Attachment A8.docx

ATTACHMENT A8

CATEGORY 2: OUTPATIENT SERVICES

ADULT AND OLDER ADULT OUTPATIENT CONTINUUM SERVICES

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 designing and operating an Adult and Older Adult Outpatient Continuum Services Program (hereafter referred to as “the program”).

Offeror shall provide comprehensive, culturally appropriate, and trauma-informed behavioral health services for adult (ages 18 through 59) and older adult clients (ages 60 and over) that combine components of recovery-oriented, evidence-based practices (EBPs), promising practices (PPs), and trauma-informed practices.

Services shall be designed to improve the emotional/behavioral functioning and enhance the abilities for clients to participate in meaningful activities such as recreational, school, employment, and independent living activities. The program shall build and nurture natural supports, which help clients remain in the communities as emotionally healthy and productive members.

Offeror shall work cooperatively with community navigators, community providers, other mental health agencies, Substance Use Treatment Service providers, physical health providers, educational systems, and other groups that provide supportive services.

Offeror may also optionally provide Individual Placement and Support | Supported Employment (IPS/SE), an evidence-based practice model that utilizes employment as a wellness goal for behavioral health clients, as part of the Outpatient services. Proposals intending to provide IPS/SE should answer the related IPS/SE questions and meet the requirement outlined when responding to the solicitation.

Operational and Logistical Requirements

1. Offeror shall have current Medi-Cal certification or become certified to provide Medi-Cal reimbursable services on or before the contract start date. In addition, Offeror shall also have Medicare certification or become certified to provide Medicare reimbursable services on or before the contract start date.

1. Offeror shall strategically operate a Medi-Cal and Medicare certified service delivery site within the identified County catchment areas. The site shall be considered home base for Offeror’s staff. Even with established sites, services can be offered in the community or wherever the clients are (e.g., work, school, home, homeless shelter, etc.), if appropriate.

Services shall strategically be situated within the identified County catchment areas. The three (3) primary regions of focus for program services are North, Central, and South County regions:

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

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

3. East County: San Jose (Foothills, Berryessa) and Northeast San Jose/Milpitas areas; and

4. South County: Gilroy, Morgan Hill, and the unincorporated area of San Martin.

Target Population

1. The program shall target previously unserved and underserved adults (age 18-59 years) and older adults (ages 60 and over). Clients served may include adult and older adults that experience at least one (1) of the following:

1. At-risk of suicide, homelessness, and/or (re-)entering into the Adult and Older Adult System of Care;

2. Diagnosed with severe and persistent mental health and/or co-occurring conditions[footnoteRef:2] that result in functional impairments or symptoms, and without treatment shall be at imminent risk of decompensation; [2: Clients require both mental health and substance use treatment services.]

3. Improper adherence to treatment with medication management; and/or

4. Identify with Lesbian, Gay, Bisexual, Transgender, Queer, Questioning, and Plus (LGBTQ+) communities;

5. Reduced access to behavioral health services due to significant situational, cultural, and linguistic needs that have isolated them; and/or

6. Require public assistance services or benefits due to mental functioning impairments and circumstances[footnoteRef:3]. [3: Examples include but are not limited to: community violence, interpersonal family violence, general neglect and exposure to trauma, social and emotional isolation, and physical decline, and/or from underserved cultural populations.]

1. Clients served are County residents that have full-scope Medi-Cal[footnoteRef:4], Medicare, or both Medi-Cal and Medicare (Medi-Medi). [4: Clients with Medi-Cal shall meet Medi-Cal necessity criteria in accordance with all laws and regulations governing Medi-Cal and Medicare programs as mandated by federal, state, and local statues. This includes California Code of Regulations (CCR) Title 9, Social Security Act Title XXII Regulations, and California Welfare and Institutions Code (WIC) § 14705.5.]

1. For programs implementing IPS/SE: In addition to the service requirements listed above, the following service requirement is specific to IPS/SE:

1. The IPS/SE services shall serve adults and older adults with mental health conditions, or those with co-occurring disorders, who currently receive Outpatient services within the BHSD system and are interested in obtaining employment. IPS/SE services shall be delivered as an integral part of Outpatient services.

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

1. Goals shall include, but not be limited to:

a. Reducing suffering from mental illness;

b. Reducing functional impairment due to psychiatric symptoms and any co-occurring substance use;

c. Reducing experiences of homelessness, incarceration, crisis, hospitalization, substance use, violence, trauma, and victimization;

d. Strengthening recovery, self-sufficiency, and other psychosocial outcomes; and

e. Encouraging adults and older adult clients to actively participate in their recovery and self-monitor milestones and goals towards self-determination, family, vocational, and recreational services.

