ESBD_File_283034_HHS0011158_OE_SUD_09.01.22.docx

Jaime Masters, Commissioner Open Enrollment For

Substance Use Disorder (SUD) Services

Enrollment Number: HHS0011158

Enrollment Period Opens: May 2, 2022

Enrollment Period Closes: August 31, 2027 NIGP Class/Item Code:

952-06 952-07

Texas Department of Family and Protective Services Substance Use Disorder Services Open Enrollment Number: HHS0011158

Updated 09/01/2022

TABLE OF CONTENTS

1.

GENERAL INFORMATION

1.1 Introduction. The Health and Human Services Commission (HHSC) on behalf of the Department of Family and Protective Services (DFPS or Department) Child Protective Services (CPS) is issuing this Open Enrollment to enter into contracts with qualified Applicants for Substance Use Disorder Services.

1.2 Point of Contact. The sole point of contact for questions and communications for this Open Enrollment is Delayne Williams at delayne.williams@dfps.texas.gov.

1.3 Open Enrollment HHS and ESBD Enrollment Posting, Amendments and Announcements. HHSC Procurement and Contracting Services (PCS) will post all official communication on behalf of DFPS for this Open Enrollment on the HHS Enrollment and Electronic State Business Daily (ESBD) site at:

HHS Enrollment (https://apps.hhs.texas.gov/pcs/openenrollment.cfm) ESBD (http://www.txsmartbuy.com/sp)

1.3.1 DFPS reserves the right to revise this Open Enrollment at any time, including the closing date of this Open Enrollment. Applicants must comply with any changes, amendments, or clarifications posted to the HHS Enrollment and ESBD site by HHSC PCS.

1.3.2 Potential Applicants and Enrolled Providers must check the HHS Enrollment and ESBD site periodically for any updates to this Open Enrollment and to comply with these requirements. The Applicant’s failure to periodically check the HHS Enrollment and ESBD site will in no way release them from any responsibility or additional costs to meet the requirements of complying with the Open Enrollment and resulting Contract.

1.4 Open Enrollment Schedule

Table 1 - Procurement Schedule

1.4.1 DFPS may adjust the closing date for this Open Enrollment for a specific Region to meet DFPS’ and its clients’ needs. Furthermore, DFPS may re-open this Open Enrollment and the enrollment period, to add a specific Region to meet DFPS’ needs.

1.4.2 All Adjustments to this Open Enrollment will be posted on the HHS Enrollment and ESBD site (See Section 1.3).

1.5 Historically Underutilized Businesses (HUB)

DFPS adheres to the administrative rules, policies, and forms developed by the Health and Human Services Commission relating to Historically Underutilized Businesses (HUBs). This PEN does not require Respondents to complete a HUB Subcontracting Plan. For more information about the HUB program at DFPS, contact the DFPS HUB Coordinator at: dfpshub@dfps.texas.gov

1.6 Open Enrollment Background

1.5 1.6

1.6.1 DFPS Mission. The mission of DFPS is to promote safe and healthy families and protect children and vulnerable adults from abuse, neglect, and exploitation.

1.6.2 CPS Purpose. The purpose of the Child Protective Services (CPS) Program is to keep children safe while partnering with parents and other family members, the community, and our providers to achieve permanency and improve child well-being.

1.7 Eligible Applicants. Applicants must comply with the following to receive a Contract award through this Open Enrollment:

1.7

1.7.1 Submit a Substance Use Disorder (SUD Services Application and Required Forms (See Section 5.1).

1.7.2 Not be debarred from receiving any federal or state funds at the time of the Contract award.

1.7.3 Be legally authorized to do business in the State of Texas and determined to be "Active" by the Texas Comptroller of Public Accounts. Applicants can check their status at:

https://mycpa.cpa.state.tx.us/coa/search.do.

1.7.4 Accept the requirements of this Open Enrollment by executing the Application in Section 5.1.

1.8 Open Enrollment Application Contract Documents

The Applicant, if awarded a Contract for this Open Enrollment, will be referred to as a “Contractor,” and agrees to comply with this Open Enrollment, the Substance Use Disorder Services Contract executed between the Parties, DFPS Vendor Uniform Terms and Conditions, and DFPS Vendor Supplemental and Special Conditions for Regional Contracts, which are located on the DFPS public website, Doing Business With DFPS, Contracting Forms:

https://www.dfps.state.tx.us/Doing_Business/forms.asp Enrolled Providers must check the above linked website periodically for any updates for any associated enrollment contracting documents. A Provider’s failure to periodically check the HHS Enrollment and ESBD site will in no way release them from any responsibility or additional costs to meet the requirements of complying with the Open Enrollment and resulting Contract.

