DYS_Optometry_RFR_final Edits 7.14.16.doc

COMPREHENSIVE VISION CARE SERVICES FOR CHILDREN/YOUTH IN THE MASSACHUSETTS DEPARTMENT OF YOUTH SERVICES

REQUEST FOR PROPOSAL FOR

MASSACHUSETTS LICENSED OPTOMETRIST/OPTOMETRY PROGRAMS

Boston, MA. 02211

GENERAL RFR INFORMATION

The terms of 801 CMR 21.00: Procurement of Commodities and Services (and 808 CMR 1.00: Compliance, Reporting and Auditing for Human and Social Services, if applicable) dated October 9, 2015 are incorporated by reference into this RFR. Words used in this RFR shall have the meanings defined in 801 CMR 21.00 (and 808 CMR 1.00, if applicable). Additional definitions may also be identified in this RFR. Unless otherwise specified in this RFR, all communications, responses, and documentation must be in English, all measurements must be provided in feet, inches, and pounds and all cost proposals or figures in U.S. currency. All responses must be submitted in accordance with the specific terms of this RFR.

1. DESCRIPTION and/or PURPOSE OF PROCUREMENT:

The Massachusetts Department of Youth Services (DYS) is soliciting proposals for the provision of comprehensive optometry services to the youth that are in the custody of the Massachusetts Department of Youth Services in all DYS facilities in all five (5) DYS Regions (Central, Metro, Northeast, Southeast and Western). It is expected that one Memorandum of Agreement (MOA) will be made in conjunction with this request with an initial duration of three years and up to five additional one-year options to renew. It is anticipated that the total contract period shall be from October 1, 2016 through September 30, 2024.

Please note that the Optometry provider/program selected under this RFR will be awarded neither funds nor capital goods.

The contractor must be a licensed optometry provider or group of optometry providers with a special interest and expertise in serving high-risk children and be actively enrolled as a provider with the Massachusetts Executive Office of Health and Human Services, Office of Medicaid (MassHealth). The program must have the capacity to provide timely follow-up appointments and effective referrals to provide and complete treatment for problems found during the examination.

Services will be provided on-site at all DYS facilities statewide, either using portable optometric equipment supplied by the contractor and/or mobile optometric suites located at a limited number of DYS facilities. Professional and technical services must be provided in accordance with the established standards of quality and health-care necessity recognized by the vision care industry and licensing agencies in Massachusetts.

The goals of the DYS Comprehensive Vision Care Program are:

· To ensure access to optimal, comprehensive on-site optometry care for DYS youth;

· To monitor and promote appropriate utilization and maintenance of vision care service among the youth according to the MassHealth EPSDT Vision Care Protocol and Periodicity Schedule;

· To maximize capacity and commitment to provide vision care services for youth at both the provider and systems levels;

· To build increasingly seamless systems of vision care services across health, education and other domains, at the facility, regional and state level;

· To foster and promote access, as well as maintain relationships with a statewide network of eye care providers who will serve DYS youth for emergent and comprehensive vision care services.

· To educate DYS youth on the importance of good eye health care.

Population To Be Served:

MASSACHUSETTS COURT-INVOLVED YOUTH

As of January 1, 2015:

675 committed youth currently being served by the Department of Youth Services

· 125 of these youth were adjudicated delinquent and had been committed as youth offenders until their 21st birthday

· 170 youth are estimated to be held on any given day at DYS detention facilities pending court action

· 63% of the current population has been committed to DYS by the courts on a violent offense (crime against the person.)

Race/Sex/Age:

· 87% Male, 13% Female

· 22% Caucasian, 33% African American, 39% Hispanic, 1% Asian, and 5% other

· Average age at time of initial commitment to DYS is 16 years

· Average age of current population is 17 years and 9 months

Placement within DYS:

· 46% of the committed population had completed a residential placement with DYS and were under supervision in the community

· 49% of the committed population were placed in facility residential programs for periods ranging from three months to several years; and 5% were placed with other agencies Typical health conditions encountered in all settings include traumatic injuries, contagious illnesses, and somatic complaints due to anxiety and stress associated with confinement and uncertainty about their future. Youth served within DYS programs most typically come from medically underserved backgrounds as a result present to the department with a range of common conditions, such as asthma, which have not had the benefit of consistent community based medical management prior to admission.

Information related to past health history, allergies, current health problems, immunization status, and the current primary care provider are frequently incomplete. The contractor will work closely with DYS medical staff to integrate medical and vision care services provided to DYS youth.

Newly committed clients are sent to assessment programs. The objective of assessment is to evaluate the client’s social, psychological, educational, health status and overall functioning. A treatment plan is developed based on the assessment. Placement decisions are based on the severity of the youth’s offense, the treatment needs, and the risk/need factors that are seen to be the driving factors for a youth’s future success.

DYS provides comprehensives on-site medical services to the youth through contracted healthcare provider. Health services contribute to the safe housing of detainees and the comprehensive evaluation and treatment of DYS clients.

DYS operates 55 residential facilities statewide, ranging from staff secure group homes to highly secure locked units. The goal of DYS is to provide a complete continuum of services for committed and detained youth in five designated regions: Metro, Northeast, Central, Southeast, and Western. The Metro Region based in Boston covers all of Suffolk County; the Southeast Region based in Taunton covers Barnstable, Bristol, Dukes, Nantucket, Norfolk (except the town of Bellingham), and Plymouth counties; the Central Region based in Westboro covers Worcester County (excluding the town of Athol and including the town of Bellingham); the Western Region, based in Springfield covers Berkshire, Hampden, Franklin and Hampshire counties and the town of Athol; and the Northeast Region recently relocated to Middleton covers Essex and Middlesex counties.

Facility-Based Programs:

The primary goal of the DYS health services program is to stabilize any health conditions of detainees and maintain the health of DYS clients by providing care that is medically necessary and organized for prevention of disease and maintenance of health. DYS, through its health services vendors, provides a comprehensive program of primary health care on-site to clients placed in the Department’s facilities.

There are three different types of programs within DYS, pre-trial detention, assessment and treatment. Pre-trial detention programs receive youth under 17 years old who have been arrested and ordered by the court to be held in temporary custody pending the outcome of their judicial proceedings. This is a custodial and public safety function that provides the opportunity for health, educational and other interventions. Youth whose pre-trial detention results in their being committed to the Department are placed in Assessment programs for 30 to 45 days and begin a process that assesses their risk to community as well as their individual educational, social, health care, and other needs. Clients are admitted to treatment programs on a scheduled basis and stay from 70 days to two years.

In order to fulfill its obligations, the Commonwealth of Massachusetts, through the Department of Youth Services provides on-site provision of medical and optometry health services and established referrals for necessary specialty care.

Comprehensive Care:

Comprehensive vision care services should be provided according to the MassHealth EPSDT Medical Protocol and Periodicity Schedule and the Massachusetts Vision Screening Protocol. All youth will be screened according to the standard primary care practice, which is to screen both by history, and by assessing visual acuity using a Snellen chart. An objective visual acuity screening will be performed by DYS Health Services staff as part of routine physical examination and will be repeated annually. If a vision screening is documented for a youth within the past 12 months, it is not necessary to repeat. Youth with distance or near acuity greater that 20/30 will be referred to the on-site optometry contractor for comprehensive eye examination and treatment. The on-site comprehensive eye examination should be conducted and if needed, eyeglasses should be prescribed by the on-site optometry provider. The eye examination results should be documented by the on-site optometry contractor and provided to DYS Health Services staff. The eye examination results should include recommendations for follow-up eye care, if needed. The eye examination report should be included in youth’s medical record.

Staffing:

The provider/program must employ sufficient, qualified and licensed staff to meet the needs of the program. The provider is expected to employ adequate personnel to deliver comprehensive optometric services to the client population. The provider will be required to obtain CORI, SORI and DCF clearance by the Department in accordance with 109 CMR 12.00 et seq. and provide clearance confirmation to DYS before they can be assigned to a DYS unit or location and no less than two (2) professional work references for all employees who will be working with the DYS population.

Affiliation/Linkage Policy:

The on-site vision care services plays a critical role in the overall service delivery system for the youth served by DYS. This requires that the optometric provider interact closely with the Department of Youth Services staff based at the facilities, the Regional Directors, and State Administrators.

Desired Program Outcomes:

The comprehensive vision care services provider selected through the RFR is expected to accomplish the following:

1. Comprehensive vision care services provided to all youth residing in all designated DYS facilities.

Measures:

a. Comprehensive vision care services provided at each designated facility.

b. The number of youth who are up to date according to the MassHealth Vision periodicity schedule compared with the total number in the target population.

c. The number of youth who receive optometric services per year compared with the total number in the target population.

d. The number of youth who received timely follow-up appointments and effective referrals for treatment compared with the total number of children with an identified need for follow-up care.

e. The number of youth who received a referral and have all needed treatment completed in a timely manner.

2. Appropriate utilization of vision care services and maintenance of vision care preventive schedules among clients.

Measures:

a. The number of service visits for each type of procedure provided.

b. The number of youth who receive a comprehensive eye examination after failed vision screening.

c. The number of youth who receive timely referral and treatment after failed comprehensive eye examination.

d. The number of youth who receive timely prescription for corrective lenses.

DEADLINE FOR RESPONSES or Procurement Calendar:

The Department will not be holding a bidder’s conference for this RFR

INSTRUCTIONS FOR SUBMISSION OF RESPONSES:

Electronic Submissions - Effective July 1, 2014, all procurements posted on COMMBUYS, known as Bids, require the submission of electronic responses, known as Quotes. To submit an electronic Quote Respondents must register and maintain an active COMMBUYS Seller subscription account. Questions regarding COMMBUYS should be directed to the COMMBUYS Help Desk at commbuys@state.ma.us.

DYS has attached a job aid to this RFR with instructions on how to submit a quote.

DYS CANNOT ACCEPT HARD COPY RESPONSES TO THIS REQUEST FOR RESPONSE.

Representatives from the Department are available to respond to both programmatic and fiscal questions specific to this RFR. All questions must be sent via e-mail to:

phillip.w.davis@state.ma.us

SUBMISSIONS MUST CONTAIN ALL FORMS REQUIRED BY THIS RFR.

a) A Table of Contents should be provided to assist the reviewers in finding relevant response information.

b) Staffing charts and scheduling narratives must be designed using only those titles contained in the Uniform Financial Report (UFR) in order to facilitate budgetary review. These titles may be found in the attachments to the Procurement Policies and Procedures Handbook.

How DYS Will Review Your Responses:

An interdisciplinary team using a standardized scoring tool will rank responses to this RFR. Scoring will focus on (1) demonstrated commitment and capacity to achieve the principles of accessible, patient-centered, continuous, comprehensive, coordinated, compassionate and culturally effective care for youth within the custody of DYS, and (2) willingness to collaborate with Massachusetts Departments of Public Health (MDPH) and Youth Services (DYS) in achieving the goals of this project and evaluating its progress. In addition, DYS will take into account geographic considerations in order to assure that all youth in DYS facilities in each Region receive comprehensive vision care services and emergent and specialty follow-up care as needed.

Once responses are ranked DYS may conduct interviews with the applicants to further review and discuss delivery of care, coordination placement in more depth, and to review the proposed rights and obligations of the Provider/Program, which will be formalized in a three year Memorandum Of Agreement.

Monitoring Requirements:

During each fiscal year, DYS staff with the assistance of the Massachusetts Department of Public Health (MDPH) will monitor and evaluate all provider performance regarding the progress made towards the specific program standards, objectives and performance results/measures in the negotiated agreement. The standards, policies and procedures for conducting these quarterly reviews will be given to the selected provider.

DYS will set standards for care and utilization of services. Statistics on numbers of DYS youth served, number of service visits and number and type of procedures performed must be submitted to DYS quarterly.

Client Record Keeping: The provider shall keep a file, preferably electronic, on each individual seen at the facility-based clinic and the community-based program, fully describing the individual’s optometric history and treatment. The contractor shall also send to the individual’s medical file at DYS, a form describing the results of the comprehensive eye examination and subsequent treatment plan.

Required Reports: The contractor will submit quarterly reports to DYS no later than 20 days after the end of each quarter of the fiscal year. The quarterly report will include the number of optometrists visits to each DYS facility, the number of DYS clients treated at each facility, the number and the type of procedures provided, the number of youth referred to a community optometrist/ophthalmologist for a follow-up treatment and the number of youth up-to-date according to the MassHealth EPSDT Vision Protocol and Periodicity Schedule. An annual report will be required no later than 30 days after the end of the fiscal year and should include a summary of activities of all four quarters of the fiscal year, as well as, a detailed evaluation of those activities. The report format should contain a program narrative section, a statistical data section and a fiscal data section according to a format established by DYS. Fiscal data will include the revenue generated from MassHealth and other sources.

Required meetings: The Provider will attend meetings held on at least a quarterly basis, with the DYS and Public Health departments.

General Program Specification:

1. The Contractor must be an actively enrolled optometric provider with the Massachusetts Executive Office of Health and Human Services, Office of Medicaid (MassHealth).

2. The Contractor must have the ability to staff and oversee the operation of multiple sites across the Commonwealth.

3. The Contractor must have the experience and expertise in providing optometric care to high-risk children/youth.

4. The Contractor must have the expertise to provide all levels of comprehensive vision care services from comprehensive eye examinations and the provision of prescription eyeglasses for the correction of visual acuity deficits.

5. The Contractor must have referral network for the provision of more comprehensive ophthalmologic care.

Staff recruitment will be the responsibility of the contractor; however, all staff must pass a CORI, SORI and DCF investigation, have a current MA license as required by professional discipline, and any other required registration/certification and/or licensure to provide the necessary services.

Any printed materials prepared by the vendor or professional articles for contracted services must be submitted to DYS for approval before materials are printed.

Fiscal Specifications:

It is anticipated that in conjunction with this RFR, DYS will enter into a Memorandum of Agreement (MOA), with one provider for comprehensive vision care services that are essential for this specific DYS population. The agreement is expected to have an initial duration of three and a half years and up to year options to renew for a potential agreement period from October 1, 2016 through September 30, 2024. Five one year renewals of this MOA will be based on the progress made towards the specific program standards, objectives and performance results/measures in the negotiated agreement.

The optometry provider/program selected under this RFR will be awarded neither funds nor capital goods. The provider is expected to bill MassHealth for all optometric services provided to these MassHealth eligible youth and it is the expectation of DYS that this revenue source will be sufficient in order to provide the required vision care service(s) as described in the RFR, as well as hire the necessary staff pattern.

APPLICATION FOR

COMPREHENSIVE VISION CARE SERVICES

FOR YOUTH IN THE CARE AND CUSTODY OF THE

MASSACHUSETTS DEPARTMENT OF YOUTH SERVICES

A signed letter from an authorized signatory of the bidder’s organization must be included with the proposal.

Questions for Response:

1. Provide practice name, postal address, email address, phone, fax, and TTY numbers.

2. Please identify the "lead optometrist" who will be the primary DYS contact person for this RFR and (if your practice is selected) for ensuing collaboration.

3. Please identify all other individuals who will serve as the “core staff group”, listing their credentials license number provided by the Massachusetts Board of Registration in Optometry, the year they started practicing optometry and briefly outlining their experience in treating youth (include resumes if you wish).

4. Describe your optometry practice/program, including information on setting, structure, specialties and experience in treating youth.

5. Provide your MassHealth Provider Number, the Provider numbers for your staff, your experience in serving MassHealth members and your administrative practices regarding MassHealth billing/claims.

6. Briefly describe your experience in providing the type of program proposed in this RFR.

7. Provide a brief abstract of the program you are proposing for the DYS youth.

8. Describe how internal and external collaborations have and will enhance your ability to target, plan, provide and evaluate the proposed program. Note how these collaborations will directly benefit the priority population, promote efficiency and/or improve effectiveness. Describe a plan to reach out to other vision care professionals in the Commonwealth and become a referral resource for the target population. Describe your ability to interact with relevant state organizations such as DYS and MDPH.

9. Describe a plan for notifying the DYS facility staff of upcoming optometry appointments, treatment provided, necessary referrals and sharing of treatment information and optometric needs with DYS staff.

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RFR DYS POS 2017-02

Massachusetts Licensed Optometrist/ Optometry Services, Statewide