Final Written Responses to Bidders Conference Questions Part 2_4.14.2021.docx

Written Responses to Bidders Conference Questions, Part 2 March 26, 2021 10am-12pm All written question submitted during the Bidders Conference on March 26, 2021, and those which are submitted as written inquiries pursuant to RFR section 7.14 as amended on March 22, 2021, will be responded to in writing and posted to COMMBUYS.

In this document, the Department is releasing only written responses to questions posed during the Bidders Conference for which there was not time to provide verbal answers during the conference, pursuant to section 7.14 of the RFR as amended on March 22, 2021.

An additional document will be released with written responses to written inquiries submitted pursuant to section 7.14 of the RFR as amended on March 22, 2021. Responses to written inquiries will be posted in a separate document.

1. Question: In proposing Shared Space do you need to submit two separate proposals, one for each program and the Shared Space Response?

· Answer: Yes. To propose shared space for two program models, follow the instructions in Section 10.07 for submitting a Program Model Response Package for each program model that will be in the shared space arrangement, and then follow the instructions in Section 10.09 for submitting a Shared Space Response Package.

2. Question: Intensive Treatment Residences have a maximum capacity of 9 youth, and Emergency Residences have a capacity of 12. If we operate a shared program with both Intensive Treatment and Emergency Residence beds, what will the maximum capacity be for that site?

· Answer: To propose shared space for an Emergency Residence and an Intensive Treatment Residence, follow the instructions in Section 10.07 for submitting a Program Model Response Package for each program model, and then follow the instructions in Section 10.09 for submitting a Shared Space Response Package. The Shared Space Response Sheet, Appendix 4Q, includes questions about the physical space. Row 8 on Appendix 3Q Shared Space Staffing Structure is for the number of proposed beds. The proposed physical space will be reviewed in relation to the proposed size of the program. Shared space proposals will be considered and be awarded at the Department’s discretion.

3. Question: I am not sure if this is a content or technical question but I am looking to understand what the rate is for the Youth Support Living Model as it is unclear which rate is attached to each model on the current rate sheet.

· Answer: Proposed rates for all of the program models are posted at https://www.mass.gov/regulations/101-CMR-41300-payments-for-youth-intermediate-term-stabilization-services-0.

· At the time of this writing, the rates are in draft form.

· To access the draft rates, click on the link “101 CMR 413 related and supporting documents” and then “Proposed Regulation (date filed: February 5, 2021)”.

Note that this draft regulation includes rates for other state agency congregate care programs, as well as Caring Together programs. The rates for the DCF Congregate Care Network can be found under the heading “Congregate Care Program” and match exactly to the names of the program models in this RFR. The rate for the Youth Supported Living program is labeled “Young Adult Supported Living”.

4. Question: For young adult community living do we need to demonstrate site control of units when submitting the response?

· Answer: If it is not requested on a Response Sheet for the program model, it is not required. For questions that ask for characteristics of the site or surrounding community, enter whatever information is known as well as plans and intentions for the site where the program will be delivered.

5. Question: The ITR Model has a 9 bed capacity. Will DCF be receptive to responses that in which a program provides 12 beds- 9 ITR beds and 3 CTR beds?

· Answer: To propose shared space for an Intensive Treatment Residence and Community Treatment Residence, follow the instructions in Section 10.07 for submitting a Program Model Response Package for each program model, and then follow the instructions in Section 10.09 for submitting a Shared Space Response Package. The Shared Space Response Sheet, Appendix 4Q, includes questions about the physical space. Row 8 on Appendix 3Q Shared Space Staffing Structure is for the number of proposed beds. The proposed physical space will be reviewed in relation to the proposed size of the program. Shared space proposals will be considered and be awarded at the Department’s discretion.

6. Question: To clarify my ARTIC question: If we are proposing to use ARTIC as our trauma informed self assessment tool, and the ARTIC tool that is available from the authors of this tool says: "do not distribute." Since the ARTIC is one of the tools that is suggested in the RFR, can we just name that we are going to use the ARTIC and list the website, without attaching the sample tool?

· Answer: Yes.

7. Question: Follow-up for the Appendix Q, Shared Space question Can you have Emergency Residence and Intensive Treatment Residence clients at the same location?

· Answer: See Appendix Q: Shared Space for a list of all program models eligible for shared space. For this question, an Emergency Residence and an Intensive Treatment Residence are eligible for shared space.

