Attachment J-1 Statement of Work.pdf

Attachment J-1 Statement of Work

SECTION C

Detained Offender Residential Treatment Service

C.1 Agency Background

The Court Services and Offender Supervision Agency (CSOSA) was established under Section 11232 of the National Capital Revitalization and Self-Government Improvement Act of 1997 to effectuate the reorganization and transition of functions relating to pretrial services, parole, adult probation, and detained offender supervision in the District of Columbia to a Federal Executive Branch agency. The mission of CSOSA is to increase public safety, prevent crime, reduce recidivism, and support the fair administration of justice in close collaboration with the community through the supervision of individuals on probation, parole, or supervised release.

For the purposes of this contract, individuals referred to the Contractor for services shall be referred to as “detained offenders participating in the Residential Treatment Program” (hereinafter referred to as “detained offender(s)”). These individuals are under the authority of the United States or the District of Columbia and are placed in residential treatment services as a condition of supervision, court order, or other lawful authority.

In addition to federal statutory authority, the Contractor shall comply with all applicable District of Columbia laws and regulations governing behavioral health services, residential treatment facilities, public health requirements, confidentiality protections, and patient rights, including but not limited to Title 22-A of the District of Columbia Municipal Regulations (DCMR), the District of Columbia Department of Behavioral Health (DBH) Certification Standards, and all applicable provisions of the D.C. Code relating to behavioral health and substance use disorder treatment services.

C.2 Objectives

C.2.1The objective of this contract is to stabilize detained offender substance use disorders, enhance supervision compliance, contain further risks of detained offender recidivism, promote prosocial engagement, enhance detained offender self-efficacy, coordinate access to community recovery systems, improve program retention, enhance the continuity of care following program completion, and return detained offenders to the community free from illicit substance use.

C.2.2 A successful program will have a 70 percent rate of detained offenders successfully completing the program, which is defined as a reduction of symptoms of substance use and non-compliant behaviors, and a 30 percent or less relapse rate while in treatment.

C.3 Referrals

C.3.1 CSOSA will make placements for Detained offender Residential Drug Treatment Services for men and women, as described below in Section C.4, based upon a detained offender’s assessed need as determined by CSOSA’s Assessment and Evaluation and Placement Unit (AEPU) clinicians.

A detained offender may also be court-ordered to participate in the specified services as part of a sentence, pre-sentence placement, or as a condition of probation, parole, or supervised release. CSOSA shall apply the ASAM Criteria 3.5 when referring detained offenders to the appropriate modalities.

C.3.2 The CSOSA Referral Placement Team (RPT) shall supply a referral package to the Contractor a minimum of twenty-four (24) hours prior to each admission. The referral package shall contain a billing authorization document (Attachment J-2), admission date, projected discharge date, detained offender information including confirmation of pre- and post-natal care services, supervision contact information, and transportation requirements when applicable.

Additionally, the referral package will contain:

• Attachment J-5 –Release of Information: Health Records

• Attachment J-4 – Release of Information: Substance Abuse Treatment

• Attachment J-6 – Release of Information: Mental Health-Sex Offender

• Attachment J-7 – Release of Information: Privacy Act Waiver Form

C.3.3 Duration. The length of placement to be provided will normally be up to 30 days, to include a 30-day restricted movement period. The length of the placement may be extended by the Contractor based on justifiable recommendations, with input from the detained offender’s assigned Community Supervision Officer (CSO). An updated Billing Authorization will be provided to the Contractor to cover any placement extension.

C.3.4 Referral/Billing Authorization. The billing authorization will have the following:

a. Detained offender name.

b. Admission date.

c. Projected discharge date.

d. Treatment duration.

e. The maximum dollar amount authorized for the treatment duration.

f. The invoicing code.

C.3.5 The billing authorization is the only document that makes CSOSA financially responsible for detained offender services provided by the Contractor. No verbal or other authorizations are recognized or allowed. CSOSA is not responsible for detained offender services provided without a billing authorization, or for any detained offender services provided that exceed the treatment duration, or the maximum dollar amount authorized for the treatment duration.

C.3.6 Estimated Quantities and Capacity. The Government anticipates requiring residential substance use disorder treatment services for approximately 120 detained offenders annually, with an estimated total annual utilization of approximately 3,650 residential treatment days. These quantities are estimates only and are not guaranteed. Actual quantities may vary based on court orders, clinical need, funding availability, and program requirements.

The Contractor shall maintain sufficient facility capacity, staffing, and resources to accept referrals and provide residential treatment services on an as-needed basis throughout the period of performance. The Government may refer detained offenders on a rolling basis, and the Contractor shall be capable of accommodating admissions as directed by CSOSA.

C.4 Tasks – Residential Drug Treatment Services. The Contractor shall provide substance use disorder treatment services for men and women at the Contractor’s facility located in the District of Columbia, Maryland, Virginia or West Virginia. The Contractor shall ensure that sufficient residential treatment capacity is maintained to support the Government’s estimated annual placement needs. The Government estimates approximately 120 detained offender placements per year with an average length of stay of approximately 30 days, totaling an estimated 3,650 residential treatment days annually. These estimates are for planning purposes only and do not guarantee a minimum number of referrals or treatment days.