2. Objectives shall be achieved by:

a. Engaging underserved clients who have not yet benefitted from outpatient mental health services due to complex risk factors including substance use, community violence, interpersonal family violence, general neglect and exposure to trauma, social and emotional isolation, and physical decline;

b. Providing behavioral health and co-occurring substance use services for clients through care coordination and utilization of EBPs, PPs, and trauma informed practices;

c. Address client substance/alcohol use and related risky behaviors (e.g., unsafe sex, criminal behaviors) as applicable;

d. Supporting clients in obtaining safe and stable housing;

e. Improving culturally and linguistically proficient client-centered services that integrate or directly provide the full range of treatment modalities and rehabilitation services and resources to meet the needs of clients and their families in their recovery process;

f. Increasing each client’s understanding pertaining to the importance of their medication adherence and treatment compliance through psychoeducation sessions;

g. Assisting clients in learning life skills that allow them to become more independent and self-sufficient;

h. Promoting meaningful use of time and capabilities in school, work, and social activities;

i. Developing, increasing, and strengthening natural networks of supportive relationships;

j. Linking clients to medical and dental healthcare, and other relevant services before discharge;

k. Improving access to community-based and eligible public benefits; and

l. Effectively promoting wellness and recovery by transitioning clients to appropriate levels of care as necessary.

3. For programs implementing IPS/SE: in addition to the service requirements listed above, the following service requirements are specific to IPS/SE and will need to be addressed by each interested Offeror:

a. Integrating employment goals as part of a client’s treatment plan which shall focus on each client’s strengths and motivations.

b. Implementing the IPS/SE model with a zero-exclusion element and focusing on the client’s preferences and individualized job support activities.

c. Connecting clients successfully to competitively paid employment and maintaining employment for as long as the client requests and needs support.

4. Key Outcomes

a. Offeror’s key outcomes plan shall incorporate and achieve the following target benchmarks:

i. Improve access for and engagement of clients into behavioral health treatment;

ii. Demonstrate the ability to successfully transition each client to lower levels of care while maintaining successful client recovery processes;

iii. Improve functioning as defined through DHCS and/or County approved assessment tool(s);

iv. Increase the number of clients engaged in educational and vocational activities;

v. Decrease the number of Emergency Psychiatric Services (EPS),Behavioral Health Urgent Care (BHUC), Emergency Department (ED) and/or other crisis services; and[footnoteRef:5] [5: BHSD will provide data as needed. ]

vi. Increase the number of clients reporting satisfaction with services.

I. Reporting and Data Collection Requirements A. Offeror shall complete the following requirements:

1. Enter client demographic information, direct and outreach services information, and other appropriate data into the BHSD’s data information system.

Enter client data into the state Client and Service Information (CSI) System.

Collect treatment and service data for outcomes data reporting.

Complete and submit the MHSA reporting template to the BHSD on a quarterly basis.[footnoteRef:6] [6: BHSD will provide MHSA reporting template upon contract award. ]

Measure client outcomes for adult and older adult clients served through the program to assist in determining areas of improvement.

When applicable, administer assessment tool(s) as part of the Program requirement(s) and collect and report on assessment tool data.

Utilize the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and/or the International Classification of Diseases, Tenth Edition (ICD-10) for diagnoses and coding purposes.

For Offerors implementing IPS/SE: Collect, document, track and report on data related to community outreach, education, and training services using BHSD provided tools.

B. Data Submission

1. Offeror shall collect and report data including the following as appropriate for the program:

a. CSI data;

b. Network Adequacy Certification Tool (NACT);

c. AOA EBP assessment tool(s);

d. Active Caseload/Length of Stay (LOS) Report;

e. Units of Service (UOS) Report;

f. Client list per staff ratio;

g. Client readmission(s) to the program (as applicable);

h. Post-discharge (e.g., placement/service(s) type, frequency, etc.);

i. Data reporting requirements as requested by the MHSA; and

j. Any County data systems or assessment tools as required by the BHSD.

2. For Offerors implementing IPS/SE: In addition to the requirements listed above, Offeror shall submit Learning Collaborative Community data.