1.8

1.8.1 If awarded a Contract, the Applicant will execute a Substance Use Disorder (SUD) Contract prepared by DFPS.

1.8.2 The Contract term will begin no sooner than September 1, 2022 and will end on August 31, 2027.

1.9 Delegation of DFPS Authority. State and federal laws generally limit DFPS’s ability to delegate certain decisions and functions to a Contractor, including but not limited to policy-making and final decision-making authorities on the acceptance or rejection of services provided under a Contract.

1.10 Texas Public Information Act. Any information submitted to DFPS in response to this Open Enrollment is subject to public disclosure in accordance with the Texas Public Information Act (the Act), and Government Code Chapter 552. DFPS will process any request for information comprising all or part of any information submitted to DFPS by the Applicant in accordance with the Act.

If an Applicant claims that information contained in any materials submitted to DFPS is exempt from required public disclosure under the Act, the Applicant must clearly identify such information and the applicable exemptions in the Act and explain in detail why such exemption is applicable.

For information concerning the application of the Act’s provisions to Applicant's Application and proprietary information, Applicants may consult the following:

Attorney General’s website: http://www.oag.state.tx.us, http://www.oag.state.tx.us/open/index.shtml Public Information Handbook: https://www.texasattorneygeneral.gov/files/og/publicinfo_hb.pdf

1.11 Use of Ideas by the State of Texas. DFPS reserves the right to use any and all ideas presented in an application unless the Applicant presents a valid legal case that such ideas are a trade secret or confidential information and identifies the information as such in its application.

An applicant may not object to the use of ideas that are not the Applicant’s intellectual property and so designated in the application that are known to DFPS before the submission of the application, are in the public domain through no fault of DFPS or become properly known to DFPS after application submission through other sources or through acceptance of the application.

1.12 Copyright Restrictions. DFPS will not consider any application that bears a copyright.

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2.

STATEMENT OF WORK

2.1. DFPS Mission

The mission of DFPS is to protect children, the elderly, and people with disabilities from abuse, neglect, and exploitation by working with clients, families, and communities.

2.2. Program Purpose

The purpose of the Child Protective Services (CPS) Program is to keep children safe and practice in a way that ensures safety, permanency and well-being for the children and youth we serve. CPS focuses on children and their families and seeks active involvement of the children’s parents and other family members, and the community to solve problems that lead to abuse or neglect. The objectives of CPS are to:

2.2.1. Prevent further harm to children and to keep children with their families when possible;

2.2.2. Provide permanence for children in substitute care by resolving danger or enhancing parental protective factors and returning children to their families; and

2.2.3. Provide permanence for children who cannot return to their families.

2.3. Need for Service

DFPS seeks to Contract with qualified providers to assist CPS in achieving its program purpose and objectives by providing Substance Use Disorder (SUD) Services. DFPS does not guarantee any minimum level of utilization or specific number of referrals. Utilization rate will vary according to the needs of staff, individual client needs, and regional allocations. The final decision for use, partial use, and non-use of these professional services lies within the authority of DFPS.

2.4. Contracted Substance Use Disorder (SUD) Services

DFPS purchases the following direct client services to meet the individual need for substance use disorder.

2.4.1 Assessments Services

A. Substance Abuse Assessment

2.4.2 Substance Use Disorder Treatment Services

A. Individual Counseling B. Group Counseling

2.4.3 Support Services (Required at DFPS Request)

A. Court Related Services B. Diagnostic Consultation

2.5 Service Delivery Areas

2.5.1 The open enrollment for Substance Use Disorder Services is released on a statewide basis; however, contracts are awarded on a regional basis. The Contract is for the DFPS Regions which can be located in Package 2 Application and Required Forms. Some regions are further divided into specific service delivery areas referred to as catchment areas.

2.5.2 Telehealth Services consist of services provided that involve direct face-to-face interactive video communication between the client and the provider. In order to provide telehealth services, the Contractor must also provide in-person services in the same region(s) and counties in which they are electing to provide telehealth services.

A. Contractor must provide telehealth services in compliance with the standards established by the respective licensing or certifying board of the professional providing these services.

B. Telephone conversations, chart reviews, electronic mail messages, and fax transmissions alone do not constitute a telehealth interactive video service and DFPS will not reimburse such as telehealth services.

C. The audio/visual fidelity and clarity and field of view of the telehealth service must be functionally equivalent to an evaluation performed on a client when the provider and client are both at the same physical location.

D. Telehealth services are reimbursed at the same rate as in-person services. See Table 3 in Section 3.2.2, Fee Schedules.

2.5.3 DFPS may adjust the service delivery areas served by the Contractor at any time to meet the service needs of DFPS.

2.6 Eligible Population

2.6.1 Individuals referred directly by DFPS are eligible for services. DFPS determines eligibility; Contractor must serve all clients properly referred by DFPS.