C.4.1 Task 1 - Pre-Admission Referral Review. Upon receipt of a referral package from CSOSA staff, the Contractor shall review the referral documentation to determine the individual’s suitability to successfully participate in treatment.

C.4.1.1 When completing the review, the Contractor shall assess the following areas:

a. Complicating Medical Conditions. To ensure the absence of any complicating medical conditions which would require the individual to attend frequent external medical appointments (to include pre and post-natal care services) or specialized medical equipment.

b. Medication Compliance. To ensure that any pre-existing medical or mental health conditions are adequately stabilized by appropriate medications.

c. Ambulatory Abilities. To ensure the requisite ambulatory abilities and physical stamina required to participate in treatment.

d. Self-Care. To ensure the individual’s ability to provide basic self-care (i.e., hygiene, etc.) during treatment.

C.4.1.2 The Contractor shall complete the review and make a suitability decision, or request for additional relevant information, to CSOSA staff, in writing, within two business days of receipt of each referral package. When necessary, CSOSA staff will coordinate with the referral source to obtain any additional relevant information requested by the Contractor.

C.4.1.3 Upon receipt of the additional information, the Contractor shall complete a secondary review and make a decision to CSOSA staff, in writing, within one business day of receipt of the additional information. In the event that the referral source is unable to supply the requested information, the Contractor shall make a decision (based on the original referral documentation) within one business day of notification of the unavailability of additional information.

C.4.2 Task 2 – Intake Process.

C.4.2.1 Admission/No Show Notification. The Contractor shall notify CSOSA of all admissions and no-shows the next business day of each scheduled admission, using the Admission Notification form that is provided with each referral/billing authorization. This notification must be provided in writing (via email) to the Contracting Officer’s Representative (COR), and the detained offender’s assigned CSO. Specific contact information and notification instructions are found in each referral package. Failure to adhere with this requirement absolves CSOSA of financial responsibility for the detained offender.

C.4.2.2 The Contractor shall have the capability to transport detained offenders from pick-up locations within the District of Columbia city limits named in the referral package. All vehicles used to transport CSOSA detained offenders shall be in good working condition and conform to all standards/requirements defined by the Department of Motor Vehicles in the jurisdiction where the vehicle is registered.

C.4.2.3 Intake Interview. The Contractor shall conduct an intake interview with each detained offender the next business day. During the intake interview the Contractor shall:

a. Conduct a Mini-Mental Status Exam.

b. Conduct an initial suicide assessment using an evidence-based assessment tool (i.e., Columbia

Suicide Severity Rating Scale).

c. Retrieve and secure any medications or prescriptions from the detained offender.

d. Identify the detained offender’s primary counselor who will make contact (via email) with the detained offender’s CSO and primary Intervention Specialist (IS) regarding admission.

e. Obtain signed waivers of confidentiality upon the informed consent of the detained offender. The waiver of confidentiality shall extend to all therapists and treatment providers treating the detained offender.

f. Restrict all detained offender movement during the first 30 days and conduct all Task 2, Intake Process requirements. This requirement is necessary to ensure detained offenders have the opportunity for program acclimation, minimize external distractions, provide an opportunity for the program staff to develop a treatment plan for the detained offenders, review the goals/objectives, and to establish a therapeutic relationship with the detained offenders. The initial restricted movement length of the time may be extended by the Contractor based on justifiable recommendations, with input from the CSO and IS.

g. Conduct a program orientation.

h. Provide the detained offender with a program handbook and program schedule.

i. Review the program rules with the detained offender, as well as the detained offender’s rights and responsibilities.

j. Conduct urinalysis/oral toxicology.

k. Administer a Patient Health Questionnaire-Version 9 (PHQ-9), Generalized Anxiety Disorder –

Version 7 (GAD-7), and Posttraumatic Check List for DSM 5 (PCL-5). A copy of the pre-test should be emailed to clinicaloutcomes@csosa.gov within 48 hours of assessment completion.

l. Conduct a nutritional assessment within three days of admission.

C.4.2.4 Detained offender Treatment File. The intake interview shall result in the creation of an individual detained offender Treatment File that shall initially contain the following:

a. Detained offender personal information sheet.

b. The entire referral package as provided by CSOSA.

c. A signed and dated copy of the detained offender’s handbook, and rights and responsibilities form

(bearing the signatures of both the detained offender and the Contractor’s staff).

d. Current medical clearance - All detained offenders will have PPD/TB test results that are valid within one year of the actual treatment placement. Detained offenders with a history of past positive PPD results will have evidence of a chest x-ray completed within the last five years, and clearance, on an annual basis, from a pulmonologist or other qualified public health facility, or a physician specializing in pulmonary disease which documents that the detained offender is currently asymptomatic. Such documentation is obtained by from the D.C. Chest Clinic or equivalent where the assessment and screening is conducted. Detained offenders who show signs of disease must adhere to the D.C. Department of Health requirements for medication management and the treatment of Tuberculosis and will not be referred.

e. Signed Treatment Consent Forms. (Attachments J-4, J-5, J-6, and J-7).

f. The detained offender treatment file shall be kept in accordance with Part 2 HIPPA Privacy Act

Rule 45 CFR 164.530(c). The file should be kept at the Contractor’s location in a locked file cabinet with access limited to those individuals who provide direct service to the detained offender. CSOSA detained offender treatment files must be kept separately from non-CSOSA detained offender treatment files. At no time should CSOSA detained offender treatment files be removed from the Contractor’s facility where services are performed. The Contractor shall comply with:

• 42 CFR Part 2 (Confidentiality of Substance Use Disorder Patient Records),

• HIPAA Privacy and Security Rules (45 CFR Parts 160 and 164),

• The D.C. Health Information Act (D.C. Code § 44-601 et seq.),

• The Privacy Act of 1974 (5 U.S.C. § 552a), where applicable.

