Exhibit A - Statement of Work.docx

Exhibit A

Exhibit A - Statement of Work Projects for Assistance in Transition from Homelessness (PATH)

1. Article 1: Purpose and Target Population

1.1. Purpose

1.1.1. The Projects for Assistance in Transition from Homelessness (PATH) Program was created as part of the Stewart B. McKinney Homeless Assistance Amendments Act of 1009 (P.L. 101.645; https://www.govinfo.gov/app/details/STATUTE-104/STATUTE-104-Pg4673) and subsequently reauthorized by Section 9004 of the 21st Century Cures Act (Public Law 114-255; https://www.congress.gov/bill/114th-congress/house-bill/34) and most recently reauthorized by Section 1218 of the Consolidated Appropriations Act, 2023 (Public Law 117-328; https://www.congress.gov/117/plaws/publ328/PLAW-117publ328.pdf). PATH is authorized under Sections 521 through 535 of the Public Health Service Act and is administered by the Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Mental Health Services (CMH; https://www.samhsa.gov/about-us/who-we-are/offices-centers/cmhs).

1.1.2. PATH represents one of the first major federal legislative responses to homelessness and provides funding to support community-based services for individuals, 18 years and older, with serious mental illness (SMI), including individuals with SMI and co-occurring substance use disorders (SUD), who are experiencing homelessness (https://www.congress.gov/bill/114th-congress/house-bill/34) or are at imminent risk of becoming homeless.

1.1.3. The Purpose of the Colorado (CO) PATH program is to support the delivery of outreach, behavioral health services and supportive resources to adult individuals (18 +) with serious mental illnesses (SMI), including those with SMI and co-occurring substance use disorder (COD) who are experiencing homelessness or at imminent risk of becoming homeless.

1.1.4. The Contractor shall provide outreach services, including both street outreach and service-setting (in-reach) outreach, in accordance with current SAMHSA PATH guidance; and case management services. Additional PATH services may include the provision and/or coordinate screening, diagnostic, treatment services, habilitation and rehabilitation services, community mental health and substance use disorder treatment, staff training, housing-related supportive services, and referrals to services that are not supported by mainstream mental health programs. Services shall be designed to engage individuals who experience barriers accessing traditional behavioral health and social service systems.

1.2. Target Population

1.2.1. Eligibility for PATH services shall be determined by the Contractor in accordance with applicable federal requirements under 42 U.S.C. § 290cc-21 through § 290cc-35 , Part C: Projects for Assistance in Transition From Homelessness (https://uscode.house.gov/view.xhtml?req=granuleid%3AUSC-prelim-title42-chapter6A-subchapterIII-A-partC&edition=prelim). To be eligible for PATH services, an adult individual must:

1.2.1.1. Be experiencing homelessness or be at risk of Homelessness.

1.2.1.2. Have a Serious Mental Illness (SMI). Individuals with SMI and COD may also be eligible to receive PATH services if SMI is their primary diagnosis.

2. Article 2: Definitions and Acronyms

2.1. “Case Management” Case management is an intentional intervention to assess individual needs to address barriers impacting behavioral or physical health. Case management includes planning, coordinating, and monitoring of services and resources to best address each individual.

2.2. “Co-Occurring Disorders (COD)” shall refer to individuals who have at least one serious mental illness and a substance use disorder, where the mental disorder and substance use disorder can be diagnosed independently of each other.

2.3. “Contact” shall refer to an interaction between a PATH-funded worker(s) and an individual who is potentially PATH eligible or enrolled in PATH. Contacts may range from a brief conversation between the PATH-funded worker and the client about the client’s well-being or needs, to a referral to service. A contact must always include the presence of the client—the facilitation of a referral between a PATH-funded worker and another case manager or service provider without the involvement of the client would not be considered a contact. A contact may occur in a street outreach setting or in a service setting such as an emergency shelter or drop-in center.

2.4. “Engagement” means the point at which an interactive client relationship results in a deliberate client assessment or the beginning of a case plan. Engagement is a one-time event, may occur on or after the project start date, and must occur prior to PATH enrollment and project exit. Clients cannot be enrolled in PATH without being engaged. Although some interactions with a client may result in a positive outcome such as assisting a client to access a shelter bed, without a deliberate client assessment or the beginning of a case plan, those interactions are not considered to be an engagement. The assessment does not have to be of a clinical nature, and neither HUD nor SAMHSA have established minimum criteria for what the assessment must include, other than the client deliberately engaging with the worker(s) to resolve the housing crisis.