2.7 Client Characteristics

Contractor must be prepared to serve individuals with characteristics including, but not limited to the following:

2.7.1 Involuntary clients, especially for assessments;

2.7.2 Parents or caregivers who care for abused and neglected children and need these services as a means of preventing future abuse; or,

2.7.3 Person(s):

A. To whom the court had ordered DFPS to provide services;

B. Who have been or are currently involved in the criminal justice system; or, C. With limited English proficiency.

2.8 Minimum Qualifications

2.8.1 Minimum Organizational Qualifications

A. Be a licensed as a Substance Abuse Treatment Facility (SATF), also known as Chemical Dependence Treatment Facility (CDTF) by the Department of State Health Services (DSHS) to provide Substance Use Disorder (SUD) Services.

B. Maintain licensure throughout the life of this contract and any renewals; and, C. CDTF must be enrolled in Medicaid and Medicaid Managed Care program(s) operating in their service area.

2.8.2 Minimum Staff Qualifications

Contractor will assign only qualified personnel to this Contract. Contractor must ensure service providers and staff responsible for their supervision complies with SATF/CDTF licensure:

A. Qualified Credentialed Counselors (QCC) as defined by the DSHS licensure standard for assessment completion;

B. Have the necessary experience to perform the service; and C. Eligible as a Medicaid provider to perform and bill for the service.

D. DFPS has provided a resource for Contractors that supports services purchased under this PEN for certification and training in Trauma-Informed Child Welfare Practice, evidence-based program interventions, and other resources at the DFPS website:

http://www.dfps.state.tx.us/training/trauma_informed_care/

2.8.3 Substitutions

Contractor may substitute appropriate key personnel to accomplish its duties so long as the substituted personnel are equally qualified and skilled in the tasks necessary to accomplish the tasks and services required as identified under SATF/CDTF licensure. Contractor will provide to DFPS prior written notice of any proposed change in key personnel who will provide services under this Contract. DFPS will make the final determination whether staff is equally skilled and qualified.

2.9 Service Authorization and Referral Process

CPS will refer Clients who receive services under this contract through a Service Authorization (Form 2054), whether services are billable to DFPS or Texas Medicaid (including Traditional Fee-for-Service or a Medicaid Managed Care Organization).

2.9.1 Authorization Form

Only services authorized on a Valid Service Authorization, Form 2054 may be billed (see Glossary for additional information).

Contractor must receive a current Form 2054 and Referral Form 2062 prior to rendering services.

A. Contractor must maintain Form 2054 authorizing the service in each client's record as basis for payment from DFPS. The individual case record must include the Form 2054 and the Contractor must follow the specifics addressed in the form, including but not limited to:

1. The time limit specified.

2. Services end at the earlies date, based on when one of these events occurs:

a. The number of units specified on the Form 2054 have been delivered; or,

b. The request for services is withdrawn by DFPS.

B. DFPS will not pay or will institute collection if payment has already been made for the following claims:

1. Services or service types not specifically authorized by this contract, for example, detoxification and in-patient services.

2. Services delivered by a person not meeting the minimum qualifications or not having received prior DFPS approval.

3. Service claims that exceed the number of units or fall outside the timeframes specified on the Form 2054.

4. Medicaid eligible without an acceptable denial.

5. Missed appointments.

2.9.2 Referral Information

The referral must include a completed:

A. Form 2062, Referral for Substance Abuse Services.

B. Form 2063, Release of Confidential Information, signed and dated by the client.

1. Section 1 completed by DFPS.

2. Section 2 must be completed by Contractor.

C. In addition, the referral packet may include:

1. A cover memo requesting the services;

2. A description of the psychological testing report or other assessment;

3. A Family Plan of Service; and

4. Other information that would help the Contractor provide appropriate services.

2.9.3 Initial Contact

Contractor must:

A. Utilize an appropriate contact method designed to maximize the changes the referred individual will respond and honor appointment dates.

B. Contact the client within three (3) business days of receipt of forms listed in Section 2.9.

C. Begin the authorized service within ten (10) business day of receipt of the completed forms listed in Section 2.9.

D. DFPS anticipates that emergency situations may occur, requiring a need for expedited services. Contractor must work with DFPS to expedite service delivery as requested.

2.10 Missed or Cancelled Appointments

2.10.1 Services Missed by Client

A. Contractor must contact the CPS caseworker by 5:00 p.m. on the business day following any missed or cancelled appointment.

B. Contractor must not bill client for a missed or cancelled appointment.

C. Missed appointments are not billable to CPS.

D. If a referred client misses or cancels two (2) consecutive appointments, the Contractor must notify the CPS caseworker or supervisor and obtain instructions on how to proceed. Do not schedule further appointments unless instructed by CPS to do so.