C. 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 by collecting the following MHSA CSS required assessment measures:

1. Clinician-completed assessments

a. Process client intake assessments to capture basic intake and demographic information; and

b. Administer a clinician assessment at follow-up and discharge events. The assessment shall include the following components:

i. Key outcomes (timeliness access, engagement in services, successful discharge, acute care readmission); and

ii. Illness Management and Recovery Scale (IMR).

2. Client-completed assessments

a. Offeror shall administer the client feedback tool (Client Satisfaction Survey) bi-annually.

B. Offeror shall develop a process to systematically monitor and analyze the performance of each targeted outcomes to be achieved, including, but not limited to the following outcome measurement methods:

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

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

3. Improve each client’s emotional and behavioral functioning and ability to participate in meaningful activities; and C. Offeror shall initiate any other monthly, quarterly, and annual measurement tools and documents, which may include Microsoft Excel and other formats as requested by the BHSD. Offeror shall supplement reviews using data sources listed in Section D.

D. For programs implementing IPS/SE: in addition to the requirements listed above, the following IPS/SE requirements will need to be addressed for each interested Offeror:

1. Provide outreach and engagement with clients and program staff regarding employment services.

2. Consistently and regularly integrate employment as a wellness goal in the treatment plan of the clients by:

a. Remaining embedded in the regular service teams to help team members better develop employment goals with their clients as part of resolving items on the problem list;

b. Remaining readily available to staff and clients to provide up-to-date statuses on their employment goals; and

c. Serving as a resource for the team regarding current regulations and benefits relating to client employment.

III. Program Description A. 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, BHSD policies and procedures, and MHSA requirements.

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

a. Medi-Cal necessity criteria;

b. Documentation redesigns;

c. Co-occurring treatment;

d. Standardized screening and transition tools;

e. Behavioral health CPT coding transition; and

f. Payment reform.

B. The program is designed to provide services to clients diagnosed with behavioral health and/or co-occurring disorders.

C. Services shall be provided in a variety of settings, including outpatient clinics, a client’s place of residence, via telehealth, and in the community, as appropriate.

D. Services may include the following:

1. Provide individual, family, and group counseling;

2. Evaluation and assessments of clients using the standard behavioral health tools, which may include BHSD Integrated Assessment (IA), American Society for Addiction Medicine (ASAM) assessment, and other tools as needed to identify issues including, but not limited to, dual diagnosis, substance use physical disabilities, and medications; [footnoteRef:7] [7: BHSD will offer training through the Learning Partnership Division, as needed.]

3. Case management and brokerage (e.g., client support plan development; accessing housing, transportation, and medical care);

4. Connect each client with a Primary Care Physician (PCP) to facilitate treatment of concurrent primary health care and ongoing behavioral health needs;

5. Medication management;

6. Individual rehabilitation services (e.g., vocational readiness, education, and skills for activities of daily living);

7. Rehabilitation and collateral services;

8. 24-hour a day, 7-days a week crisis intervention to respond to and support a crisis, if needed; and

9. Coordination and linkage with other providers and institutions including community-based resources that serve adults and/or older adults in Santa Clara County, recognizing that older adults may be less experienced in seeking resources.

E. Offeror shall prioritize cultural competence and the ability to engage in action or create conditions that maximize the optimal development of the client and client systems. Service array shall reflect the BHSD’s values pertaining to client and family empowerment, best practices, health and wellness, and cultural responsiveness, including the following:

1. Offeror shall provide cultural, ethnic and language specific services to meet the individual recovery needs of the client (e.g., culture, preferred language(s) and communication needs, lived experience, related trauma, and access to systems).

2. Staff shall utilize EBPs, PPs, cultural and trauma-informed practices whenever clinically indicated and based on clients’ diagnoses. EBPs and PPs recommended for the program may include the following: Motivational Interviewing (MI), Stages of Change, Cognitive Behavioral Therapy (CBT), Solution-Focused Brief Therapy (SFBT), trauma-informed approaches, and integrated co-occurring disorder practices and peer supports such as Wellness Recovery Action Planning.

3. Offeror shall provide services based on the client’s problem list.

4. Offeror shall provide client injection(s) and related medication management services as necessary in the outpatient clinics.

5. For programs implementing IPS/SE: in addition to the requirements listed above, the Offeror shall follow the IPS/SE requirements below:

a. Operate in accordance with IPS/SE model and achieve fidelity to the program (e.g., job development standards, employer communications, supports for clients post-job award);

b. Outreach and engagement with clients and program staff regarding employment services;

c. Pre-vocational services to include assisting clients to explore their motivation for returning to the workforce, readiness to return to work, and employment-oriented interpersonal skill set;

d. Integration of employment as a wellness goal in the treatment plan of the client;

e. Job placement and retention support using IPS/SE principles; and

f. Provide care coordination with Department of Rehabilitation (DOR) to ensure client care and warm hand-off.

