Attachment J_RFP Evaluation Rubric_07.2025.pdf

Broome County Mental Health Department - RFP Evaluation Rubric Broome County RFP Mobile Crisis Services Applicant Name Reviewer Name

PART 1: INSTRUCTIONS - For Sections A-B & C, select if the Applicant’s Submission 0 = Incomplete or Missing Information

1 = Somewhat Addressed Submission includes relevant information however some details are missing and does not adequately meet submission criteria.

2 = Mostly Addressed Submission includes requested Information and adequately addresses proposal criteria.

3 = Clearly Addressed Submission includes all required information, is thorough, and exceeds expectations.

Criteria Description Score Notes / Comments

A. COVER SHEET / COVER LETTER Weight: 0.5% 10.2.a Submission contained a Cover Sheet / Cover Letter that identifies:

1 10.2.a.1 Applicant organization’s name and address, division/department under which the Mobile Crisis service will be operated.

2 10.2.a.2 3.1.b

Name, phone number, and e-mail address for the primary contact person for this submission.

3 10.2.a.3 3.1.c

Name, title, and signature of the individual authorized to act on behalf of the organization for submission of the application.

Section A. Subtotal Score

B. FORMAT Weight: 0.5%

10.2.b Proposal Narrative was prepared in accordance with instructions:

1 10.2.b.1 Single-spaced and prepared in a true-type, size 12 font

2 10.2.b.2 Proposal does not exceed ten (10) pages.

3 10.2.b.3 All documentation – including attachments - is clearly labeled.

Section B. Subtotal Score

C. REQUIRED DOCUMENATION Weight: 9.0 %

Documentation demonstrates Applicant meets Eligibility Criteria and Meets Minimum Qualifications 1 3.1.a

10.5.a Documentation demonstrating applicant’s status as a 501(c)(3)

2 3.1.b 10.5.b

Description/documentation demonstrating applicant’s current operations within Broome County.

3 3.1.c 10.5.c

Documentation of current licensure/certification for organization demonstrating applicant’s status as a current service provider for NYS OASAS, OMH, or DOH.

PART 1: INSTRUCTIONS - For Sections A-B & C, select if the Applicant’s Submission 0 = Incomplete/Missing Information 1 = Somewhat Addressed 2 = Mostly Addressed 3 = Clearly Addressed

C. REQUIRED DOCUMENATION [cont’d] Weight: 9.0 % Documentation demonstrates Applicant meets Eligibility Criteria and Meets Minimum Qualifications

4 10.3.a Submission contains a BUDGET for annual program operations.

5 10.4.c Submission contains a BUDGET NARRATIVE for annual program operations.

6 3.3 10.5.d

Attachment H - Attestation A: Citing understanding/acknowledgment to engage in the process to become certified as an OMH-approved Mobile Crisis Services provider.

7 10.5.e Attachment H - Attestation B: Citing understanding/acknowledgment of the applicant to develop relationships and work closely with all behavioral health programs within Broome County’s Crisis Continuum of Care including, but not limited to local hospital emergency departments, - local hospital emergency departments, the existing Comprehensive Psychiatric Emergency Program located at United Health Services, Binghamton General Hospital, the planned Supportive Crisis Stabilization Center, the region’s 988 – Suicide and Crisis Lifeline provider, Broome-based law enforcement, and the Broome County Mental Health Department – Local Government Unit.

8 10.5.f Attachment H - Attestation C: Citing understanding/acknowledgment of applicant to adhere to – and remain in compliance with - all guidance for programmatic implementation and billing requirements as issued from Broome County, NYS Office of Addiction Services and Supports, Office of Mental Health, and NYS Department of Health, and federal Centers for Medicare and Medicaid Services (CMS).

9 8.3.b 10.5.g

Attachment H - Attestation D: Citing understanding/acknowledgement of applicant has read, and agrees to the Program Deliverables, Data Collection and LGU collaboration and oversight, Program Components and Implementation Plan as outlined in the Mobile Crisis Guidelines for Broome County document [Attachment D].

Section C. Subtotal Score

0 = Incomplete/Missing Information 1 = Somewhat Addressed 2 = Mostly Addressed 3 = Clearly Addressed

D. ORGANIZATION EXPERIENCE Weight: 20.0 % 10.2.c Narrative / documentation demonstrates/describes organization’s experience in the following areas:

1 10.2.c.1 Applicant organization’s qualifications and capacity to provide the proposed services.

2 3.1.c 10.2.c.2

Describe any current or historic programming / affiliation with NYS Office of Addiction Services and Supports (OASAS), Office of Mental Health (OMH) or the NYS Department of Health (DOH) - clinical and/or non-clinical/supportive services provided to youth and/or adults living with mental illness, substance use, intellectual/developmental disabilities and/or an emotional distressing situation.

3 10.2.c.3 Cross-systems collaboration with community providers to address the diverse needs of the population. Include specific examples of partnerships that have enhanced service coordination, streamlined access to care, and improved outcomes for individuals requiring behavioral health support.

4 3.4 10.2.c.4

Application describes how the organization fosters ongoing collaboration with providers across sectors, including mental health, substance use and intellectual/developmental disability services.

5 10.2.c.5 Describes experience with delivery of crisis intervention services including crisis assessment, intervention, supportive counseling, and referrals for individuals with mental illness, substance use, and intellectual/developmental disabilities.