2.5. “Enrollment” means the point at which the PATH-funded worker can determine if a person is eligible for the PATH Program. Only persons eligible for PATH can receive a PATH-funded service or referral. Additionally, the PATH-eligible individual and a PATH provider have mutually and formally agreed to engage in services and the provider has initiated an individual file or record for that individual. HMIS Data Element P3 PATH Status provides additional information regarding PATH enrollment.

2.6. “Government Performance and Results Act (GPRA)” requires federal agencies to track and report results, including measuring what funded programs accomplish. GPRA metrics are obtained through HMIS data.

2.7. “Homeless Management Information System (HMIS)” refers to a database used by service providers to securely track and coordinate housing, services, and client-level data for individuals and families experiencing or at risk of homelessness.

2.8. “Imminent Risk of Becoming Homeless” shall include one or more of the following criteria: doubled-up living arrangements where the individual’s name is not on a lease, living in a condemned building without a place to move, having arrears in rent/utility payments, receiving an eviction notice without a place to move, living in temporary or transitional housing that carries time limits, and/or being discharged from a health care or criminal justice institution without a place to live.

2.9. “Individual Experiencing Homelessness” shall be as least restrictive as defined by the PHS Act Section 33(h)(5)(A): “an individual who lacks housing (without regard to whether the individual is a member of a family), including an individual whose primary residence during the night is a supervised public or private facility that provides temporary living accommodations, and an individual who is a resident in transitional housing.

2.10. “Intended Use Plan (IUP)” A Brief description of the contractor’s organization, their participation in the Department of Housing and Urban Development’s (HUD’s) CoC program, their partnerships with local community organizations, and their plan to provide services to eligible PATH clients.

2.11. “Matching Funds” means non-Federal funds provided by the Subrecipient to satisfy statutory PATH program match requirements (42 U.S.C. 290cc-23). While federal law requires an overall $1 non-Federal match for every $3 of federal funds, Subrecipients must provide a non-Federal match equal to 36% of their federal subaward to account for the total state allocation. Matching funds must be expended concurrently with federal PATH funds, may consist of local public or non-Federal cash and/or in-kind contributions, and must support allowable PATH activities for PATH-enrolled individuals.

2.12. “Outreach” In the context of homelessness and serious mental illness (SMI), street outreach refers to the intentional efforts to locate unsheltered individuals in parks, encampments, abandoned buildings, or other locations they may congregate that are different than traditional clinic or shelter setting (also referred to as Street Outreach), to connect individuals with housing, health, and social services in order to address both their immediate safety needs and long-term recovery goals. Whereas “in-reach” (also referred to as Service Setting) outreach refers to the intentional, person-centered efforts to connect to individuals within more traditional settings such as clinics or service offices.

2.13. “PATH” means Projects for Assistance in Transition from Homelessness

2.14. “PATH DATA Exchange” (PDX) is a portal for PATH funded contractors to enter HMIS reporting data that informs quarterly progress and annual reports.

2.15. “PATH Funded Worker” means a staff member whose salary is paid for by PATH funds.

2.16. “Private nonprofit organization” means an organization that: -

2.16.1. (A) no part of the net earnings of which inures to the benefit of any member, founder, contributor, or individual;

2.16.2. (B) Has a voluntary board of directors;

2.16.3. (C) Has an accounting system or has designated a fiscal agent in accordance with requirements established by the Secretary; and

2.16.4. (D) Practices nondiscrimination in the provision of assistance.

2.17. “SAMHSA” means Substance Abuse and Mental Health Services Administration (SAMHSA)

2.17.1. https://www.samhsa.gov/grants

2.18. “Serious Mental Illness (SMI)” means adults, 18 years of age or older, with a diagnosable mental disorder of such severity and duration as to result in functional impairment that substantially interferes with or limits major life activities.

3. Article 3: Activities and Services

3.1. The Contractor shall provide the activities and services associated with the PATH continuum of care as described in this Article. The PATH continuum includes meeting individuals who may or may not be eligible for PATH-funded services, and continuing to gather information through relationship building to acquire data needed to determine eligibility. If eligibility criteria is met and an individual agrees to enrollment, a living individual service plan document is established to guide PATH-funded activities and services. While PATH legislation allows 8 major service categories (https://www.samhsa.gov/communities/homelessness-programs-resources/grants/path), The State of Colorado’s expectation is that each provider shall conduct both outreach services, including street outreach and service-setting (in-reach) outreach, in accordance with current SAMHSA PATH guidance and case management. In addition, providers may also conduct other legislatively allowable services as dictated by local needs.

