AttC_SampleGroupBenefitsContract_ScopeOfWork.pdf

OEBB Contract No. #______ Sample Group Benefits Contract Employee Assistance Program Services Exhibit B, Scope of Work

EXHIBIT B

SCOPE OF WORK

Contractor is expected to provide, at minimum, the services described below. Collectively, these descriptions plus other obligations described in this and other RFP documents represent the Work that will be required under the RFP’s resulting Contract. OEBB expects to negotiate the resulting Contract’s Statement of Work by using this Scope of Work as a starting framework and adding details of the Work based on business needs and requirements as well as the ASP’s Proposal.

I. Administrative Services and Standards

At minimum, Contractor shall provide the administrative services and related standards described in the subsequent categories below.

A. Implementation and Integration. Contractor shall:

1. Provide implementation support for OEBB Entities, including providing an implementation manager, drafting and reviewing communications, supporting open enrollment activities and training sessions for OEBB and Entities.

2. Demonstrate the ability to integrate with OEBB’s vendor partners in order to highly engage Members and provide seamless experience at the time behavioral health services would be most helpful.

3. Establish and implement referral pathways with medical plans and other vendors to support coordination and transfer of care to medical plan behavioral health coverage when EAP sessions are exhausted or when higher levels of care may be needed.

B. Account Management. Contractor shall provide:

1. A strong and attentive account management team with a single point of contact account manager.

2. An account management team with experience supporting organizations of OEBB’s size and complexity and an ability to navigate different Entity needs across OEBB.

3. Robust reporting on sub-levels to inform population needs and best practices as more fully described in the Reporting and Performance Guarantee Section below.

4. Prompt complaint resolution related to the OEBB account.

C. Meeting Attendance. Contractor shall:

1. Attend public and private meetings as requested by OEBB. These meetings include, but are not limited to, monthly public Board meetings, various public committee and workgroup meetings related to the Board, as well as private meetings with OEBB staff or its contracted Consultant.

2. Be responsible for paying all costs incurred for attending meetings, including, but not limited to travel, lodging, parking, etc., for attendance at any meeting.

D. Presentations. Contractor shall:

1. Draft and present various presentations at OEBB’s request. Presentations may be requested for both public and private meetings; however, it is expected that the presentation materials will be public records for both public and private meetings (note: disclosure exemptions may still apply).

Employee Assistance Program Services Exhibit B, Scope of Work

2. Provide OEBB and its contracted Consultant with a reasonable opportunity to review and comment on presentations in advance.

E. Invoicing and Payment. Contractor shall:

1. Be paid on a per employee per month (PEPM) basis for Member services and on an hourly basis for on-site Entity services (to the extent negotiated and included in the resulting Contract), in the amounts set forth in the resulting Contract. The monthly premium for an Entity is the sum of the PEPM fee and the applicable hourly fees, if any.

2. Observe and follow the expected invoice and payment process described below unless a different arrangement is negotiated in the resulting Contract:

a. At annual Open Enrollment (OE), the Entity notifies OEBB of the EAP benefit plan selected, consisting of the number of visits for Member services and the number of hours, if any, of on-site services. On-site hours elected at OE will be billed monthly in twelve (12) equal parts, while additional on-site hours purchased after OE (if allowed) will be invoiced in total following the month of purchase. PEPM count is updated once a year during OE, unless OEBB agrees to more frequent updating of PEPM counts in the resulting Contract.

b. On the first business day of each month, OEBB shall upload a report to its EAP vendor webpage on its MyOEBB website. The report will identify, for each Entity participating in OEBB’s EAP program: (i) enrollment count, (ii) hours purchased at Open Enrollment, (iii) and hours purchased after Open Enrollment.

c. Contractor shall then email its invoice to OEBB by the fifth business day of each month to oebb.financialservices@odhsoha.oregon.gov. The monthly invoices must indicate the total premium due by OEBB and include a break down that identifies the amount owed by each Entity and the number of Members enrolled through each such Entity.

d. OEBB shall provide payment no later than the twenty-first (21st) day of each month and shall be made via electronic fund transfer (EFT).

F. Communications and Marketing. Besides any communication and marketing requirements described in other sections (such as Section II.B), Contractor shall also at minimum draft, allow OEBB to review and comment on, and distribute to Member and Entities the following types of marketing and promotional products:

1. A summary description of benefits available to Members and their dependents that includes instructions n how to access the services;

2. Brochures and posters, both electronic and hard copy, that describes EAP services available to Members and Entities;

3. A promotional calendar that describes upcoming promotional events and how to attend them;

4. Emails for Contractor, OEBB, and Entities to send out to its various Members and groups, informing them of various topics to be determined by Contractor and OEBB.

G. Reporting, Outcome Measurement, and Performance Guarantees. Contractor shall:

1. Demonstrate symptom improvement through clinically validated assessments.

2. Provide quarterly reporting and make measurements available to validate the clinical metrics and outcomes of the OEBB population.

3. Provide reporting metrics when cross referrals to OEBB’s vendor partners are provided.

mailto:oebb.financialservices@odhsoha.oregon.gov

Employee Assistance Program Services Exhibit B, Scope of Work

4. Agree to allow a third party to perform a clinical assessment of the program and services on OEBB’s behalf.

5. Be able to capture REALD/SOGI data on Members and provide aggregate reporting on services utilizing REALD/SOGI data.

II. Benefit and Service Delivery and Standards

At minimum, Contractor shall provide the services and related standards described in the subsequent categories below for Member services as well as for Entity services.

