ESBD_361825_1718715732200_HHS0013368V1 Geriatr_Forensic_Inpatient_Psych._Hosp._Svcs.pdf

PCS 550 HHS RFQ Template, RFQ No. HHS0013368V1 Page 1 of 50 Version 1.0 (10/11/2022)

Cecile E. Young, Executive Commissioner

Request for Qualifications (RFQ) for

Geriatric Forensic Inpatient Psychiatric Hospital Services

RFQ No. HHS0013368V1

Date of Release: June 18, 2024

See Section 3.1 for Schedule of Events

948-07 – Administration Services, Health 948-46 – Hospital Services, Inpatient and Outpatient 948-64 – Nursing Services 948-74 – Professional Medical Services: Physicians, Pharmacists, and All Specialties 948-76 – Psychologists, Psychological and Psychiatric Services, Including Behavioral

Management Services 948-87 - *Telemedical Professional Services 952-62 – Mental Health Services: Vocational, Residential, Etc.

(*) Automated Information Systems (AIS)

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Contents Article I. Introduction, Definitions, and Authority

1.1 Introduction

1.2 Definitions

1.3 Authority

Article II. Scope of Work

2.1 Description of Services

2.2 Contract Award, Term, and Historical Compensation

2.3 No Guarantee of Volume, Usage, or Compensation

2.4 Data Use Agreement and Security Privacy Inquiry

Article III. Administrative Information

3.1 Schedule of Events

3.2 Ambiguity, Conflict, or Discrepancy

3.3 Inquiries

3.4 HSP Training

3.5 Solicitation Response Composition

3.6 Solicitation Response Submission and Delivery

Article IV. Solicitation Response Evaluation and Award Process

4.1 Conformance with State Law

4.2 Best Value Determination

4.3 Questions or Requests for Clarification

Article V. Statement of Qualifications

5.1 Executive Summary

5.2 Minimum Qualification Documentation

5.3 Qualifications

5.4 Experience

5.5 Approach and Work Plan

5.6 Proposed Staffing Plan

5.7 Readiness

Article VI. Required Respondent Information

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6.1 Narrative and Company Information

6.2 Authorization to Conduct Business in Texas

6.3 References

6.4 Affirmations and Certifications

6.5 Financial Capacity

6.6 Corporate Guarantee

Article VII. HSP Requirement

7.1 HSP Submission Instructions

Article VIII. General Terms and Conditions

8.1 General Conditions

8.2 Insurance

8.3 Protest

Article IX. List of Exhibits

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ARTICLE I. INTRODUCTION, DEFINITIONS, AND AUTHORITY

1.1 INTRODUCTION

The Health and Human Services Commission of the State of Texas (HHSC) is soliciting proposals from qualified hospitals to provide Geriatric inpatient psychiatric services for Forensic populations based on a maximum capacity of 16 patients. The purpose of this Solicitation is to support the growing need for competency restoration and inpatient mental care services in State Hospitals, as demonstrated by the increasing number of patients who have been committed to a State Hospital and are awaiting State Hospital admission.

Procurement and Contracting Services (HHSC PCS) will administer the procurement process for this Solicitation, which includes RFQ publication, handling of communications from vendors, as well as the receipt of Solicitation Responses for review and evaluation.

To be considered for Contract award, Respondent must complete and sign Exhibit A, HHS Solicitation Affirmations, Version 2.4 of this Solicitation and provide all other required information and documentation as set forth in this Solicitation.

HHSC oversees operations of the entire Health and Human Services System in Texas. The HHS System comprises two state agencies: HHSC and the Department of State Health Services (DSHS).

Information regarding HHSC and its programs is available online and can currently be accessed at https://www.hhs.texas.gov.

1.2 DEFINITIONS

As used in this Solicitation, unless a different definition is specified or the context clearly indicates otherwise, the terms and conditions have the meanings assigned below. Refer to Exhibit B, Health and Human Services (HHS) Uniform Terms and Conditions – Vendor, Version 3.4 for additional definitions (e.g., Contract, Contractor, Deliverable, Effective Date, HUB, Services, Solicitation Response, Subcontractor, System Agency, Work, and Work Order).

“Addendum” means a written clarification or revision to this Solicitation posted to the ESBD.

“Advancement Criteria” means the published criteria for Respondent to advance to the next phase of evaluation if multiple evaluation methods are utilized.

“Award Consideration (AC) Documents” means documents Respondent must submit as part of the Solicitation Response to be considered for negotiations or award.

https://www.hhs.texas.gov/

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“Bed Days” refers to any day(s) during which a person admitted as an inpatient stay overnight in a hospital.

“Business Days” refers to any day(s) in which normal business operations of HHSC are conducted.

“Calendar Days” refers to any day(s) shown on the calendar beginning at 12:00 Midnight, including Saturdays, Sundays, and holidays.

“Capital Expenditures” refers to money spent by a business or organization on acquiring or maintaining fixed assets, such as land, buildings, and equipment.

“Centers for Medicare & Medicaid Services (CMS)” is the federal agency within the U.S.

Department of Health and Human Services (HHS) that administers the nation’s major healthcare programs including Medicare, Medicaid, the Children's Health Insurance Program (CHIP), and the State and federal health insurance marketplaces.