C.4.2.5 Medical Screening. The Contractor shall ensure that the detained offender receives a medical screening either on-site at the Contractor’s facility, or in the community, within 72 hours of admission, to determine the detained offender’s baseline level of physical and mental health functioning. The Contractor’s admission criteria shall include exclusionary factors such as medical or mental health conditions, or specific criminal offenses that would deem the detained offender unacceptable for admission.

The Contractor shall have the right to refuse to treat any detained offender to the extent allowed by relevant laws and regulations who, after a medical screening, is considered to be medically/mentally unstable, or who has a significant medical/mental condition that will unduly interfere with treatment. The RPT staff shall be notified in writing (via email or facsimile) of any decision to refuse to treat an detained offender and the rationale for the decision.

mailto:clinicaloutcomes@csosa.gov

C.4.2.6 Individualized Treatment Needs Assessment. The Contractor shall conduct an individualized treatment needs assessment for each detained offender within seven business days of admission. The individualized treatment needs assessment shall use a Comprehensive Bio-Psychosocial assessment and shall be conducted by a Case Manager or other licensed professional (proper interpretation must be within the assessor’s scope of practice).

C.4.2.7 Comprehensive Bio-Psychosocial Needs Assessment. The Comprehensive Bio-Psychosocial Needs Assessment must include, at a minimum:

a. A detailed description of the detained offender’s substance use history, mental health history, and any prior treatment experiences.

b. A complete personal history, including information related to the detained offender’s educational/vocational achievements, and experiences.

c. Any other information that may be helpful in determining detained offender treatment and individualized needs consistent with ASAM Criteria.

C.4.2.8 Assessments. CSOSA may supply an Addiction Severity Index (ASI), or other Government approved assessment tool(s), that was conducted within six months of the admission date. The Contractor shall incorporate all prior assessment information received from CSOSA, such as the Central Intervention Team (CIT) Assessment, or the detained offender’s Performance Contract into its initial individualized assessment/treatment plan and also shall include references to relevant factors in its discharge summary to support a seamless continuum of care. Results of this individualized assessment shall be documented and kept in the detained offender treatment file.

C.4.2.9 Treatment Plan. The Contractor shall develop an individualized treatment plan for each detained offender within three business days of admission, based on the results of the treatment needs assessment and referral information provided by CSOSA.

C.4.2.9.1 The individualized treatment plan shall include problem formulation, short-term and long-term measurable treatment goals, with specific services and activities designed to achieve those goals.

It also shall include a schedule for service delivery, identifying frequency and duration of services.

C.4.2.9.2 The individualized treatment plan shall also reflect case management activities conducted by on-site staff, coordination of additional treatment, health, dental, and mental health interventions, and pro-social supports, vocational, and housing services, along with any other services at this and other levels of care shall be noted in this plan.

C.4.2.9.3 The plan shall be developed in collaboration with the detained offender and reflect the detained offender’s personal goals. A signed and dated copy of the treatment plan, with signatures of both the detained offender and Contractor staff, shall be kept in the detained offender’s treatment file and a copy provided to the detained offender. A copy with a signed Release of Information form shall be sent to the assigned IS and CSO.

C.4.2.9.4 At a minimum, treatment plans must be reviewed and reassessed weekly by an inter-disciplinary treatment team which, at minimum, consists of the Clinical Supervisor, Case Manager or Counselor, IS, and CSO. Treatment plans also must be reviewed, updated, and modified when major clinical changes occur, or when major life, family, or social circumstances may complicate treatment.

When treatment plans are revised and resigned by the detained offender and Contractor staff, a copy shall be provided to the detained offender and the IS and CSO with a signed Release of Information

(ROI).

C.4.2.9.5 The Contractor shall document the evidence of treatment plan reviews in the detained offender treatment file. The Contractor shall document treatment plan review by completing a signed and dated entry in the progress notes, or on the Vendor Clinical Staffing Form (Attachment J-8), or in the form of a signed and dated revised treatment plan.

C.4.3 Task 3 –Residential Drug Treatment Services.

C.4.3.1 Residential Drug Treatment Services. The expected outcome of Residential Drug Treatment Services is to prepare detained offenders for successful entry into the community by targeting the detained offender’s level of functioning based on the needs identified in one or more of the identified problem areas in accordance with the ASAM Criteria (i.e., substance use disorders, criminal involvement, vocational, housing, medical, mental health, family/social and legal). The Contractor shall administer a post PHQ-9, GAD-7, and PCL-5 no later than 7 days prior to the detained offender’s discharge. A copy of the post-test should be emailed to clinicaloutcomes@csosa.gov within 48 hours of assessment completion.

