CTR077671_Contract_Documents.pdf

1 July 25

July 1, 2025

CTR077671

Solicitation Requirements Request for Proposal (RFP)

Solicitation No.: BPM006528

Description: Behavioral Supported Group Home Services

RFP Solicitation Requirements (10-23) Available Online at https://app.az.gov Page 1 of 82

DESCRIPTION: In accordance with A.R.S. §41-2534, the Arizona Department of Economic Security (ADES) is requesting sealed proposals from Contractors for Behavioral Supported Group Home Services

SOLICITATION NUMBER BPM006528

SOLICITATION DUE DATE/TIME: November 4th, 2024 at 3:00 P.M. local Arizona time

SUBMITTAL LOCATION

Submit via Arizona Procurement Portal (https://app.az.gov)

Note: Questions on how to submit the bid shall be directed to the Arizona Procurement Portal Help Desk at app@azdoa.gov or (602) 542-7600

PRE-OFFER CONFERENCE:

Pre-offer Conference will be held via Virtual Conference September 24th, 2024 at 10:00 A.M. local AZ time Link: meet.google.com/yxm-tqpy-poa

Phone Number: +1 478-324-0843 Pin: 462 351 419#

CONTACT PERSON:

Anthony Beckum, Senior Procurement Officer Tel. (480) 578-6567 Email: Abeckum@azdes.gov

Prospective Offerors are strongly encouraged to read the RFP in its entirety before submitting Offers, to ensure that all requirements in the RFP are understood.

● RFP Solicitation Requirements is comprised of the Notice Page, Scope of Work, DDD Special Terms and

Conditions, DES Special Terms and Conditions, Uniform Terms and Conditions, and Exhibits.

● RFP Solicitation Instructions contains the Special Instructions to Offerors, Uniform Instructions to Offerors, and Submittal Documents that should be submitted as the Offeror’s response.

Sealed offers in response to this Solicitation shall be submitted within the State’s e-Procurement system, Arizona Procurement Portal (https://app.az.gov) by the due date and time indicated in the State’s e-Procurement system as the Bid Due Date. Late submittals will not be considered. Offers received by the due date and time will be electronically opened.

Offers submitted outside the State’s e-Procurement system, or those that are received after the due date and time, shall be rejected. Additional instructions for preparing an Offer are included in this Solicitation.

Offerors shall download and save attachments to their computer, save the information entered, and submit (upload) the completed information as a new, appropriately renamed Attachment in the State’s e-Procurement system. The State’s e- Procurement system will not save information entered directly on the attachments.

It is Offeror’s responsibility to routinely check the State’s e-Procurement system for Solicitation Amendments.

Inquiries regarding this Solicitation are required to be submitted online through the State’s e-Procurement system using the Discussion Forum tab, seven (7) calendar days prior to the Bid Due Date.

For submission of an exception or to request a substitution to this Solicitation, see Uniform Instructions to Offerors, section 2.4, Timeliness.

With seventy-two (72) hours prior notice, persons with disabilities may request special accommodations such as interpreters, alternative formats, or assistance with physical accessibility. Such requests are to be addressed to this Solicitation contact person named above.

https://app.az.gov/ https://app.az.gov/ mailto:appsuppliers@azdoa.gov file://obf-ood/shared/Procurement_New/03%20PROCUREMENT/DDD/SOLICITATIONS/BPM006528%20-%20Behavioral%20Supported%20Group%20Home%20Services/2%20Solicitation%20Documents/meet.google.com/yxm-tqpy-poa https://app.az.gov/

Solicitation Requirements Request for Proposal (RFP)

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Table of Contents

Section Page

Scope of Work

DDD Special Terms and Conditions

ADES Special Terms and Conditions

Uniform Terms and Conditions

Exhibit A - Habilitation Behavioral-Supported Group Home Service Requirements

Exhibit B - Room and Board Service Requirements

Exhibit C - Home Requirements

Scope of Work

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1. ADES Mission and Vision Statements

1.1 ADES Mission: To strengthen individuals, families, and communities for a better quality of life.

1.2 ADES Vision: A thriving Arizona.

1.3 DDD Mission: To empower Arizonans with developmental disabilities to lead self-directed, healthy, and meaningful lives.

2. Purpose

2.1. Purpose Statement: The purpose of this contract will be to enable a Contractor to establish Behavioral

Supported Group Homes (BSGH) for one to three (1–3) DDD Members with Complex Needs.

2.2. Legal Authority: A.R.S. § 41-1954(A)(6) provides the Arizona Department of Economic Security, hereafter referred to as the Department, the authority to contract and incur obligations within the general scope of its activities and operations.

2.3. Projected Awards: It is in the intent for the Arizona Department of Economic Services (ADES) and the Division of Developmental Disabilities (DDD) to award one or more contractor(s) to enable the DDD to utilize up to ten (10) operational Behavioral-Supported Group Home service sites based on DDD Member needs. ADES/DDD will notify contractors if the need increases to more than ten (10) homes to allow for expansion.

2.4. Projected Utilization: This contract is on an as needed, if needed, basis. ADES/DDD makes no guarantee of the number of payment units to be authorized.

2.5. Funding: A combination of federal and state legislature funds as approved in the DDD rate book and designated in A.R.S. § 35-154.

3. Service Description

3.1 Taxonomy Definition: H004-00 – Alternative Residential Services - An alternative setting to an individual’s own home that is licensed or certified to provide one or more of the following: room and board, health care, health related services, behavioral health services and/or habilitation for residents on a continuing basis.

The setting is not a licensed nursing care institution.