“Client Assignment and Registration System (CARE)” is the system that registers and tracks Texas Health and Human Services (Texas HHS) individuals throughout the mental health and intellectual and developmental disability delivery system. The mainframe CARE system uses unique, statewide individual identification numbers to maintain descriptive information, such as demographics, county of residence, financial status, diagnostics, commitment status, and mental health and IDD needs.

“Contract Term” means the duration of the Contract, including any exercised extensions or renewals, commencing on the Effective Date and ending when the Contract expires in accordance with its terms, or when it has been terminated.

“Competitive Range” has the same meaning as the definition under Texas Administrative Code, Title 1, Part 15, Chapter 391, Subchapter A, Rule §391.107(3).

“ESBD” or “Electronic State Business Daily” means the electronic marketplace, operated by the Texas Comptroller of Public Accounts (Texas Comptroller), where agencies of the State post bid opportunities that are valued at or above $25,000. The ESBD currently may be accessed at http://www.txsmartbuy.com/sp/.

“Final Written Response Score” refers to the final scoring of the written response as documented in the Solicitation.

“Forensic” refers specifically to services that are provided to patients who have been committed to the Texas State Hospitals by a Texas State court under the authority of Texas Code of Criminal Procedure, Title 1, Chapter 46B (relating to Incompetency to Stand Trial).

“Geriatric” refers to an older aged (65+) individual with chronic illness, physical impairments and or cognitive impairments.

https://texreg.sos.state.tx.us/public/readtac$ext.TacPage?sl=R&app=9&p_dir=&p_rloc=&p_tloc=&p_ploc=&pg=1&p_tac=&ti=1&pt=15&ch=391&rl=107 http://www.txsmartbuy.com/sp/ https://statutes.capitol.texas.gov/Docs/CR/htm/CR.46B.htm https://statutes.capitol.texas.gov/Docs/CR/htm/CR.46B.htm

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“HHSC” means the Texas Health and Human Services Commission.

“HHSC PCS” means the Procurement and Contracting Services division of HHSC. HHSC PCS provides purchasing support services to DSHS and the Department of Family and Protective Services pursuant to Section 531.00553 of the Texas Government Code.

“Hospital” or “Inpatient Mental Health Facility” means an entity that is licensed in Texas to perform as a general hospital or as a special hospital. A “general hospital” is an establishment that: (a) offers services, facilities, and beds for use for more than 24 hours for two (2) or more unrelated patients who require diagnosis, treatment, or care for illness, injury, deformity, abnormality, or pregnancy; and (b) regularly maintains, at a minimum, clinical laboratory services, diagnostic X-ray services, treatment facilities including surgery or obstetrical care or both, and other definitive medical or surgical treatment of similar extent. A “special hospital” is an establishment that: (a) offers services, facilities, and beds for use for more than 24 hours for two

(2) or more unrelated patients who are regularly admitted, treated, and discharged and who require services more intensive than room, board, personal services, and general nursing care; and (b) has clinical laboratory facilities, diagnostic X-ray facilities, treatment facilities, or other definitive medical treatment. Both general and special hospitals must have medical staff (which include Texas-licensed physician(s)) in regular attendance and must maintain records of the services provided to each patient.

“HUB Subcontracting Plan” or “HSP” means the written documentation regarding the use of Subcontractors that is required by Section 2161.252 of the Texas Government Code for a purchase with an expected value of $100,000 or more when the state agency has determined subcontracting opportunities are probable. The HSP subsequently becomes a provision of the Contract and Contractor’s compliance with the HSP will be monitored during the Contract Term.

“Joint Commission [The]” or “TJC” refers to the independent not-for-profit organization that accredits and certifies the majority of health care organizations and programs in the United States, including hospitals and health care organizations that provide ambulatory and office-based surgery, behavioral health, home health care, laboratory, and nursing care center services. Founded in 1951, The Joint Commission is the nation's oldest and largest standards-setting and accrediting body in health care.

“Respondent” means an entity that submits a written request for consideration for Contract award in answer to this Solicitation.

“Startup Costs” refers to the expenses incurred during the process of creating a new business.

“Solicitation” means this RFQ including all exhibits and any Addenda.

“Solicitation Consideration (SC) Documents” means documents that must be submitted by Respondent with the Solicitation Response in order to be considered for evaluation and cannot be https://www.jointcommission.org/what-we-offer/accreditation/become-accredited/what-is-accreditation/?utm_source=google&utm_medium=cpc&utm_campaign=tjcaccreditation&gclid=EAIaIQobChMIn5jSyML7-gIV9xXUAR1kRgPEEAAYASAAEgLS6PD_BwE

PCS 550 HHS RFQ Template, RFQ No. HHS0013368V1 Page 7 of 50 resubmitted or have errors remedied after the submission due date and time in the Schedule of Events has passed.

“Solicitation Response” means Respondent’s submissions in answer to this Solicitation.

“State” means the State of Texas and its instrumentalities, including HHSC and any other State agency, its officers, employees, or authorized agents.

“Statement of Qualifications” or “SOQ” means the portion of the Solicitation Response that comprises a Respondent’s qualifications and skills as set out in Article V, Statement of Qualifications of the Solicitation.

“State Hospital” means one of the inpatient hospitals providing psychiatric treatment and care that are owned and operated by HHSC.

“TAC” means Texas Administrative Code.

“Telehealth Service” means a health service, other than a telemedicine medical service, delivered by a health professional who is licensed, certified, or otherwise entitled to practice in the State and who is acting within the scope of the health professional’s license, certification, or entitlement in the treatment of a patient at a different physical location than the health professional using telecommunications or information technology.