C.4.3.2 The Contractor shall provide a highly structured, safe and secure, drug and crime free environment that consists of organized programming seven days per week using evidence-based Cognitive Behavioral Interventions (CBI), such as Thinking for a Change, to address anti-social attitudes and cognition or other Government approved best-practiced curriculum targeting criminal thinking and attitudes, motivational enhancement, and expressive therapy. Program services shall include daily clinical practices to educate, and reinforce the information directed at improving the detained offender’s development and practice of pro-social behaviors. The Contractor’s programming activities schedule shall be posted in plain sight for the detained offender and staff’s information.

C.4.3.3 Progress Notes.

C.4.3.3.1 The Contractor shall keep weekly progress notes for each detained offender that clearly reflect implementation of the treatment plan, the detained offender’s response to treatment, and all other therapeutic interventions. A progress note shall be entered for each intervention service within one business day. The individualized progress notes shall be kept in the detained offender’s treatment file.

C.4.3.3.2 The notes shall be maintained in the DAP (Data, Assessment, and Plan) or SOAP (Subjective, Objective, Assessment and Plan) format.

C.4.3.3.3 Each weekly progress note must be signed and dated by the Contractor’s staff providing direct care services. All progress notes shall be placed in reverse chronological order, maintained in the detained offender treatment file with the most recent note on top.

C.4.3.4 The Contractor shall be able to provide services to detained offenders that have co-occurring disorders, and sexual offenses.

C.4.3.5 The Contractor shall use therapeutic interventions specific to the criminal justice involved detained offender, such as approaches to increase retention in the program, coordination with court hearings, addressing criminal involvement, and cooperation with criminal justice requirements. The Contractor shall coordinate and cooperate with CSOs and IS’, utilizing a team approach for case planning, treatment and behavioral interventions, and case monitoring. The Contractor shall demonstrate evidence of this working relationship by scheduling clinical and crisis intervention staffing’s, and coordinating individualized case planning which shall be documented on the CSOSA Vendor Clinical Staffing Form (Attachment J-8), submitting required documents (i.e., weekly reports, discharge planning), and utilizing a team approach for treatment interventions, case monitoring, and individualized discharge and planning for the next continuum of care.

C.4.3.6 The Contractor shall practice cognitive-behavioral (CB) approaches to clinical interventions that focus on teaching detained offenders skills directed towards addressing cognitive distortions/criminal thinking, maintaining abstinence, enhancing self-efficacy, stabilizing housing, and setting independent living goals. The Contractor shall demonstrate the use of evidence-based practices, including Cognitive- Behavioral Therapy (CBT) and Motivational Interviewing (MI) through curricula, role modeling and the use of techniques that can be observed in groups, individual sessions, and clinical staffing’s. Program staff shall model appropriate behaviors consistent with this approach.

mailto:clinicaloutcomes@csosa.gov

C.4.3.7 The Contractor shall have a process in place to ensure that detained offenders have access to the appropriate interventions, through a seamless and integrated collaboration with external partners, if psychopharmacologic and addiction pharmacotherapy interventions are not supplied onsite.

C.4.3.8 The Contractor shall ensure that assessment and programming services incorporate other individuals or programs, as clinically indicated, who are likely to support the detained offender's recovery process as indicated. These might include family psychoeducation or multi-family peer support groups or family therapy and incorporate a focus on the issues of homelessness.

C.4.3.9 While in the Residential Drug Treatment Services program the Contractor shall provide case management services designed to address specific detained offender needs that contribute to substance use disorders, addictive and antisocial behaviors, dysfunctional lifestyles, value systems and, independent living skills problems for detained offenders considered amenable and appropriate for treatment services.

C.4.3.10 The Contractor shall establish a system of incentives and sanctions (as approved by CSOSA) to increase detained offender engagement and adherence to program requirements. Additionally, in order to improve outcomes and to gauge detained offender satisfaction with the program, the Contractor shall survey the detained offenders prior to discharge and provide a copy of the survey to the COR.

C.4.3.11 The Contractor shall address substance use disorders in the discharge planning process. Upon discharge, amenable detained offenders should be connected with recovery and homelessness support services including, but not limited to, recovery check-ups, a referral to telephone peer recovery support, and referrals for appropriate housing programs and opportunities.

C.4.3.12 Treatment Expectations for Residential Drug Treatment.

C.4.3.12.1 The Contractor shall provide supervised residential drug treatment services to adult male and female detained offenders with substance abuse treatment needs that approximates the ASAM Level 3.5 standard of care as identified below.

C.4.3.12.2 The Contractor shall provide professional clinical services designed to address addiction and living skills problems for detained offenders with substance abuse diagnosis who require short term treatment stays to support and promote recovery.

C.4.3.12.3 The Contractor shall ensure that the residential drug treatment services include no less than 20 hours per week of group and individual counseling services. The counseling/group services shall include:

a. Individual: Three hours per week minimum.

b. Group: Ten hours per week minimum (a minimum of four sessions weekly).

c. Family: To be included during course of treatment as clinically indicated.

