Final_RFP_729_2100000136_1_SO_FORM.PDF

Document ID: RFP 729 2100000136 Page: 1

Commonwealth of Kentucky

SOLICITATION

Addenda: No Addenda #:

TITLE: Outwood ICF Management & Operations (C2749)

Date Issued:

4/15/21 Record Date:

2021-04-09

Solicitation Closes Date:

5/28/21 Time:

14:00

Solicitation No:

RFP 729 2100000136

Online Bidding Prohibited: Yes

For Information Call:

David Locker 502-564-7736

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See Terms & Conditions for Bid Submission Instructions

Other KY

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__ Sole Proprietorship __ Partnership __ Corporation __ Other_________________________

SIGNATURE OF AUTHORIZED AGENT IS REQUIRED UNLESS RESPONSE

IS SUBMITTED ELECTRONICALLY. FAILURE TO SIGN SHALL RENDER

THE BID INVALID.

Signature X_________________________________________ FEIN#____________________ Date____________

All offers subject to all terms and conditions contained in this solicitation.

Document ID: RFP 729 2100000136 Page: 2

Line Items

Commodity Group: Default

Line CL Description Quantity UOM Unit Cost Line Total or Contract Amnt

1 FY22 Management Fee (TSMD)

Comm Code Comm Description Manufacturer Model # Manuf Part #

952PS PSC-HUMAN SERVICES

Extended Description FY22 Management Fee (TSMD)

Line CL Description Quantity UOM Unit Cost Line Total or Contract Amnt

2 FY22 Personnel & Operating (TSMD)

Comm Code Comm Description Manufacturer Model # Manuf Part #

952PS PSC-HUMAN SERVICES

Extended Description FY22 Personnel & Operating (TSMD)

Shipping Information

Billing Information CHFS DBHDID - Commissioner

275 E Main Street 4WF

Frankfort KY 42240

Document ID: RFP 729 2100000136 Page: 3

Submission Checklist

The following items will be required to be submitted with bid:

Item Technical Proposal 1250 points Cost Proposal 500 points Oral Presentation (If Applicable) 300 points

Revised February 2021

PROPOSAL SUBMISSION CHECKLIST

The contractor MUST include the following with the proposal submission.

If the items highlighted below are not submitted with the proposal submission, the Commonwealth MUST deem the proposal non-responsive and SHALL NOT consider for award.

All other items MUST be submitted prior to award.

_____ SIGNED AND COMPLETED SOLICITATION (Section 8.10 of this RFP (not required is submitting electronically)

_____ *PROPOSED SOLUTION (TECHNICAL) UNDER SEALED COVER AND BY CLOSING DATE

Section(s) 8.00 and 8.10 of this RFP

_____ *PROPOSED SOLUTION (COST) UNDER SEALED COVER AND BY CLOSING DATE

Section(s) 8.00 and 8.20 of this RFP

_____ TRANSMITTAL LETTER – Section 8.10 of this RFP

_____ PROOF OF REGISTRATION WITH SECRETARY OF STATE BY A FOREIGN ENTITY

(Section 8.01 of the Personal Service Contract Terms and Conditions of this RFP)

_____ REQUIRED AFFIDAVIT(S) – Section 8.01of this RFP

_____ PROOF OF LIABILITY, MALPRACTICE, WORKERS COMPENSATION INSURANCE, AND

CERTIFICATES OR PROFESSIONAL (MEDICAL) AND CONTRACTUAL LIABILITY INSURANCE AT A

MINIMUM OF $1,000,000 PER INCIDENT AND $3,000,000 PER YEAR. – Section 2.06 of this RFP

*The Commonwealth defines SEALED as “a closure that must be broken to be opened and that thus reveals tampering” (Merriam-Webster Dictionary, https://www.merriam-webster.com/dictionary/seal

REQUEST FOR PROPOSAL

FOR

PERSONAL SERVICE CONTRACT

Cabinet for Health and Family Services/Department for Behavioral Health, Developmental and Intellectual Disabilities Outwood Intermediate Care Facility Management and Operations

RFP 729 2100000136

Document Description Page 4

2100000136 Outwood ICF Management & Operations (C2749) https://www.merriam-webster.com/dictionary/seal

This document constitutes a Request for Proposals for a Personal Service Contract from qualified individuals and organizations to furnish those services as described herein for the Commonwealth of Kentucky, Cabinet for Health and Family Services on the behalf of the Department for Behavioral Health, Developmental and Intellectual Disabilities.

Offerors are advised that any personal service contract resulting from this RFP must comply with all applicable provisions of KRS 45A and KRS 12.210 prior to becoming effective.

A contract, based on this RFP, may or may not be awarded. Any contract award from this RFP is invalid until properly approved and executed by the Finance and Administration Cabinet and filed with the Legislative Research Commission, Government Contract Review Committee.