“Waitlist” means a register of defendants, whether charged with felonies or with misdemeanors punishable by confinement, who are awaiting admission to a facility that provides inpatient competency restoration services.

“VPTS” means the Vendor Performance Tracking System maintained by the Texas Comptroller of Public Accounts. The VPTS may be currently accessed at https://comptroller.texas.gov/purchasing/programs/vendor-performance-tracking/.

1.3 AUTHORITY

HHSC is soliciting the services herein under the authority of Texas Government Code, Section

2155.144 (relating to Procurements by Health and Human Services Agencies) and Chapter 2254, Subchapter A (relating to Professional Services).

The remainder of this page is left blank intentionally.

https://comptroller.texas.gov/purchasing/programs/vendor-performance-tracking/

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ARTICLE II. SCOPE OF WORK

2.1 DESCRIPTION OF SERVICES

Texas State Hospitals, operated by HHSC, serve a large population of Geriatric patients. HHSC intends to create additional options for forensic populations who are particularly vulnerable in a standard inpatient psychiatric unit and who require inpatient competency restoration services.

Patients who require these services have been committed to a Texas State Hospital by a Texas State court. Contractor will begin providing services pursuant to this Solicitation as agreed upon by HHSC or within three (3) months of contract execution and satisfy the requirements of this Solicitation, as well as demonstrate the ability to meet or exceed requirements to provide administrative and professional hospital operational services.

2.1.1 Eligibility Criteria

A. Contractor must currently provide Inpatient Competency Restoration Program (ICRP) Services; and

B. Contractor must possess capacity and the necessary staff to support 16 beds for inpatient Services, and be ready-to-occupy at full capacity within three (3) months of contract execution or as agreed upon by HHSC. HHSC will not cover Startup Costs or Capital Expenditures.

2.1.2 Eligible Population to be Served

A. Geriatric individuals who have significant chronic medical needs that do not require ongoing medical/surgical inpatient care and in accordance with Exhibit I, Appropriate Use Criteria;

or

B. If Geriatric occupancy capacity cannot be filled, Hospitals may fill vacancies with Individuals who:

1. Are the age of 18 years or older that have similar milieu as a geriatric patient and similar clinical presentation; and

2. In accordance with Exhibit I, Appropriate Use Criteria, should there be an available bed that requires occupancy to meet the required census.

C. In case of imminent concurrent admissions, between individuals age of 18 years or older and Geriatric individuals, the Geriatric populations are to receive priority admission.

D. Individuals committed to the Texas State Hospitals by a Texas State court under Texas Code of Criminal Procedure (Texas CCP) Title 1, Chapter 46B.

https://statutes.capitol.texas.gov/Docs/CR/htm/CR.46B.htm

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2.1.3 Service Area work

The patients served will be transfer patients from Texas State Hospitals. Contractor may accept direct admits from the Clearinghouse Waitlist as referenced in Exhibit H, Forensic Admission Referral and Coordination, when an appropriate person has been identified. HHSC reserves the right to negotiate the geographic boundaries of a designated service delivery area(s).

2.1.4 Inpatient Competency Restoration Program

Competency restoration is the process by which accused criminal defendants, who have been found incompetent to stand trial, are provided with treatment and education in order to obtain a rational and factual understanding of the legal proceedings they will encounter. HHSC operates several mental health facilities that provide inpatient competency restoration services throughout the State. Pursuant to Texas Code of Criminal Procedure (CCP) Article 46B, only facilities that are either operated by HHSC or under contract with HHSC are allowed to provide these services.

The contracted services must be provided in accordance with Texas CCP Article 46B, which requires an Inpatient Mental Health Facility that provides ICRP Services to do the following:

A. Develop a patient treatment plan for patients committed to the facility for competency restoration;

B. Assess whether competency is attainable in the near future;

C. Report to the court and the Local Mental Health Authority (LMHA)/Local Behavioral Health Authority (LBHA) on progress towards competency at least once during the commitment period;

D. Provide notice to the court when competency is attained, competency is not achievable in the near future, when the term of the commitment order is set to expire, if criteria for civil commitment is met, and when the final competency report is available; and

E. Provide competency restoration education services that includes:

1. Definitions of important persons in the courtroom and important legal terms;

2. Instructions on how to behave in the courtroom and effectively work with counsel;

3. Information about court-ordered medications and rights as a Forensic patient; and

4. An explanation of criminal charges and potential consequences.

F. In developing and implementing the ICRP, Contractor must:

1. Begin accepting eligible Forensic patients as set forth above in Section 2.1.2 (Eligible

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Population to be Served) and implement an ICRP for those patients;

2. Maintain operations of the minimum number of Forensic beds for the ICRP, as set forth above in Section 2.1.1 (Eligibility Criteria);

3. In collaboration with the Texas State Hospitals Admissions Management Team and as guided by the instructions in Exhibit H, Forensic Admission Referral and Coordination, accept all referrals that meet the criteria in Exhibit I, Appropriate Use Criteria from the Texas State Hospitals Non-Maximum Security Unit Clearinghouse List, which applies to patients who do not require admission to a maximum-security hospital and who can be served in a hospital designated by HHSC pursuant to Texas CCP, Title 1, Chapter 46B Articles 46B.073(c) (relating to Commitment for Restoration to Competency). Furthermore, the Contractors selected through this Solicitation will be specifically designated by HHSC to accept admission of patients pursuant to the Texas CCP, Title 1, Chapter 46B Article 46B.0021;