C.4.3.12.4 The Contractor shall provide a minimum of eight hours of structured programming daily.

(Note: Self-help meetings may be included as part of structured activities.) The structured programming shall include:

a. Didactic group sessions: Eight hours per week minimum

b. Housing stabilization coordination: Two hours per 30-day period

c. Mentoring/pro social supports: One hour per 30-day period

d. Structured Activities: Seven hours per day of the following are required:

1. Counseling Services (individual, group)

2. Psychoeducation

3. Vocational Training

4. Recovery Support Services

5. Recreation

6. Family Education and Information sessions as clinically indicated.

C.4.3.13 The Contractor shall provide or arrange for detained offender services in the following need/problem areas:

a. Mental health

b. Medical

c. Laboratory and toxicology services, as appropriate to the severity and urgency of the detained offender’s condition

d. Comprehensive needs assessment

e. Treatment planning

f. Individual counseling

g. Group counseling

h. Substance abuse education

i. Discharge/aftercare planning (as required).

j. Other essential services as required to stabilize the detained offender to return them to the community and prepare them for independent living is also required.

C.4.3.14 The Contractor shall hold clinical staffing’s on the 14th and 21st days of treatment with invited CSOs and IS’, which may include the CSOSA supervisory staff. During these staffing’s, the Contractor shall review the detained offender’s treatment planning progress, skills development, and positive accomplishments; address behavioral/compliance issues; and conduct ongoing individualized discharge planning, as well as other meetings and interventions considered necessary by CSOSA. The Contractor shall notify the assigned CSO of all scheduled clinical staffing’s in writing, no later than seven calendar days in advance, and document the notification on the CSOSA Contact Form (Attachment J-10). The treatment plan review shall be documented on the Vendor Clinical Staffing Form (Attachment J-8) and shall be filed in the detained offender’s treatment file.

C.4.3.15 Personnel. All Contractor personnel who oversee Personally Identifiable Information (PII) must adhere to Part 2 HIPPA Privacy Act Rule 45 CFR 164.530 c and CSOSA’s security requirements outlined in Section H.9.

C.4.3.16 Urinalysis/Oral Toxicology. The Contractor shall conduct a random urinalysis or oral toxicology test (if the detained offender is unable to void a urine sample) on all detained offenders a minimum of once per seven-day week and within 24 hours of the detained offender’s return from any activity outside the facility. Random drug screening should be incorporated to shape behavior and reinforce treatment gains, as appropriate to the detained offender’s individual treatment plan. The Contractor shall observe the following screening levels for all CSOSA detained offenders:

a. Amphetamines/Methamphetamine 500 ng/ml

b. Cocaine Metabolite 150 ng/ml

c. Marijuana 50 ng/ml

d. Methadone 300 ng/ml

e. Opiates 300 ng/ml

f. Heroin 10 ng/ml

g. PCP 25 ng/ml

h. Alcohol 20 mg/dl

i. Creatinine 20 mg/dl

j. Synthetic Cannabinoids 10 ng/ml

C.4.3.16.1 The Contractor shall follow the specimen chain of custody protocols of the appropriate regulatory accreditation bodies.

C.4.3.16.2 Results of all urinalysis/oral toxicology tests shall be kept in the detained offender treatment file.

C.4.3.16.3 The Contractor shall notify the CSO or IS in writing, within 24 hours (or the next business day), of any detained offender who receives a positive urinalysis/oral toxicology result, refuses to provide a sample (behavioral positive), adulterates a sample, or submits a water loaded sample, while in treatment. This information may be transmitted via secured email or facsimile method that protects PII (See H.10.4).

C.4.3.16.4 The Contractor shall collaborate with the IS or CSO to coordinate a response to any detained offender positive test result(s). The Contractor shall be prohibited from discharging any detained offender from treatment without coordinating a case conference with the IS or CSO.

C.4.3.17 Outings/Visitations. Detained offender movement outside the facility shall be limited to address medical and mental health emergencies and therapeutic activities only.

C.4.3.17.1 The Contractor shall test all detained offenders for drug and alcohol use via urinalysis within 24 hours of return from activities outside of the facility.

C.4.3.17.2 The Contractor shall conduct a proper search of detained offender and detained offender’s personal belongings upon return to the facility.

C.4.3.17.3 The Contractor shall keep a system of accountability to track detained offender movement outside of the facility which includes documentation. The Contractor shall confirm the destination, point(s) of contact, departure and return times, and the identified need which requires external movement (i.e., appointments, referrals, CSO office visits, or any other external movement approved by the Government.)

C.4.3.17.4 The Contractor, in conjunction with their tracking procedures, shall keep security protocols to reduce the introduction of contrabands into the facility (interior and exterior). These may include, but are not limited to, the following: search of the person/belongings, search, urine drug testing upon return from the outside, room search/inspections, and all other residential area searches.

C.4.3.18 Medication Storage and Administration.

