Final Written Responses to Written Inquiries 4.14.2021.docx

Written Responses to Written Inquires April 14, 2021 All written inquiries submitted pursuant to RFR section 7.14, as amended on March 22, 2021, will be responded to in writing and posted to COMMBUYS.

This document contains all written inquiries submitted per the requirements in RFR section 7.14, as amended on March 22, 2021, and the Department’s written responses.

1. Question: The maximum size of Intensive Treatment Residence is 9 beds. If a provider operates a unit with capacity for 12, is it permissible to co-locate a 9 bed Intensive Treatment Residence with a 3 bed Specialty Treatment Residence? If so, are all the resources of the 9 bed Specialty Treatment Residence simply divided by 3 to generate the resources for the 3-bed model, e.g., all clinical, direct care, and management resources, etc.?

· Answer: To propose shared space for a Specialty Treatment 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.

· Regarding how to distribute the staffing resources, Bidders are responsible for proposing a staffing structure, which is submitted on Response Sheets 2 and 3.

2. Question: The rate information and staffing released by EOHHS indicates resources for a 9 bed Specialty Treatment Residence. The max size for this program type is 12 beds. Are ALL of the resources of the 9-bed model increased by one third in order to staff the 12-bed model e.g. all clinical, direct care, and management resources, etc.? The answer could impact how providers decide to organize their proposed staffing model to align with the daily rate that will be offered to all providers of a given service.

· Answer: The staffing models used to create rates are not mandates. Response Sheets 2 and 3 are Bidders’ opportunity to propose the staff-to-client ratio and the configuration of staff that will allow you to achieve outcomes of safety, permanency, and well-being for the youth in the program. DCF will review and assess the proposals.

3. Question: In a shared space, can you flip a bed to meet the needs of a client who is stepping down or stepping up? For example, if you have a shared space between Community Treatment and Intensive Treatment Residence, can the youth stay and just receive matched services within the shared program? Is there a limit to this scenario?

· Answer: Per Section 7.05 Acquisition Method, both Intensive Treatment Residence and Community Treatment Residence will be acquired through non-competitive bids. Therefore, a provider can, in collaboration with DCF, periodically shift the ratio of number of beds in a shared space arrangement. However, the beds cannot be “flipped” on a day-to-day basis.

· Question 30 on the Written Responses to Bidders Conference Questions, Part 1 asked a similar question but asked if the bed numbers could be changed “1 year later.” The answer to that question was “yes,” because it was not asking for bed ratios to be changed on a day-to-day basis. The limit to the scenario is that the changes in bed number for the two different programs have to be planned changes in collaboration with DCF.

· 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.

4. Question: We are planning to submit a shared space proposal for 9 ITR and 3 CTR beds; this is our ultimate goal. We know we need to submit separately a 9 bed ITR proposal and a CTR proposal, but obviously a 3 bed CTR stand alone is impossible financially, and the staffing would make no sense. Should we submit the CTR proposal with a higher number in order to provide a reasonable and complete proposal, despite knowing that our goal is not to run a CTR stand-alone? To put this question in generic terms: “Must shared-space applications be accompanied by two separate applications that are each large enough to operate as stand-alones along with a shared space application that reduces the count in one or both separate applications, even if the provider’s goal is to operate only the shared space configuration?”

· Answer: The plan for submittal of a 9 bed Community Treatment Residence as described above is acceptable. Shared space proposals will be considered and be awarded at the Department’s discretion.

5. Question: The RFR indicates an ability to share space between a number of models including Res/Ed, in proposing programs of a particular size, is it permissible to overlap Res/Ed and other beds? For example, if you currently operate a 12-bed unit that serves both Res/Ed and GH youth under Caring Together, can you propose a 12 bed Intensive Treatment Residence that will share space with a 12 bed Res/Ed program so that you have an ability to flexibility shift the number of Res/Ed and Intensive Treatment Residence youth up and down depending upon the demand for one or the other service?

· Answer: Per Appendix D Intensive Treatment Residence, the maximum size for an Intensive Treatment Residence is 9.