F. Staffing Requirements

1. Offeror shall ensure that the psychiatrist and clinical staff required by the program are in place prior to the start of the Program and shall remain available to provide services to the clients on an ongoing basis.

2. Offeror shall maintain adequate staffing for the program, including the following as appropriate for the program:

a. Psychiatrist;

b. Direct service staff, such as:

i. Licensed or associate social workers;

ii. Licensed Professional Clinical Counselors;

iii. Marriage and family therapists and interns;

iv. Social workers;

v. California Association of Alcoholism and Drug Abuse Counselor (CAADAC)

vi. Peer mentors;

vii. Rehabilitation counselors; and

viii. Other direct service staff, as appropriate.

b. Licenced Professional Clinical Counselors;

c. Nursing staff and/or psychiatric nurse; and

d. Quality assurance staff.

3. Offeror’s staff shall meet all BHSD training and licensing requirements, including but not limited to:

a. BHSD reflective supervision, reflective practice, and clinical supervision requirements;

b. County policy (staff which meet specific discipline requirements; appropriately trained Licensed Practitioner of the Healing Arts [LPHA]); and

c. State and Federal (Title 9, Title 19, and Title 22 of Medi-Cal Regulations) policy.

4. Offeror shall complete Appendix B8 and include the following supplemental information per program:

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;

b. Detailed plan to recruit and maintain appropriate staffing to meet the diverse population of Santa Clara County;

c. Personnel retention plan for the program, 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;

d. Approximate percentage turnover of the direct service staff over the past three (3) years; and

e. Plan to provide continuity of care for clients and their families during staff turnover.

5. Offeror’s staff shall meet the BHSD Co-Occurring Standards. The BHSD Co-Occurring Standards expect all paraprofessional and professional practitioners to have the minimal core skills and be trained according to the following three-core skill levels:

a. Co-Occurring Informed: This level of practice identifies the core skills needed to support treatment. The identified domains for this level are screening, engagement, readiness and retention, education, advocacy, and collaboration.

b. Co-Occurring Capable: This level of practice identifies the core skills needed to provide an integrated assessment and provide treatment to clients and families facing mild to moderate co-occurring disorders. The identified domains for this level are screening, assessment, diagnosis, and co-occurring capable treatment.

c. Co-Occurring Enhanced: This level of practice identifies the expertise needed to provide fully integrated treatment to clients and families challenged with moderate to severe co-occurring disorders. The identified domains are assessment, diagnosis, and integrated treatment.

6. Offeror shall maintain practices related to recruiting, hiring, and promoting multi-lingual staff and/or a culturally or ethnically diverse workforce. Offeror 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).

7. Offeror’s staff shall participate in trainings related to the MHSA CSS required data collection and reporting. Offeror’s staff shall also participate in the Sexual Orientation and Gender Identity and Expression (SOGIE) 101 Training.

8. Offeror shall ensure that appropriate staff shall attend all system-wide BHSD trainings and shall participate in all required trainings specific to the needs of the program.

9. For programs implementing IPS/SE: in addition to the requirements listed above, the following IPS/SE requirements will need to be addressed for each interested Offeror:

a. Offeror shall have designated staff that receive IPS/SE training from the IPS/SE Employment Center prior to full implementation of the employment services.

b. Offeror shall obtain and/or maintain current IPS/SE certification prior to program start date. If already IPS/SE certified, Offeror shall provide the BHSD Program Monitor or proof of IPS/SE certification prior to the contract start date.

c. IPS/SE shall provide competitive job options that have permanent status rather than temporary or time-limited status (e.g., Transitional Employment [TE] positions).

G. 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. The program shall be reflective of the ethnic, cultural, and linguistically diverse populations of the County and preferences of each client. 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. The program shall be composed of staff who are proficient in the six (6) Santa Clara County threshold languages (Spanish, Vietnamese, Mandarin, Cantonese, Tagalog, and Farsi). Offeror’s organization shall have a plan to address barriers when they do not have staff available to meet the County threshold languages 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.

H. Referrals and Admissions

1. Offeror shall accept referrals from the BHSD Call Center. Offeror shall also accept inter-agency transfers and walk-ins from the community.