A. Services for Members

1. Access to Care. Contractor shall:

a. Be able to provide referrals to counselors within two business days and provide access to licensed therapists and other types of providers with confirmed availability within five business days.

b. Offer easy access to care in various modalities including in-person, virtual, and self-directed digital care.

c. Provide a staffed 24/7 crisis line for in the moment support.

d. Provide guided assistance and scheduling support, including scheduling of first appointment and provider alignment with health plan.

e. Provide critical incident support within 24-36 hours of request.

2. Network Quality and Management. Contractor shall:

a. Provide access to a broad network of evaluated behavioral health providers to meet the diverse needs of the OEBB population.

b. Make available a provider network that includes licensed clinicians providing services to children and adolescents.

c. Have or implement a process to search and match Members with a provider by race, ethnicity and language, LGBTQ+, and religious preference as well as clinical competencies to ensure the best patient to provider match.

d. Have a rigorous process in place for credentialing providers and accepting new providers into the network, including a process for single case agreements.

e. Proactively identify and fill network gaps, including having a process for monitoring capacity and availability of providers.

3. Clinical Processes and Support. Contractor shall:

a. Have clear and concise crisis protocols in place to ensure high acuity cases are identified and connected with needed care and resources, with documented follow up to ensure care and resources were received.

b. Monitor quality of care oversight and have quality assurance and quality improvement processes in place to address quality or care issues.

c. Ensure evidence-based therapies are offered and utilized.

4. Member Experience. Contractor shall:

a. Provide a Member experience aligned with OEBB's culture.

b. Make available concierge service to OEBB members in life’s most difficult times.

c. Offer customer service support at appropriate times for Pacific Time Zones.

Employee Assistance Program Services Exhibit B, Scope of Work

d. Provide easy to navigate web-based platform and applications.

e. Provide modern resources and tools that are easy to find, relatable to the OEBB population, and engages the entire family.

5. Equity and Inclusion. Contractor shall:

a. Have or implement capabilities to provide concordant services for Members based on race, ethnicity, language, sexual orientation and gender preference.

b. Make available a diverse network of providers that provide culturally and linguistically appropriate services.

c. Demonstrate equity strategies that ensure inclusiveness and accessibility through culturally and linguistically appropriate services (WCAG 2.1, language services offered, language level on all communications).

6. Technology and Innovation. Contractor shall:

a. Provide a solid roadmap demonstrating its commitment to future solution developments to improve services.

7. Programing and Service Options. Contractor shall:

a. Make available specific offerings for special populations (i.e. educators, law enforcement, teens & adolescents).

b. Offer services related to work-life balance and social determinants of health screenings to connect Members to the most appropriate resources.

c. Offer a broad spectrum of services to meet sub-clinical and clinical needs or OEBB’s population.

d. Offer Member EAP counseling services both virtually and in-person, depending on the need of the Member as well as clinical guidelines, and address a wide variety of topics including, but not limited to, job related problems, stress/anxiety, family related problems (including divorce as well as child and elder care issues), career counseling, crisis intervention, alcohol and chemical dependency issues, financial and legal issues, domestic violence, conflict resolution, grieving, stress management, and housing support.

e. Provide, besides the Member counseling services described above, other services to its Members, including:

i. Child care and elder care services;

ii. Identity theft services

iii. Resource retrieval services;

iv. Legal consultations and mediation;

v. Financial coaching;

vi. E-support (online assistance with navigating Contractor’s services);

vii. Home ownership services;

viii. Assistance in developing simple wills; and,

ix. An interactive website with online supporting tools.

B. Services for Entities

1. General Organizational Training and Support. Contractor shall:

a. Partner with OEBB on developing anti-stigma messaging by providing custom communications and promotions.

Employee Assistance Program Services Exhibit B, Scope of Work

b. Provide employee trainings, peer support, and/or clinician led support groups.

c. Provide best in market manager training and toolkits.

d. Provide strong and attentive critical incidence responses, including in-person, from quality provider(s) that includes a plan that details the incident, services initiated, and follow-up.

e. Offer manager consultations and in the moment telephonic crisis support for managers and supervisors.

f. Coordinate with OEBB’s disability leave vendor to support Members in the care they need to return to work.

g. Be proactive and flexible, having the ability to pivot to meet the unique needs of OEBB’s population.

2. Supervisor Support and Consultations. Contractor shall:

a. Provide general psychoeducational training sessions for Entity managers and supervisors that address topics such as and coping with stress, workplace change, workplace communication, team building, parenting, and balancing work and life issues.

b. Provide direct manager or supervisor consultations where the manager or supervisor can privately discuss methods of supervision and management skills, including, but not limited to, conflict resolution, coaching, return-to-work issues, last-chance agreements, and problem solving.

3. Critical Incident Stress Debriefings (CISDs). Contractor shall provide CISDs after experiencing a traumatic and tragic event, including but not limited to, natural death, suicide, robbery, severe injury, natural disasters, and workplace violence, committed by or on a co-worker, family member, or stranger. This session will be provided at the worksite or virtually.