ESBD_File_342808_HHS0014002v2_Inpatient Psychiatric Stabilization and Transition Beds for Children (5).pdf

Stephanie Muth, Commissioner

Request for Information (RFI) for

Inpatient Psychiatric Stabilization and Transition Beds for Children

RFI No. HHS0014002v2

Date of Release: 11/17/2023

Responses Due: 12/19/2023

NIGP Class/Item Codes:

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.

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Table of Contents

1. Introduction

1.1 Purpose

1.2 Background

1.3 RFI Objectives

2. General Instructions and Response Requirements

2.1 Response Requirements

2.2 Response Submission, Date, Time and Location

2.3 Designated Point of Contact

2.4 Response Format

2.5 Texas Public Information Act

2.6 Disclaimers

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1. Introduction

The Health and Human Services Commission (HHSC) Procurement and Contracting Services (PCS) on behalf of the Department of Family and Protective Services (DFPS) Child Protective Services Program (CPS) is issuing a Request for Information (RFI) to receive information regarding a range of psychiatric stabilization, psychiatric transition, and placement services for children who have a history of placement instability due to frequent psychiatric hospitalizations and require highly structured support and treatment.

DFPS is gathering information on the current statewide capacity of all psychiatric hospitals, inpatient behavioral health programs, Residential Treatment Centers (RTC), and Community Crisis Respite Centers to provide extended stay inpatient psychiatric stabilization or psychiatric transition beds for children with complex behavioral health needs in DFPS conservatorship.

Information regarding DFPS and its programs is available online and can currently be accessed at http://www.dfps.state.tx.us/.

HHSC PCS will administer the procurement process for this RFI and manage Respondent communications as well as the receipt of Solicitation Responses for review and evaluation.

1.1 Purpose

This RFI is to obtain information on the availability and capability for operating inpatient psychiatric stabilization beds, psychiatric transition beds, or community beds for up to 90 days for children with complex behavioral health needs in DFPS conservatorship. DFPS seeks information on current psychiatric hospitals, RTCs, and community resources and capacity to serve this population and what current challenges are to expanding the availability of this service in Texas.

The psychiatric inpatient stabilization program will provide daily care, supervision, assessment, training, education and treatment services that meet the needs of this small population of children and youth. Psychiatric inpatient stabilization programs will provide “active treatment” (intended to reduce or eliminate symptoms) to individuals with serious mental illness in need of psychiatric stabilization or transition to a community setting. The psychiatric inpatient stabilization program will provide daily care, supervision, assessment, training, education, and treatment services that meet the needs of these children and youth. Services will be delivered by staff that have advanced training and skills in safely serving children that are with severe psychiatric symptoms.

In partnership with facilities providing acute services, this time-limited psychiatric inpatient stabilization program is intended to expand the type of capacity available in the Texas foster care continuum by allowing an in-state

RFI No. HHS0014002 3 of 8RFI No. HHS0014002v2 3 http://www.dfps.state.tx.us/ solution to assist and provide more stability to a child or youth with a history of psychiatric hospitalizations who is no longer considered acute but needs more supports in order to transition to a less restrictive child care setting.

Treatment provided under this model will include an extended trauma-informed therapeutic, behavioral, and social milieu intervention in a highly structured hospital or residential type setting. Additionally, this treatment model will promote healthy well-being, provide educational services, and community interaction to prepare the child/youth for transition to a less restrictive setting upon successful completion of the psychiatric inpatient stabilization program.

Multiple community providers are already offering similar psychiatric inpatient stabilization programs. One provider’s “Youth Therapeutic Respite Program” is a crisis respite program offered to provide short-term care (30 days) for youth who need wraparound care (therapies, care coordination, family services, psychiatric evaluation, medication management). Youth receive individualized treatment plans to resolve the crisis, increase coping skills, and stabilize the placement.