4. Provide clinically appropriate and effective Services and treatment in accordance with professional practices and conditional release/discharge planning for patients who are adjudicated incompetent to stand trial pursuant to Texas CCP, Title 1, Chapter 46B;

5. Regularly assess and evaluate patients for restoration of competency as guided by the Texas CCP, Title 1, Chapter 46B and competency restoration best practices;

6. Provide timely reports to the courts and to each patient’s assigned LMHA regarding the patient’s progress toward achieving competency to stand trial, including recommendations for extended mental health treatment, pursuant to Texas CCP, Title 1, Chapter 46B Article 46B.077 (relating to Individual Treatment Program);

7. Make reasonable efforts with the designated LMHA, LBHA, or Local Intellectual and Developmental Disability Authority (LIDDA) to provide discharge planning for persons who are discharged unexpectedly, which shall include discharge due to:

a. A patient’s unauthorized departure;

b. Criminal charges being dropped, or court otherwise releasing the patient;

c. Death of the patient; or

d. Execution of an arrest warrant for the patient;

8. Provide continuity of care to patients entering and completing the program as outlined in TAC Title 26, Part 1, Chapter 306, Subchapter D (relating to Mental Health Services – Admission, Continuity, and Discharge);

https://statutes.capitol.texas.gov/Docs/CR/htm/CR.46B.htm https://statutes.capitol.texas.gov/Docs/CR/htm/CR.46B.htm https://statutes.capitol.texas.gov/Docs/CR/htm/CR.46B.htm https://statutes.capitol.texas.gov/Docs/CR/htm/CR.46B.htm#46B.073 https://statutes.capitol.texas.gov/Docs/CR/htm/CR.46B.htm#46B.0021 https://statutes.capitol.texas.gov/Docs/CR/htm/CR.46B.htm#46B.0021 https://statutes.capitol.texas.gov/Docs/CR/htm/CR.46B.htm#46B.0021 https://statutes.capitol.texas.gov/Docs/CR/htm/CR.46B.htm https://statutes.capitol.texas.gov/Docs/CR/htm/CR.46B.htm https://statutes.capitol.texas.gov/Docs/CR/htm/CR.46B.htm https://statutes.capitol.texas.gov/Docs/CR/htm/CR.46B.htm#46B.102 https://statutes.capitol.texas.gov/Docs/CR/htm/CR.46B.htm#46B.102

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9. Collaborate with committing courts and other appropriate entities within the judicial or mental health systems as permitted by law or requested by the court; and

10. Use best practices and reasonable efforts to maintain an average daily census that is 95% of the designated Forensic, bed capacity. Average daily census is computed by dividing the total number of Bed Days used during the month by the number of Calendar Days in the month.

11. If a Contractor suspects that a patient has an intellectual and developmental disability, then the Contractor shall notify the Texas State Hospitals Chief of Forensic Medicine or designee by e-mailing the Forensic admissions mailbox at (forensicadmissions@hhsc.state.tx.us), unless instructed otherwise in the Contract or in writing by an authorized HHSC representative.

12. If the patient’s initial commitment under Texas CCP, Title 1, Chapter 46B Article 46B.073, inclusive of the statutorily allowed 60 day extension, is approaching expiration and the Contractor determines that it is clinically appropriate for the patient to receive continued Services at the Hospital, the Contractor will obtain a commitment order for the patient pursuant to Texas CCP, Title 1, Chapter 46B Article 46B.102 and continue serving that patient with no disruption in care until the patient can be transferred to a State hospital for longer-term treatment in accordance with the process outlined in the Exhibit J, Notification and Transfer of Forensic Patients.

13. If the patient’s initial commitment is approaching expiration and the Hospital determines, through clinical assessment and observation, that the patient is not likely to be restored to competency, Contractor will contact the Forensic admissions mailbox (forensicadmissions@hhsc.state.tx.us), unless instructed otherwise in the Contract or in writing by an authorized HHSC representative, to arrange the next course of treatment for the patient, prior to discharging the patient back to court, including but not limited to a formal competency evaluation report stating the opinion of non-restorability.

14. For medical and dental care and treatment that cannot be adequately provided by the Contractor, Contractor shall contact HHSC for prior approval of patient transfer either to another qualified provider or to a HHSC facility. Contractor is expected to keep patients on their census until an effective transfer has taken place. For medical care and treatment costs that extend beyond routine and preventive care (extraordinary care), Contractor shall contact HHSC for prior approval of the costs and reimbursement of payment shall be made to Contractor by HHSC if the medical care and treatment is medically necessary and complies with the requirements of Health and Safety Code Chapters 552 and 576.

mailto:forensicadmissions@hhsc.state.tx.us https://statutes.capitol.texas.gov/Docs/CR/htm/CR.46B.htm mailto:forensicadmissions@hhsc.state.tx.us

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G. Usual routine and preventative care is defined as the diagnosis and treatment of acute and chronic medical problems and medically warranted screening and preventative care that is typically provided on an outpatient basis. It is the type of medical care individuals, with access to health care, receive in the community. This would include appropriate over the counter treatment as well as evaluation, diagnostic labs, prescriptions, treatment, and health monitoring received by a primary care provider.