3.2. Outreach and Engagement:

3.2.1. The Contractor shall conduct street outreach services, in-reach outreach, and community-based engagement activities to identify, contact, and engage individuals who may be eligible for PATH services. Outreach services shall be conducted at minimum 50% of program hours per week, and include:

3.2.1.1. Identifying and engaging individuals with SMI and are experiencing homelessness or are at imminent risk of homelessness. Examples of community based locations for PATH outreach include, but are not limited to:

a. Encampments or other areas where people who are unsheltered are living

b. Day shelters, Winter/Summer Cooling centers, community centers, or other public locations

c. frequented by people experiencing unsheltered homelessness

d. Emergency shelters

e. Food service programs

3.2.1.2. Outreach to veterans with SMI who are experiencing homelessness or are at imminent risk of homelessness.

3.2.1.3. Establishing contact and building relationships with individuals who may not currently be connected to mainstream behavioral health or supportive services;

3.2.1.4. Conducting engagement activities necessary to support PATH enrollment;

3.2.1.5. Coordinating connections to behavioral health, housing, healthcare, and other community-based resources.

3.3. Case Management:

3.3.1. The Contractor shall provide and or coordinate the following case management services based on individual participant needs and eligibility. When services are provided through external community partners, the Contractor shall maintain documentation of referrals and coordination efforts. Case management services and supportive services shall include:

3.3.1.1. Preparing an individualized plan for the provision of community mental health services to eligible PATH participants and reviewing such plan not less than once every three (3) months;

3.3.1.2. Providing assistance in obtaining and coordinating social and maintenance services for eligible individuals who experience homelessness, including:

a. Services related to daily living activities;

b. Peer support;

c. Personal financial planning;

d. Transportation;

e. Habilitation and rehabilitation;

f. Prevocational and vocational training, and

g. Housing services.

3.3.1.3. Providing assistance to eligible individuals in obtaining income support services, including:

a. Housing assistance;

b. Food assistance, and

c. Supplemental Security Income (SSI) benefits, as applicable;

3.3.1.4. Referring eligible individuals to other appropriate services

3.3.1.5. Providing representative payee services in accordance with Section 1631(a)(2) of the Social Security Act, when applicable, if the eligible individuals are receiving aid under Title XVI of such Act;

3.3.2. Behavioral Health Services and Referrals:

3.3.2.1. The Contractor shall provide and/or coordinate the following services, as needed, for individuals with SMI and SMI and COD who are experiencing homelessness or at imminent risk of becoming homeless:

a. Screening and diagnostic services;

b. Habilitation and rehabilitation services;

c. Community mental health services, including recovery support services, such as peer specialist and/or recovery coaches;

d. Alcohol or drug treatment services;

e. Staff training as needed;

f. Provide supportive and supervisory services in residential settings, including shelters, group homes, supported apartments and other residential settings specifically serving those living with SMI or SMI and COD; and

g. Provide referrals for primary health services, job training, educational services, and relevant housing services.

3.4. Housing Services:

3.4.1. The Contractor shall provide and/or coordinate housing services, as specified in Section 522(b)(10) of the Public Health Service (PHS) Act as amended (USC Section 290cc-22(b)) (https://www.govinfo.gov/content/pkg/COMPS-8776/pdf/COMPS-8776.pdf). Housing services shall not exceed 20% of the Contractor’s PATH budget, and may include:

3.4.1.1. Minor renovation, expansion and repair of housing;

3.4.1.2. Planning of housing;

3.4.1.3. Technical assistance in applying for housing assistance;

3.4.1.4. Improving the coordination of housing services;

3.4.1.5. Security deposits;

3.4.1.6. Costs associated with matching eligible individuals who are experiencing homelessness with appropriate housing situations; and

3.4.1.7. One-time rental payments to prevent eviction.

3.5. HMIS Data Entry

3.5.1. To be aligned with SAMHSA expectations the contractor shall enter PATH data into HMIS in accordance with PATH Program HMIS Manual.

3.5.1.1. https://files.hudexchange.info/resources/documents/PATH-Program-HMIS-Manual.pdf

3.6. Program Coordination and Administration:

3.6.1. The Contractor shall collaborate with the U.S. Department of Housing and Urban Development (HUD) Continuum of Care (CoC) Program (https://www.cohmis.org/) to access and properly utilize the Homeless Management Information System (HMIS) for coordinated entry, and PATH data entry, and to access training and technical assistance. The contractor shall follow SAMHSA PATH guidelines for data entry as outlined in the PATH Program HMIS Manual (Link included in 3.5.1.1).