Information being sought should be as specific as possible to provide DFPS local input to best determine statewide need, impact, and potential cost to develop a programmatic framework for potential implementation. DFPS is also interested in obtaining information on current hospital or community services or barriers to serving a population that may include:

a. Children who may be survivors of Domestic Minor Sex Trafficking (DMST) or other forms of Commercial Sexual Exploitation (CSE), domestic violence, or sexual assault.

b. Children who have experienced trauma including abuse.

c. Children with complex mental health needs.

d. Children who are physically aggressive.

e. Children over the age of 13.

f. Children with an intellectual or developmental disability; including

Autism Spectrum Disorder.

g. Children who may exhibit other high risk or high need behavior(s).

h. Children with coexisting medical conditions and behavioral health needs.

1.2 Background

DFPS would like to obtain information on inpatient and community psychiatric options for children available in Texas with the intent of evaluating feasibility of establishing a child-specific model.

Due to the nature of some mental illness and/or serious emotional disorders, manifesting in extremely destructive behaviors (destroying property, aggression, threat of harm to self or others, etc.), certain children require an

RFI No. HHS0014002 4 of 8RFI No. HHS0014002v2 4 extended time to stabilize from an acute psychiatric hospitalization. To discharge them to a less restrictive childcare setting prior to stabilization or transition often can result in a revolving door of repeated brief hospitalizations with very little continuity in treatment or ability to benefit from treatment. An extended highly structured inpatient clinical treatment program is ideal in stabilizing this population of children as well as preparing them for success in a less-restrictive child-care setting that supports permanency.

To be eligible to receive these services, a child/youth must meet all of the following criteria. The child/youth must:

a. Be in DFPS conservatorship;

b. Be between the ages of 6-17; and

c. All of the following criteria apply:

1. Has a mental illness or demonstrates symptoms of a serious emotional disorder;

2. Presents a risk of serious harm to self or others if not immediately restrained or hospitalized; and

3. Has a history of placement instability, due to a history of psychiatric hospitalizations.

1.3 RFI Objectives

This RFI is issued for the purpose of obtaining information regarding inpatient psychiatric stabilization, psychiatric transition, and crisis respite capacity for children to support the agency and its programs. All interested parties, including hospitals, RTCs, and/or other health-care related organizations are encouraged to respond to this RFI.

This RFI does not constitute a solicitation of proposals, a commitment to conduct procurement, or an offer of a contract or prospective contract. DFPS will not award a contract directly as a result of this RFI. DFPS will not be liable for any costs incurred by respondents in the preparation and submission of information in response to this RFI.

All information received by DFPS becomes the property of DFPS and will not be returned to the sender. There will be no acknowledgement by DFPS of receipt of the information. Acceptance of responses to this RFI places no obligations of any kind upon DFPS.

The descriptions presented in this RFI are tentative and may undergo change prior to actual release of any potential RFI related to the scope of this RFI. It is not the intent of DFPS to provide answers, but if additional information is issued related to the RFI, it will be made available on the Electronic State Business Daily (ESBD).

RFI No. HHS0014002 5 of 8RFI No. HHS0014002v2 5 http://www.txsmartbuy.com/esbd http://www.txsmartbuy.com/esbd

2. General Instructions and Response Requirements

2.1 Response Requirements

Respondents are encouraged to provide information regarding, but not limited to, the following aspects of their proposed system:

Implementation Approach

1. How would your organization implement an (60-90 days) inpatient stabilization or community psychiatric beds for the population in Section 1.2? Describe any existing resources that could be used for this population and any needed resources and changes for implementation including a requested bed day rate.

2. Describe how many extended stay inpatient stabilization or community beds your organization would be able to provide considering current constraints. Does your organization have a separate unit that could be used for this population?

3. Describe the staffing patterns that would be appropriate for a psychiatric inpatient stabilization unit for the population in Section 1.2.

4. Describe how children could be referred to a psychiatric inpatient stabilization program or community unit.

5. How would your organization manage brief needs for acute services for children admitted to the psychiatric inpatient stabilization program?

Operational Costs

6. Describe costs associated with implementing a stabilization (60-90 days) inpatient or community psychiatric beds for a high-risk youth population.