8. Question: For young adult supported living programs is a program considered "located" where it is headquartered or where the living units actually are if these locations are different? For example the program offices are located in Sawnsea but the living units are located in Taunton/Attleboro/Fall River/etc

· Answer: The program location is where the youth will be living.

9. Question: If we have 2 Emergency Residences with different capacities, do we submit 2 separate program model response packages?

· Answer: See Section 10.07(E)(ii)(1). To propose two of the same program models that have different bed sizes, Bidders shall submit two separate Program Model Response Packages.

10. Question: Can you confirm if a Residential School must follow MAP (Med admin)? I don't see an exception in Appendix M

· Answer: Per the DPH Drug Control Program, DPH School Health Unit, and 101 CMR 210 The Administration of Prescription Medications in Public and Private Schools, Residential Schools are required to use either licensed health care professionals to administer medication or the School Health medication administration model at a minimum during the school day.

· Residential Schools do not need to follow MAP. However, MAP is an option for medication administration in Residential Schools during non-school hours provided that all eligibility and DPH/MAP policy requirements are followed. In particular, if MAP is selected for medication administration in a school’s residential areas, all children to be served must qualify for MAP in that they are part of a program that is licensed, funded or operated by DCF.

11. Question: Why don't the rates vary based on program size? Specifically, for Emergency Residences, there is only one rate.

· Answer: In the Caring Together procurement, most program models had only one rate, regardless of bed size. However, the STARR model in Caring Together had rates that varied by bed size. In the Congregate Care Network procurement, the rates do not vary by bed size.

· Specifically, for Emergency Residences the rate is a daily accommodation rate. To calculate the daily accommodation rate for the entire program, multiply the daily rate by the total number of beds in the program. To calculate the monthly accommodation rate for the entire program, multiple the daily accommodation rate for the entire program by the number of days in a month.

12. Question: Youth and Young Adult Supported Community Living allows for 17 year olds...but it does not appear to need to be licensed by EEC. Are we understanding this correctly?

· Answer: For Appendix J Youth and Young Adult Supported Living Community, responses to serve adolescents and young adults within the age range of 17-22 will be reviewed.

· Should a Bidder propose to serve 17 year olds in this program model, the program will have to be licensed by EEC. Appendix J will be amended to reflect the need for EEC licensure in Youth and Young Adult Supported Living Community programs serving 17 year olds.

13. Question: If you have Emergency Residences that serve latency age children at four different locations, but capacity (12 bed vs 6 bed) is different, do you need separate response packets?

· Answer: See Section 10.07(E)(ii)(1). To propose two of the same program models that have different bed sizes, Bidders shall submit two separate Program Model Response Packages.

14. Question: If we submit ITR and CTR responses but the only difference is age range- one for ages 12-18 and one for ages 17-22 do we have to submit separate responses? Same clinical profile.

· Answer: Follow the instructions in Section 10.07 for submitting one Program Model Response Package for Intensive Treatment Residence and one Program Model Response Package for Community Treatment Residence.

· See Appendix A for the clinical profile of youth to be served in Community Treatment Residences and Appendix D for the clinical profile of youth to be served in Intensive Treatment Residences. The clinical profiles are different.

15. Question: When naming our zip files when we are submitting multiple Program model response packages -- can and/or should we add to the end of the name of the program model such as ITR to distinguish it at a glance (so we know what it is without having to open it)? Of course we can just open it to see what it is, but when reviewing our attachments before submitting it would be helpful for us - just as a way to organize ourselves when we are uploading everything.

· Answer: Yes.

16. Question: And when naming files, would it be acceptable to add characters to the end of the file name that help us (the bidder) distinguish what program sites we are talking about?

· Answer: Yes.

17. Question: We plan to propose a shared space 9 bed ITR and 3 bed CTR; we understand we need to submit two separate proposals and then the shared space proposal. Clearly a 3 bed CTR as a stand alone will not work; we presume we need to submit it as a 9 bed but then in the shared space explain we would only provide 3. Is that okay? So 9 bed ITR + 9 bed CTR and a 9/3 shared space proposal.

· Answer: The plan for submittal described above is acceptable. Shared space proposals will be considered and be awarded at the Department’s discretion.

18. Question: Looking forward at implementation of these new models, if a current Intensive GH 1:3 residence serves 18 individuals and we submit a proposal for an Intensive Treatment Residence (ITR) with a max-bed size of 9, would 9 of the placed youth at the time of implementation be forced to be relocated to reduce census to the new maximum capacity size?