3.6.2. The Contractor shall coordinate with other community partners, including behavioral health providers, housing providers, health providers and other organizations serving individuals experiencing homelessness, as appropriate.

3.6.3. The Contractor shall attend bimonthly meetings facilitated by BHA. Meetings may include, but are not limited to:

3.6.3.1. Program updates;

3.6.3.2. State-level requirements;

3.6.3.3. Data entry;

3.6.3.4. HMIS submissions;

3.6.3.5. Billing requirements;

3.6.3.6. Contracted services;

3.6.3.7. Training opportunities;

3.6.3.8. Strategies to improve program quality;

3.6.3.9. Annual reporting requirements;

3.6.3.10. Guidance from the Substance Abuse and Mental Health Services Administration (SAMHSA), including reporting requirements.

3.6.4. The Contractor shall coordinate with BHA to schedule and participate in PATH program site visits as requested by BHA.

3.7. The Contractor shall collect and report PATH program data (https://cthmis.com/wp-content/uploads/2024/08/Intro%20to%20PATH%20Data%20Collection%20for%20Providers%206.17.24.pdf) through HMIS and applicable PATH reporting systems, including the PATH Data Exchange (PDX; https://pathpdx.samhsa.gov/users/sign_in), in accordance with applicable federal PATH program requirements and reporting instructions provided by SAMHSA. The Contractor shall:

3.7.1. Collect PATH data through the Homeless Management Information System (HMIS);

3.7.2. Ensure all PATH program annual data is submitted through the PATH Data Exchange (PDX) via reports generated through HMIS.

3.7.3. Develop actions to facilitate flexible use of PATH administrative funds to support HMIS activities, as applicable;

3.7.4. Report Government Performance and Reporting Accountability (GPRA) data into HMIS, which measure outcomes, and coordinated services across their community's homeless service system to meet federal and state grant requirements and includes:

3.7.4.1. Number of homeless persons contacted;

3.7.4.2. Percentage of enrolled homeless persons in the PATH program who receive community mental health services; and

3.7.4.3. Percentage of contacted homeless persons with serious mental illness who become enrolled in services.

3.7.5. To comply with SAMHSA requirements, the Contractor shall report the following outcome measures:

3.7.5.1. Number of persons referred to and attaining housing;

3.7.5.2. Number of persons referred to and attaining mental health services; and

3.7.5.3. Number of persons referred to and attaining substance use disorder services.

3.8. Financial Management and Fiscal Compliance

3.8.1. Financial Management and Allowable Costs.

3.8.1.1. The Contractor shall maintain financial management systems, accounting records, and internal controls sufficient to ensure that all PATH expenditures are allowable, reasonable, necessary, allocable, and adequately documented in accordance with 2 CFR Part 200, applicable PATH and SAMHSA requirements, and all BHA contract requirements.

3.8.1.2. The Contractor shall maintain documentation supporting all expenditures and make such records available to BHA upon request for monitoring, audit, or financial review.

3.8.2. Budget Management.

3.8.2.1. The Contractor shall expend funds in accordance with the approved contract budget. Any budget revisions requiring BHA approval shall be submitted in accordance with contract requirements before implementation.

3.8.3. Dual Funding and Cost Allocation.

3.8.3.1. In accordance with 2 CFR § 200.306, 403, 405(c)(d), the Contractor shall ensure PATH funds are not used to duplicate payment or reimbursement for the same service, activity, or cost.

3.8.3.2. When multiple funding sources support related activities, the Contractor shall maintain sufficient fiscal and programmatic controls to ensure expenditures are appropriately allocated and duplicate reimbursement does not occur.

4. Article 4: Minimum Qualifications.

4.1. The Contractor shall possess the organizational capacity, qualifications, and resources necessary to perform the services described in this Statement of Work. The Contractor shall comply with all applicable federal, State, and local laws, regulations, and program requirements related to the services provided under this Contract.

4.2. Organizational Licensure and Compliance

4.2.1. The Contractor shall maintain all applicable licenses, certifications, and approvals required to provide the services described in this Scope of Work.

4.2.2. If the Contractor directly provides behavioral health treatment services, including mental health or substance use disorder treatment services, the Contractor shall maintain all applicable BHA licenses and any other required State or federal licenses throughout the duration of the Contract.

4.3. Personnel Qualifications

4.3.1. The Contractor shall ensure staff providing PATH services have the appropriate qualifications, experience, training, and credentials necessary to perform assigned duties, including experience serving individuals experiencing homelessness, individuals with SMI, and individuals with SMI and COD.