3.2 Actual Service Description: A temporary intensive behavioral support program in a community residential setting for select DDD Members. This service supports the DDD Members’ choice to live in and access opportunities in their communities. The services offered in Behavioral Supported Group Home enable the DDD Members to return or transition into a less restrictive environment when clinically appropriate with the result of reduced psychiatric hospitalizations, medical hospitalizations, and emergency room visits.

3.3 Background: The Division of Developmental Disabilities (DDD) is responsible for serving over 54,000 eligible members in the State of Arizona. The DDD is working to strengthen the behavioral health supports needed by DDD Members within a safe and healthy residential living environment. This includes providing

RFP Solicitation Requirements (10-23) Available Online at https://app.az.gov Page 4 of 82 time-limited, intensive behavioral health treatment in a residential setting that will meet both the physical daily living, personal care, and behavioral supports for DDD Members with Complex Needs. DDD Members residing in a Behavioral-Supported Group Home (BSGH) are required to receive a variety of interventions designed to maximize their independence including, but not limited to sensorimotor development, habilitative therapies, skill development, and behavior supports. The intention of the BSGH service is to support a plan to allow the DDD Member to transition into less restrictive services when deemed clinically appropriate.

4. Definitions

4.1 Applied Behavior Analysis (ABA): The implementation of established principles of learning, behavioral strategies, and environmental modifications to improve and teach new behaviors.

4.2 Arizona Department of Health Services (ADHS): The department of the State of Arizona responsible for regulating health services.

4.3 Behavior Analyst Certification Board (BACB): Behavior Analyst Certification Board.

4.4 Board Certified Behavior Analyst (BCBA): Graduate-level certification in behavior analysis certified at the BCBA level are independent practitioners who provide behavior-analytic services.

4.5 Behavior Plan (BP): An integrated, individualized, written plan which may be based on a Behavioral Health Professional’s provisional or principal diagnosis and assessment of behavior and the treatment needs, abilities, resources, and circumstances of a DDD Member, that includes one or more treatment goals and one or more treatment methods.

4.6 Behavioral Health Professional (BHP): An individual licensed under A.R.S. Title 32, Chapter 33 whose scope of practice allows the individual to independently engage in the practice of behavioral health services including psychiatrist, psychologist, physician; registered nurse practitioner licensed as an adult psychiatric and mental health nurse practitioner; or a behavior analyst.

4.7 Behavioral Health Technician (BHT):1. With clinical oversight by a BHP, services that, if provided in a setting other than a health care institution, would be required to be provided by an individual licensed as specified in A.R.S. § 32, Chapter 33, and 2. Health-related services.

4.8 Behavioral-Supported Group Home (BSGH): A time-limited service, designed for DDD Members who have been deemed to need intensive behavioral support that supports the Member’s choice to live in and access opportunities in their communities through services offered in their Group Home A.R.S.36-591.01.

4.9 Complex Needs: Means a client with dual disorders, including psychiatric disorders and developmental disabilities who engage in behaviors that are disruptive, socially inappropriate, or harmful or dangerous to self or others that interfere with functioning and quality of life or may cause destruction to property.

4.10 Contractor Quality Management & Performance Improvement (CQM/PI) Committee: The purpose of the CQM/PI Committee is to guide the overall quality strategy to monitor and provide oversight of the BSGH Program to ensure, continual process improvement, quality outcomes for members, and compliance with requirements.

4.11 DDD Member: An individual with a developmental disability who has been determined to be eligible for service(s) by the Division of Developmental Disabilities (DDD).

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4.12 Direct Support Professional (DSP): A person who is hired to explicitly perform and deliver Home and Community Based Services (HCBS) directly to DDD Members, may also be referred to as Direct Care Worker (DCW).

4.13 Division of Developmental Disabilities (DDD): The division within the Arizona Department of Economic

Security responsible for providing supports and services for ALTCS/Title XIX eligible members established by A.R.S. Title 36, Chapter 5.1.

4.14 “Emergency Safety Situation” means unanticipated Unsafe Behavior.

4.15 Functional Behavioral Assessment (FBA): Functional Behavior Assessment” or “FBA” means a comprehensive assessment consisting of different observations of the member in one or more settings, with one or more caregivers; and includes a comprehensive review of historical documents (e.g., Planning Documents, medical and behavioral health evaluations, progress reports, Individualized Education Program, data collection), indirect and direct assessment, and recommendations for treatment.

4.16 Home and Community Based Service (HCBS): Provides help with daily activities while allowing many individuals to remain in their own homes or live with their families by reducing the need for institutional care.

4.17 Integrated Treatment Plan: As defined as A.R.S. 36-591.01, C, (2). An Integrated Treatment Plan is created by the contractor based on the DDD Member's comprehensive assessment that includes measurable objectives and the methods for meeting the objectives.

4.18 Multidisciplinary Team: A group of healthcare professionals from different fields working to establish a treatment plan with appropriate service providers from behavioral health, medical, nursing and nutrition providers, physical, occupational and speech therapists, educational personnel, and DSPs to support the DDD Member.

4.19 Physical Intervention: means a technique used on an emergency basis by an individual who is providing care or service to a DDD Member to restrict the movement of the DDD Member by direct physical contact to prevent the DDD Member from seriously harming self or others.

4.20 Planning Document: A written plan of services to be provided to DDD Members as determined by the

Planning Team.

4.21 Planning Team: The defined group of individuals including family members, friends, service providers, community resource providers, representatives from religious or spiritual organizations, and agents from other service systems that assist the DDD Member to best determine service needs to meet the individuals’ goals.

4.22 Positive Behavioral Supports (PBS): Research-based strategies used to increase quality of life and decrease problem behavior by teaching new skills and making changes in a person’s environment.

4.23 Prevention and Support (P & S): Means specific techniques and preventative strategies used by trained personnel during an Emergency Safety Situation.

4.24 Primary Care Provider (PCP): A physician or medical clinician responsible for the management of the DDD

Member's physical and behavioral health care services.

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4.25 Program Review Committee (PRC): A team of volunteers that review the Behavior Plans and provide guidance on strategies to address behaviors that interfere with DDD Members’ ability to lead self-directed, healthy, and meaningful lives.

4.26 Registered Behavioral Technicians (RBT): A paraprofessional who works one-on-one or in small groups with individuals and their families or caregivers and who work under the supervision of a Board-Certified Behavior Analyst (BCBA), to collect data and carry out treatment protocols or behavior plans.

4.27 Responsible Person: The parent or guardian of a minor with a developmental disability, the guardian of an adult with a developmental disability or an adult with a developmental disability who is a client or an applicant for whom no guardian has been appointed.

4.28 Unsafe Behavior: means a DDD Member’s action or activity, whether intentional, unintentional, or negligent, that causes a risk of imminent harm to the DDD Member or others.

4.29 Quality Management & Performance Improvement (QM/PI) Committee: The purpose of the QM/PI Committee is to guide the overall quality strategy to monitor and provide oversight of the Contractor’s QM Program to ensure, continual process improvement, quality outcomes for members, and compliance with requirements.

5. Contractor Requirements

The Contractor shall:

5.1 Have a minimum of two (2) years’ experience supporting adolescents or adults with intellectual and developmental disabilities, dual diagnosis, and complex support needs in a Home and Community Based Setting (HCBS).

5.2 Have experience transitioning adolescents or adults with intellectual and developmental disabilities, dual diagnosis, and complex support needs into a less-restrictive residential environment.

5.3 Be licensed, certified, and maintain good standing in accordance with applicable State and Federal laws, including without limitation the provisions of A.R.S. Section 36-591, A.A.C. Title 6, Chapter 6, Article 15 (R6-6-1501 et seq.) and A.A.C. R9-22-503.

5.4 Comply with, and meet all applicable provisions of Federal and State laws, regulations, codes, and policies and procedures, including without limitation the requirements and standards set out in:

5.4.1 A.R.S. Title 36, Chapter 5.1 (section 36-551 et seq.); A.A.C. Title 6, Chapter 6 (A.A.C. R6-6-10-1 et seq.) and all policies and procedures promulgated by the Department of Economic Security and its Division of Developmental Disabilities; with special attention to A.A.C. Title 6, Chapter 6, Article 9 (R6-6-901 et seq., Managing Inappropriate Behaviors.

5.4.2 A.A.C. Title 9, Chapter 22, Article 2 (AHCCCS), and Title 9, Chapter 28 (Arizona Health Care Cost

Containment System-Arizona Long Term Care System).

5.4.3 42 CFR Parts 430, 431, et. al.

5.4.4 Division policy which can be located at https://des.az.gov/services/disabilities/developmental-disabilities/policies-and-rules/policies https://des.az.gov/services/disabilities/developmental-disabilities/policies-and-rules/policies

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5.4.5 Division forms which can be located at https://des.az.gov/documents-center

5.5 Be enrolled as a provider with AHCCCS and obtain and maintain all licenses, permits and authority necessary to do business and render service under this contract and, where applicable, shall comply with all laws regarding safety, unemployment insurance, disability insurance and worker's compensation.

5.5.1 AHCCCS enrollment information can be found on the AHCCCS website:

https://www.azahcccs.gov/PlansProviders/APEP/ProviderEnrollment.html

5.6 Comply with the Division’s Credentialing as an Organization Provider as outlined in Division Medical Manual Chapter 950 prior to accepting authorizations.

https://des.az.gov/sites/default/files/media/Division_Medical_Policy_Manual_950_Credentialing_and_Rec redentialing_Processes.pdf?time=1726154356901

5.7 Complete and maintain the requirements for BSGHs including, but are not limited to:

5.7.1 Arizona Health Care Cost Containment Provider Identification Number;

5.7.2 Arizona Department of Health (ADHS) License;

5.7.3 ADES/ DDD Contractor credentialing

5.7.4 ADES/ DDD BSGH Home credentialing; and

5.7.5 DDD Monitoring Unit Compliance.

5.8 Qualifications of Key Personnel

5.8.1 Maintain Key Personnel responsible for the business operation of the business entity, who may be an owner, chief executive officer (CEO), chief financial officer (CFO) business administrator or similar title, shall meet the following requirements:

5.8.1.1 Earned a bachelor’s degree or more in finance, business administration, or another closely related field from an accredited college or university, with at least two (2) years of experience working in finance, business administration, or another closely related field; or

5.8.1.2 Earned an associate’s degree or more in finance, business administration, or another closely related field from an accredited college or university, with at least five (5) years of experience working in finance, business administration, or another closely related field; or

5.8.1.3 Have at least seven (7) years of experience working as an owner, CEO, CFO, director, administrator, business administrator, or similar title.

5.8.2 Maintain and ensure Key Personnel responsible for service provision shall meet the following requirements:

https://des.az.gov/documents-center https://www.azahcccs.gov/PlansProviders/APEP/ProviderEnrollment.html https://des.az.gov/sites/default/files/media/Division_Medical_Policy_Manual_950_Credentialing_and_Recredentialing_Processes.pdf?time=1726154356901 https://des.az.gov/sites/default/files/media/Division_Medical_Policy_Manual_950_Credentialing_and_Recredentialing_Processes.pdf?time=1726154356901

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5.8.2.1 Earned a bachelor’s degree or more in social science, health education, psychology, sociology, social work, health sciences, early childhood education, special education, rehabilitation counseling, or another closely related field from an accredited college or university, with at least two (2) years of management or supervision experience in a human service field or developmental disability service field; or

5.8.2.2 Have at least five (5) years of experience in leadership or management of an entity that services the ID/ DD population or other similar population; or

5.8.2.3 Have at least two (2) years of experience working directly with people with ID/DD, meet the federal requirements for a Qualified Intellectual Disabilities Professional (QIDP) specified in 42 C.F.R. § 483.430, and be licensed, certified, or registered in the State of Arizona with a minimum of one (1) of the following occupations:

5.8.2.3.1 Doctor of medicine or osteopathy;

5.8.2.3.2 Registered nurse;

5.8.2.3.3 Occupational therapist;

5.8.2.3.4 Occupational therapy assistant;

5.8.2.3.5 Physical therapist;

5.8.2.3.6 Psychologist;

5.8.2.3.7 Social worker;

5.8.2.3.8 Speech language pathologist;

5.8.2.3.9 Audiologist;

5.8.2.3.10 Professional dietitian, registered by the American Dietetic Association; or

5.8.2.3.11 Have earned a bachelor’s degree in a human services field, such as sociology, special education, rehabilitation counseling, or psychology.

5.8.3 Complete Attachment Twelve (12) Key Personnel/Clinical Professional Form and submit an email notification to the DDD Specialty Contracts Unit DDDSpecialtyContracts@azdes.gov within ten (10) days of a change in Key Personnel/Clinical Professional, or upon request of DDD.

5.8.4 Provide an organizational chart that includes key personnel, clinical professionals, direct support professionals, including all employees and subcontracted personnel. upon request of DDD.

5.8.5 Employ or subcontract with an individual or entity to act as the Contractor’s medical billing coder.

5.8.6 Employ or subcontract with a certified public accountant.

mailto:DDDSpecialtyContracts@azdes.gov

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5.9 Ensure all staff employed as clinical professionals have met and maintain the required qualifications, licensures, and certifications as applicable:

5.9.1 BHP,

5.9.2 BCBA,

5.9.3 RBT,

5.9.4 BHT, and

5.9.5 DSP.

5.10 Verify all DSP employed have met and maintain required trainings as applicable:

5.10.1 Cardiopulmonary Resuscitation (CPR) and First Aid provided or sponsored by a Nationally recognized organization, with in-person skills demonstration, such as chest compressions and first aid. CPR and first aid certification shall be maintained;

5.10.2 Article 9, Managing Inappropriate Behaviors by instructors certified by the DDD and following the

DDD’s training and testing guidelines;

5.10.3 Specific training indicated in the DDD Member’s Planning Document,

5.10.4 Prevention and Support, or other Physical Intervention curriculum as indicated on the DDD Member’s Planning Document and must be provided by an instructor certified or approved by the

DDD;

5.10.5 Positive Behavior Support by instructors certified by the DDD and following the DDD’s training and testing guidelines.

5.10.6 Training on the needs of the specific DDD Member services and the operations of the Contractor’s program; and

5.10.7 Additional skills needed to address the special or extraordinary needs of the DDD Member as required by the DDD Member’s Planning Document.

5.11 Develop the curriculum and provide training to Contractor’s staff that includes, but is not limited to (DDD resources available to the Contractor can be found here https://des.az.gov/services/disabilities/developmental-disabilities/vendors-providers/current/training):

5.11.1 Mission and values of the DDD and the community residential setting;

5.11.2 Orientation to DDD Members in the residential setting;

5.11.3 Interactions with DDD Members;

5.11.4 Communication with families;

5.11.5 DDD Member rights;

https://des.az.gov/services/disabilities/developmental-disabilities/vendors-providers/current/training

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5.11.6 Agency health and safety policies and procedures;

5.11.7 Safety procedures;

5.11.8 Medication administration, if relevant;

5.11.9 Seizures, if relevant;

5.11.10 Planning process; and

5.11.11 Confidentiality.

5.12 Provide training curriculum, competency testing and attendance verification to the DDD upon request.

5.13 Maintain records for DSPs documenting age above eighteen (18) years, background checks, criminal record, references from non-family DDD Members, certifications, and training.

5.14 Ensure all DSPs demonstrate competency in knowledge, application, and generalization of skills to novel situations.

5.15 Ensure all DSPs participate in ongoing training to assure acquisition of specified behavioral and program components inclusive of assessment and measurement of behavior, skill acquisition strategies, behavior prevention and reduction, documentation, reporting, professional conduct, scope of practice, and ability to promote independence.

5.16 Provide utilization control and quality assurance including, but not limited to:

5.16.1 Maintain an internal quality assurance system in accordance with current applicable AHCCCS rules and policies and Federal regulations as specified in the current 42 C.F.R. Part 456 Subparts A & B, as implemented by AHCCCS and the DDD.

5.16.1.1 Quality assurance requirements shall include but are not limited to:

5.16.1.1.1 Completing statistical or program reports including tracking and trending incidents upon request from the DDD; and

5.17 Complying with any recommendations made by the DDD’s Statewide QM/PI Committee.

5.17.1 Create and manage a QM/PI Committee. The purpose of the QM/PI Committee is to guide the overall quality strategy to monitor and provide oversight of the BSGH Program to ensure continual process improvement, quality outcomes for DDD Members, and compliance with requirements.

5.18 Produce available records to the DDD upon request.

5.19 Allow persons authorized by the DDD access to settings where services are provided at any hour of the day or night as deemed appropriate by the DDD.

5.20 Provide program design information to the DDD upon request.

5.21 Cooperate with the DDD and AHCCCS quality assurance programs and reviews as outlined in the DDD

Medical Policy Manual Chapter 960.

RFP Solicitation Requirements (10-23) Available Online at https://app.az.gov Page 11 of 82 https://des.az.gov/sites/default/files/media/Division_Medical_Policy_Manual_960_Quality_of_Care_Conc erns.pdf?time=1726257250371

5.22 Ensure the following plans are in place as outlined in the DDD policy manuals and provided to DDD upon request:

5.22.1 Quality Management Plan,

5.22.2 Workforce Development Plan,

5.22.3 Business Continuity Plan, and

5.22.4 Pandemic Performance Plan.

5.23 Member Progress Reports: Submit Member Progress Reports as outlined in DDD’s Provider Manual -

Chapter 35 or as amended.

6. General Requirements

6.1. Act in accordance with the DDD Operations, Medical, Behavior Supports and Provider Manual Policies which can be found at:

6.2. Ensure all staff directly working with children or vulnerable adults comply with the Background Checks for

Employment through Central Registry requirement outlined in Section Six (6) of the ADES Special Terms and Conditions.

6.2.1. Staff shall be required to resubmit their Background Checks for Employment through Central

Registry on a yearly basis (one (1) year from their most recent check).

6.3. Complete DDD Billing and Payments System Training to obtain a Provider Identification Number.

6.4. Provide BSGH services to DDD Members as identified and referred by the DDD to include the following:

6.4.1. Ensure that each DDD Member’s FBA, behavior plan, and Integrated Treatment Plan is developed, integrated, coordinated, and monitored by the appropriate clinical professionals.

6.4.2. Complete the required DDD Member assessments and care plans including, but not limited to:

6.4.2.1. FBA and Behavior Plan – Due within thirty (30) days of the DDD Members’ move in date.

6.4.2.2. Integrated Treatment Plan due within ninety (90) days of the DDD Members’ move in date.

6.4.3. Manage direct care, supervision, and implement the services as listed in the DDD Member’s Planning Document.

https://app.az.gov/ https://des.az.gov/sites/default/files/media/Division_Medical_Policy_Manual_960_Quality_of_Care_Concerns.pdf?time=1726257250371 https://des.az.gov/sites/default/files/media/Division_Medical_Policy_Manual_960_Quality_of_Care_Concerns.pdf?time=1726257250371 https://des.az.gov/services/disabilities/developmental-disabilities/policies-and-rules/policies

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6.4.4. Ensure all DSPs obtain and maintain current licenses and credentials as required by their standard of practice and provide to the DDD upon request.

6.4.5. Ensure clinical professionals are available as designated in the DDD Member’s Planning Document.

6.4.6. Ensure all DSPs participate in direct observation to ensure they exhibit a willingness to engage with

DDD Member(s) in a positive, instructive, and nurturing manner during DSP and DDD Member engagements.

6.4.7. Provide Behavioral-Supported Group Home, Habilitation Services according to requirements listed in Exhibit A.

6.4.8. Provide Behavioral-Supported Group Home, Room and Board Services according to requirements listed in Exhibit B.

6.4.9. Establish a Behavioral-Supported Group Home Setting for designated DDD Members according to Home Requirements listed in Exhibit C.

6.5. Provide case records including, but not limited to, the DDD Member’s healthcare, Integrated Treatment

Plan, social information, and protection of DDD Member rights in accordance with A.R.S. § 36-551.01, upon request of the DDD.

6.6. Provide internal investigative reports in relation to the provision of services to the DDD Members and subsequent corrective actions, upon request of the DDD.

6.7. Provide policies and procedures governing the release of any DDD Member information, including consents necessary from the DDD Member, or Responsible Person, to the DDD upon request.

6.8. Provide policies and procedures governing the use of electronic monitoring to align with A.R.S. 36-568 and

Provider Manual Chapter 42.

6.9. Comply with the requirements related to reporting to a peace officer or Department of Child Safety (DCS) incidents of crimes against minors as specified in A.R.S. §13-3620 (as may be amended).

6.10. Comply with the requirements in A.R.S. § 46-454 related to reporting to a peace officer or to a protective services worker any reason to believe that abuse, neglect of a vulnerable adult, or exploitation of a vulnerable adult’s property has occurred.

6.11. Comply with the requirements outlined in DDD Provider Manual Chapter 70- Qualified Vendor Incident Reporting to notify the DDD and Responsible Person of incidents and changes in the DDD Member’s condition.

6.12. Manage and maintain records of DDD Members’ personal funds and provide the records to the DDD upon request as outlined in the DDD Provider Manual and Operations Manual.

6.13. Ensure a log of personal belongings of the DDD Member is maintained and continually updated, and available to the DDD, the DDD Member, and the Responsible Person upon request.

https://app.az.gov/

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6.14. Provide Emergency Plan (according to CMS requirements - https://www.cms.gov/Regulations-and-

Guidance/Guidance/Manuals/Internet-Only-Manuals-IOMs-Items/CMS1201984.html to the DDD upon request.

6.15. Provide evacuation drill records and subsequent corrective actions, as applicable, to the DDD upon request.

6.16. Provide infection control prevention program records, any related investigations, and subsequent corrective actions, as applicable, to the DDD upon request.

6.17. Prepare and submit the DDD Form DDD-2206A as outlined in Clinical Oversight Standard Agenda form in the DDD Provider Manual Chapter 54 https://des.az.gov/services/disabilities/developmental-disabilities/policies-and-rules/policies

6.17.1. DDD Form DDD-2206A as may be amended is located at:

https://des.az.gov/documents-center?qt-content-tab=1

6.18. Provide services and supports to individuals with developmental disabilities, dual diagnosis, and Complex Needs in a community residential setting as outlined in this RFP and resulting contract.

6.19. Implementation Plan

6.19.1. Provide a written implementation plan, which includes projected timelines for the:

6.19.1.1. Purchase or lease of residential properties,

6.19.1.2. Necessary licenses, certifications, approvals from ADHS/DDD regarding the

BSGH,

6.19.1.3. Required site modifications as outlined in Exhibit C,

6.19.1.4. Recruitment and hiring of staff related to the provision of BSGH services, and

6.19.1.5. Transition identified DDD Members into each BSGH.

6.20. Provide a written plan describing how the Contractor will retain staff to ensure services are provided.

7. Reporting Requirements

7.1. Incident Reports -Submit Incident Reports as defined in DDD’s Operations Manual – Chapter 6000 or as amended.

https://des.az.gov/sites/default/files/Provider-Quick-Guide-For-Incident-Reporting.pdf

7.1.1. Report all serious incidents no later than twenty-four (24) hours following the incident;

7.1.2. Report all other incidents by close of business day following the incident; and

7.1.3. Submit all incidents to the DDD Member’s support coordinator, Responsible Person, and the DDD

District as designated in the Incident Reporting requirements.

https://app.az.gov/ https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Internet-Only-Manuals-IOMs-https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Internet-Only-Manuals-IOMs-https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Internet-Only-Manuals-IOMs-Items/CMS1201984.html https://des.az.gov/services/disabilities/developmental-disabilities/policies-and-rules/policies https://des.az.gov/documents-center?qt-content-tab=1 https://des.az.gov/sites/default/files/Provider-Quick-Guide-For-Incident-Reporting.pdf

RFP Solicitation Requirements (10-23) Available Online at https://app.az.gov Page 14 of 82

7.1.3.1. For any behavioral incidents that involve crisis, police, or transfer to a higher level of care, submit the incident report to the DDD Behavioral Health Administration in addition to the entities listed above.

7.2. Disciplinary Action Reports

7.2.1. Send notification to the DDD Specialty Contracts Unit DDDSpecialtyContracts@azdes.gov within five (5) business days of receiving notification from an applicable Arizona licensing and regulatory board or agency, of any disciplinary action taken on the license of any service setting or of the Contractor’s personnel or subcontractors.

7.3. Member Progress Reports -Submit Member Progress Reports as outlined in Scope of Work Section 5.22.

7.4. Submit completed DDD Form DDD-2206A “Behavior Supported Group Home Oversight Meeting Agenda” two (2) days prior to each oversight meeting.

7.5. Financial Viability Standards

7.5.1. The Contractor shall comply with the AHCCCS financial viability standards. AHCCCS’ current financial viability standards include current assets divided by current liabilities shall be equal to or greater than a ratio of 1.00 (one). Current assets may include any long-term investments that can be converted to cash within twenty-four (24) hours without significant penalty (i.e., greater than twenty percent (20%). If current assets include a receivable from a parent company, the parent company shall have liquid assets that support the amount of the inter-company loan.

7.5.2. The Contractor shall prepare financial reports in accordance with Generally Accepted Accounting Principles (GAAP). Annual financial audit reports shall be conducted in accordance with Generally Accepted Auditing Standards (GAAS) audited by an independent certified public accountant. The completed audited Financial Statement Report Package shall be submitted to the DDD within thirty

(30) days after completion of the audit, or at least annually, unless a different time is requested and approved by the DDD. Audits of non-profit corporations receiving Federal or State monies required pursuant to Federal or State law shall be conducted as provided in 31 United States Code (U.S.C.)

§ 7501, et seq. and A.R.S. § 35-181.03 and any other applicable statutes, rules, regulations, and standards.

7.5.3. A Contractor receiving seven million dollars ($7,000,000) or more in payments from the DDD in any State fiscal year shall provide the DDD the following: (a) Quarterly financial statements no later than sixty (60) days following the end of the quarter, and (b) Annual audited financial statements no later than thirty (30) days after the completion of the audit unless a different time has been requested and approved by the Department.

7.5.4. A Contractor receiving payments from the DDD in any State fiscal year in the amount of at least four million dollars ($4,000,000) but less than seven million dollars ($7,000,000) shall provide the DDD the following according to the contractors fiscal year: (a) Semi-annual financial statements no later than sixty (60) days following the end of the second quarter; and (b) Annual financial mailto:DDDSpecialtyContracts@azdes.gov

RFP Solicitation Requirements (10-23) Available Online at https://app.az.gov Page 15 of 82 statements that have been reviewed by an independent certified public accountant. The review report shall consist of at least a balance sheet, income statement and statement of cash flows.

Annual financial statements shall be submitted to the Division no later than thirty (30) days after the completion of the review unless a different time has been requested and approved by the Division.

7.5.5. A Contractor receiving payments from the DDD in any State fiscal year in the amount of at least one million dollars ($1,000,000) to less than four million dollars ($4,000,000) shall provide the DDD an annual financial compilation that has been compiled by an independent certified public accountant and according to the Contractors fiscal year. A compilation shall consist of at least a balance sheet, income statement and statement of cash flows. Annual financial statements shall be submitted to the Division no later than thirty (30) Days after the completion of the compilation unless a different time has been requested and approved by the Division.

7.5.6. A Contractor receiving payments from the DDD in any state fiscal year less than one million dollars ($1,000,000) shall provide the DDD an annual financial statement based upon the Contractor’s fiscal year that consists of a balance sheet, income statement, and statement of cash flows within one hundred twenty (120) Days after fiscal year end.

7.5.7. The Contractor shall report the term of their Fiscal Year to the DDD. If the Contractor is a sole proprietor (not incorporated) entity without employees, it May submit its tax returns for the fiscal year (in lieu of the financial Statements) no later than one hundred twenty (120) Days after the fiscal year ends.

8. Payment units

8.1. Payment Units

8.1.1. The Contractor will be paid in accordance with the following categories (pricing can be located in the Items tab of the Contract in the Arizona Procurement Portal (APP)):

8.1.1.1. Habilitation Rate, Per DDD Member, Per Day;

8.1.1.2. Occupied Bed, (Room and Board), Per DDD Member, Per Day; and

8.1.1.3. Exceptional Rate, Per DDD Member, Per Day

8.1.1.3.1. This rate is intended to be used in situations where the DDD Member has more extreme behavioral support needs, the use of this rate shall require DDD approval.

8.1.2. One (1) Residential Day - is applicable to a DDD Member receiving service at 11:59 P.M. of any day. This will be considered a full-service day. If the DDD Member stays for only part of the day, the day of intake is considered a full-service day.

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8.1.3. Payment for a DDD Member who is not physically in the facility will end on the same day the DDD Member leaves the facility. If on the day of exit, the DDD Member leaves prior to 11:59 P.M., no part of that day is counted for payment.

8.1.4. The daily rate includes all costs associated with providing the service including transportation costs for the DDD Member.

8.2. Payments will only be made by the DDD with a complete and accurate claim.

8.3. Payments will only be made by the DDD with an active DDD Member authorization in FOCUS for dates of the billed rates and correct amounts billed.

8.4. Payments will only be made by the DDD upon completion of service, billing not to exceed thirty (30) days after completion of service.

8.5. Payment includes all costs associated with the provision of the service including, but not limited to:

8.5.1. Salaries;

8.5.2. Operating costs;

8.5.3. Training materials;

8.5.4. Supplies;

8.5.5. Transportation;

8.5.6. Insurance;

8.5.7. Preparation of billing; and

8.5.8. Reports.

9. Billing and Payments

9.1. Refer to the links below to review the Billing Instruction Guide and the Uniform billing template.

Billing Instruction Guide -https://des.az.gov/sites/default/files/billingdocpresoweb.pdf?time=1693320723207

Uniform billing template

9.2. Understand that the DDD is not obligated to pay for services provided without prior authorization.

9.3. Understand that an initial claim for services must be received by DDD no later than six (6) months from the date of service unless the claim involved retro eligibility. Claims initially received beyond the six (6) month time frame, except claims involving retro-eligibility, will be denied.

https://des.az.gov/sites/default/files/billingdocpresoweb.pdf?time=1693320723207 https://des.az.gov/sites/default/files/legacy/dl/Uniform%20Billing%20Document%20Short%20Form.xls

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9.4. Understand if a claim is originally received within the six (6) month time frame, the Contractor will have up to twelve (12) months from the date of service or sixty (60) days from the date of the recoupment to correctly resubmit the claim in order to achieve clean claim status or to adjust a previously processed claim, unless the claim involves retro-eligibility.

9.5. Understand if a claim does not achieve clean claim status or is not adjusted correctly within twelve (12) months, DES/DDD is not liable for payment.

10. Notices and Correspondence

10.1. Submit all Behavioral-Supported Group Home Residential Service questions to:

Division of Developmental Disabilities - Network Residential Unit networkresidentialrequests@azdes.gov

10.2. Contact the DDD Provider Customer Service Unit to schedule training:

DDD Provider Customer Service Unit 1-844-770-9500 option 1 DDDCustomerServiceCenter@azdes.gov

10.3. Submit all clinical questions and incident reports related to behavioral incidents to:

Division of Developmental Disabilities - Behavioral Health Administration DDDBHAdministration@azdes.gov

10.4. Submit all billing questions to:

Division of Developmental Disabilities - Customer Service Center Tel: 1(844) 770-9500, DDDCustomerService-Providers@azdes.gov

10.5. Submit all contract questions to:

Division of Developmental Disabilities - Contracts Administration DDDSpecialtyContracts@azdes.gov

10.6. Submit all correspondence and questions regarding insurance to:

MYCOI, 8520 Allison Pointe Blvd, Ste 223 PMB 49940, Indianapolis, IN 46250 Telephone Number: (888) 692-6448 ext. 105, Email: www.mycoitracking.com

10.6.1. Upon execution of contract, the contractor shall register with www.mycoitracking.com to submit

Certificates of Insurance, Accord form(s) and Endorsements within 10 business days, as listed in the Special Terms and Conditions.

10.6.2. Updated copies of the contractors Certificates of Insurance, Accord form(s) and Endorsements are required to be submitted within 10 calendars of expiration and renewal to www.mycoitracking.com.

https://app.az.gov/ mailto:networkresidentialrequests@azdes.gov mailto:DDDCustomerServiceCenter@azdes.gov mailto:DDDBHAdministration@azdes.gov mailto:DDDCustomerService-Providers@azdes.gov mailto:DDDSpecialtyContracts@azdes.gov about:blank about:blank http://www.mycoitracking.com/

DDD Special Terms and Conditions

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1. Definition of Terms

In addition to the terms and conditions defined in the Uniform Terms and Conditions and the Arizona Department of Economic Security (DES or Department) Special Terms and Conditions, the following shall apply:

1.1. “Arizona Health Care Cost Containment System (AHCCCS)”, the Arizona Medicaid Program established in

Arizona Revised Statutes (A.R.S.) § 36-2903.

1.2. “Arizona Health Care Cost Containment System Administration (AHCCCS or Administration)” (as defined in A.R.S. § 36-2901(1).

1.3. “AHCCCS Minimum Subcontract Provisions” - AHCCCS / ALTCS requirements for the Department's contractors and subcontractors providing services to DDD / ALTCS eligible members on the AHCCCS website located at https://www.azahcccs.gov/PlansProviders/HealthPlans/minimumsubcontractprovisions.html

1.4. “Arizona Long Term Care System (ALTCS)” - the program under AHCCCS that delivers long term, acute, behavioral health care and case management services to eligible members, as established by A.R.S. § 36- 2932.

1.5. “Division of Developmental Disabilities, (Division or DDD)” - the division within the Department responsible for providing supports and services for eligible members established by A.R.S. Title 36, Chapter 5.1.

1.6. “Encounter” - the record of a care related service submitted to or by the Division and processed by AHCCCS that is rendered by an AHCCCS-registered provider to a member who is enrolled with the Division on the date of service for which the Division incurs a financial liability (A.AC. R9-22-701).

1.7. “Planning Document (formerly Individual Service/Support Plan (ISP)” - a written statement of services to be provided to a member with developmental disabilities including habilitation goals and objectives and a listing of the services, if any, the member is authorized to receive. The Planning Document incorporates and replaces the Individual Support Plan, the Individual Program Plan, the placement evaluation, the individualized service program plan, and the service program plan used in A.RS. § 36- 557 (as may be amended). The planning document incorporates the Individual Family Service Plan (IFSP), as defined in Chapter 4004-A of the DES/DDD Operations Policy Manual, as well as a Person Centered Plan, which describes the type, frequency, and duration of the services and supports needed to achieve the appropriate outcomes for a member.

1.8. “DDD Member” - person who is authorized by the Division to receive services.

1.9. “Third Party Liability” - the resources available from a person or entity that is or may be, by agreement, circumstances, or otherwise, liable to pay all or part of the medical expenses incurred by a member authorized to receive services from the Division (A.A.C. R6-6-101.71; A.A.C. Title 9, Chapter 22, Article 10).

1.10. “Third Party Payer” - any individual, entity, or program that is or may be liable to pay all or part of the medical cost of injury, disease, or disability of a member authorized to receive services from the Division (A.A.C.

R6-6-101.72).

https://www.azahcccs.gov/PlansProviders/HealthPlans/minimumsubcontractprovisions.html

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2. Certification of Compliance - Anti-Kickback and Laboratory Testing

By signing this Contract, the Contractor certifies that it has not engaged in any violation of the Medicare Anti- Kickback statute [42 United States Code (U.S.C.) §§ 1320a - 7b] or the "Stark I" and "Stark II" laws governing related-entity referrals [(Public Law (P.L.) 101- 239 and P.L. 101-432] and compensation there from. If the Contractor provides laboratory testing, it certifies that it has complied with 42 C.F.R § 411.350-389 and has sent to AHCCCS simultaneous copies of the information required by that rule to be sent to the Centers for Medicare and Medicaid Services (42 U.S.C. §§ 1320a-7b; P.L. 101-239 and P.L. 101-432; 42 C.F.R. § 411.361).

3. Certification of Truthfulness of Representation. By signing this Contract, the Contractor certifies the following:

3.1. That all representations set forth herein are true to the best of its knowledge; and

3.2. That it will maintain all representations, comply with all covenants, and perform all duties throughout the term of the Contract

4. Compliance with Applicable Laws

4.1. The Contractor shall cooperate with all Division investigations, including investigations pursuant to A.RS. §

36-557(G)(3) that involve danger to the health and safety of a member. This includes notification to the Division of all incidents involving a member. An incident is defined as an occurrence, which could potentially impact the health and well-being of a member enrolled with the Division or community. The process for notifying the Division of incidents is found in Chapter 6000 (Incident Management) of the DES/DDD Operation Policy Manual.

4.2. The Contractor shall comply with all applicable Federal and State laws, rules, regulations and policies, including, without limitation, Title XIX of the Social Security Act, the Omnibus Budget Reconciliation Act of 1981 (P.L. 97-35), Title 42 of the C.F.R., and Title 45 C.F.R., Parts 74 and 96. If the Contractor receives Title XX funds, the Contractor shall comply with The Arizona Title XX Social Services Plan and Section 2352, Title XX Block Grants, of the Omnibus Budget Reconciliation Act of 1981.

4.3. The Contractor and any subcontractor shall comply with all applicable licensure, certification, and registration standards established by the Department, the Division, AHCCCS, the Arizona Department of Health Services (ADHS) and applicable State laws. The Contractor shall, and shall ensure that any subcontractor, comply with all applicable Department and Division administrative rules, policies, procedures, service standards, guidelines, and other authorities (regardless of whether specifically cited in this Contract) that relate to the Contractor's services, operations, or business including, but not limited to:

4.3.1. Hiring of ex-offenders;

4.3.2. Fingerprinting of contractor's and subcontractor's staff;

4.3.3. Completing of Fire Risk Profile requirements;

4.3.4. Reporting of unusual…