· Answer: To transition to the new program models, individual plans will be created for any youth served in a program model that will not be in existence under the DCF Congregate Care Network RFR.

19. Question: How should providers propose to deal with the EEC requirement of 1:2 staff:child ratio for infants and toddlers? Should a staff add-on be used or does DCF have a different expectation for accommodating the ratio expectation of EEC?

· Answer: DCF contacted EEC about staffing ratios in licensing standards. EEC communicated that there are no staffing ratios in 606 CMR 3.00: Standards for the Licensure or Approval of Residential Programs Serving Children and Teen Parents.

20. Question: The Department provide clarification for Trauma Assessment requirements - does the CANS assessment cover requirements for a Trauma assessment tool in accordance with the RFR or do providers need a separate trauma assessment outside of the CANS?

· Answer: The Department’s expectation is that there will be trauma assessment outside of the CANS.

21. Question: If we are proposing a program with 2 models with 2 locations, do we submit one shared space application or two?

· Answer: Please follow the instructions in Section 10.09(B) to submit a separate Shared Space Response Package for each shared space proposal.

· The Department is not sure about the interpretation of the question. If the question is asking about proposing two shared space programs in two different locations, the response is to submit two Shared Space Response Packages – one for each shared space proposal.

22. Question: Are the comprehensive, trauma & substance abuse assessment standards the same for the residential programs and the YYA programs?

· Answer: The General Specifications for assessments are stated in Section 4.04(A). See the Program Model Specifications in Appendices A – M for any program-specific differences between the specifications listed in Section 4.04(A) and what is expected for a specific program model.

23. Question: Are all program modes required to complete the CANS?

· Answer: Yes. See RFR Section 4.04 A (i)(4)(c) page 26, CANS is the selected tool for all youth 5-20 referred to congregate care programs. For young adults older than age 20, CANS is not appropriate and is not required.

24. Question: Are all programs required to list a physical location/address? If a program does not have a current physical site how is that indicated in the submission? If the site is TBD, do bidders need to submit an EOHHS Siting Form?

· Answer: A finalized site is not required. For questions that ask for characteristics of the site or surrounding community, enter whatever information is known as well as plans and intentions for the site where the program will be delivered.

· Should the proposal be accepted, the start date discussion, which can include final arrangements for a site, will occur during contract negotiation.

· To submit the EOHHS Siting Form, the site address is required.

25. Question: For the Young Parent Living Program (YPLP; Appendix L) is it allowable to submit an apartment model for this service to meet the unique needs of this population? If so, would a YPLP in an apartment setting require DEEC licensure?

· Answer: As stated in Appendix L, “This program model shall be licensed by the Massachusetts Department of Early Education and Care (EEC) as Group Care Services. See 606 CMR 3.00 for EEC licensure standards.”

· Young Parent Living Programs will be delivered in a variety of settings from group homes to connected apartments in the same building that includes a shared entrance to the building and common space, along with bedrooms where young parents and their children will reside together.

26. Question: What is meant by a standardized tool?

· Answer: In Section 4.04(A)(i)(4). Unstandardized tools include informal observations and unstructured interviews that focus on different behaviors or include different questions based on who is conducting the interview. In contrast, a standardized tool contains a structure for conducting an observation or an interview to ensure that the same behaviors will be observed, or the same questions will be asked regardless of who uses the tool.

· In Section 4.04(B)(i)(3). A standardized tool for self-assessment of adherence to a trauma-informed treatment framework is one that, like the examples listed in that Section, is a valid and reliable instrument developed through research.

27. Question: Self-assessment – in the well-being section – do these tools refer to the client? Ability of program to provide trauma-informed env for the well-being of the clients? Correct? Include STS as impact on care of youth? Organizational and program used within the same Q – used interchangeably? Do you really want to know what the agency does or Component?

· 3 levels: client, program, org

· CoA is endorsement of agency/program’s use of trauma-informed care. DCF Q 17 – 7 Qs on CoA or the standards themselves

· The Department does not understand all aspects of this question. This response is written to provide an answer to what the Department thinks is being asked.

Answer: In Section 4.04(B)(i)(3), “self-assessment” refers to an assessment that a program conducts to evaluate program adherence to a trauma-informed treatment framework.

28. Question: DCF 18 – programmatic Q – just link to standardized self-assessment tool (Res = ARC, TIL = Restorative Justice or Emotional scale)

· The Department does not understand this question. This response is written to provide an answer to what the Department thinks is being asked.

Answer: In Section 4.04(B)(i)(3), “self-assessment tool” refers to an assessment that a program conducts to evaluate program adherence to a trauma-informed treatment framework.

29. Question: IER Adolescent Programs – can a bidder propose to serve under age 13?

· Answer: No. Please see Appendix F for age ranges.

30. Question: On the Appendix 3 Staffing Response sheets, if we are adding positions like Administrative Assistant and/or Maintenance, which are currently not in the model budget, which section should they be added?

· Answer: Appendices 3A -3Q are Response Sheets 3. The instructions state that Bidders may insert additional rows if needed for additional staff positions. Determine what location to insert a position based on the function of the position. For example, an Administrative Assistant to the Program Director could be inserted into the Management section of the spreadsheet. An Administrative Assistant with primary responsibilities for assisting with youths’ medical records could be inserted into the Nursing section.

31. Question: Our young adult supported living program is headquartered in two towns with living sites in three DCF regions and multiple towns. On Response Sheet 1 there are several questions that are location specific (B4 & L10) related to elected officials and community resources. Should these be listed for every town a living site is located in?

· Answer: See RFR Amendment 3.22.2021 page 8, number 9 for instructions on how to accommodate questions about the local community when proposing multiple sites for a single program model.

32. Question: Under Caring together, the STARR model did not fall under rehab options. What was considered in now requiring the emergency residence models to comply with rehab options?

· Answer: The considerations included the Federal requirements for the Rehab Option program and the characteristics of the new Emergency Residence program model.

33. Question: We noticed that the RFR indicates that programmatic Add On’s need to be short term - however, if we are proposing a program model that requires higher staffing ratio, can this add on be permanent?

· Answer: As stated on Appendix N, programmatic add-ons will be negotiated individually with each Bidder. Programmatic add-ons should be considered temporary, not permanent, additions to a program.

34. Question: What is the maximum cost per bed per month for the Young Parent Program? Is DCF setting a maximum and the applicant has to build its staffing model around that maximum?

· Answer: Proposed rates for all of the program models are posted at https://www.mass.gov/regulations/101-CMR-41300-payments-for-youth-intermediate-term-stabilization-services-0.

· At the time of this writing, the rates are in draft form.

· To access the draft rates, click on the link “101 CMR 413 related and supporting documents” and then “Proposed Regulation (date filed: February 5, 2021)”.

Note that this draft regulation includes rates for other state agency congregate care programs, as well as Caring Together programs. The rates for the DCF Congregate Care Network can be found under the heading “Congregate Care Program” and match exactly to the names of the program models in this RFR. The rate for the Youth Supported Living program is labeled “Young Adult Supported Living”.

· When rates are finalized, the rate for a program model will be the maximum amount that the Department will pay for that program model.

35. Question: For the Young Parent Living Program, is the rate the maximum that DCF will pay for a bed for a month? We are struggling with building our program and staffing model within those rates.

· Answer: Proposed rates for all of the program models are posted at https://www.mass.gov/regulations/101-CMR-41300-payments-for-youth-intermediate-term-stabilization-services-0.

· At the time of this writing, the rates are in draft form.

· To access the draft rates, click on the link “101 CMR 413 related and supporting documents” and then “Proposed Regulation (date filed: February 5, 2021)”.

Note that this draft regulation includes rates for other state agency congregate care programs, as well as Caring Together programs. The rates for the DCF Congregate Care Network can be found under the heading “Congregate Care Program” and match exactly to the names of the program models in this RFR. The rate for the Youth Supported Living program is labeled “Young Adult Supported Living”.

· When rates are finalized, the rate for a program model will be the maximum amount that the Department will pay for that program model.

36. Question: Are programs limited to the maximum rate?

· Answer: Proposed rates for all of the program models, except Residential Schools, are posted at https://www.mass.gov/regulations/101-CMR-41300-payments-for-youth-intermediate-term-stabilization-services-0.

· At the time of this writing, the rates are in draft form. To access the draft rates, click on the link “101 CMR 413 related and supporting documents” and then “Proposed Regulation (date filed: February 5, 2021)”. Note that this draft regulation includes rates for other state agency congregate care programs, as well as Caring Together programs. The rates for the DCF Congregate Care Network can be found under the heading “Congregate Care Program” and match exactly to the names of the program models in this RFR. The rate for the CSEC program is labeled “Specialty Treatment Residence (Commercially Sexually Exploited Children)”.

· When rates are finalized, the rate for a program model will be the maximum amount that the Department will pay for that program model.

37. Question: How is the assessment calculation used for the Young Parent Program? Is it based on actual costs or the DCF template? Are agencies proposing our own cost structure and reimbursement rate or is the DCF rate the maximum or the reimbursed rate?

· Answer: Young Parent Assessment will be a one-time assessment administered when a youth is initially admitted to a Young Parent Living Program as the first time receiving the service, not necessarily each time a youth is admitted to a young parent program. The add-on will be a one-time payment per youth. Billing instructions for how to bill for the assessment will be provided.

· The rates for the assessment for the young parent program can be found at https://www.mass.gov/regulations/101-CMR-41300-payments-for-youth-intermediate-term-stabilization-services-0. To access the draft rates, click on the link “101 CMR 413 related and supporting documents” and then “Proposed Regulation (date filed: February 5, 2021)”. The rates for the DCF Congregate Care Network can be found under the heading “Congregate Care Program” and match exactly to the names of the program models in this RFR. The rate for the assessment is labeled “Young Parent Assessment.

38. Question: For Appendix G & I Med Complex/Med C&Beh sections 4.05&4.06 Assessment & Tx Planning (w/ corresponding sections in the full RFR) there are no questions on the 1G or 1H Response Sheets for these areas, but these sections have related questions in the other program models. Is this in error, or should we address assessment & tx planning across our other responses?

· Answer: Appendices 1G and 1H include the questions for which the Department is requesting responses for those models.

39. Question: For an Intensive Treatment Residence (ITR), it is clear that the max size is listed at 9 beds and that a proposal would not be accepted for more than a 9-bed model. However, should a 9-bed ITR be awarded and the Dept has a need to place additional clients beyond the 9-bed capacity (i.e., a 10th or 11th client), would a provider be allowed to serve more than 9 DCF clients at a time? If so, would this be funded at the same unit rate?

· Answer: DCF does not intend to contract for programs that exceed the maximum capacity listed on each Program Model Specification in Appendices A – M.

40. Question: If we have a program that is licensed for and can accommodate 12 beds and the max bed capacity for Intensive Treatment Residence is 9 beds, can we utilize the additional 3 beds? Can we get permission to use the additional 3 beds for Intensive Treatment Residence or Community Treatment Residence?

· Answer: To propose shared space for an Emergency Residence and an Intensive Treatment Residence, follow the instructions in Section 10.07 for submitting a Program Model Response Package for each program model, and then follow the instructions in Section 10.09 for submitting a Shared Space Response Package. The Shared Space Response Sheet, Appendix 4Q, includes questions about the physical space. Row 8 on Appendix 3Q Shared Space Staffing Structure is for the number of proposed beds. The proposed physical space will be reviewed in relation to the proposed size of the program. Shared space proposals will be considered and be awarded at the Department’s discretion.

41. Question: Is an agency able to submit the request for QRTP once fully accredited, after all submission. Program is expecting full accreditation by 2022.

· Answer: Yes, there will be opportunity after the initial submission deadline to submit the QRTP application.

42. Question: On Appendix 2A-L, Section B, Nursing. How does a Young Parent Living Program answer that question when we do not have the programmatic need for an onsite nursing staff? Do we answer with our community partners who provide all health care needs for the young parents and their children?

· Answer: On Appendix 3L, leave the Nursing section blank.

43. Question: Can CSEC programs apply for start up costs? Can CSEC programs apply for emergency beds?

· Answer: No. See Section 8.09, the only program models eligible for start-up are Emergency Residences and Intensive Emergency Residences.

44. Question: Can DCF provide clarification on the ability for us to provide additional staffing via programmatic add-on?

· Answer: Programmatic Add-Ons need to serve all or most of the youth in a program. Programmatic add-on will be considered and be awarded at the Department’s discretion. Programmatic add-ons should be considered temporary, not permanent, additions to a program.

45. Question: The Staffing models have baseline staff. Do we have to provide all the staff outlined? For Instance, for CSEC it shows 1 FTE for Occupational Therapist. Does that mean we have to include an OT or do we have the flexibility to include difference Clinical Staff?

· Answer: A Bidder may propose an alternative staffing model. To propose a staffing model that does not include an Occupational Therapist (OT) use Response Sheet 3 and provide the justification on Response Sheet 2. An OT is included because emotional self- regulation is an important goal for youth in congregate care and there is research evidence that rich sensory diets developed and overseen by trained OTs help modulate sensory processing and promote relaxation, tolerance, and increased self-regulation. OT is not the only discipline that can contribute to decreases in behavioral health symptoms and increases in self-regulation. Justification is needed to explain how the outcomes of safety, permanency, and well-being will be achieved with the proposed alternative staffing pattern.

46. Question: If DTA provides beds for the program model we are going for, is there something additional we need to do?

· Answer: No.

47. Question: Are Programs applying as residential schools required to be accredited?

· Answer: No.

48. Question: What happens if DCF determines that a youth needs a residential school bit the school doesn’t want to fund it? Will that referral likely turn into a group home (Intensive Treatment Residence) referral?

· Answer: Each situation in which DCF and a Local Education Agency disagree is addressed and resolved on a case-by-case. Given the individual nature of each case, it is not possible to speculate what is likely to happen.

49. Question: What is the recommended approach for managing the differential between the established hourly rates for direct care staff and the new Boston Living Wage? (There us a $3/hour difference)

· Answer: Questions and comments about rates are referred to the EOHHS rate setting process.

50. Question: What specific contact information are you looking for in question one – response form 1? It asks for Names and “Contact Information” for govt officials.

· Answer: “Contact information” could include office street address, office phone number, cell number, email. Include the contact information that is available for these officials.

51. Question: Section 4.08( C) indicates that “Staff must be prepared to administer skilled and humane physical restraint”. Does this indicate that providers must be trained in physical management techniques even if they are a Restraint free program in policy and practice? For example, for the past 7 years we utilize and training TCI, but not in the physical management portion of the model.

· Answer: The DCF Congregate Care Network RFR is written to align with the simultaneous goals to eliminate the need for physical restraints, to eliminate calls to law enforcement for involvement with behavioral health issues, and to ensure that any physical restraints that do occur are delivered in a skilled and humane manner.

· Bidders for all program models, except the Medically Complex Residence, are asked to respond to the following question on Response Sheet 1:

What behavior support and management program will be used in the program? Include a link to the website that describes the behavior support and management program. In the absence of a website, include a copy of the behavior support and management program manual.

The Department will review and evaluate responses to this question against the expectations in the RFR for safety and behavior support and management, which state that the behavior support and management program must:

· Match the developmental level and behavioral health needs of the youth in the program;

· Include at least as much training on skills for preventing and de-escalating behaviors as for responding to behaviors with physical restraint;

· Have written documentation and training curricula.

· Should a Bidder choose to submit a behavior support and management program that does not include training for staff to be prepared to deliver skilled and humane physical restraint in the event of a behavioral health crisis that poses threat of imminent, serious, physical harm to a youth or others when de-escalation strategies are ineffective, the Bidder will submit the following additional information for the Department’s review:

· A description of the developmental and behavioral health needs of the youth that the Bidder will be prepared to accept for intake into the proposed program;

· A copy of the training curricula or written policy that guides staff in how to respond when attempts at redirection and de-escalation are not effective and there is threat of imminent, serious, physical harm to a youth who is exhibiting dangerous behaviors, to other youth in the program, to staff in the program, or to individuals in the community; and

· A copy of the written policy and procedures described in Section 4.10(C)(x) of the RFR that will be used by program staff for 24/7/365 responding to escalation of behavioral health symptoms and that includes the objective criteria and cultural considerations that will be used to determine when to contact the local police and which staff members are responsible for contacting the local police.

These materials may be submitted as an attachment, which will not be counted in the page limit for Response Sheet 1.

· Should the Department award a contract to a program that does not include training for staff to be prepared to deliver skilled and humane physical restraint in the event of a behavioral health crisis that poses threat of imminent, serious, physical harm to a youth or others when de-escalation strategies are ineffective and the program would have otherwise qualified to follow CQI Level I as described in Section 4.13 of the RFR, the program will be required to follow CQI Level II to ensure that data on safety, including calls to 911/law enforcement, are collected regularly and reviewed on a monthly basis.

52. Question: If an Emergency Residence proposes to serve a combination of 3 latency beds and 6 adolescent beds, is this considered one program or two? If is it considered one, does it only have to provide one submission of response forms 1,2, and 3 for the program model?

· Answer: It would be considered one Emergency Residence. Submit only one Program Model Response package for a single program. On Appendix 1E Response Sheet 1, in response to question 2, which asks for the proposed ages of youth to be served, list the actual ages rather than using the terms “latency” or “adolescent.” Should the Department review and select this program for contract, the contract would be for 9 beds for children and youth in the age range submitted in the response, not for a fixed number of beds for children and a fixed number of beds for adolescents.

53. Question: Related to previous ITR question, can we propose a 12-bed ITR program? 9 beds and 3 beds but in the same setting/facility.

· Answer: DCF does not intend to contract for programs that exceed the maximum capacity listed on each Program Model Specification in Appendices A – M.

54. Question: In this case of Emergency Residence model, can a bidder propose to combine the 3-bed adolescent Taunton/Cape beds and the 6-adolescent Brockton beds to be served at the same location? If so, does this require one response or two?

· Answer: Yes, the beds can be combined in one proposal. It will require one Program Model Response Package. Emergency Residence and Intensive Emergency Residence will not be owned by a single DCF Area Office but there will continue to be a close working relationship between DCF Area Offices and the Emergency Residences and Intensive Emergency Residences that are geographically close.

55. Question: Appendix I for Youth and Young Adult Group Residence does not specify that a Trauma assessment, Substance Abuse or CANS assessment is needed under Section 4.05. Are assessments for Trauma, substance abuse and CANS required in this model?

· Answer: Assessments for trauma, substance use, and CANS are required. Appendix I will be amended.

56. Question: In Appendix 1L, Question #15. Do staff of YPLP’s need to be CANS certified?

· Answer: A Young Parent Living Program may either employ a staff member or members certified to conduct CANS or arrange for an external provider to conduct CANS. For either arrangement, ensure timely completion of CANS for any youth for whom a CANS assessment is required.

57. Question: Related to Question 3 on Young Adult Supported – Given that the requirements for Living and Youth & Young Adult Supported Community Living have changed (no longer requiring certificates of inspection etc.) where should we document our plan for facility safety?

· Answer: If it is not requested on a Response Sheet for the program model, it is not required as part of the proposal submission.

· Should a Bidder’s Young Adult Supported Living program be awarded a contract, arrangements will be made for reviewing plans for facility safety.

58. Question: Are we required to have a specific site identified for Youth and Young Adult Supported Community Living (J)? We wouldn’t seek a site until we were approved….

· Answer: It is not required to have a site. For questions that ask for characteristics of the site or surrounding community, enter whatever information is known as well as plans and intentions for the site where the program will be delivered. Should the proposal be accepted, the start date discussion, which can include final arrangements for a site, will occur during contract negotiation.

59. Question: Are some positions required in staffing response?

· Answer: Yes. See Section 4.12(A) Licensed Staff for staffing requirements.

60. Question: to follow up on a previous question on shared space for ResEd an ITR, are you saying that if we can only physically hold 9 youth, we can apply for 9 beds for each? Even though neighter (..neither) will ever be full? I believe this is what you said. I just want to confirm.

· Answer: If the physical space available for a program can only accommodate 9 youth, then on line 8 Number of Beds on Appendix 3Q Shared Space Proposed Staffing Structure, enter the number “9.”

· To propose shared space, follow the instructions in Section 10.07 for submitting a Program Model Response Package for each program model that will be in the shared space arrangement, and then follow the instructions in Section 10.09 for submitting a Shared Space Response Package.

61. Question: In proposing Shared Space do you need to submit two separate proposals, one for each program and the Shared Space Response?

· Answer: Yes. To propose shared space for two program models, follow the instructions in Section 10.07 for submitting a Program Model Response Package for each program model that will be in the shared space arrangement, and then follow the instructions in Section 10.09 for submitting a Shared Space Response Package.

62. Question: Under the current Caring Together contract, DCF allows having STARR and Group Home 1:3 at the same location – as an example 9 STARR beds and three 1:3 group home beds. This arrangement has proven beneficial for clients who are not able to return to a family setting. This ensures continuity of care. Appendix Q, Shared Space – Is this allowed under the new RFR? For Example, having Emergency Residence and Intensive Treatment Residence clients at the same location?

1. Answer: See Appendix Q Shared Space for a list of which program models are and are not eligible for Shared Space. The STARR model best crosswalks to the new Emergency Residences and Intensive Emergency Residences models. The existing Intensive Group Home 1:3 model in Caring Together is not an exact crosswalk to one specific program model in the new RFR. Bidders are advised to use Appendix Q Shared Space to determine whether the program models they are considering are eligible for Shared Space.

63. Question: Can the QRTP add on apply to Emergency Residence Model?

· Answer: No. See Appendix O for the list of program models eligible to apply for QRTP.

64. Question: To follow the response questions. If you have same model different locations but with number of beds. Young Parent I response

· Answer: DCF is not sure what this incomplete question is asking but suggests referring to Section 10.07 Requirements for a Program Model Response Package for submittal instructions.