C.4.3.18.1 The Contractor shall meet all Federal and State requirements and develop policies to support compliance for any drugs administered, to include methadone schedule and buprenorphine, including regulations established by the Food and Drug Administration, or the U.S. Drug Enforcement Agency. If operating within the District of Columbia, the Contractor shall comply with all applicable District of Columbia Board of Pharmacy regulations, D.C. Code § 48-901 et seq. (Uniform Controlled Substances Act), and federal 42 CFR Part 8 requirements governing Medication Assisted Treatment (MAT), including OTP requirements where applicable.

C.4.3.18.2 The Contractor shall ensure that all medications are administered in accordance with the prescribing physician’s orders. The Contractor shall ensure that “watch-take” procedures are implemented when each detained offender takes his/her medications and document any refusal to take their prescribed medication.

C.4.3.18.3 All medication (prescription and non-prescription) must be kept in a locked storage area maintained by the Contractor. Any prescription medication brought into the facility by an detained offender shall not be administered or self-administered until the medication can be identified and the attending practitioner’s written order or approval is documented in the detained offender record. All medications, both prescription and over the counter, brought into the facility must be packaged and labeled in accordance with federal and state laws and regulations. All medication dispensation must be performed by a duly trained staff member and shall be recorded in a daily log that shows the name, dosage, date and time of dispensation. Any changes to the medication type, dosage, or administration frequency shall be approved by a licensed Physician or Psychiatrist.

The Contractor shall maintain an Overdose Prevention Protocol consistent with District of Columbia Department of Health guidelines and shall ensure Naloxone (Narcan) is readily available onsite in accordance with D.C. Code § 48-1203.01. If operating within the District of Columbia, the Contractor shall report all incidents required under DBH Incident Reporting Guidelines within the timeframes established by DBH in addition to CSOSA reporting requirements.

C.4.3.18.4 Medications requiring refrigeration shall be kept in a separate and secure refrigerator, labeled “For Medication Only” and shall be maintained at a temperature between thirty-six and forty-six degrees Fahrenheit. All refrigerators shall have thermometers, which are easily readable, in proper working condition, and accurate within a range of plus or minus two degrees Fahrenheit.

C.4.3.18.5 The Contractor shall track and monitor the detained offender’s on hand supply of medication(s) to ensure that the detained offender secures his/her supply of medication no later than seven days prior to the detained offender’s planned discharge date. In the event that the medication cannot be obtained before the detained offender discharges, the Contractor shall ensure that the detained offender has a valid written prescription.

C.4.3.18.6 The Contractor shall ensure that the results for detained offenders who require monitoring of daily blood sugar levels and high blood pressure levels are documented and stored in the detained offender’s treatment file.

C.4.3.19 Surge Capacity. The Contractor shall be capable of providing surge residential treatment services when referral volume exceeds projected quantities. Surge services shall be provided at the same level of care, staffing, supervision, programming, and daily rate as standard residential treatment services unless otherwise authorized by the Contracting Officer. Surge capacity may be required due to court orders, enforcement initiatives, public safety needs, or other programmatic requirements. Surge quantities are estimates only and are not guaranteed.

C.4.4 Task 4 - Discharge Process.

C.4.4.1 Discharge Planning Staffing. The Contractor shall coordinate the discharge planning staffing with the CSO (or his/her designee), and the detained offender, no later than 7 calendar days before the proposed discharge planning staffing. This discharge staffing must include a review of the detained offender’s course of treatment, treatment plan progress, aftercare planning, and recommendations for the next phase of treatment. Regardless of the type of discharge, the Contractor is responsible for providing transportation back to the District of Columbia as designated by the CSO, SCSO, and/or the Branch Chief.

The COR shall also be notified by the vendor of the drop off date and location.

C.4.4.2 Discharge Staffing. The Contractor shall conduct a discharge staffing no later than seven calendar days prior to the detained offender’s completion of the program. The staffing shall include the submission of a written, comprehensive, and individualized aftercare/relapse prevention plan that summarizes the results of the discharge planning staffing and outlines recommendations for further treatment or other needed services. CSOSA will assess the outcome of the Residential Drug Treatment Services intervention by reviewing the detained offender’s level of functioning 7 days before his/her discharge date.

C.4.4.3 Discharge Plan. The Contractor shall prepare a written discharge plan no later than 7 calendar days prior to the detained offender’s completion of the program. The discharge plan must contain:

a. The detained offender’s name.

b. The admission date.

c. The date of the discharge staffing.

d. The individuals in attendance for the discharge staffing.

e. The discharge date.

f. The length of the detained offender’s stay in the program.

g. Any DSM-5 diagnoses.

h. A summary of the overall treatment experience.

i. An aftercare/relapse prevention plan.

j. The discharge prognosis.

k. A list of the specific programs the detained offender must attend for aftercare services such as community mental health care or community based support meeting times, to include the locations with verified addresses, and the points of contact.

l. The name and telephone number of an individual who can be contacted should CSOSA require more information.

m. The signature of the preparer and Clinical Supervisor, or Program Director.

n. Once signed, the Contractor shall email a copy of the completed plan to the CSO and IS within three calendar days of the detained offender’s discharge.

o. The Contractor shall file the original signed discharge plan in the detained offender’s treatment file.