· In a shared space arrangement, the maximum number of beds is entered on line 8 Appendix 3Q Shared Space Proposed Staffing Structure. The number of beds is the total number for the entire shared space arrangement.

· Question 30 on the Written Responses to Bidders Conference Questions, Part 1 asked a similar question but asked if the bed numbers could be changed “1 year later.” The answer to that question was “yes,” because it was not asking for bed ratios to be changed on a day-to-day basis. Changes in bed number for the two different programs have to be planned changes in collaboration with DCF.

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

· Answer: Yes.

7. Question: What is the impact of requirements of licenses, specifically for shared space, do we need two separate licenses for two different programs sharing a space in one house?

· Answer: EEC licensure per 606 CMR 3.00 is the same for all program models.

8. Question: Under the concept of Shared space, is there a limit of number of contracts we can apply for under one space? For example, if we have a 9-bed capacity, can we apply for the max of nine under each proposal allowing for each type of service full access to the beds OR can we only apply for a total of nine across all proposal, so if you apply for two programs, can it only equal to 9 or can each have the capacity of 9?

· Answer: In a shared space arrangement, there will be one contract for one shared space location.

· The maximum number of beds is entered on line 8 Appendix 3Q Shared Space Proposed Staffing Structure. The number of beds is the total number for the entire shared space arrangement.

· Question 30 on the Written Responses to Bidders Conference Questions, Part 1 asked a similar question but asked if the bed numbers could be changed “1 year later.” The answer to that question was “yes,” because it was not asking for bed ratios to be changed on a day-to-day basis. Changes in bed number for the two different programs have to be planned changes in collaboration with DCF.

9. Question: In a large apartment building, would a separate unit with fully contained living space in one part be ok for a program like CSEC if another unit in the same building housed a DHCD family in shelter (if we were careful about who we placed there)? There would be no sharing of any space, staff, etc. and no co-mingling at all. DHCD is fine with this shared arrangement - is DCF?

· Answer: Shared Space as described in Appendix Q addresses only program models procured by the Department. This question asks about a scenario in which a Bidder wishes to site a program model procured by a different state agency at the same address or in the same building as a program model procured by the Department.

· The time to discuss the characteristics of a program site with the Department is at initial contract negotiation.

· It is the Bidder’s responsibility to obtain agreement for the arrangement from the other state agency.

· DCF cautions Bidders that the Specialty Treatment CSEC model is listed on Appendix Q as a program model that is not eligible for shared space. The reason is because the youth in a Specialty Treatment CSEC require specialized treatments and a specialized environment that is tailored to their needs. When considering which programs may be best suited for siting at the same address or in the same building, Bidders are advised to consider programs that are listed as eligible for shared space on Appendix Q.

10. Question: Section 8.09 Start-Up Costs states: "The Department may enter into separate contracts for start-up costs for Emergency Residences or Intensive Emergency Residences programs. Such contracts will have Maximum Obligation Amounts. This is determined on a case-by-case basis at the sole discretion of the Department." Will the Department consider start-up costs for a Specialty Treatment CSEC Program during the negotiation phase of the contract? Our agency is interested in submitting a CSEC proposal but will need assistance funding a building.

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

11. Question: We are a current Independent Living Service Provider and are responding to the Department’s RFP to provide YASL services. We would like to propose an aftercare position with add-on services. Will this be allowed? We believe this aftercare is essential for young people who are having difficulty meeting adult expectations and may not have the support of their families or other adult informal support systems.

· Answer: Although aftercare is not required in the Young Adult Supported Living program model, the idea makes sense. This is not saying that the proposal will be approved. Use Appendix 4N to propose a Programmatic Add-On, which is subject to review and approval by the Department.

12. Question: The specifications for the YASL model say that participants must be able to live independently (with program supports) and access educational and vocational programs. Our current program does not always find that these abilities are present within the young people referred by DCF for Independent Living Services; sometimes the young people cannot remain in placement. Many of our participants have long placement histories which often include group care/residential placements and it seems as if we are often the option of last resort due to their age. At the same time, there are literally thousands of young people who would be a fit for and benefit from our model, but DCF has historically given them vendor payments and not supported their enrollment in a program like ours. We would love to serve youth who can manage the independence of our model because these are the youth with whom we do our best work and who benefit the most from our services. Does the Department envision that it will refer young people consistent with this profile? It is our understanding that young people in congregate care have moderate to severe behavioral health needs; otherwise, they would be supported at home with their families.

· Answer: Appendix K Young Adult Supported Living describes the profiles of young people that the Department envisions referring to this program model.

13. Question: Can providers select which area office they are applying for Emergency Residence and Intensive Emergency Residence beds or are all of those “beds” considered regional and will be managed as regional? If providers CAN indicate which areas offices they are applying for ER and IER, should this be indicated in the cover sheet or in the narrative of the proposal?

· Answer: All of the beds will be considered Regional beds. 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.

14. Question: If we are submitting for QRTP status in two Community Treatment Residence programs, one latency age and one adolescent, do we need to submit two separate Appendix 4O Qualified Treatment Residence Response Sheets?

· Answer: Yes, submit two separate Appendix 40 Qualified Residential Treatment Program Response Sheets. The QRTP response sheet is required for each model because QRTP will be awarded at the program model level, not the agency level.

15. Question: Do we need to submit QRTP add on for Emergency Residence models even though there is no differentiation in the rate?

· Answer: Emergency Residence is not eligible for QRTP. See Appendix O for program models eligible for QRTP.

16. Question: Can you please explain your rationale for applying Rehab Options to the Emergency and Intensive Emergency Residence models? Under the Caring Together procurement, Rehab Options did not apply to the STARR programs, which are like the new emergency residence models.

· Answer: The decision to include the Emergency Residences and Intensive Emergency Residences was based on review of the Federal requirements for the Rehab Option program and the characteristics of the new Emergency Residences and Intensive Emergency Residences program models that differ from the previous STARR model.

17. Question: If we have no clinician at a Young Adult Supported Living program, only case managers providing case management, is it then okay to discuss only Case Management services on questions 6-8 on Appendix 2A-L? And N/A for clinical services?

· Answer: Questions 6-8 on Appendix 2A-L apply to clinical and case management services. To respond to those questions, describe the plan for clinical and case management services in the proposed program. Include statements of what services will and will not be provided by program staff.

18. Question: For Young Adult Supported Living and Young Parent Living Program, for administering the CANS, can we use CANS assessors from other JRI programs?

· Answer. Yes.

19. Question: Is there a checklist of all of the required documents for the Young Parent Program response and a list of what is required if the contract is awarded?

· Answer: Bidders interested in submitting a proposal for any program model, including Young Parent Living Program, are advised to review and complete the Program Model Checklist, which lists the required documents and is in the Forms and Checklist folder on COMMBUYS.

· See item 10 on page 6 of the document RFR Amdendments_3-05-21, which is posted on COMMBUYS, for the list of forms required if a contract is awarded.

20. Question: DCF has stated that submissions for program models acquired using the Non-Competitive method received after Monday, May 3, 2021 will be reviewed on a quarterly basis. When will that quarterly basis begin, i.e., what month in 2021? After the review and if a program is approved, how long thereafter can a provider expect to receive a contract?

· Answer: The Department anticipates starting the rolling, quarterly review process during the fourth quarter of calendar year 2021, i.e., October – December 2021. An expectation for contract initiation would be the first quarter of calendar year 2021, i.e., January – March 2022.

21. Question: We will be applying for Emergency Residence and Intensive Treatment Residence in multiple locations serving the same # of clients and same client profile. Section B, question 6 asks for the name and location of the mental health center, etc. Can the answer be provided in an attachment?

· Answer: Yes. 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.

22. Question: We will be applying for Emergency Residence and Intensive Treatment Residence in multiple locations serving the same # of clients and same client profile . Program Model Specifications Section I, Motivation and Experience , question 3,asks for the name and location of the mental health center… that is used to provide med. Management services Can the answer be provided in an attachment?

· Answer: Yes. 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.

23. Question: Can the Young Adult Supported Living be housed in a program site that has single bedrooms for each young adult, with shared living space?