1.00 Purpose and Background

It is the purpose of this Request for Proposal for the Cabinet for Health and Family Services (CHFS), Department for Behavioral Health, Developmental and Intellectual Disabilities (DBHDID) to obtain the contract services of a single entity to manage and operate Outwood Intermediate Care Facility/Individuals with Intellectual Disability (ICF/IID) (Outwood), a state owned intermediate care facility licensed to support up to eighty (80) people located on Highway 109, in Dawson Springs, Kentucky. The census as of 10/27/2020 is 32.

From 1922 until 1962, Outwood was operated as a veteran’s hospital by the Veteran’s Administration.

In 1962, the facility was deeded to the Commonwealth of Kentucky by the Veteran’s Administration for a residential facility for persons with intellectual and developmental disabilities. In June 1974, the Commonwealth decided to replace the existing physical plant with a 300 person facility, and a contract with private management for the operation of the facility. On August 1, 1975, the Commonwealth contracted with Excepticon, Inc. for the operation and management of the facility. On August 29, 1977, the then Department for Human Resources revised its plans from a 300 bed facility to a 176 bed facility.

However, litigation delayed construction. On November 14, 1980, the Department for Human Resources decided to proceed with construction of an 80 person replacement ICF/IID facility. The new facility was occupied on September 7, 1983, under the management of ResCare, Inc. The company has had the management contract since that time.

The Outwood campus is located in the northwestern corner of Christian County, approximately three (3) miles south of Dawson Springs and 24 miles north of Hopkinsville on State Highway 109. The facility occupies approximately 185 acres of land. The old campus property impacts approximately 75 to 80 acres of the total tract at its highest point of elevation. The remaining acreage is moderately sloped and landscaped. This portion of the property covers approximately 60-65 acres and is the site of the new facility.

The Contractor shall provide a full range of residential services including assessment, evaluation and treatment of residents in accordance with the highest standards of care, humanitarian treatment that respects the dignity and rights of each individual while extending treatment that is least restrictive to the liberty of the residents and maximizes their opportunities for independent living.

The Contractor, in regards to COVID-19, shall comply with current guidelines based on evidence-based recommendations from the Centers for Disease Control and Prevention (CDC), Centers for Medicare and Medicaid Services (CMS), Cabinet for Health and Family Services (CHFS), Department for Public Health (DPH), White House Coronavirus Task Force, and the CHFS Long-Term Care Advocacy Task Force.

2.00 Scope of Work

2.01 Required Services

The contractor shall be required to perform, but not be limited to, the following services:

A. Manage and operate Outwood Intermediate Care Facility/Individuals with Intellectual Disability (ICF/ IID) (Outwood), a state owned intermediate care facility licensed to support up to eighty (80) people located on Highway 109, in Dawson Springs, Kentucky.

B. Manage and operate Outwood so as to provide the highest possible quality of care to the individuals who reside at Outwood in a manner that ensures individuals’ dignity and respect and also ensure they are afforded supports and training in the least restrictive environment possible.

C. Provide, directly or through contract, competitive/supported employment/work training for all individuals residing at Outwood.

Document Description Page 5

D. Maintain the quality of care and treatment services in accordance with 902 KAR 20:086 and 42 CFR 483, Subpart I and in a manner acceptable to the Cabinet.

E. Maintain compliance with the Strategic Action Plan (Attachment A) as approved in the 2006 Settlement Agreement between the Cabinet and the U.S. Department of Justice.

F. Maintain the types of services and supports, or equivalents, to meet the needs of the individuals and to ensure continuity of care is provided to all those residing at Outwood.

G. Implement, utilize and maintain the electronic medical records system as required by the DBHDID. The software system, as required by DBHDID, integrates Medical Records, Admission/Discharge/Transfer, Accounts Receivable, Billing and Pharmacy. The Contractor may be required to implement additional electronic systems that are adopted by DBHDID facilities to maintain standardization. Any additional electronic system that the contractor desires to utilize on site for the facility shall be approved through the DBHDID Commissioner’s Office prior to implementation. The contractor shall coordinate additional staffing, systems, programs and equipment if required in order for the facility to comply with regulatory agencies and operational requirements and procedures.

H. Provide, at a minimum, the following Supports and Services. Services shall be provided for individuals based upon the individual’s personal goals identified in their person centered service plan. If needed, services shall include:

1. Communication Supports - Emphasis will be on increasing each individual’s ability to communicate with others using a broad range of communication techniques, including but not limited to, verbal communication, sign language, and augmentative communication.

2. Personal Care Services - Training emphasis will be on support and activities of daily living.

3. Self-Determination - Support will be provided to each individual to facilitate supported decision-making and independence. This shall include assistance to regain any rights currently restricted.

4. Support Coordination - Support Coordination is the process of coordinating resources to meet the individual’s needs based on the person centered planning process. As applied to an individual plan, coordination includes obtaining direct services, linking services, identifying gaps in services, monitoring the progress and satisfaction of the individual, and advocating for services.

5. Crisis Prevention Plan - A crisis prevention plan that addresses any potential crisis situation which impacts the health, safety or welfare of an individual shall be developed by the Qualified Intellectual Disability Professional (QIDP) in coordination with other service providers. The plan shall include prevention, reduction and intervention strategies for unplanned critical situations for the individual, training and staff/personnel requirements, and the development of crisis response team(s). All staff working at the ICF shall be trained on individual crisis prevention plans.