C.4.4.4 For those detained offenders who will be entering another treatment modality upon discharge, CSOSA will send all relevant information from the detained offender’s treatment file to the appropriate treatment provider. CSOSA will supply the necessary contact information and send instructions prior to the detained offender’s discharge date. The Contractor is required to provide a copy of the detained offender treatment file to the next provider at the time of transfer, or within 24 hours of a request from CSOSA. The treatment file should be sent electronically with the appropriate electronic security.

C.4.4.5 Discharge for Compliance or Behavioral Management Issues. Keeping detained offenders involved in treatment activities and receiving required services is an expected goal. However, there are three types of discharges or removals from treatment that CSOSA considers to be an intervention of the highest sanction in response to non-compliant behavior(s); they are non-threatening behavior, high-risk or threatening behavior, and abscondences. The intervention results in the termination of an detained offender's active involvement with the program for any of the identified discharge types. If any of these occur, it is CSOSA’s expectation that the detained offender be returned to community supervision to include a Continuity of Care Plan and required discharge report type. Detained offenders who exhibit non-compliant behavior/behavioral management issues may be discharged or removed from treatment after an emergency staffing (by telephone or in person) is held with the CSO.

C.4.4.5.1 Compliance Problems.

C.4.4.5.1.1 The Contractor shall email the CSO, COR, and Office of Community Supervision and Intervention Services (OCSIS) Rapid Engagement Team (RET) (ocsisrapidengagement@csosa.gov) regarding any non-compliant detained offender behavior within 24 hours of each occurrence. Examples of non-compliant behavior include, but are not limited to:

a. Medications refusal

b. Intoxication

c. Suspicion of drug use

d. Sexual activity

e. Anti-social behavior

f. Lack of adequate participation in required treatment programming.

C.4.4.5.1.2 In the event that the IS or CSO are unable to be reached, the Contractor must notify the Supervisory Community Supervision Officer (SCSO). The first notification may be via telephone or email and shall be in writing (by email or fax) and shall include:

b. Date and time of the non-compliant behavior.

c. A description of the behavior observed.

mailto:ocsisrapidengagement@csosa.gov

d. The name(s) of the CSOSA staff to whom the incident was reported.

e. The action taken by the Contractor in response to the non-compliance.

f. The name and telephone number of the reporting person, or an alternate person, who can be contacted should CSOSA require more information from the Contractor.

g. The Contractor shall sign and date the Non-Compliant Behavior report and the Contractor shall email the completed report to the CSO and Treatment Specialist within 48 hours of the occurrence.

h. The Contractor shall keep copies of all non-compliance reports in the detained offender’s treatment file.

C.4.4.5.2 Discharge for Non-Threatening Behavior.

C.4.4.5.2.1 The Contractor shall notify the CSO, IS, and OCSIS RET (ocsisrapidengagement@csosa.gov) via telephone or email prior to discharging any detained offender for non-threatening behavior. In the event that the CSO is unable to be reached, the Contractor must contact the SCSO.

C.4.4.5.2.2 Upon receiving CSO, SCSO, or IS concurrence, the Contractor shall discharge the detained offender with instructions to report to his or her CSO immediately. The Contractor shall document the type of contact made with CSOSA on the CSOSA Contact Form.

C.4.4.5.2.3 The Contractor shall prepare and send a written discharge report to the CSO and IS within eight hours of the detained offender’s discharge. The discharge report must contain:

c. Discharge date.

d. Any DSM-5 diagnoses.

e. Length of stay in the program.

f. A clear and detailed description of the circumstances under which the detained offender was discharged, to include a copy of the unusual incident report which will, at a minimum, address the following:

1. The name of the CSOSA staff to whom the incident was reported.

2. The name and telephone number of the reporting person or an alternate person that can be contacted should CSOSA require more information from the Contractor.

g. After signing and dating the discharge report, the preparer shall send it to the Contractor’s Clinical Supervisor or Program Director for review and signature before sending it to CSOSA. Once signed, the Contractor shall email the completed report to the CSO and IS.

h. The discharge report must be filed in the detained offender’s treatment file.

C.4.4.5.3 Discharge for High Risk or Threatening Behavior. If an detained offender engages in aggressive behavior(s) or poses an imminent threat of harm to self, others, or the Contractor’s property, the Contractor may discharge the detained offender prior to contacting the CSO. If the behavior constitutes criminal activity, the Contractor must contact the appropriate legal authority (i.e., local police department). If the detained offender poses a high risk to self or others (medically or psychiatrically), the Contractor shall develop a Continuity of Care Plan which provides for the referral and appropriate transfer of the detained offender along with treatment information, medications, and other relevant information.

C.4.4.5.3.1 The Contractor shall contact the CSO, IS, and OCSIS RET via email (ocsisrapidengagement@csosa.gov) and telephone (within one hour of any discharge under these circumstances. In the event that the CSO is unable to be reached, the Contractor shall contact the SCSO. If such an incident occurs during non-business hours, the Contractor must contact the emergency point of contact identified in the referral package in order to provide notification of the discharge.