2.10.2 Services Cancelled by Contractor

A. The Contractor must provide at least a twenty-four (24) hour notification to clients when a group session must be cancelled.

B. If the twenty-four (24) hour notification cannot be met due to unforeseen circumstances such as acts of nature, notification to the CPS caseworker must occur by the next workday following the cancelled session.

C. Contractor must maintain documentation of notification and contacts with each client and CPS caseworker regarding cancellation of any session.

D. Services cancelled by the Contractor are not billable.

2.11 Major Service Deliverables

DFPS purchases SUD SERVICES to assess individual service needs and meet identified need for treatment, as appropriate for clients who abuse alcohol or engage in the abuse of, improper use of, or dependency on illegal or legal drugs. Major Service deliverables include any individual or combination of the following:

A. Assessments;

B. Substance Use Disorder treatment;

C. Court related services; and D. Case specific diagnostic consultation.

2.11.1 Substance Abuse Assessment

An assessment will be authorized for each individual referred to the CDTF. Individuals must be assessed by a qualified credentialed counselor (QCC), as defined by the DSHS licensure standard) to determine the severity of a client’s substance abuse disorder and identify their treatment needs.

As part of child safety, substance abuse assessment needs to address current use of drugs and alcohol. The assessment process consists of two main tasks:

A. Intake, which includes the completion of the following:

1. Basic demographics;

2. Reason for referral;

3. Substances abuses; and

4. To some extent, a brief summation of the client’s expectations regarding the proposed services.

B. Assessment The administration and the determination of results of a substance abuse assessment tool. The assessment tool should identify problems associated with substance use including but not limited to the following minimum requirements:

1. The most recent version of Diagnostic and Statistical Manual (DSM) diagnosis, if applicable;

2. The issues identified in the CPS client referral information;

3. The identification of the parent/caregiver’s strengths, diminished protective capacities and unmet needs of the child(ren);

4. The parent/caregivers’ perception of family problems, to include how the parent/caregivers’ substance use poses threat to child safety and risk and why the child is in care or involved with CPS;

5. The parent/caregivers’ ability to protect the child(ren) from abuse or neglect;

6. The parent/caregiver’s ability to problem solve and utilize resources;

7. The family’s support system and extended family;

8. Substance Abuse;

9. Family Violence Issues;

10. Parent/Caregivers’ ability to function as provider for the family;

11. Evaluation of safety threats and continued risk to the child; and,

12. Specific recommendations for further evaluation or continued treatment.

2.11.2 Additional Assessments

DFPS normally authorizes only one assessment per client; however, additional assessments may be considered when:

A. Medically indicated; or, B. Individual is transitioning in their level of treatment (e.g. residential to outpatient treatment).

Assessment is due to DFPS not later than ten (10) business days following face to face meeting. Documentation of the assessment must be maintained in the client's record, and must include a copy of completed Form 2063.

2.11.3 Substance Use Disorder Treatment

DFPS will authorize substance use disorder treatment services individually as a separate service after review of the assessment report completed by CDTF. DFPS may consult with the CDTF, but the decision to refer for treatment is solely that of DFPS.

A. Substance abuse treatment must be provided:

1. On an outpatient basis;

2. Face to face; and,

3. Within guidelines consistent with Medicaid requirements.

B. DFPS does not authorize detoxification, residential treatment, or medical services under this contract. DFPS may authorize two types of counseling treatment:

1. Group Counseling Group counseling by QCC is the preferred DFPS treatment. Treatment is designed to equip clients with skills needed to understand the disease concept and maintain sobriety.

2. Individual Counseling.

If there are issues with group counseling, DFPS may, after consultation with the CDTF authorize individual counseling; however, the decision to refer client for individual counseling treatment is solely that of DFPS.

2.11.4 Support Services

Support Services are an array of services that aid in ensuring child safety, permanency and well-being. Support Services include:

A. Court Related Services B. Case Specific Diagnostic Consultation Contractor must provide Support Services upon CPS request.

2.11.5 Court Related Services

This involves testimony in judicial and administrative proceedings only at the request of CPS. To the extent possible, Contractor must also assist CPS in locating Contractor's past employees, agents, volunteers, consultants, or subcontractors when CPS requires past employees, agents, volunteers, consultants, or subcontractors to appear and testify.

DFPS purchases Court Related Services when legally necessary.

A. Service Requirements

1. Preparation The Contractor and its representatives must ensure applicable service providers have personal knowledge of the matters to be discussed and are adequately prepared to provide case-specific testimony.

2. Attendance The Contractor must ensure that requested or subpoenaed parties attend depositions and court appearances at the times requested by CPS.