6. Behavioral Support - Have and maintain written Behavior Support policies and procedures which define the behavior support techniques and procedures which may be used, including the hierarchy of interventions to be used with an emphasis on the use of positive approaches, use of emergency procedures, plan to reduce/eliminate physical restraints if currently used, functional analysis, data collection, and record keeping system, Behavior Support and Human Rights Committees. Behavioral support shall be the systematic application of techniques and methods to influence or change a behavior in a desired way. Support shall be provided to assist the individual to learn new behaviors that are directly related to existing challenging behaviors or functionally equivalent replacement behaviors for identified challenging behaviors; and shall be designed to equip the individual to communicate his/her needs and to participate in age appropriate activities. The behavioral support plan shall include the hierarchy of behavior interventions ranging from the least to the most restrictive;

reflect the use of positive approaches; and prohibit the use of:

a. Prone or Supine Restraints: Prone is any restraint that places the individual on their stomach, face down. Supine is any restraint that places the individual on their back, face up.

b. Corporal punishment: The application of painful stimuli to the body as a penalty for certain behavior, includes, but is not limited to, forced physical activity or exercise, hitting, pinching, the use of electrical shock or other infliction of pain, whether or not applied as part of a systematic behavioral support program.

c. Seclusion: The placement of an individual alone in a room or other area from which exit is prevented.

Document Description Page 6

d. Verbal abuse: Screaming, swearing, name-calling, or other verbal activity that may cause damage to an individual’s self-respect or may reduce the individual’s dignity when observed or overheard by others.

e. Any procedure that denies visitation or communication privately with family, legal representative or advocate.

f. Any procedure that denies requisite sleep, shelter, bedding, food, drink, or use of bathroom facilities.

All individuals performing services under this contract shall be trained on the use of any behavior support plan.

When drugs, which are not necessary for a mental illness, are used for behavior, there shall be a plan for drug reduction or documentation that a drug reduction plan has been implemented and proven ineffective. The individual’s physician shall approve the drug reduction plan or provide documentation that the medication cannot be reduced.

7. Employment Services - Provide either directly or through subcontract, supported/competitive employment for all individuals residing in the ICF. The contractor shall ensure an individual is placed in an adult day training program only after his/her team has concluded that supported employment cannot be adapted to his/her needs as evidenced by trial placements; or that health, skill, or behavioral deficits preclude placement; or that employment positions are not readily available at a particular time. Placement in a non-integrated training program shall be transitional, limited to no more than six (6) months, and based on the needs of the individual. Individuals not in supported or competitive employment will receive training to remove barriers and develop skills necessary to work in the community.

8. Evaluation for institutionalization - Facilitate (according to KRS 202B) court ordered evaluations for individuals in crisis to assess if criteria is met for temporary involuntary institutionalization for intensive assessment, treatment and stabilization.

9. Access to Community – Ensure that individuals residing in Outwood are given ample and sufficient supports and services necessary to ensure they are able to become an active member within the community which will assist with enhancing one’s quality of life.

I. Perform the following Administrative and Operational Services as described below:

1. Licensure - Maintain the necessary standards for licensure of Outwood as an ICF pursuant to 902 KAR 20:086 and federal certification pursuant to 42 CFR 440.150 and 42 CFR 483, Subpart I. The Contract shall not use the ICF Homes for any other purpose.

2. Compliance - Comply with 908 KAR 3:010; 908 KAR 3:020 ; 908 KAR 3:030; 908 KAR 3:040; and applicable portions of 42 CFR 483.10 regarding resident funds.

3. Comply with all applicable standards, orders, or regulations issued pursuant to:

a. The Clean Air Act of 1970 (42 U.S.C. 1857 et seq.);

b. The Federal Water Pollution Control Act (33 U.S.C. 1251 et seq.) as amended;

c. KRS 202A.400 Duty to Warn;

d. 920 KAR 1:070 Deaf and Hard of Hearing Services;

e. KRS 210.235 Confidential nature of records and HIPAA Privacy Rule, 45 CFR Parts 160 and 164, established under the Health Insurance Portability and Accountability Act, Public Law 104-191 (42 USC 1320d);

f. Drug free workplace in accordance with 2 CFR Part 182;

g. KRS 620.030 Duty to report dependency, neglect or abuse;

h. KRS 209.030 Reporting of adult abuse or neglect;

i. Americans with Disabilities Act of 1990, 42 U.S.C. 12132, as amended; and

j. 2006 Federal Settlement Agreement between the Cabinet and the U.S. Department of Justice and the associated Strategic Action Plan and OutwoodTransformation Plan and Strategic Action Plan (Attachment A) as approved in the 2006 Settlement Agreement between the Cabinet and the U.S. Department of Justice.