C.4.4.5.3.2 If an detained offender demonstrates new substance use, an extensive pattern of relapse, or a repeated inability to control his/her impulses to use alcohol or other drugs, or repeated behavioral problems, the Contractor shall immediately contact the CSO and IS for an intervention staffing resulting in a behavior contract. If the detained offender fails to comply with the signed behavior contract, the Contractor shall discharge the detained offender with instructions to report to his/her CSO immediately. The Contractor shall document the type of contact made with CSOSA on the CSOSA Contact Form.

C.4.4.5.3.3 The Contractor shall prepare and send a written discharge report to the CSO and IS within eight hours of the detained offender’s discharge. The discharge report must contain:

c. Discharge date.

d. Length of stay in the program.

e. Any DSM-5 diagnoses.

f. A clear and detailed description of the circumstances under which the detained offender was discharged, to include a copy of the unusual incident report.

g. The name of the CSOSA staff whom the incident was reported.

h. The name and telephone number of the reporting person, or an alternate person, who can be contacted should CSOSA require additional information from the Contractor.

i. After signing and dating the discharge report, the preparer shall send it to the Clinical

Supervisor or Program Director for review and signature before submitting it to the Government. Once signed, the Contractor shall email the completed report to the CSO and IS.

j. The discharge report must be filed in the detained offender’s treatment file.

C.4.4.5.4 Abscondences.

C.4.4.5.4.1 The Contractor shall notify the IS, CSO, and OCSIS RET (ocsisrapidengagement@csosa.gov), via email, within one hour for any detained offender who absconds from the program. In the event that the CSO is unable to be reached, the Contractor must contact the SCSO.

C.4.4.5.4.2 A written discharge report must be prepared and sent to the CSO within eight hours.

The discharge report must contain:

c. Discharge date.

d. Length of stay in the program.

e. Any DSM-5 diagnoses.

f. A clear and detailed description of the circumstances under which the detained offender was discharged, to include a copy of the unusual incident report.

g. The name of the CSOSA staff to which the incident was reported.

h. The name and telephone number of the reporting person, or an alternate person, who can be contacted should CSOSA require more information from the Contractor.

i. After signing and dating the discharge report, the preparer shall forward it to the Clinical

Supervisor or Program Director for review and signature before submitting it to the Government. Once signed, the Contractor shall send via secured email the completed report to the SCSO, CSO and Treatment Specialist.

j. The discharge report must be filed in the detained offender’s treatment file.

C.4.5 Task 5 – Administration.

C.4.5.1 Detained offender Treatment File Management.

C.4.5.1.1 File Entries. The Contractor is required to document all detained offender encounters in the detained offender’s treatment file in accordance with the requirement identified in the contract. The Contractor shall make the determination as to whether the detained offender case management file will be maintained in an electronic or hard copy format. Notwithstanding the detained offender case management file format chosen by the Contractor, all detained offender case management file documentation provided to CSOSA shall be provided in a MS-Word or PDF document. File material shall be organized via identifiable tabs of file contents with a Table of Contents, items shall be filed chronologically and should be consistently organized in accordance with standard case management practices. The Contractor shall ensure that Contractor staff maintains complete confidentiality of all detained offender case management files. The detained offender case management file shall, at a minimum, include:

a. Treatment Authorization Package.

b. All referral information provided by CSOSA.

c. CSOSA Consent for the Release of Sensitive Information Form, signed and dated.

d. Assessment Reports, to include, but not be limited to:

1. ASI

2. Comprehensive Bio-Psychosocial Assessment

3. Other Government approved assessment tool(s)

4. PHQ-9

5. PCL-5

6. GAD-7

e. Treatment Plan signed by the detained offender, the CSO, the SCSO, and the Contractor.

f. Weekly Progress Notes.

g. Monthly Progress Reports (if applicable).

h. Clinical Material (if provided).

i. Termination Report.

j. Chronological Contact Sheet

C.4.5.1.2 File Storage and Removal. The Contractor shall ensure that all detained offender records are stored in a secured manner and location within the Contractor’s facility. To ensure proper tracking of detained offender treatment files, the Contractor shall establish a file tracking protocol to ensure that all detained offender treatment files are organized in a manner to ensure accountability of the records and proper disposition upon the detained offender’s discharge.

C.4.5.1.3 Active Treatment File Transition.

C.4.5.1.3.1 Upon notice from the CSOSA Contracting Officer (CO), or COR, that the contract will not be extended or continued, all detained offender treatment files in the possession of the Contractor should be clearly marked with the detained offender’s last name, first name, PDID#, and disposed of in accordance with CSOSA guidance.

C.4.5.1.3.2 CSOSA has the choice of directing that a copy of an detained offender’s treatment file be securely transported to the physical custody of another CSOSA contractor providing detained offender treatment services or returned to CSOSA. Detained offender treatment files should always be sent electronically, in a secured manner.

C.4.5.1.4 Closed Detained Offender Treatment Files. When a detained offender is no longer receiving services from the Contractor, and CSOSA has not directed the detained offender treatment file be provided to another CSOSA contractor taking over a detained offender’s treatment, the detained offender treatment file is considered closed. In the case of hard copy treatment files, the Contractor shall close the detained offender’s treatment file and return it to the COR within three business days of the detained offender’s completion of, or departure from, the treatment program.