65. Question: If I am planning to open a not yet licensed program (it will be of course). It will be located across the street from current Resi School. It is not to expand current but to add a “transition” living service through our school. Should we apply under the rolling model later or include a description of it in the proposal submitted on 5/3.

· Answer: See Section 7.09 (A) for a list of the program models being procured on a rolling basis. The deadline on 5/3/2021 is for completed proposals.

66. Question: Should a provider propose two models that are able to share a physical space, are they able to accept contracts at the maximum number of beds and make their own decisions about allotting beds based on referrals to each service? For example, if there is a program space with 9 beds and provider has applied for 9 beds ITR and 9 beds Residential School and both contracts are awarded as they are Non-competitive, could a provider, based on referrals say that they will share the space by filling 6 ITR beds and 3 Res beds (assuming all state agency policies are followed), then, 1 year later, should referrals for Residential School eclipse ITR referrals, could a provider opt to change the mix to 3 ITR beds and 6 Residential School beds?

· Answer: Per Appendix Q Shared Space, both Intensive Treatment Residence and Residential School are eligible for shared space. Per Section 7.05 Acquisition Method, both Intensive Treatment Residence and Residential School will be acquired through non-competitive bids. Therefore, the answer to the question about changing the number of beds in each model is “yes.” For the three program models that will be acquired through competitive bids – Emergency Residences, Intensive Emergency Residences, and Young Parent Living Programs – the awarded contracts will have bed numbers that are not changeable.

67. Question: If my question is confusing because it includes Res School, choose any other model (follow up to question #71, might not need to be a separate question

· Answer: DCF does not understand the reference to question #71. The assumption made to answer the question is that this is a question about Shared Space.

· Per Appendix Q Shared Space, both Intensive Treatment Residence and Residential School are eligible for shared space. Per Section 7.05 Acquisition Method, both Intensive Treatment Residence and Residential School will be acquired through non-competitive bids. Therefore, the answer to the question about changing the number of beds in each model is “yes.” For the two program models that will be acquired through competitive bids and that are eligible for shared space – Emergency Residences and Intensive Emergency Residences – the awarded contracts will have bed numbers that are not changeable.

68. Question: We are considering 5-day response for admissions decision from the date the referral is COMPLETE, meaning the date we receive all the material needed to fully assess a referral. On the date of initial referral, we rarely have adequate information to make an informed decision. Will there be a problem with the way we are conceptualizing this?

· Answer: The expected timeframes for each program model are included on each Program Model Specification in Appendices A – M. This question does not indicate which program model is being considered.

· As stated in Section 4.03, The Department expects Contractors to be responsive to the fast-paced, and often crisis-driven, speed of child welfare work as well as to youths’ needs for stability.

69. Question: Earlier you stated “all providers who participate in rehab option”. It was my sense that most program models (A,B,C,D,E,F,I,M) require participation in Rehab Option and that it is not optional. Is that Correct?

· Answer: See Section 6.03(A) for all program models required to participate in Rehab Option.

70. Question: Some of the questions are lengthy. Are there instances when a question can be abbreviated so that i doesn’t take up so much space? For example, Appendix 1D, Section J. Practice example 1.

· Answer: Please keep questions on the Response Sheets intact.

71. Question: To be clear if submitting same single Program response for multiple locations the question in Community Connections and Relationships that refers to providing a “list” and the question on List of Locations and Community integration that asks to describe “community resources”, can this be included as an attachment as page limits would not allow otherwise.

· Answer: See RFR Amendment 3.22.2021 page 8, number 9 for instructions on how to accommodate questions about the local community when proposing multiple sites for a single program model.

72. Question: There is a requirement to report the relationship with elected officials. Is that specific to local/town elected officials or is the expectation to include state/federal elected officials (ie. state reps, state senators)?

· Answer: The question refers to local elected officials. Bidders may choose to include state legislators.

73. Question: We understand that the staffing models are not mandates and only represent one possible staffing pattern however these models seen to have minimal amount of clinical staffing (ex. 55 combined clinical staffing for a 9 bed emergency residence) particularly given the requirements of rehab options. What were the departments thoughts around proposing this level of clinical staffing in the models?

· Answer: See Section 4.12(A) Licensed Staff and Section 6.03(B) for statements about the clinical staff requirements for Rehab Option. As stated in the question, the staffing models are not mandates, which allows Bidders to propose alternative staffing models.