B. Client Record Documentation Requirements The following information must be maintained in the client file:

1. A copy of the completed Service Authorization, Form 2054

2. Court Related Services Case Note, Form 2057

3. Subpoena, if applicable

C. Billing The Contractor must comply with the following requirements.

1. The unit of service is hourly, billed in 15-minute increments.

a. 1 hour = 1 unit

b. 45 minutes = 0.75 unit

c. 30 minutes = 0.50 unit

d. 15 minutes = 0.25 unit

2. Billing time begins at the time that the Contractor is requested to arrive for testimony or actual time of arrival, whichever is later, and ends immediately upon notification that no further service is required, or testimony is complete.

3. Mileage traveling to and from a courthouse or the site of service is not billable.

4. Refer to 5500CHEM, Invoicing Procedures for Chemical Dependency located on the Regional CPS Contracting Forms Website at the following URL.

https://www.dfps.state.tx.us/Doing_Business/Purchased_Client_Services/Regional_CPS_Contracts/forms.asp

5. The Contractor must:

a. Receive a valid Service Authorization, Form 2054, prior to the service being delivered;

b. Complete the Court Related Services Case Note, Form 2057, for each court appearance; and

c. Submit a completed, signed Form 2057 with its associated monthly billing invoice attesting to the delivery of service.

2.11.6 Case Specific Diagnostic Consultation

A. A Diagnostic Consultation is participation in a formal meeting or staffing, initiated by DFPS, to discuss a specific case.

DFPS purchases case specific Diagnostic Consultation Services to obtain an analysis of a specific CPS case to identify the cause or nature of a condition, situation, or problem, and provide advice, opinions, and recommendations to CPS.

1. Service Requirements

a. CPS must initiate and authorize a diagnostic consultation.

b. Contractor must receive a valid Service Authorization (Form 2054) prior to delivery of services.

c. Upon CPS request, Contractor must provide a completed Case Note (Form 5615) to the caseworker.

2. Client Record Documentation Requirements Contractor must complete a Diagnostic Consultation Services Case Note Form 5615 include it in the client case file. The Case Note must include, but is not limited to the following components:

a. Name of client;

b. Date of service;

c. Start and end time of consultation;

d. Location of consultation;

e. Purpose of Diagnostic Consultation;

f. Brief summary of case information shared at consultation;

g. Summary of case information shared at consultation;

h. Date and manner in which the report was submitted to the CPS caseworker, if requested by CPS; and

i. Date, signature and credential(s) of the performing provider.

3. Billing Requirements The Contractor must comply with the following requirements. The unit of service is hourly, billed in 15-minute increments.

a. 1 hour = 1 unit

b. 45 minutes = 0.75 unit

c. 30 minutes = 0.50 unit

d. 15 minutes = 0.25 unit

A. Billing time begins at the time the Contractor is requested to begin/arrive for consultation or actual time of arrival, whichever is later, and ends immediately upon notification that no further service is required.

B. Time traveling to and from the site of service is not billable.

C. Refer to 5500 CHEM, Invoicing Procedures for Chemical Dependency located on the CPS Regional Contracting Forms website at the following URL.

D. https://www.dfps.state.tx.us/Doing_Business/Purchased_Client_Services/Regional_CPS_Contracts/forms.asp

2.12 Communication to CPS

2.12.1 Substance Abuse Treatment Expectations

Form 2040, Substance Abuse Treatment and Intervention Exception Form must:

A. Be completed by the Contractor as a means of communicating client changes to CPS;

B. Be sent to the CPS Caseworker/Supervisor within twenty-four (24) hours of appointment;

C. Provide this information in at least two (2) of the following ways:

1. Phone Call;

2. E-mail; or,

3. Fax.

2.12.2 Treatment Plan

All treatment services require documentation to support the medical necessity of the service rendered. The client’s written treatment plan is therefore required and must be provided and maintained within requirements outlined below throughout the course of treatment:

A. Initial Treatment Plan The Contractor's initial treatment plan shall identify the issues, intervention strategies, and goals of treatment.

B. Treatment Plan Minimum Requirements A treatment plan and supporting documentation must include, but is not limited to, the following components:

1. Identification and rank the issues to be addressed based on the client’s assessment; including those identified in the CPS referral and any child safety threats

2. define goals;

3. write an objective for each goal;

4. determine strategies/interventions;

5. Address DSM-TR axis;

6. Recommended projected length of services and frequency;

7. Dated signature of participating client;

8. Dated signature of performing CDTF staff;

9. Drug tested method and frequency of testing, if appropriate;

10. A Relapse Prevention Safety Plan; and

11. Date and manner in which the plan was submitted to the CPS Caseworker.

C. Due Date for Initial Plan Initial treatment plan is due to the DFPS caseworker no later than twenty-one (21) business days following the initial referral for treatment.