4.4. Organizational Experience and Capacity

4.4.1. The Contractor shall demonstrate experience providing outreach and community-based services to individuals experiencing homelessness or who are at imminent risk of homelessness, including individuals with SMI and COD.

4.4.2. The Contractor shall demonstrate the ability to provide or coordinate outreach, case management, behavioral health services, housing-related services, referrals, and community partnerships necessary to support PATH participants.

4.4.3. The Contractor shall demonstrate experience providing fiscal oversight to ensure Good Accounting Practices (GAP) including but not limited to:

4.4.3.1. Allowable expenses align with budget;

4.4.3.2. Reimbursement documentation is provided for each invoice;

4.4.3.3. Timely invoice submission;

4.4.3.4. Matching funds are accounted for on each invoice.

4.5. Data Reporting Capability

4.5.1. The Contractor shall demonstrate the ability to collect, maintain, and report PATH program data through required reporting systems, including HMIS and the PATH Data Exchange (PDX), as applicable. All data collection points in the PATH Program HMIS manual shall be collected in an accurate manner.

5. Article 5: Deliverables.

5.1. The Contractor shall submit the following deliverables in accordance with the timelines identified below. Deliverables shall support monitoring of PATH program activities, participant services, program performance and compliance with applicable PATH reporting requirements.

5.2. The Contractor shall submit an annual PATH report through the PATH Data Exchange (PDX) in accordance with applicable PATH reporting requirements.The report shall include, at a minimum, information related to:

5.2.1. PATH participants served;

5.2.2. Outreach and engagement activities;

5.2.3. Services provided;

5.2.4. Participant referrals and outcomes;

5.2.5. Required performance measures; and

5.2.6. Other information required through the PATH reporting system.

5.2.6.1. DELIVERABLE: PATH Annual Report

5.2.6.2. DUE DATE: November 1st of each Contract year

5.2.6.3. DELIVERED TO: PATH Data Exchange (PDX); https://pathpdx.samhsa.gov/

5.3. The Contractor shall submit quarterly progress reports through PDX on the 30th day following the end of each quarter. This report should include year-to-date program data from information collected from HMIS reports.

5.3.1.1. DELIVERABLE: Quarterly PATH Progress Report

5.3.1.2. DUE DATE: 30th Day following the end of each quarter :Q1 - July-September, Q2 Oct-December, Q3 Jan-March, Q4 April-June

5.3.1.3. DELIVERED TO: PATH Data Exchange (PDX); https://pathpdx.samhsa.gov/

5.4. The Contractor shall submit an annual Intended Use Plan (IUP) on an annual basis within two (2) weeks of BHA request. The IUP shall include, at a minimum:

5.4.1. Description of the Contractor's planned use of PATH funds;

5.4.2. Planned services and activities;

5.4.3. Target population to be served;

5.4.4. Collaboration with community partners; and

5.4.5. Other information required by BHA.

5.4.5.1. DELIVERABLE: Annual Intended Use Plan

5.4.5.2. DUE DATE: Within Two (2) Weeks of BHA Request

5.4.5.3. DELIVERED TO: BHA PATH Program Manager

5.5. The Contractor shall provide non-federal matching funds equal to 36% of the federal subaward amount. This match fulfills the subrecipient’s proportional share of the statutory 1:3 non-federal match requirement for the State’s overall PATH grant award.

5.5.1. The Contractor shall submit a matching funds report with each monthly invoice documenting how the matching requirement was met.

5.5.2. Documentation shall include allowable expenses supporting the reported match contribution.

5.5.3. Federal funds shall not be used as a matching source.

5.5.3.1. DELIVERABLE: Matching Funds Report and Supporting Documentation

5.5.3.2. DUE DATE: Monthly accounting with invoice and supporting reimbursement documentation.

5.5.3.3. DELIVERED TO: cdhs_bhapayment@state.co.us

5.5.3.4. FILE NAME: Vendor Name - FY[XX] - PATH Matching Funds Report and Supporting Documentation

5.6. Deliverables Table

PATH Data Exchange (PDX); https://pathpdx.samhsa.gov/

5.6.1. Deliverable deadlines occurring after contract end date are contingent upon contract renewal.

5.6.2. Deadlines may be altered administratively

6. Article 6: Performance Outcome Measures

6.1. The Contractor’s performance shall be monitored through the following outcome measures. These measures are intended to assess program effectiveness and progress toward achieving PATH program goals. Outcome data shall be collected and reported in accordance with applicable PATH, BHA, and SAMHSA reporting requirements, including the reporting requirements identified in Article 5 – Deliverables.