Document Description Page 7

2100000136 Outwood ICF Management & Operations (C2749) https://www.ecfr.gov/cgi-bin/retrieveECFR?gp=43&SID=eeeece486384c7a3de66750aa3fdcbbe&ty=HTML&h=L&mc=true&n=pt45.1.160&r=PART https://www.ecfr.gov/cgi-bin/retrieveECFR?gp=46&SID=eeeece486384c7a3de66750aa3fdcbbe&ty=HTML&h=L&mc=true&n=pt45.1.164&r=PART http://uscode.house.gov/view.xhtml?req=(title:42%20section:1320d%20edition:prelim)

4. Evaluation - Conduct an evaluation of the overall effectiveness of the organization at least annually. This evaluation is a process of self-assessment to evaluate solutions and potential improvements from different perspectives. The evaluation shall be data and outcome-based. The contractor shall implement an on-going quality improvement plan, and submit analysis of its quality improvement plan including performance outcomes to the Department at the end of each quarter.

5. Supports - Provide respectful supports to all individuals in the homes and protect at all times each individual’s rights as provided by applicable Federal and State laws and regulations, including safeguarding and accounting of each individual’s personal funds and investment thereof in interest-bearing accounts.

6. Admissions – The contractor shall ensure all admissions are approved in writing by the Director of the Division of Developmental and Intellectual Disabilities prior to admission, and promptly notify this Division of any planned discharges, including the projected date of and reason for discharge.

7. Individual Care and Treatment - Provide services to individuals living at the home in a manner that ensures dignity and respect for the person served, recognizes and supports cultural diversity, and is based on the goals of the person served. The contractor shall ensure individual care and treatment recognizes the community as a valued resource, utilizes funds of this contract in a flexible and cost effective manner, makes use of natural generic and specialized resources, evaluates services on the basis of individual outcomes, and determines whether individual treatment needs can be met in an integrated community-based setting.

8. Patient Records Management - The Department mandates a person-centered approach to planning for services and supports that is reflected in a totally integrated plan and system of documentation. Individual records shall be accessible and available to authorized personnel of the Cabinet. The contractor shall maintain the records necessary to fully disclose the extent of the services provided. These records shall be maintained for a period of not less than five (5) years from the date of service and for any additional time as may be necessary in the event of an audit exception or other dispute. The contractor shall provide to the department or its authorized representative, as requested, information regarding any claims for services provided. The contractor shall open records for review or copying by duly authorized representatives of the Cabinet for the purpose of audit of services for which program payment has been made and the monitoring of the health, welfare, and safety of an individual.

The contractor shall ensure that the individual record includes the following:

a. Name, social security number and MAID (Medicaid Assigned Identification) number;

b. Intake or face sheet;

c. Self-assessment;

d. Assessment summaries relevant to the service area (Residential Needs, Adaptive Skills);

e. Current support plan;

f. The training objectives for any support which facilitates achievement of the individual’s chosen outcomes;

g. Staff notes or attendance records;

h. Emergency telephone numbers;

i. History of allergies with appropriate allergy alerts in instance of severe allergies;

j. Individual medication records, including a copy of the prescription and medication logs, if medications are administered at the service site;

k. A recognizable photograph of the individual;

l. Legally adequate consents for the provision of services or other treatment, including those requiring emergency attention;

m. Individualized Educational Plan (IEP), if applicable; and

n. Social history.

9. The contractor shall maintain all information necessary for the delivery of an individual’s services in a cumulative and readily accessible individual record. Entries in the records of an individual served shall be legible, and include the date (month, day, and year), the time when providedand the

Document Description Page 8 individual provider’s signature, with date and title appropriate to the service being provided. Symbols and abbreviations used in making record entries shall be identified in a legend that is available to individuals who have access to the records. The use of an Electronic Medical Record (EMR) will be acceptable, however, a hard copy of the full medical record shall be made available upon request by the department or other state or federal agency in response to licensure and certification surveys or investigations.

10. The contractor shall have and follow policies and procedures that allow availability of the record to the individual and his family or legal representative.

11. Confidentiality - The contractor shall maintain the confidentiality of the individual’s record and other personal information by ensuring that an individual served, or their legal representative, as appropriate, decides when to share that information. The contractor shall also ensure the record’s safety from loss, destruction, or use by unauthorized persons.

12. Incident Reporting - Report incidents to DBHDID in accordance with the current Facility Risk Management Protocol for ICF/IIDs.

13. Permits, Licenses, and State Registration - The contractor shall procure all necessary permits and licenses and abide by all applicable laws, regulations, and ordinances of the United States, the Commonwealth, and political subdivisions in which work under this contract is performed.

14. Training – Provide orientation, competency based training and at least semi-annual in-service training to all staff as appropriate to their responsibilities. All training shall be documented in staff personnel records as to date, time, type of training, and measure of competency. Training shall include at a minimum: CPR/First Aid, Medication Administration, Medications and Seizures, Crisis Prevention, Abuse/Neglect/Exploitation Prevention, Supported Employment, Rights of Persons with Intellectual Disabilities. Core Training, which includes Values, Attitudes and Stereotypes; Building Community Inclusion; Person Centered Planning; Positive Behavior Support; Human Sexuality and Persons with Disabilities; Self Determination and Strategies for Successful Teaching shall be completed within six

(6) months of hire.