D. Updates to Treatment Plan Treatment plan must be updated at least every ninety (90) days, and at one (1) year.

E. Due Date for Updates Treatment Plan Contractor must submit each update to the plan to the CPS Caseworker no later than ten (10) business days following the cycles cited in Section 2.12.2 (A) and Section 2.12.2 (D).

2.12.3 Quarterly Summary Notes

Contractor must provide quarterly summary notes to DFPS caseworker detailing approach, progress or lack of progress at least every ninety (90) days. Notes must include sufficient information to keep the DFPS caseworker updated at a minimum the notes must address:

A. Sessions scheduled and attended by the client;

B. Primary purpose of the session;

C. Level of participation, engagement, and responsiveness of client;

D. Discussion summary by session;

E. Progress towards treatment goals;

F. Number of substance abuse tests, results; and, G. Plans for upcoming sessions.

It may be necessary or required between quarterly summary notes to communicate in writing with CPS. Form 2040, Substance Abuse Treatment and Intervention Exception Form is one tool available to the Contractor for that purpose.

2.12.4 Discharge Plan

To document and report closure of treatment services case due to either completion or termination. Contractor must provide a discharge plan to DFPS no later than ten (10) business days after closure. A Discharge Plan must include, but is not limited to, the following:

A. Name of client(s) seen;

B. Summary with sufficient detail to support the client’s participation and progress, or lack thereof, in meeting goals identified in the Treatment Plan as applicable;

C. Reason for case closure;

D. Dated signature of performing QCC;

E. Date and manner in which the summary report was submitted to the CPS caseworker; and F. Any recommended protective measures.

2.12.5 Substance Abuse and Alcohol Testing

Substance abuse and alcohol testing is not payable as a separate expense in this Contract. It is expected that the Contractor will have a method for testing as needed for treatment services.

Positive Test Results A. Client Admission

DFPS considers a clients’ admission of current drug use or abuse of alcohol as a "positive" drug result. Clients’ denial of drug use should not be considered a negative drug test result.

B. Documentation

Contractor must communicate and document the clients’ self-reporting or the positive test result to the DFPS caseworker within twenty-four (24) hours, including:

1. Substances Tested; and,

2. Cut off levels.

2.12.6 Limits on Service Duration

Limits on service duration are defined by:

A. Medicaid protocol; or, B. Form 2054, Service Authorization; and C. The needs of the referred client; and D. Request from CPS for discontinuation of services.

Specific maximum units are detailed in Section 3.2.2 (B), Table 3, Fee Schedule for Substance Use Disorder Services.

2.13 Required Record Keeping

The Contractor must ensure compliance with all record keeping requirements stated in this contract as well the DFPS Standard Terms and Conditions, Record Keeping. Contractor must house all records in a central location and made available and accessible to DFPS without limitations.

Table 1 - Required Records

2.13.1 Individual Client Service Case Record

A. Valid Form 2054, “Service Authorization,” date stamped with receipt date;

B. Referral Form - Form 2062;

C. Release of Confidential Information Form – Form 2063 D. Additional referral information, if applicable;

E. All contacts, attempts to contact;

F. All appointments including:

1. The agreed upon date and time;

2. Any subsequent additional appointments or rescheduling; and

3. Record of missed or rescheduled appointments including required notifications to CPS Caseworker.

G. Record of CPS worker notifications or other contract related contacts;

H. Copy of each Form 2040 completed and shared with CPS;

I. Completed Substance Abuse Assessment to include:

1. Contractor’s signed and dated review and notes;

2. Completed tools and any information provided by the client;

3. Specific results of the assessment;

4. Specific recommendations, if any, to reference additional treatment; and

5. Date submitted to DFPS and to whom it was submitted.

J. If applicable, records detailing Substance Abuse Treatment to include:

1. Treatment Plan

2. Session notes specific to each group and individual session held;

3. Changes to Treatment Plan as treatment progresses; and

4. Results of any drug or alcohol tests and date and name of DFPS staff to whom any positive results were reported.

K. Detail of any court related services, if provided;

L. Detail of any case specific diagnostic consultation, if provided;

M. Detail of any other service authorized and provided under this contract; and N. Copy of all required reports.

2.13.2 Required Personnel Records

A. Documentation clearly establishing that the Contractor's service providers meet the minimum qualifications required by:

1. Medicaid;

2. Any State Licensing Authority;

3. The Contractor’s personnel policy; and

4. Requirements stated in this contract.

B. Copy of Forms 2970c and 2971c, Criminal and DFPS History Check;

C. Copy of background check results;

D. Copy of Insurance, if applicable;

E. Copy of signed DFPS Form PCS-102SUD including approval to work on contract; and F. Subcontract, if applicable.

2.13.3 Billing Records

A. Copy of all pre-bills provided by DFPS and submitted by the Contractor as an invoice;

B. Form 2016, delivered Services Input;

C. Form 4116X, State of Texas Purchase Voucher;

D. Documentation clearly establishing date signed invoice was submitted; and E. Any other supporting documentation requested by DFPS.