H. Extraordinary care is defined as care that is above and beyond the medical care a contracted provider is expected to provide. An example of extraordinary care is a situation that require patients to be admitted to medical/surgical hospital for at least 72 hours. If HHSC agrees that a patient requires extraordinary care, the Texas State Hospitals will assume the financial responsibility of the care the patient requires. If needed, the patient will be transferred to a State Hospital bed when no longer requiring medical/surgical inpatient level of care. However, if the precipitating medical condition necessitating medical/surgical hospitalization is resolved, it may be appropriate to return to the contracted bed. Such instances will be evaluated on a case-by-case basis. Other situations, such as potential costs of cancer treatment that does not necessarily require medical/surgical hospitalization, will be evaluated on a case-by-case basis.

I. In the event a patient requires care in a medical/surgical hospital setting longer than 72 hours, HHSC requests Contractor contact HHSC for possible transfer options. Contractor is expected to keep patients on their census until an effective transfer has taken place.

J. In the event a patient is transferred to an alternative setting (e.g., for an outside medical appointment), it remains the Contractor’s responsibility to maintain ongoing or continuous supervision until the patient is returned to the Contractor’s facility.

2.1.5 Admission, Continuity of Care and Discharge Requirements

A. Contractor must ensure that patients are provided with a full array of Services, including treatment that:

1. Is effective, responsive, individualized, goal-directed, culturally competent, least restrictive, and evidence-based;

2. Is provided through the development and implementation of a comprehensive treatment plan by an interdisciplinary team and corresponding intervention(s) including but not limited to:

a. A reasonable and appropriate discharge plan that is developed by the Contractor, LMHA/LBHA or LIDDA, courts, and/or the patient’s legal authorized representatives;

and

b. Communication that will facilitate the exchange of information between the Contractor, LMHA/LBHA or LIDDA, court, or other parties needed to accomplish

PCS 550 HHS RFQ Template, RFQ No. HHS0013368V1 Page 13 of 50 common admission, transfer, and discharge activities;

3. Promotes recovery, independence, and self-sufficiency;

4. Upholds all state and federal privacy rules, include HIPPA and 42 CFR Part 2;

5. Protects comprehensive patient rights consistent with State and federal regulations, and Joint Commission requirements;

6. Incorporates a behavior management program as appropriate; and

7. Provides Telehealth Services and telemedicine as needed.

B. Contractor must demonstrate efforts to reduce restraint and seclusion by adopting and implementing the following along with follow up in accordance with CMS guidelines and state laws when a restraint is appropriately used with:

1. Assessment tools to identify risk factors for violence and seclusion and restraint history;

2. A trauma assessment;

3. Clinical tools to identify persons with risk factors for death and injury;

4. De-escalating or safety surveys; and

5. Environmental changes to include comfort and sensory rooms and other meaningful clinical interventions that assist people in emotional self- management.

C. Contractor must comply with the following standards regarding admission, continuity of care, and discharge:

1. For admissions ordered under Texas CCP, Title 1, Chapter 46B Article 46B.073, the Contractor must collaborate with the Texas State Hospitals Admissions Management Team on:

a. Receiving information about persons on the State hospital Waitlist; and

b. Coordinating the admission of those persons as shown in Exhibit H, Forensic Admission Referral and Coordination. When the Contractor admits a patient, a licensed physician must issue and sign a written order admitting the patient.

2. Contractor must conduct an intake process as soon as possible, but not later than 24 hours after the patient is admitted. The intake process shall include:

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a. Obtaining relevant information about the patient, including information about finances, third-party coverage or insurance benefits, and advance directives; and

b. Explaining, orally and in writing, the patient's rights described in TAC Title 25, Part 1, Chapter 404, Subchapter E (relating to Rights of Persons Receiving Mental Health Services), including:

c. Services and treatment as they relate to the patient; and

d. The existence, purpose, telephone number, and address of the protection and advocacy system established in Texas, which is Disability Rights, Texas, as required by Texas Health and Safety Code §576.008 (relating to Notification of Protection and Advocacy System).

3. Upon Contractor patient admission, the Contractor must promptly, but no later than 24 after admission, notify the LMHA of residence of the patient’s admission.

4. Contractor must ensure entry of CARE assignments, including discharges, for Forensic patients served within the Hospital. The Contractor must develop and use local reporting unit(s) for the ICRP that will provide an assigned location for all patients served at the Hospital. This information shall also be entered into CARE when reporting on beds utilized at the Hospital.

5. Contractor must begin discharge planning for the patient upon admission of a patient to the Hospital.

6. Discharge planning must involve the patient, Hospital treatment team, LMHA/LBHA, or LIDDA as appropriate. Discharge planning for patients committed for competency restoration must also involve court personnel, the patient’s attorney, LAR, and any other service providers, parties, or agencies as appropriate. Involvement in discharge planning may be held via teleconference or videoconference. The Contractor is responsible for notifying individuals involved in discharge planning of scheduled treatment team meetings and case reviews.

7. Discharge planning must include, at a minimum, the following activities:

a. Identifying and recommending clinical services and supports needed by the patient after discharge or transfer;

b. Counseling the patient and the patient’s Legally Authorized Representative (LAR), if applicable, to prepare them for care after discharge or transfer; and

c. If applicable and deemed necessary, preparing a continuing care plan by the patient’s treating physician which includes:

http://www.disabilityrightstx.org/ http://www.disabilityrightstx.org/ https://statutes.capitol.texas.gov/Docs/HS/htm/HS.576.htm#576.008 https://statutes.capitol.texas.gov/Docs/HS/htm/HS.576.htm#576.008

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i. A description of recommended services and supports the patient may receive after discharge or transfer;

ii. A description of problems identified at discharge or transfer, which may include any issues that disrupt the patient’s stability;

iii. The patient’s goals, interventions, and objectives as stated in the patient’s treatment plan in the Hospital;

iv. Comments or additional information;

v. A final diagnosis based on the most current edition of the Diagnostic Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association;

vi. The provider(s) to whom the patient will be referred to for any services or supports after discharge or transfer; and

vii. Development of a transportation plan in conjunction with law enforcement or other entity as appropriate;

viii. Provision of seven (7) days of medications provided upon discharge or transfer;

and

ix. A prescription for 14 days for each medication the patient will need.

d. After discharge or transfer the Contractor will be responsible for providing and paying for the seven (7) days of medication needed after discharge or transfer until the patient is evaluated by a physician.

2.1.6 Disaster Services

A. Contractor must develop a disaster services plan for when the Contractor is unable to fully operate or cannot provide Services at all due to storm damage or other disasters. Contractor must report the quarterly expenditures to HHSC for each authorized service provided under the disaster services plan.

B. During periods of disasters beyond the Contractor’s control, the Contractor may utilize funding allocated by HHSC, with prior HHSC approval, to the Contractor for purchasing the following:

1. Crisis respite beds;

2. Adult psychiatric inpatient beds;

3. Psychiatric assessment and coordination; and

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4. Mental health transport.

C. If the ICRP is not fully operational due to storm damage or other disaster, the Contractor, with HHSC approval, may utilize funding allocated by HHSC to the Contractor during times when the Contractor is not fully operational to purchase alternate facility inpatient beds meeting standards for this committed population.

2.1.7 Telehealth Services and Telemedicine Medical Services

Contractor may use Telehealth Services and telemedicine medical services pursuant to Chapter 111 of the Texas Occupations Code (relating to Telemedicine, Teledentistry, and Telehealth) and other applicable State and federal laws regarding payment sources, including provisions in Chapter 531 of the Texas Government Code –Sections 531.0216, 531.02161, 531.0217(b) and 531.02253.

Contractor must comply with all of the following in providing Telehealth Services and telemedicine services:

A. Patients, or a patient’s LAR, must give written consent to receive services via Telehealth Services and telemedicine;

B. Telehealth Services and telemedicine services must comply with all Texas Medicaid requirements for Telehealth Services, as well as the licensure/practice act requirements for each physician or health professional; and

C. Technology used to provide Telehealth Services must be compliant with HIPAA and the Family Educational Rights and Privacy Act of 1974 (“FERPA”), as may be applicable to the patient.

2.1.8 Personnel Staffing Standards and Requirements

A. Contractor must maintain qualified personnel, including but not limited to, physicians and health professionals, in accordance with all Joint Commission standards, Texas statutory requirements, HHSC regulations and policies, and established industry standards for Inpatient Mental Health Facilities.

B. Contractor is solely responsible for hiring, directing, supervising, terminating, and compensating Hospital personnel, representatives, agents, subcontractors, and third-party service providers delivering Services under the Contract. The Contractor shall have no claim against HHSC for vacation pay, sick leave, retirement benefits, social security, worker’s compensation, health or disability benefits, unemployment insurance benefits, or employee benefits of any kind.

C. Contractor must conduct criminal background checks on all Hospital personnel, including but not limited to, full-time staff, part-time staff, professors, medical fellowships, medical residents, medical students, interns, or volunteers, or any other staff whose primary duty station

PCS 550 HHS RFQ Template, RFQ No. HHS0013368V1 Page 17 of 50 is at the Hospital. All background checks/clearances must be conducted in accordance with Chapter 250 of the Texas Health and Safety Code. If the results of any criminal background check show that an individual has been convicted of or received deferred adjudication for any of the criminal offenses listed in Texas Health and Safety Code §250.006 (relating to Convictions Barring Employment) or other applicable laws, that individual will be barred from the Hospital premises and from participating in any activities or services related to the Contract.

D. Contractor must provide written notification to HHSC of changes in the Hospital’s Chief Executive Officer, Chief Operating Officer, Chief Medical Officer, and executive and clinical leadership team for the ICRP within 30 Calendar Days after the change.

2.1.9 Program Requirements to Maintain

A. Contractor must ensure detailed financial records are kept throughout the life of the Contract that account for all expenditures of funding allocated by HHSC, including but not limited to, all detailed expenditures for the support, maintenance, and treatment related to providing the Services.

Contractor will participate as a non-voting member of the governing body for State hospitals and will participate in governing body subcommittees as appropriate.

B. Contractor shall ensure that funding allocated by HHSC for inpatient competency restoration services, after any available third-party insurance, indigent care programs, or other local medical care programs, covers the costs for all medical care and treatment including the cost of psychiatric and physician services and all non-prescription and prescription medications (including discharge medications) incurred by or on behalf of patients admitted to the Hospital.

This includes all on-site medical care and treatment, and any cost related to the initial evaluation and diagnosis of patient conditions, that are incurred by or on behalf of patients admitted. The Contractor acknowledges and accepts the HHSC stipulation that no additional HHSC funds will be provided for inpatient competency restoration services beyond the agreed upon funding amount for the agreed upon funding period between HHSC and the Contractor.

C. Contractor shall promote and protect patient rights and value patient feedback and satisfaction as measures of Contractor service quality. To support this function, the Contractor shall designate a rights protection officer who receives, investigates, collects, and reviews data and reports quarterly to HHSC on patient, family, or other complaints related to the rights of Hospital patients.

D. Contractor shall report all allegations of abuse, neglect, or exploitation of a patient in a bed to the Texas Abuse Hotline by calling (800) 252-5400 or by reporting online at https://www.txabusehotline.org; and the Contractor shall follow all requirements related to the reporting and investigation of abuse, neglect or exploitation in accordance with Chapter 48 of https://www.txabusehotline.org/

PCS 550 HHS RFQ Template, RFQ No. HHS0013368V1 Page 18 of 50 the Texas Human Resources Code (relating to Investigations and Protective Services for Elderly Persons and Persons With Disabilities).

E. Contractor must ensure compliance with all standards established by and maintain accreditation with The Joint Commission, or other accrediting body granted deeming authority by the CMS, throughout the term of the Contract and maintain an up-to-date Environment of Care Suicide Risk Assessment Inventory that addresses all risks, along with a mitigation plan per The Joint Commission Standard National Patient Safety Goal 15.01.01.01.

F. Contractor must ensure compliance with all applicable federal and State laws, rules, regulations, standards, guidelines, and policies in effect beginning on the effective date of this Contract unless amended, including, but not limited to:

1. Emergency Medical Treatment and Labor Act of 1986 (EMTALA);

2. Texas Health and Safety Code Chapters 241 and 571 through 577; and

3. Texas Code of Criminal Procedure Chapter 46B.

G. Contractor must ensure compliance with all State and federal statutes and regulations, as well as all HHSC rules, policies, procedures, and guidelines governing the provision of inpatient mental health services, including but not limited to:

1. TAC Title 25, Part 1, Chapters 133, 404, 405, 411, 414, 415; TAC Title 26, Part 1, Chapter 306; and TAC Title 40, Part 19, Chapter 705; and

2. Other HHSC rules, policies, procedures, and guidelines. The aforementioned rules in TAC Titles 25, 26, and 40, as they relate to the provision of inpatient mental health services, may be further modified, revised, and transferred within their existing titles or into another title during the term of this Contract. In the event of such modifications or transfers, the Contractor shall be required to comply with said rules.

H. Contractor, in delivering inpatient competency restoration services, must work with HHSC on capacity-management for State hospitals with the goal of increasing access to services and decreasing wait times of persons on the State hospital Waitlist. This includes, but is not limited to, serving patients from other State hospitals and expedited admissions as determined by the Texas State Hospitals Associate Commissioner or an authorized designee.

2.1.10 Primary and Secondary Points of Contact

Contractor must designate primary and secondary points of contact, as well as an emergency contact roster of persons, all of whom will be responsible for communicating, corresponding, responding, and reporting to HHSC during and after business hours regarding delivery of the ICRP outlined in this Solicitation. The Contractor’s points of contact shall contact the Texas State

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Hospitals Capacity Management Team, inquires initiated by HHSC within four (4) hours. HHSC will endeavor to contact non-primary points of contact only in an emergency. Communication with the Contractor’s points of contacts are not intended to limit conversations between medical leadership, clinical teams, and central office admission management staff with like Hospital personnel.

2.1.11 Medications and Medication Related Services

Contractor must provide all medications and medication-related services to patients served under the Contract in accordance with all applicable State and federal statutes and regulations, as well as HHSC rules, policies, procedures, and guidelines governing medications and medication-related services, including but not limited to, TAC Title 26, Part 1, Chapter 306, Subchapter G, and HHSC rules, policies, procedures.

2.1.12 Reporting Requirements

Contractor must ensure that all reports, supporting documentation, and other information the Contractor is required to submit to HHSC, under the Contract, are submitted via e-mail to sh_contracted_hospital_reports@hhs.texas.gov. A copy of any correspondence also must be provided to the designated HHSC representative, unless instructed otherwise in the Contract or in writing by an authorized HHSC representative.

A. Contractor must notify HHSC of all reports of death, abuse, neglect, exploitation, illegal, unethical or unprofessional conduct, or other unusual incidents impacting the Contractor and report the investigation disposition of each incident using Exhibit K, Example Unusual Incident Summary Reporting Form immediately of the initial disposition.

B. Contractor must report the daily census of the contracted hospital beds, using either a contractor-developed and HHSC-approved report format or by submitting the Daily Census Report using the form in Exhibit L, Example Daily Census Report, each day no later than 8:00 a.m.

Central Time. Via e-mail to sh_contracted_hospital_reports@hhs.texas.gov.

C. Contractor shall report to the Texas State Hospitals Incident Management Coordinator within two (2) Business Days of an incident, or initial disposition, via email to incidentnotificationsh@hhsc.state.tx.us, the following incidents involving patients served under contract:

1. Severe weather resulting in damage to person or property;

2. Fire resulting in destruction of property;

3. Computer, power, and telephone outages that affect Contractor operations or communications to or from the Hospital;

mailto:sh_contracted_hospital_reports@hhs.texas.gov mailto:sh_contracted_hospital_reports@hhs.texas.gov mailto:sh_contracted_hospital_reports@hhs.texas.gov mailto:incidentnotificationsh@hhsc.state.tx.us

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4. Cyber ransomware attacks;

5. Accidents on Hospital grounds resulting in serious injury or loss of property;

6. Unannounced visits by The Joint Commission, Centers for Medicare & Medicaid Services, HHSC Regulatory, Texas State Auditor’s Office, or other State or federal regulatory or oversight entities;

7. Infectious diseases, other than COVID-19, that affect Contractor operations or census.

Patients testing positive or are symptomatic for COVID-19 must be reported to HHSC on Exhibit L, Example Daily Census Report; and

8. Any other incident that is likely to present a legal liability to HHSC or to the Contractor (including its officers, executives, directors, employees, or authorized agents), or create media attention.

D. Contractor shall report all allegations of abuse, neglect, or exploitation (ANE) of a patient in a bed to the Texas Abuse Hotline by calling (800) 252-5400 or reporting online at https://www.txabusehotline.org within one (1) hour of discovery and shall follow all requirements related to the reporting and investigation of ANE in accordance with Texas Human Resources Code, Chapter 48, and all other applicable state and federal laws. HHSC Provider Investigations (PI) Unit shall ensure allegations of ANE are investigated thoroughly and shall determine whether the allegation is confirmed or unconfirmed. HHSC PI shall notify the Contractor of the outcome of the investigation. Contractor shall keep a record of all allegations and the disposition of the investigation onsite. At any time, HHSC, including HHSC Office of Inspector General (OIG), may request access to these records for review. In cases where an allegation may have resulted in a crime being committed, Contractor shall refer it to the local police department.

E. Contractor must notify HHSC within one (1) hour at incidentnotificationsh@hhsc.state.tx.us and sh_contracted_hospital_reports@hhs.texas.gov of all reports of death, abuse, neglect, exploitation, illegal, unethical, or unprofessional conduct, or other unusual incidents impacting patients in contracted beds and report the investigation disposition of each incident using the Example Unusual Incident Outcome Notification Summary Form, attached hereto as Exhibit K.

F. Contractor must track and address patient complaints and grievances and, within 30 Calendar Days of the close of the quarter, provide HHSC with a quarterly summary report containing each patient grievance, the Contractor’s findings, and resolution status. The summary report must be delivered to HHSC, via e-mail, to sh_contracted_hospital_reports@hhs.texas.gov and a copy of any correspondence also sent to HHSC’s designated representative, unless instructed otherwise in this Contract or in writing by an authorized HHSC representative.

mailto:incidentnotificationsh@hhsc.state.tx.us

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G. Contractor, within 30 Calendar Days of the end of each quarter of the State fiscal year, must submit a performance indicator report using the form Exhibit N, Example Quarterly Performance Indicator Summary, with measures that are agreed to by HHSC and the Contractor. Alternately, if approved in advance by HHSC, contractor may choose to use the TJC performance indicator reporting tool (Accelerate PI™) that is accessed in the “Resources and Tools” section of an accredited organizations’ secure Joint Commission extranet site.

H. Contractor must submit to HHSC the total number of patients admitted to the ICRP during the previous fiscal quarter. HHSC will monitor attainment toward annual occupancy performance each quarter. HHSC may, in its sole discretion, grant exceptions from expected attainment on a case-by case basis for good cause shown. Any deviation of Forensic bed capacity funded under the Contract’s statement of work must be submitted in writing to HHSC prior to implementation of such changes.

I. Contractor must submit a quarterly expenditure report, using the form Exhibit M, Example FYXX Quarterly Financial Report of this Solicitation, within 30 Calendar Days of the end of the quarter. The quarters shall be based upon the State fiscal year.

2.1.13 HHSC’s Responsibilities

A. HHSC will coordinate a centralized admissions process to effectively manage the capacity needs of State hospitals and the successful Contractor through the Texas State Hospitals Admissions Management Team.

B. HHSC will provide Contractor with information about patients who have been court-ordered into State hospitals through the Texas State Hospitals Admissions Management Team.

C. HHSC will review and approve any requests for expedited admissions of patients on the Texas State Hospitals Non-Maximum Security Clearinghouse List through the Texas State Hospitals Associate Commissioner or an authorized designee(s).

D. For patients in the Hospital who need extended mental health treatment under Texas CCP, Title 1, Chapter 46B Article 46B.102, HHSC will provide oversight and coordination for their transfer to a State hospital via the Texas State Hospitals Admissions Management Team or an authorized designee(s).

2.1.14 Payment and Invoicing

A. Contractor must request payment on a monthly basis, based on the number of beds and the number of Calendar Days in the month by submitting an invoice.

B. HHSC expects 95% average occupancy. In the event the total Bed Days paid for the quarter fall below the equivalent of a 95% occupancy rate, an adjustment to future payments or a refund will be required at the proposed Bed Day rate.

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2.1.15 Monitoring by HHSC

A. HHSC will monitor the performance of the Contract. HHSC will conduct monitoring for fiscal, programmatic, and administrative components.

B. Contractor must provide all services and deliverables under the Contract at an acceptable quality level and in a manner consistent with the Contract and Contractor requirements.

C. HHSC reserves the right to pursue additional remedies under the Contract if the Contractor fails to meet its contractual responsibilities. Those remedies include, but are not limited to:

1. Requiring the Contractor to submit written…