15. Olmstead – The contractor shall participate in the implementation of the Kentucky Olmstead Plan, as evidenced by the adoption of policies and their implementation consistent with the policies and procedures of the Department and the Office of Civil Rights. Regular status reports regarding the implementation of the Olmstead plan and individuals who may be impacted by this decision shall be provided to the Department.

16. Participate with DBHDID in the development and implementation of a patient/guardian satisfaction survey. Survey results may be used in the evaluation of contractor performance. Surveys shall be submitted to the Director of the Division of Developmental and Intellectual Disabilities.

J. General Programmatic Services

The contractor shall provide all services and supports as identified through the assessment and person-centered treatment planning process and be consistent with the ICF/IID’s regulatory requirements cited in Section 2.01 D and the Strategic Action Plan (Attachment A). A full array of services shall be provided which are differentiated to meet the wide range of individual needs. The contractor shall perform the following general programmatic services as described:

1. Initiate services beginning with a self-assessment survey by the individual or his or her family and the identification of preferences, personal goals and needed services.

2. The Inter-Disciplinary Team (IDT) shall adhere to the following meeting timeframes for new admissions:

a. Initial meeting within twenty-four (24) hours of admission.

b. IDT Planning Conference within seven (7) days after admission.

c. IDT review of Individual Learning Plan (ILP) within fourteen (14) days after admission.

d. IDT review of ILP within twenty-eight (28) days of admission and monthly thereafter.

3. Within thirty (30) days of initiation of service, the contractor shall ensure assessments are completed in each of the following areas:

a. Physical examination and health assessment (within fourteen (14) days of admission).

Document Description Page 9

b. Dental examination and health assessment of oral hygiene practices completed within the past six (6) months.

c. Social evaluation that includes a social and developmental history, delineation of the type and frequency of social interactions and descriptions of the individual’s social support network.

d. Psychological evaluation completed within the past three (3) years, which includes an assessment of emotional and intellectual status.

e. Functional assessment of adaptive behavior or independent living skills.

f. Educational or vocational evaluation completed within the past year. Vocational assessments should identify the individual’s work interests, work skills and related behaviors and identify current and potential employment options.

g. Medication and immunization history.

h. Screenings for nutritional, vision, auditory and speech and language

i. When indicated by screening results, comprehensive evaluations in the area in which needs were identified are to be obtained within sixty (60) days of admission unless they have been completed within the past year.

4. Within thirty (30) days of admission, the individual’s team shall synthesize the results of all assessments into a comprehensive individualized plan, utilizing the person–centered planning process.

5. The designated QIDP shall review the individual’s plan on a monthly basis in order to ensure that the plan has been implemented and that it continues to meet the needs of the individual. This documented review analyzes data on the individual’s progress toward attainment of criteria within behavioral objectives and progress on attainment of service objectives. Copies shall be in the individual’s home.

6. The individual plan shall be reviewed and revised at least annually by the person centered planning team unless problems or changes in the individual’s status call for review and revision more frequently.

7. At least annually, the individual shall be reassessed in the following areas unless such assessment is determined unnecessary by the team: a physical and health examination, dental examination, an evaluation of cognitive and emotional function, an assessment of adaptive behavior or independent living skills, educational or vocational evaluation.

2.02 Department of Justice (DOJ)

On September 21, 2004, the Commonwealth of Kentucky entered into a Memorandum of Understanding (MOU) with the United States Department of Justice (DOJ) to implement and maintain a strategic plan for Facilities serving individuals with intellectual and developmental disabilities. In 2006, a Settlement Agreement was reached between the DOJ and the Cabinet for Health and Family Services.

The MOU and subsequent Settlement Agreement are the result of an investigation performed by the DOJ on November 5-9, 2001, which resulted in allegations by the United States Assistant Attorney General, Civil Rights Division, that persons residing in or confined to Oakwood were being subjected to conditions that deprived them of rights, privileges and immunities secured by the Constitution or laws of the United States, further clarified by a Settlement Agreement between the Commonwealth and the DOJ and filed in Federal court on August 31, 2006 (Attachment E). Specific allegations by the DOJ against Oakwood included:

1. The failure to protect residents from harm;

2. The failure to provide residents adequate care from treatment teams by providing inadequate individual support plans, behavioral support plans and behavioral and psychological services;

3. The provision of psychiatric services, general medical care, nursing care, nutritional management and physical therapy that fell substantially below generally accepted professional standards of care;

4. The provision of inadequate quality improvement programs to address appropriate care, and

5. The failure to accommodate persons who desire to live in the community.

Document Description Page 10

The investigation was performed pursuant to the Civil Rights of Institutionalized Persons Act (“CRIPA”), 42 U.S.C. § 1997.

The Commonwealth, through the Cabinet, is committed to ensuring its most vulnerable citizens have the freedom to live a life of dignity and respect. As a result, the Commonwealth, in collaboration with DOJ, created a Strategic Action Plan (“SAP”) for Oakwood.

A national consultant assisted in the drafting and implementation of the SAP. Implementation in all state facilities for persons with intellectual disabilities is ongoing. The goal is to ensure collaboration, coordination, cooperation, and continued implementation of the DOJ agreement and current SAP, as well as any future actions deemed necessary by the DOJ.

2.03 Mission, Values, and Goals

The contractor shall ensure the mission, values, goals, and objectives embraced at Outwood detailed as follows:

A. Mission

Outwood, owned by the Kentucky Cabinet for Health and Family Services, was established with a primary mission of providing a residential environment for care and development. The homes’ role in the State Comprehensive Intellectual Disability Program is to provide living and training for individuals who do not have lesser restrictive community options available. They shall provide the type of enriching environment needed to maximize the intellectual, social, and physical development of each person. Outwood shall accept individuals for services without regard to religion, ethnic origin, sex, degree of disability, or ability to pay.

The long-range objective of the Outwood is to provide residential supports and training to persons with intellectual disabilities to enable them to transition to less restrictive community homes when ready.

Treatment shall focus on skills training to address barriers and enable individuals to attain a level of self-sufficiency consistent with his/her capabilities and be supported in the least restrictive environment possible. This objective is mandated through adherence to stated values and a commitment to the presentation of quality services.

B. Values

1. Each individual has the capacity for growth and development;

2. Each individual shall have access to services and opportunities that enhance his or her development, autonomy, independence, productivity, well-being, and capacities for social interactions with others, including those without disabilities;

3. Each person shall have access to the most culturally normative and least restrictive social and physical environments possible;

4. Each individual’s services and supports should be provided, as much as possible, in settings that are integrated into the community and that promote interaction with family members, friends and other persons without disabilities; and

5. Each person’s services and supports should be delivered in accordance with an individual plan that is developed from an approved assessment of support needs, monitored, coordinated, and revised by members of a person-centered team of people who are important in the life of the person served.

C. Goals

1. Each person’s rights shall be protected and assistance provided to exercise those rights.

2. Persons served, their families/guardians, and community agencies shall be involved in the delivery of services as determined by the individual and the person centered planning team.

3. Services and supports shall be person centered based on each person’s vision and dreams for the future. Services and supports shall be individualized and address the unique wants, needs and strengths of each person.

4. All support and training shall be geared to increasing the individual’s control over the environment and making personal choices.

D. Individual Outcomes and Required Benchmarks

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1. Individuals, with any needed assistance from their team, will explore community based, non-congregated activities and the use of natural supports to aid in participation.

As evidenced by: Interviews with individuals, family, guardians, staff, and individuals’ records.

Benchmark: Seventy-five percent (75%) of individuals in sample receive supports to participate in the life of the community; balance of sample has documentation demonstrating that the individual is not receiving supports to participate in the life of the community based upon personal preference/choice but that this has been explored at length with them.

2. Individuals will explore and establish a supportive employment plan.

Benchmark: One-hundred percent (100%) of individuals will be made aware of options for obtaining paid work through visits, training, etc. Individuals interested in pursuing supported employment will have an established plan to accomplish the goal. For individuals who prefer not to pursue supported employment, this will be clearly documented in the individual’s record along with educational activities provided to remove barriers and to promote active participation in the community

As evidenced by: Individuals’ records. Interviews with individuals, family, guardians, staff.

Benchmark: Fifty percent (50%) of individuals interested in obtaining paid work participate in supported employment; balance of individuals interested in working have documentation (or other evidence) demonstrating that the individual is not participating in supported employment, but is participating in a structured day program or regular volunteer work geared towards employment.

E. Organizational Outcomes and Required Benchmarks

The organization demonstrates a systematic approach to continuous quality improvement in the areas of

(1) individual’s safety, (2) individual’s rights, and (3) medication/healthcare.

As evidenced by: Quality Improvement (QI) plan; Analysis of QI plan with actions taken to address identified areas for improvement; Incident reports, individuals’ records, satisfaction surveys, complaint/ grievance protocol and records.

Benchmark: The Quality Improvement Plan addresses the organization’s identified areas needing improvement. Periodic (quarterly) reporting to be submitted on specific plans to address needs, progress, reassessment, and revisions.

2.04 Location and Facility Design

A. Location of the Campus

The Outwood campus is located in the northwestern corner of Christian County, approximately three (3) miles south of Dawson Springs and 24 miles north of Hopkinsville on State Highway 109. The facility occupies approximately 185 acres of land. The old campus property impacts approximately 75 to 80 acres of the total tract at its highest point of elevation. The remaining acreage is moderately sloped and landscaped. This portion of the property covers approximately 60-65 acres and is the site of the new facility.

There are sixteen (16) units within five (5) buildings, a resident life center, chapel, sheltered workshop, water tower, three (3) old storage buildings, maintenance shop storage building, facility storage building, and pavilion. The Chapel is not usable at this time, and improvements are not budgeted during this biennium. Please see the Outwood ICF site map for layout of the campus.

B. Facility-Design Concept

The 80 bed, five (5) cottage facility design creates a residential care facility with functionality, future needs, ease of administration, individual mobility, safety, and security in mind. The five (5) cottages allow the housing of a maximum of sixteen (16) individuals to a cottage. Each apartment has four (4) bedrooms with two (2) shared baths. All cottages are carpeted in the living areas.

There is a dining/recreation room and a separate living room, kitchen, and record station. The two (2) apartments share use of a staff locker room, clean and soiled linen room, medication room, laundry, room for personal clothing, and observation room with bath (for medical isolation). This room may be used for a private bedroom.

All of the cottages have fully equipped kitchens. Each cottage has a small outdoor patio and grill. Food services are provided in the apartments, including preparation with paraprofessional staff eating some

Document Description Page 12 meals with individuals in the apartments. All other employee meals are prepared in a central kitchen. The cottages have separate electric heating and cooling units. Cottages are connected to a transfer switch, which can provide electricity via generator during a power outage.

C. Service Groups

The Residential Services Office houses staff responsible for the programmatic administration of the residential areas. It consists of three offices, open office space, and storage areas.

The hub of the facility is the Resident Life Center with its eight (8) satellite units. The Resident Life Center incorporates essential programmatic and support services. The Center has space for administrative offices; therapy workrooms (occupational and physical therapy, communications coordinator for speech and hearing); and support services (psychology, medical, dental, laboratory, pharmacy); and a Central Supply area.

Psychiatric services are provided on campus or off campus under contract with the Community Mental Health Center (CMHC). Dental services are performed both on site and off. Laboratory and Pharmacy services are being provided under contract. All individual support services such as dietary and health records are contained within the individual’s primary record at the cottage. Linen services are contracted out.

The core of the Resident Life Center is the multi-purpose room, which is designed to serve as a gymnasium/recreation room, dining area for special occasions and community center. Additionally, the building contains the hobby room and a dining/break room that serves the individuals providing services meals and contains vending machines.

The basement of the Resident Life Center contains essential linen; dry, cold and frozen food storage areas; mechanical/boiler rooms and maintenance rooms.

The sixteen (16) work/training rooms are spaced in three (3) buildings of six (6), eight (8) and two (2) units each. All are similar in design, except that between two groupings of rooms; additional space has been allocated for one way observation rooms of the units. Removing a folding partition can enlarge three

(3) of the rooms. If necessary this will then provide sufficient square footage to meet federal and state educational classroom size specifications in the event that these units were ever needed for providing mandatory public education. This use, however, would be subject to the approval of the Department for Behavioral Health, Developmental and Intellectual Disabilities.

The work/training units are designed to allow for flexibility in their utilization, depending upon individual needs. The units provide the space essential for modular training, vocational skill development and/or other therapy training programs.

In November 1986, a new sheltered workshop building became operational. The building is approximately 7,600 square feet and resembles an industrial work setting. In addition to the work floor, there are offices, a meeting room, a break room, and a lunchroom. Shipping and receiving capabilities (loading dock) are incorporated into the design.

Other buildings on the grounds include a chapel, which is not being used at this time, three (3) storage buildings from the old facility (Quonset hut is the only old storage building that is utilized), a new maintenance shop/tractor shed, and new facility storage building that contains a storage area for each cottage and for administrative storage needs, and a pavilion.

D. Physical Plant and Utilities

The Resident Life Center and work/training units are heated with natural gas and are capable of using fuel oil as an alternative energy source. Also incorporated into the design is an emergency generator system for the Resident Life Center which provides emergency lighting in the event of a power outage.

The buildings are primarily of protected ordinary construction consisting of wood trusses or truss joints on masonry bearing walls of concrete block with brick exteriors. All combustible framing material is protected with fire code drywall. There is sprinkler protection throughout, with smoke detection where required by codes. All of the state’s requirements for insulation are met with a combination of batts and rigid insulation. All roofs with a slope equal to 1:4 are covered with Class “A” asphalt shingles. All roofs with slope of less than 1:4 are of lightweight insulating concrete with a gravel protected built-up roof. Interior partitions in living areas are of concrete block.

The facility currently receives its water from the Christian County Water District. The pump house and small water tank located on the grounds at the entrance to the facility are the property of the Water

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District. There is an elevated water tower located on the grounds of the old facility, which was renovated in 1988-1989 and most recently worked on in December 2019 – January 2020. The elevated tank is strictly used for fire suppression only. The new meter installed by the Chrisitian County Water District is to feed domestic water to the facility.

Kentucky Utilities presently services the Outwood campus through its offices and substations located in Dawson Springs. Atmos Energy supplies natural gas to the site and the facility is connected to the city of Dawson Springs sewer system.

The facility shall maintain a fire control and evacuation plan to be practiced at least quarterly for each shift of personnel with all staff and individuals participating. Drills shall be held at different times of the day.

The fire alarm must have an inspection deadline or claim form posted. The facility has agreements with the Dawson Springs Fire Department for fire protection. A $500 retainer fee is involved as well as a “per call” fee, which varies upon time involved.

E. Community Involvement

Dawson Springs is a small community of approximately 3,500 people with limited economic and industrial resources. The community is a resource for the facility for shopping, recreation, spiritual growth and entertainment. Also, many community integration activities take place in the surrounding areas. Therefore, transportation resources must be provided by the contractor to allow for community participation, medical and home visits, supported community work activities and activities of personal interest, etc. Currently, one (1) truck, five (5) mini vans, one (1) accessible van, one (1) SUV, and three

(3) cars are leased to meet the transportation needs of individuals living at Outwood ICF/IID

It is expected that the facility would continue its function and continue to increase involvement in the community with the local school districts, CMHC, social, religious, recreational groups, supported community activities and the community as a whole. The facility also has Community Advisory Committees, which are advisory bodies to the facility and provide input into facility operations.

2.05 Goals and Objectives

The contractor shall be responsible for the following goals and objectives:

1. Provision of the highest possible level of care to the individuals who reside at Outwood, in a manner that ensures these individuals are afforded genuine choice, treatment and training in the least restrictive environment possible. Individuals residing at Outwood shall be provided a safe environment and protected from abuse, neglect or exploitation.

2. Significantly improve the quality of care and treatment services for the individuals who reside at Outwood in accordance with Federal and State ICF/IID standards and regulations, the 2006 Settlement Agreement between the Cabinet and the DOJ, and the associated Strategic Action Plan (Attachment A), in a manner acceptable to the Cabinet.

3. Implementation of a Community Transition Plan that provides training necessary to remove barriers to community involvement and placement; educates individuals, families and guardians regarding community support options; and allows for any resident who seeks and is appropriate for community placement to transition to the community. Transition planning and implementation shall begin upon admission, be ongoing and be consistent with the Department Facility Transition Process to ensure safe and successful transitions.

4. Cooperation and effective working relationships with the parents/guardians of residents.

5. Assurance of timely communication and cooperation with individual parents/guardians and the Parent/ Guardian organization, the Outwood Family Group. The Outwwod Family Group is an instrumental entity supporting administration of the Facility, communicating concerns, supporting enhancement of the quality of life of all residents and communicating with all parents/legal guardians to ensure a unified effort to support the operation of Outwood. The contractor shall utilize the Outwood Family Group in an advisory capacity, have a representative on the Facility Advisory Board, and have routinely scheduled monthly meetings with the Outwood Family Group and as requested by the Family Group or Department.

2.06 Outwood ICF Staffing Requirements

A. It shall be the contractor’s prerogative to determine the number of staff required and to organize staff in whatever manner that satisfies the delivery of quality services to ensure continued licensure in accordance with Section 2.01 D.

1. Adherence to the approved staffing plan shall be utilized in performanceevaluations.

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2. Contractor shall maintain an employee personnel policy and procedures manual that includes the agency’s philosophy and gives information regarding salary ranges, vacation and leave procedure, health insurance, retirement benefits, opportunities for continuing education and grievance procedures. Individuals providing services under this contract shall be guaranteed at least minimum wage.

3. Contractor shall have adequate personnel to meet the needs of individuals on a twenty-four (24) hour basis. The number and classification of personnel required shall be based on the number of individuals, the amount and the kind of personal care, nursing care, supervision and program need to meet the needs of the individual as determined by the person’s team, and the services required by regulations listed in Section 2.01 D and this RFP.

B. Contractor shall follow all local, state, and federal guidelines relative to employees with infectious diseases.

C. A written job description shall be maintained for each individual providing services under this contract which describes the individual’s duties and responsibilities. Contractor shall review job description at least annually and revise, as needed.

D. Contractor shall evaluate the performance of each individual providing services under this contract according to job description specifications at the completion of the contractor’s designated probationary period and at least annually thereafter.

E. Contractor shall report staffing information to include number of staff, individual employee information such as name, position, salary or hourly rate, and any additional detail required, upon request of the

DBHDID.

F. The Cabinet reserves the right to have the contractor replace any individual performing services under this contract at the ICF without cause. Contractor shall notify the DBHDID two (2) weeks prior to replacing any key staff including Facility Director and Medical Director.

G. Mandatory Requirements

Contractor is required to provide the following credentials for any individual designated to provide services under this contract prior to beginning work at Outwood:

1. Record Checks: All individuals providing services under the contract shall have a current and satisfactory criminal and nurse aide abuse registry check in accordance with KRS 216.793, KRS 27A.300, KRS 17.151 and 902 KAR 20:410, Section 5(5) before beginning work. Current is within the last thirty (30) days. Satisfactory is with no convictions or outstanding charges which would constitute a felony conviction under 902 KAR 20:410, Section 5(5). In the Commonwealth of Kentucky there are only two approved sources for criminal record data. One is the Information Center, Kentucky State Police and the second is the Administrative Office of the Courts. The State Justice Cabinet approves both.

If an individual providing services under the contract has resided or worked in a state other than Kentucky, a satisfactory records check shall be required of those states also.

A check of the Kentucky Nurse Aide Registry shall be completed for…