2.14 Required Reports

Table 2 - Required Reports

2.14.1 Substance Abuse Assessment

A. Elements and items identified in Section 2.11.1, Substance Abuse Assessment.

2.14.2 Form 2040, Substance Abuse Treatment and Intervention Exception Form

A. Information referenced in Form 2040 applicable to the event or information being reported.

2.14.3 Treatment Plans

D. Treatment plan must be updated at least every ninety (90) days and at one (1) year if services are still authorized.

2.14.4 Quarterly Summary Notes

A. Elements and items identified in Section 2.12.3, Quarterly Summary Notes.

2.14.5 Substance Abuse and Alcohol Testing

2.14.6 Discharge Plan

A. Elements and items identified in Section 2.12.4, Discharge Plan.

2.14.7 Contract Performance Data Report

2.14.8 Complaint Report

2.15 Performance Measures

Pursuant to Texas Human Resources Code §40.058, all contracts for client services must include clearly defined goals and outcomes that can be measured to determine whether the objectives of the program are being achieved.

DFPS reserves the right to revise performance measures at any time deemed necessary by the Department. Contractors will receive notice prior to any changes to performance measures. Upon notice of changes to the performance measures, Contractors may agree to the changes or opt to cancel the contract in accordance with contract requirements.

2.15.1 Performance Measures

CRITICAL TASK #1

PERFORMANCE PERIOD: Contractor performance for this measure is determined for one or more of the following Performance Periods, wholly or partially, depending on the contract start and end dates: September 1 through February 28/29 (Performance Period 1); March 1 through August 31 (Performance Period 2).

INDICATOR: Percent of Initial Treatment plans delivered to DFPS Caseworker(s) within twenty-one (21) business days following initial referral for treatment.

TARGET: 95%

DATA SOURCE: Self-reported by Contractor.

METHODOLOGY:

Numerator:

The total number of Initial Treatment plans (from the denominator) delivered to DFPS Caseworker(s) within twenty-one (21) business days of receipt of required referral documents.

Denominator:

The total number of Initial Treatment plans due to DFPS Caseworker(s) after receipt of required referral documents during the Performance Period.

CRITICAL TASK #2

PERFORMANCE PERIOD: Contractor performance for this measure is determined for one or more of the following Performance Periods, wholly or partially, depending on the contract start and end dates: September 1 through February 28/29 (Performance Period 1); March 1 through August 31 (Performance Period 2).

INDICATOR: Percent of clients’ admission(s) of current drug use or abuse of alcohol or clients’ positive test result(s) reported to DFPS Caseworker(s) within twenty-four (24) hours.

TARGET: 95%

DATA SOURCE: Self-reported by Contractor.

METHODOLOGY:

Numerator:

The total number of clients’ admission(s) of current drug use or abuse of alcohol or clients’ positive test result(s) (from the denominator) communicated to DFPS Caseworker(s) and documented within twenty-four (24) hours.

Denominator:

The total number of clients’ admission(s) of current drug use or abuse of alcohol or clients’ positive test result(s) (while under the Contractor’s care) during the Performance Period.

2.15.2 Performance Measure Requirements

The Contractor will be responsible for supporting the collection of performance measure data for Critical Task #1 & Critical Task #2 as well as other required metrics. The Contractor must:

A. Enter the total number of Initial Treatment plans due to DFPS Caseworker(s) after receipt of required referral documents during the Performance Period.

B. Enter the total number of Initial Treatment plans delivered to DFPS Caseworker(s) within twenty-one (21) business days of receipt of required referral documents during the Performance Period.

C. Enter the total number of clients’ admission(s) of current drug use or abuse of alcohol or clients’ positive test result(s) (while under the Contractor’s care) during the Performance Period.

D. Enter the total number of clients’ admission(s) of current drug use or abuse of alcohol or clients’ positive test result(s) (while under the Contractor’s care) communicated to DFPS Caseworker(s) and documented within twenty-four (24) hours.

E. Keep all records of: clients, client referral documentation including 2054s, authorized services and services provided, client evaluations or assessments, test results, treatment plans, discharges, admissions of use, and all other data associated with the verification of Performance Measure data, and all other contractually required or associated data, as well as verification of submission on file and available to DFPS upon request for the time period specified by DFPS for records maintenance. The records must be maintained in a manner to allow for ease in testing of the validity of the results being reported. Required documentation must be maintained for each Performance Period, including a copy of the performance results which were reported to DFPS Contract Performance.

