis and treatment options, evidence-based interventions, and ways to seek help if needed;

e. Developing and implementing strategies to identify and address barriers that may prevent individuals from seeking help or accessing resources;

f. Monitoring outcomes of awareness campaigns, resource networks, and other initiatives to ensure program effectiveness;

g. Working with local partners to coordinate services and ensure access to care for those affected by mental health issues;

h. Evaluating program effectiveness and making necessary adjustments to ensure successful outcomes; and

i. Supporting spiritual and cultural activities as therapeutic interventions.

I. Reporting and Data Collection Requirements A. Offeror shall be responsible for the completion and submission of data, including the following as appropriate for the program:

1. Quarterly reviews (or more frequent reviews as needed) from the following data sources:

a. Client and Service Information (CSI) data; and

b. County data system data (ex. MyAvatar).

2. Services received by clients that take part in activities and events of the program by tracking information, including but not limited to:

a. Type of services accessed/participated;

b. Services participation frequency;

c. Client feedback on effects of activities in improving their lives; and

d. Clients’ or clinical staff request for referrals to new programs/services and services beyond 12 months.

3. Track the following information from clients served:

a. Number of clients already receiving services from the BHSD or from the BHSD contracted providers;

b. Number of clients referred to the program and type of referral; and

c. Demographic information of those that participate, including but not limited to ethnicity, age, gender, etc.

B. Offeror shall provide incident reports on all incidents that occur during any time that programs and/or sponsored events are occurring, using the standard County-issued incident report form.

C. Offeror shall request clients to complete a Client Satisfaction Survey (five to ten [5-10] question survey) to measure satisfaction with existing services on a quarterly basis.

D. 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.

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

1. Assisting clients in further developing their knowledge of wellness and recovery principles;

1. Increasing clients’ healthy coping behaviors by providing wellness and recovery-focused group services and activities provided;

1. Reducing Behavioral Health Stigma by engaging consumers to complete surveys; and

1. Conducting pre- and post-peer services surveys to measure behavioral health attitudes in the program.

1. Offeror shall achieve the following outcome measurement methods:

1. Client and Service Information (CSI) data;

1. County’s data system(s); and

1. Other data reporting requirements as requested by the BHSD.

B. Offeror shall achieve data submission guidelines by following the County’s data reporting requirements described in Section V above, including but not limited to:

1. Submit quarterly reports demonstrating performance in the outcomes and survey metrics;

2. Review run charts that demonstrate monthly performance and shall include discussion of improvement activities related to the targeted performance;

3. Submit an annual Quality Improvement Plan (QIP) for review and approval as set forth by the County. Offeror shall be able to assess performance in the outcomes and survey metrics and shall be able to address improvements in the QIP.

III. Program Description A. Service Description

1. Offeror shall provide group counseling, activities, and psychoeducational services to the general community, which shall include structured and unstructured wellness and recovery-focused groups and activities, and counseling support groups, focusing on increasing and maintaining the stability of the client’s mental health and social supports through the program.

2. Offeror shall refer clients receiving services in the program to other outpatient services, or to other appropriate levels of care, either through the Call Center if not a current BHSD client, or via transfer to other BHSD programs if the client already has an open case with a service team.

3. Offeror shall provide a range of groups and activities that support clients in developing the necessary skills to live meaningful and productive lives in the community. Groups shall range in topic, but are not limited to the following types of wellness and recovery focus:

a. Dual diagnosis;

b. Psychotropic medications;

c. Mental health symptom management;

d. Coping skills;

e. Life skills (such as money and home management);

f. Leisure;

g. Health;

h. Social;

i. Spiritual;

j. Emotional; and

k. Environmental/community.

4. Offeror shall ensure that the program services shall have the following core elements:

a. Groups that address mental health, substance use, and life skills;

b. One-on-ones by staff and peer support as needed to address specific needs;

c. Linkages to behavioral health, vocational service, housing, money management, case management;

d. On-site money management and assistance in budgeting; and

e. Program member peer-driven activities.

5. Offeror shall provide the education and support necessary for the clients to succeed in their mental health and substance use recovery by planning and providing the following groups and activities:

a. Relapse prevention groups;

b. Alcoholics Anonymous/Narcotics Anonymous (AA/NA) groups;

c. Skill building groups;

d. Nutrition and healthy living groups;

e. Daily activities for exercise and enrichment;

f. Organized community activities; and

g. Discrimination Reduction Programs include, but are not limited to:

i. Social marketing campaigns;

ii. Speakers’ bureaus;

iii. Direct-contact approaches[footnoteRef:2]; [2: E.g., targeted education, training, and anti-stigma advocacy.]

iv. Web-based campaigns;

v. Efforts to combat multiple stigmas that have been shown to discourage individuals from seeking mental health services;

vi. Efforts to encourage self-acceptance for individuals with a mental illness; and

vii. Stigma and Discrimination Reduction Programs[footnoteRef:3]. [3: Program shall include culturally congruent approaches with the values of the populations for whom changes in attitudes, knowledge, and behavior are intended.]