Section D. Subtotal Score

0 = Incomplete/Missing Information 1 = Somewhat Addressed 2 = Mostly Addressed 3 = Clearly Addressed

E. ORGANIZATION’S DOCUMENTATION PLATFORMS AND PROCEDURES Weight 10.0% 10.2.d Describe the organization’s documentation platforms and procedures in the following areas:

1 10.2.d.1 Application describes the Electronic Health Record (EHR)/ Electronic Medical Record (EMR) platform/system utilized and the ability to function effectively for a mobile, in-community-based services.

2 10.2.d.2 Application describes the protocols/ written procedures related to the expectations for documentation the organization current employs.

3 10.2.d.3 Summary of the organization’s capacity/experience for billing Medicare, Medicaid and private payors for services, including details on any previously billable programs.

4 10.2.d.4 Name of the Compliance Officer and an outline of the Compliance Program pursuant federal Centers for Medicare and Medicaid Services (CMS) and NYS Office of Medicaid Inspector General (OMIG).

5 10.2.d.5 Protocols/written procedures to ensure adherence to billing regulations, audits and best practices for reimbursement processes.

Section E. Subtotal Score

F. PERSONNEL Weight 10.0%

10.2.e Narrative / documentation must describe the organization’s proposed staffing plan 1 10.2.e.1 Application describes the organization’s proposed programmatic staffing plan that includes roles, credentials.

2 10.2.e.2 Describe how regular, consistent supervision will be provided - and documented - for all Mobile Crisis personnel.

0 = Incomplete/Missing Information 1 = Somewhat Addressed 2 = Mostly Addressed 3 = Clearly Addressed

F. PERSONNEL (cont’d) Weight 10.0% 3 10.2.e.3 Describe the organization’s current staffing plan/organizational chart – and how existing personnel could assist with supporting Mobile Crisis services in the event of call-ins, staffing demands.

4 10.2.e.4 Describe methods for recruitment and retainment of qualified and diverse personnel.

5 10.2.e.5 Submission includes proposed job descriptions for key personnel included in the budget – including minimum qualifications for education and experience.

Section F. Subtotal Score

G. STAFF SUPERVISION AND TRAINING Weight 10.0% 1 10.2.f.1 Describe training methods / expectations that will ensure the staff designated to provide Mobile Crisis services are equipped to provide comprehensive and integrated care. Training should address the diverse needs of individuals experiencing mental health challenges, substance use disorders and/or co-occurring conditions.

2 10.2.f.2 Outline how staff will be prepared to respond effectively to crisis situations, coordinate care and support long-term stabilization.

Section G. Subtotal Score

0 = Incomplete/Missing Information 1 = Somewhat Addressed 2 = Mostly Addressed 3 = Clearly Addressed

H. CULTURAL HUMILITY AND LANGUAGE Weight 5.0 % 1 10.2.g.1 Describe how the organization will ensure that services reach marginalized and underrepresented populations including but not limited to, unhoused persons, non-English speaking and/or immigrants, racial and ethnic minorities in Broome County.

2 10.2.g.2 Describe the organization’s experience with planning and service delivery regarding cultural diversity, equity, and inclusion.

Section H. Subtotal Score

I. SCREENING AND ASSESSMENT TOOLS / EVIDENCE-BASED PRACTICES Weight 5.0% 1 10.2.h.1 Submission identifies specific evidence-based diagnostic tools and/or screening instruments the organization proposes to utilize when assessing individuals in crisis, (i.e. SAMSHA’s SAFE-T risk assessment tool with Columbia-Suicide Severity Rating Scale), with explication of how these tools will be integrated into the proposed workflow.

Section I. Subtotal Score

J. BUDGET AND BUDGET NARRATIVE Weight 30%

10.3 10.4

Utilizing the Budget Template provided, applicant submitted a Budget for annual operations.

The Budget Narrative corresponds to – and explains – the proposed annual budget.

1 5.3 10.3.a 10.3.b 10.4.a

Submission contains a budget and budget narrative for annual program operations – that addresses each of the budget template categories.

2 10.3.a.6 Applicant entity’s budget reflects that Administrative costs do not exceed 15% of the Personnel and OTPS costs.

0 = Incomplete/Missing Information 1 = Somewhat Addressed 2 = Mostly Addressed 3 = Clearly Addressed

J. BUDGET / BUDGET NARRATIVE (cont’d) Weight 30% 3 5.3

5.4 Applicant entity’s budget is within the RFP award amount

4 5.6 10.4.b

Budget submission details how the applicant intends to implement and grow a billing structure to support program sustainability.

Section J. Subtotal Score

SCORING TOOL

Section (1)

Description (2)

Weighted Percentage

(3)

Section Subtotal

(4)

Calculated Decimal

(5)

Total Weighted Points (6)

Multiply Section Subtotal (4) by Calculated Weighted Decimal (5)

A COVER SHEET / COVER LETTER 0.5 % 0.005

B FORMAT 0.5 % 0.005

C REQUIRED DOCUMENTATION 9.0 % 0.09

D ORGANIZATION EXPERIENCE 20.0 % 0.20

E ORGANIZATION’S DOCUMENTATION PLATFORMS AND PROCEDURES 10.0 % 0.10

F PERSONNEL 10.0 % 0.10

G STAFF SUPERVISION AND TRAINING 10.0 % 0.10

H CULTURAL HUMILITY AND LANGUAGE 5.0 % 0.05

I SCREENING AND ASSESSMENT TOOLS / EVIDENCE-BASED PRACTICES 5.0 % 0.05

J BUDGET / BUDGET NARRATIVE 30.0 % 0.30

TOTAL SCORE

Reviewer Attestation: By signing below, I attest I have read and scored the identified proposal without interference or prejudice and the scores/comments reflect my true opinion.

Name: [print]

Signature:

Date: