DOH24-021 RFI QA Addendum.pdf

Mission:

To protect, promote and improve the health of all people in Florida through integrated state, county and community efforts.

Ron DeSantis Governor

Joseph A. Ladapo, MD, PhD

State Surgeon General

Vision: To be the Healthiest State in the Nation

Florida Department of Health Division of Administration • Bureau of General Services 4052 Bald Cypress Way, Bin B-07 • Tallahassee, FL 32399

PHONE: 850-245-4199

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Accredited Health Department Public Health Accreditation Board

Addendum 1 Questions and Answers

RFI DOH24-021

Mental Health and Substance Use Disorder Services

DATE: 03/14/2025

TO: Prospective Vendors

FROM: Summer Lindsley, Procurement Officer

Florida Department of Health Central Purchasing Office

SUBJECT: Addendum 1

The purpose of this addendum is to answer questions received in accordance with Section VIII, Questions, of the Request for Information (RFI). Please see the Department’s response to questions below.

A. Responses to Questions received pursuant to Section VIII, Questions: Please see the

Department’s response to questions received by the due date outlined in Section VIII Questions, of the RFI, below:

Addendum 1 Questions and Answers

# Question Answer

1.

Is this Pinellas County Program and Health Care for the Homeless RFI to integrate some of our staff into existing facilities which serves the Health Care for Homeless plus our existing facilities along with our services?

The goal is to integrate mental health and substance use disorder services into the locations Pinellas County Health Program and Health Care for the Homeless patients access primary care.

2.

Can the practitioner (MH Counselor and psych- APRN/psychiatrist) be a remote staff, providing services via telehealth?

The proposed implementation approach could include services provided via telehealth, keeping in mind that the patient population being served may have limited access to technology needed for telehealth and the goal is for the majority of services to be provided onsite within the primary care setting.

3.

Will staff have remote access to the DOH EHR system to document services?

The Pinellas County EHR system will be accessible outside of the primary care service sites as it is a Cloud based system.

4.

Are we expected to have staff physically available at all hours at each site?

The proposed staffing model should include staff physically available during the operating hours of each site at a frequency that best meets the needs of the patients, which does not have to include all operating hours at each site.

5.

Are we expected to provide all services every day a site is open for services?

The proposed implementation approach should include services that are available during the operating hours of each site at a frequency that best meets the needs of the patients, which does not have to include all days or operating hours of each site.

6.

How are MAT medications paid for? Do we need to include medication costs in our proposal or are there other ways for medications to be paid?

Yes, if the proposed implementation approach includes the provision of MAT medications, medications costs should be included in the proposed annual budget. Patient Assistance Programs offered via pharmaceutical companies should be leveraged when available.

7.

Will the County Blue Card cover medications, including mental health and all FDA-approved MAT medications?

Medications currently covered under the health program formulary can be accessed here: https://pinellas.gov/pchp-formulary/. For any other proposed mental health and/or MAT medications not available via formulary, you must have method to secure directly for clients and include costs in proposed budget.

8.

Will the MH/SA provider be prescribing the meds or will the DOH provider prescribe the medications?

The proposed implementation approach could include DOH providers prescribing some medications, but the mental health and substance use disorder provider must also have the capacity to prescribe covered medications for patients under their direct care.

https://pinellas.gov/pchp-formulary/

9.

Will we serve non-Blue Card participants?

Patients to be served under this funding include Pinellas County Health Program and Health Care for the Homeless Program eligible patients. All Pinellas County Health Program patients are uninsured with coverage for specialty services under the health program only.

The Health Care for the Homeless program serves all patients regardless of insurance status, so patients may have Medicaid and Medicare for example with specialty care covered by insurer and not the health program.

10.

Is this funding replacing current County contracts for similar services?

Yes

11.

Can you provide the number of clients served at each DOH location? Broken down by location.

In 2024, DOH provided medical encounters for 1,828 Pinellas County Health Program and 1,836 Health Care for the Homeless patients as follows:

• St. Petersburg Health Department: 825 patients

• Pinellas Park Health Department: 351 patients

• Mid County Health Department: 370 patients

• Clearwater Health Department: 390 patients

• Tarpon Springs Health Department: 118 patients

• Bayside Health Clinic: 1,178

• Mobile Medical Unit: 810 patients

• Street Medicine: 212 patients

12.

Can you provide the service volume for each site by peak times so we can determine appropriate hourly coverage?

Peak hours for each site are Monday – Friday between 8am and 5pm.

13.

What is the available office space at each location for the MH/SA provider staff?

Space will be made available for Provider staff at each service site based on proposed staffing model and implementation approach.

14.

The RFI states that, based on the LOCUS, “Care for those assessed at a level above Low Intensity Community Based Services will be referred externally with coordinated management.” Can you provide a breakdown of the number of the anticipated 1400-2000 patients with respect to each level of care/intensity needed?

While a breakdown based on LOCUS is not currently available, the majority of estimated patients should fall within LOCUS levels 1 and 2.

15.

Is there an estimated number of people who would need SA/MH services that need to be served on site?

The estimated number of patients to be served is 1,400 - 2,000 annually. The majority of services should be provided at locations these patients are accessing primary care.

16.

Does the Pinellas County DOH EHR support HIPAA-compliant Direct Secure Messaging (DSM)?

Yes, the Pinellas County EHR supports HIPAA-compliant Direct Secure Messaging (DSM).

17.

What will the process be to integrate our EHR with the County EHR to create data entry efficiencies?

The County is willing to explore integrations with vendor’s EHR. Data entry for patients served under this funding will be in the Pinellas County EHR, unless integration between the two EHRs is a possibility.

18.

Looking at the reporting requirements in section IV.13, would we be required to report on data entered in the Pinellas County EHR or just data entered in our own systems?

Reporting requirements will include data entered in the EHR to meet contractual requirements for reimbursement; further details on reporting will be finalized as part of contract negotiations.

19.

Is on call or 24/7 coverage expected as part of the services offered by the MH/SA provider or will this be covered by

DOH?

DOH has 24/7 on call medical provider availability for program patients. The proposed implementation approach should include explanation of any additional coverage to be provided by the mental health and substance use disorder provider.

20.

Which services within the LOCUS level 1 and 2 are expected to be provided? For example, Level 2 Low Intensity Community Based Services should provide access to 24-hour emergency evaluation and brief intervention. Is the MH/SA expected to provide this service?

All services appropriate to LOCUS levels 1 and 2 are expected to be available to patients, whether provided directly or through partnership and/or subcontract, and should be detailed in implementation approach.

21.

Can you please clarify what Street Medicine consists of (staffing, times, activities, etc.) and what services are expected to be provided by the MH/SA provider?

Street Medicine currently includes primary care and supportive services provided by a team that includes an APRN, RN, clerical support staff, and case manager during the hours of Monday through Friday 8am – 5pm. The proposed implementation approach and staffing model for mental health and substance use disorder services in the Street Medicine setting should include screening, brief intervention, referral coordination and case management services at a minimum.

22.

Will DOH manage patient scheduling for individuals identified as needing MH/SA services at the DOH locations (LOCUS Levels 1 and 2) or will they need to be scheduled by the MH/SA provider?

The proposed implementation approach should include options for scheduling for mental health and substance use disorder services by both DOH and the mental health and substance use disorder services provider.

23.

Is there a cap on the indirect rate? Indirect rate included in budget should not exceed 15%.

24.

Is this a County DOH pilot program or are other counties potentially expanding or realigning services this way?

This is not a pilot program. The goals of Pinellas County and the Department are specific to the Pinellas County Health Program and Health Care for the Homeless Program, and we are unaware of other counties potentially expanding or realigning services this way.

25.

The SAMHSA guidelines talk about “one-agency,” is the preference to work with a single agency or is the preference to collaborate with other agencies?

The preference is to work with one agency that may collaborate and/or subcontract with other agencies.

26.

Incorporating Equine-Assisted Therapy – Would there be an opportunity for complementary or alternative therapies, such as equine-assisted therapy, to be integrated into the continuum of care for mental health and substance use disorder patients?

The Department welcomes unique implementation approaches that will satisfy goals and are within available budget and fall with health program covered services. However, complementary and alternative therapies are not currently covered by the Pinellas County Health Program.

27.

Community Partnerships – Is the county considering partnerships with non-traditional therapy providers to enhance the holistic well-being of patients, particularly those experiencing trauma, PTSD, or anxiety-related conditions?

The Department welcomes unique implementation approaches that will satisfy goals and are within available budget. However, complementary and alternative therapies are not currently covered by the Pinellas County Health Program.

28.

Funding & Reimbursement – If alternative therapies were considered, how might they be funded or reimbursed under the Pinellas County Health Program and Health Care for the Homeless Program?

N/A, complementary and alternative therapies are not currently covered by the Pinellas County Health Program.

29.

Program Referrals & Integration – How does the county envision collaboration between primary care providers and community-based organizations like Quantum Leap Farm in delivering integrated behavioral health services?

Complementary and alternative therapies are not currently covered by the Pinellas County Health Program and community based organizations must provide services within Pinellas County.

30.

Transportation Support – Given that access to transportation can be a barrier to care, are there provisions within the program to support patient transportation to offsite therapy providers or community-based wellness programs?

Patients of the Pinellas County Health Program and Health Care for the Homeless Program have access to transportation assistance via bus and taxi services for all services including mental health and substance use disorder services within Pinellas County. Also, under this funding, the majority of services should be provided within the primary care sites.

31.

Next Steps – If our services align with the county’s needs, what would be the best way to engage in further discussions or participate in the procurement process?

DOH will reach out for any further discussion and provide notification of any future procurement process related to these services.

32.

The outlined performance measures in Goal #4 focus on depression, anxiety, alcohol, and substance use. Will the program allow selected vendors to serve those with co-occurring mental health and substance used disorders to include addiction, substance misuse disorders and more persistent mental health conditions?

Selected vendors may serve those with co-occurring mental health and substance used disorders under this funding as long as they are within LOCUS criteria for Low Intensity Community Based Services.

Covered services-may be limited for those with SPMI and higher level of care needs.

33.

Per Objective #6, duplicate data entry is expensive, time consuming and rife with error, would the Department be willing to work with the selected vendor to identify system solutions that do not include duplicate data entry?

Duplicate data entry is not required. Data entry for patients served under this funding will be in the Pinellas County EHR, unless integration between the two EHRs is a possibility which the County is willing to explore.

34.

Objective #10 duplicate data entry is expensive, time consuming and rife with error, would the Department be willing to work with the selected vendor to identify system solutions that do not include duplicate data entry?

Duplicate data entry is not required. Data entry for patients served under this funding will be in the Pinellas County EHR, unless integration between the two EHRs is a possibility which the County is willing to explore.

35.

Per Objective #13, if all required data is entered into the designated system, what is the purpose of additional reporting requirements such as ODS?

Further details on reporting will be finalized as part of contract negotiations, but ODS reporting may include data captured outside of the EHR as the Optimal Data Set measures system levels access, capacity, and quality of behavioral health services in Pinellas County versus the individual data for patients served under this funding source.

36.

Is the selected vendor required to generate program income? From what sources?

Vendor is not required to generate program income, but if they do generate program income, it must be reported. While Pinellas County Health Program patients are uninsured, a portion of Health Care for the Homeless Patients served may have insurance such as Medicare or Medicaid which should be billed if vendor has ability to bill.

37.

Will all individuals served under this program be enrolled in the Pinellas County Health Plan/Healthcare for the Homeless?

Patients to be served under this funding include Pinellas County Health Program and Health Care for the Homeless Program eligible patients. All Pinellas County Health Program patients are uninsured with coverage for specialty services provided by the health program only. The Health Care for the Homeless program serves all patients regardless of insurance status, so patients may have Medicaid and Medicare for example with specialty care covered by insurer and not the health program.

38.

Is the Department able to schedule all behavioral health appointments?

The proposed implementation approach could include DOH scheduling appointments for mental health and substance use disorder services, however, both DOH and vendor should have access to schedule appointments.