6. 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.

7. 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:4] treatment; [4: 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 describe the existing staff who shall be providing the services and program components described in this Request for Statement of Qualifications (RFSQ).

2. Offeror shall include a staffing table and credentials for those who shall be providing and supporting these services and indicate position title, linguistic and cultural skills, education, experience, licensure, and certifications, including administrative, supervisory, and direct service staff. Updated agency plan for administrative coverage or program-related changes to the BHSD Division Director shall be submitted at the beginning of each new fiscal year and when any changes to this plan occur for approval prior to implementation.

3. 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 been with the organization.

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

5. Offeror shall maintain adequate staffing as appropriate for the program, including the following as listed below:

a. Direct service staff such as licensed or waivered social workers and marriage and family therapists and/or associates, social worker and marriage and family interns, and peer counselor/rehabilitation worker; and

b. Quality assurance staff.

6. Offeror shall ensure that the direct services staff required by the program are in place prior to the start of contract and shall remain available to provide services to the clients on an ongoing basis.

7. Offeror shall have staff who are appropriately trained and meet the qualifications of Licensed Practitioner of the Healing Arts (LPHA) as well as meet specific discipline requirements.

8. Offeror’s staff shall at least meet the licensing requirements as set forth in Title 9, Title 19, and Title 22 of Medi-Cal regulations.

9. Offeror shall provide the BHSD Contract Monitor and Division Director a complete and updated list of all staff, regardless of professional credentials, including specific information regarding languages spoken and certification in specific languages. Staffing shall be provided at the minimum licensing requirements as set forth in the California Code of Regulations.

10. Offeror shall provide documentation that all staff are qualified and have been trained in accordance with the licensing requirements and the applicable regulations for the program. In addition, Offeror shall ensure that their staff are trained and proficient in the following:

a. Knowledge and skills in the principles of psychosocial rehabilitation and recovery processes;

b. Confidentiality;

c. Crisis assessment and intervention;

d. Understanding of psychopathology and physical health problems within the context of client’s age and culture;

e. Effectively address client’s cultural and language needs;

f. Awareness of language and cultural influences on the client;

g. Knowledge of the local community resources available to the client population, including other self-help centers and ethnic community resources;

h. Understanding of the mental health system of care; and

i. Capability to collaborate and coordinate with local providers of health and human services.

11. Peer support license-waivered and non-licensed professionals shall be used to manage non-clinical groups, services, and events, provided that a licensed mental health provider is available to support and manage the program.

12. Clinical services shall be provided by fully licensed and/or board-certified staff, or be supervised by same, if license waivered.

13. Offeror’s organization shall maintain practices related to recruiting, hiring, and promoting bi/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).

s 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 the effectiveness of their culturally responsive services/practices to continually improve service quality and make adjustments as appropriate 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.

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

D. Referrals and Admissions

1. Offeror shall evaluate clients as needed, identify needs, and link the clients to appropriate services and resources. Staff shall support each client’s needs and include the client’s primary care provider, substance use/recovery partners, and/or specialty mental health programs and services.

E. Care Coordination

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

a. Offeror shall partner and collaborate with other service providers in the County to link to services connected to other resources and supports, and to provide information and referral to clients who are seeking additional resources that shall further improve their daily life management (e.g., legal guidance, food, clothing and shelter referrals, access to mental health services in the County, referrals to Department of Rehabilitation work programs, etc.).

F. Program Hours of Operations

1. Offeror shall be open for services Monday through Friday 8:00 AM to 6:00 PM. Offeror shall be requested to have group activities and services available during evening hours and on weekends.

G. Evaluations, Transitional Planning, and Discharge

1. Clients shall engage in services for as long as it is supportive and helpful.

2. Clients shall receive behavioral health treatment services and activities outside of the program as deemed necessary.

3. When clients and/or family express need for higher levels of care, program staff shall follow County transition procedures to refer clients/families to appropriate services. Clients/families who are referred to higher levels of care shall continue to receive program services.

4. The program shall be in compliance with the MHSA PEI data and evaluation regulations.

IV. 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 B5 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 A5: Ethnic and Culture Specific Wellness Centers Scope of Work CATEGORY 1: Prevention and Early Intervention Services