General Questions

7. Would your organization be able to accommodate this high-risk population? Describe the barriers with serving this population and any pre-requisites your organization may have prior to accepting this population.

8. What are your organization’s training needs to best serve children who have a dual diagnosis of a serious mental illness and intellectual and developmental disability or Autism Spectrum Disorder? What are other barriers to serving this population?

9. What services would your organization be able to provide on a daily and weekly basis to children and youth that are admitted to a psychiatric inpatient stabilization program or discharged from an acute psychiatric hospital stay?

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10. In what ways would a stabilization bed be different than an acute psychiatric bed at your organization?

11. How does your organization network with other child-serving agencies in your area to provide continuity of care for children once they are discharged? Are there barriers to this networking? If so, please list.

12. What type of engagement would your facility provide with the legal guardians? Would the family be involved in your treatment modality?

Respondents are encouraged to provide any additional information which may assist

DFPS.

2.2 Response Submission, Date, Time and Location

DFPS welcomes written responses and comments related to this RFI by:

12/19/2023

Responses must be submitted via e-mail to DFPS’ designated point-of-contact, as identified in Section 2.2. Faxed responses or verbal inquiries will not be accepted. It is not the intent of DFPS to respond to comments or questions, but if additional information is issued relating to the RFI, it will be made available on the DFPS web site.

2.3 Designated Point of Contact

DFPS’ official single point of contact for this RFI and the delivery point for all responses and correspondence is:

Lauren Morgan E-mail: Lauren.Morgan2@dfps.texas.gov

All communications relating to this RFI must be directed to the DFPS contact person named above. All communications between respondents and other DFPS staff members concerning this RFI are strictly prohibited.

2.4 Response Format

All responses must be:

a. Clearly legible.

b. Sequentially page-numbered and include the respondent’s name at the top of each page.

c. Correctly identified with the RFI number and submittal deadline.

d. In Arial or Times New Roman font, size 12 for normal text, no less than size 10 for tables, graphs and appendices.

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e. Respondents must respond by email.

f. DFPS will not accept any submission or portion of a submission containing a copyright.

All pages of the response should include the RFI title consistently in either the footer or header of each page. The page limit for RFI responses is 20 pages.

Vendor should submit supporting material, if any, as attachments along with RFI responses. All proposals become the property of DFPS after submission.

2.5 Texas Public Information Act

A response submitted to this RFI is subject to the Texas Public Information Act (the Act), located in Texas Government Code Chapter 552 and may be disclosed to the public upon request. Subject to the Act, respondents may protect trade secret and confidential information from public release. If the respondent asserts that information provided in the proposal is trade secrets or other confidential information, it must be clearly marked such information in boldface type and include the words “confidential” or “trade secret” at top of the page. Furthermore, the respondent must identify trade secret or confidential information, and provide an explanation of why the information is excepted from public disclosure, on the Respondent Information and Disclosures form.

DFPS will process any request from a member of the public in accordance with the procedures outlined in the Act. Respondents should consult the Texas Attorney General’s website (www.oag.state.tx.us) for information concerning the Act’s application to proposals and potential exceptions to disclosure.

2.6 Disclaimers

DFPS and HHSC, at its sole discretion, may or may not issue a related solicitation or may issue multiple solicitations based on the responses to this RFI. Responding to this RFI is not a condition for eligibility to respond to any subsequent solicitation.

Responses to this RFI will not have any bearing, positive or negative, on the evaluation and respondent selection resulting from any proposals that may be received in response to any subsequent solicitation.

Any information received from respondents to the RFI in any form may be used by DFPS without restriction for any purpose determined by DFPS.

RFI No. HHS0014002 8 of 8RFI No. HHS0014002v2 8 http://www.statutes.legis.state.tx.us/DocViewer.aspx?K2DocKey=odbc%3a%2f%2fTCAS%2fASUPUBLIC.dbo.vwTCAS%2fGV%2fS%2fGV.552%40TCAS2&QueryText=552&HighlightType=1 http://www.oag.state.tx.us/