F. Report the Performance Measure data for each Performance Period using the web based PMET (Performance Management Evaluation Tool). An account must be registered in the PMET system following the provision of the first service provided under this contract. The Contractor TIN (Taxpayer Identification Number) and the Contract Number are needed to register. Instructions can be found at www.dfps.state.tx.us/application/PCSPMET. Select Help > PMET User Guide.

a. Comply with report date timeframes. Performance Measure reporting is to be entered into PMET within 30 days of the end of the Performance Period in accordance with the table below.

2.16 Continuity of Treatment Care

2.16.1 The Contractor must ensure continuity of care.

2.16.2 The term continuity is used to refer to the client record or information as it applies to treatment providers working with parents or caregiver involved in a case with CPS. The documentation of client records is thought to improve the quality of care in at least two ways:

A. First by improving efficiency by preventing duplication and promoting follow-up of important clinical findings; and B. Second, by reducing possible harm by preventing inappropriate actions or taking actions that the patient has expressly declined.

2.16.3 A continuous treatment relationship is thought to promote trust which is a core part of the clinician-patient relationship and can itself be a part of the healing process. In the event there is a reason for a treatment provider to discontinue treatment provision to a client, that provider must:

A. Work with the new provider to prevent a disruption in treatment; and, B. Provide client records to the new treatment provider that contains all relevant information and is up-to-date, accurate, retrievable, understood, and used by the new provider.

C. New providers are required to read and use the information as they work with the new client.

2.17 Develop, Manage, and Maintain Quality

2.17.1 Quality Product Delivered to DFPS

The Contractor must implement and maintain quality assurance to ensure the product satisfies the requirements of this contract. Contractor must respond to feedback from appropriate parties relative to services provided under contract and incorporating that feedback into SUD services provided to DFPS.

The Contractor must monitor, evaluate, and apply actions necessary for continuous improvement of SUD services.

2.17.2 Timely Product Delivered to DFPS

Contractor must manage referrals to ensure timeframes and quality expectations can be met.

2.18 Provide Contract Maintenance

2.18.1 Contract Monitoring and Evaluation

The contractor must cooperate with DFPS in monitoring and evaluating services provided under this contract.

2.18.2 Provide Feedback to CPS Staff

At the request of DFPS, the Contractor must provide DFPS informal information on the status and progress of referrals. The informal information will be at no charge to DFPS.

2.18.3 Participate in Contract Meetings

DFPS can request meetings related to the contract, such as complaint investigations, billing issues, and other contract related issues. The Contractor and appropriate Service Providers must attend contract meetings at no cost to DFPS.

2.19 Contractor Insurance Requirements

In order to mitigate risk under this Contract, DFPS will require the Contractor to submit required verification of insurance/bond coverage that meets or exceeds current minimum DFPS insurance requirements and Certificate of Insurance (COI) or equivalent for each policy currently in force and referenced within, before this Contract is executed.

2.19.1 If the coverage will be provided through an insurance policy or other similar insurance document, then the issuing insurance company has to be authorized to do business in the State of Texas and have "B" rating. Contractor must attach the A.M. Best rating for all insurance companies issuing insurance policies for the contract insurance requirements.

2.19.2 All required insurance policies will include an endorsement stating that the Department will be given thirty-(30) calendar days written notice of policy or bond cancellation or a material change in the policy or bond. If a Contractor is unable to obtain applicable coverage after completing good faith efforts that have been documented in the contract file, the Contractor will bear the cost of any losses during the entire term of the agreement.

2.19.3 If the coverage will be provided through a Self-Insurance Plan, then the plan submitted has to demonstrate that it meets or exceeds these requirements.

2.19.4 The Contractor will provide DFPS with documentation that meet these requirements. DFPS reserves sole discretion to determine whether a document provided to DFPS meets the current minimum insurance requirements, coverage, or limits.

2.19.5 The following current DFPS minimum insurance coverage and limits must be maintained throughout the resulting Contract term.

A. Commercial General Liability Insurance or equivalent insurance coverage including, but not limited to, liability with minimum combined bodily injury (including death) and property damage limits of $1,000,000 per occurrence and $2,000,000 aggregate.

B. Commercial Crime Insurance or equivalent insurance coverage to cover losses from fraudulent and dishonest acts with a minimum limit of $25,000. The Commercial Crime Insurance or equivalent insurance coverage must include a third-party endorsement and an employee dishonesty endorsement or equivalent endorsements. Sole Proprietors with no employees or other individuals with access to fiscal resources such as unpaid volunteers or independent contractors, are exempt from this insurance requirement.

C. Professional Liability insurance or equivalent insurance coverage to cover losses from errors and omissions during professional services with a minimum limit of $1,000,000 per occurrence and $2,000,000 aggregate.

Insurance may be…