2. Offeror shall ensure that referrals that do not meet the criteria for behavioral health services or that need a different level of care, shall be directed, and linked by the program to appropriate alternative resources or another provider.

3. Offeror shall be prepared to accept urgent and emergent outpatient referrals received from the BHSD call center, ensure referrals are triaged within twenty-four (24) hours of receipt and are to be seen within five (5) business days.

4. Offeror shall be aware that based on the level of care per BHSD policy and procedure (P&P) 412-330, the BHSD call center shall refer non-English-speaking urgent care clients to clinics having availability regardless of language and cultural specialization. Offeror, at the request of the client, shall initiate a transfer to a program of the client’s choice as soon as there is availability at that program per P&P 412-330.

5. For programs implementing IPS/SE: in addition to the requirements listed above, the following IPS/SE requirements will need to be addressed for each interested Offeror:

a. IPS/SE referrals shall be made internally from the Provider or from another BHSD outpatient treatment team.

b. Referrals may be accepted based on active capacity and/or programs utilization.

c. For referrals that come from an external BHSD Outpatient Provider, the Outpatient Provider shall need to provide the IPS/SE team with appropriate and complete documentation such as assessment, treatment plan, and other necessary documentation as appropriate and needed.

I. 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. Integrated co-occurring disorder practices and peer supports such as Wellness Recovery Action Planning.

g. Review each client’s status and progress towards planned goals annually to determine possible discharge planning and/or step down to a less intensive type of service. Offeror shall re-write client goals as necessary to match the level of care needed.

h. Link clients to community-based resources as well as primary care services.

i. Communicate with clients and their families to ensure comprehensive and consistent care, good communication with system partners and other serving agencies, and/or institutions involved in service delivery.

j. Co-occurring substance use treatment shall be based on harm reduction principles. If the Offeror is unable to provide this treatment specialty within their scope, a referral to appropriate services shall be facilitated and collaboration between the two (2) providers shall address any co-occurring treatment needs.

J. Program Hours of Operations

1. Offeror shall be open for services during regular office hours Monday through Friday, with after-hours services available to accommodate clients requiring evening and weekend appointments, as well as crisis outpatient services available twenty-four (24) hours a day, seven (7) days a week to address the emergency needs of clients under the Program. Offeror shall be required to maintain coverage that shall include California WIC 5150 evaluations for clients as needed.

2. Offeror shall ensure that the 24-hour coverage plan shall be on file with the BHSD Division Director. Offeror shall provide an updated agency plan for 24-hour coverage to the BHSD Division Director and the BHSD Program Monitor for approval prior to implementation at the beginning of each new fiscal year and when any changes to this plan occur.

3. Holidays: Offeror shall maintain at minimum a skeleton crew that shall facilitate the processing of referrals coming from the BHSD Call Center, 24-Hour Care unit, crisis coverage, and the ability to initiate Lanterman-Petris-Short (LPS) protocols.

K. Evaluations, Transitional Planning, and Discharge

1. Offeror shall transfer clients who have graduated from the program to lower levels of care, such as Primary Care, based on the client's level of care need as determined by relevant screening tool.

2. Offeror shall facilitate transitions to other agencies for additional or more specialized support for clients requiring higher levels of care, such as Full Partnership Service (FSP) Maintenance.

3. Offeror shall discharge clients when they meet at least one (1) of the following criteria:

a. Upon mutual agreement by the client and therapist that the client completed the program successfully;

b. Upon a good faith determination by Offeror that the program cannot effectively serve the client;

c. Upon client or guardian's unilateral decision to terminate treatment (against medical advice);

d. Upon transfer to a lower level of care or another mental health provider;

e. Upon transfer to another County mental health program, in which Offeror shall comply with a Feedback Loop Process to ensure that referral sources are notified of the status of the referral, provided the appropriate sections of the assessment, and informed of outcomes and/or next steps;

f. Upon notification of client admission into an institutionalized setting (e.g., Institute of Mental Disorder [IMD], Mental Health Rehabilitation Center [MHRC] or locked Skilled Nursing Facility [SNF]), with the BHSD 24-hour Care Team re-assigning the client to outpatient services as appropriate;

g. When the client is incarcerated for over thirty (30) days;

h. When the client no longer meets Medi-Cal medical necessity criteria; and/or

i. When the client is not engaged and responsive after thirty (30) days of persistent efforts to locate them and following all County policies and procedures.

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 B8 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 1 of 3 ATTACHMENT A8: Adult and Older Adult Outpatient Continuum Services Scope of Work CATEGORY 2: Outpatient Services