· Answer: No. See Appendix K Young Adult Supported Living, which states that this program model shall be delivered in housing units (e.g., apartments, townhomes, condominiums).

24. Question: On response form 1 for the Emergency Residence model Section M question 12, can the answer be submitted as an attachment if the response includes two different communities?

· Answer: Yes. 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.

25. Question: On response form 1 for the Group Residence model Section L question 9, can the answer be submitted as an attachment if the response includes two different communities?

· Answer: Yes. 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.

26. Question: On response form 3 for an Emergency Treatment Residence or Group Residence, if a position you plan to include in the staffing structure is not listed (ie- cook, Admin Assistant or maintenance staff), can they be listed under the Direct Care Category or should you add a new category with rows for such positions?

· 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.

27. Question: We will be submitting separate proposals for Emergency Residence and Intensive Treatment Residence each in multiple locations serving the same # of clients in each and the same client profile as described under 4. Youth’s Strengths and Needs . In respect to age crossover, can we still submit a single proposal for each if we propose an age range of 8-18 in one location and 10 to 18 in another location or will the different age ranges require separate submissions. The age range would do the only difference in our response.

· Answer: Submit one Program Model Response Package for each program model and explain the proposed range of ages to be served on Response Sheet 1 in the section that asks for ages of youth to be served.

28. Question: Can you explain your thinking about the proposed staffing models with minimal clinical staffing, particularly for the emergency residences, which are now subject to Rehab Options?

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

29. Question: DCF has indicated that community resources for clinical work and psychiatry are intended to “supplement” the resources in a program. What are they supplementing? Are program clinicians expected to provide individual, family, and group therapy and if so at what frequency? Do providers have an ability to bill insurance for clinical services like what is allowable in some of the current Caring Together models (e.g., 1:4 Group Home where individual therapy is billable outside of the contract rate). Does the ability to bill insurance extend to psychiatry should a provider opt to provide this service on site as well? Are we allowed to provide on-site clinical service through our own organization’s clinic license?

· Answer: The RFR states expectations for the delivery of behavioral health (BH) services and treatments within the program, including the sustained delivery of a 24/7 trauma-informed therapeutic milieu.

· The frequency, intensity, and duration of treatments will be based on the individual needs of each youth and will be reflected on a youth’s treatment plan. When a youth’s BH needs cannot be met by internal capacity, programs are expected to supplement internal services with BH treatments available across systems and providers, including providers paid by insurance.

· Services that may exceed a program’s internal capability might include substance use disorder treatment, psychiatric assessment, psychopharmacology prescribing and monitoring, family therapy.

· Services that exceed a residential program’s internal capability may be provided by a community-based provider of BH services. The community-based provider may be the same organization that operates a residential program.

30. Question: The RFR indicates that providers have flexibility to propose staffing models so long as there are “sufficient qualified and competent staff” to meet the RFR expectations. Are there any positions for which a minimum level of FTE is required? For example, which it the minimum number of FTEs for program director, assistant program director, licensed clinician? Does a provider have to hire a BCBA and an OT and if so, is there a minimum FTE required for these roles as well? Or are none of the positions other than an LPHA for Rehab options and some number of hours of licensed clinician required? Which FTEs from the model on which the rate is based can be shifted to other roles and which FTEs cannot?

· Answer: Bidders have flexibility to propose alternative staffing structures. The following statement is from the DCF First Amendment of Notice of Intent to Procure Congregate Care Network, “Although the rates are based on a staffing model, which is comprised of staff positions, educational level/credential, and FTE, providers will be able to propose an alternative staffing structure that will achieve safety, permanency, and well-being outcomes. The list of staff positions along with the accompanying educational level/credential and FTE in the model budget do not represent a staffing mandate.”

· See Section 4.12(A) of the RFR for licensed staff requirements.

31. Question: What was the reason for the extended deadline?

· Answer: To give Bidders ample time to response to the RFR.

32. Question: Could you please confirm that the submission date for Congregate Care Proposals has been extended to April, 20, 2021.

· Answer: The submission date is May 3, 2021 at 2 pm.

33. Question: What time on May 3, 2021 are responses due?

· Answer: The submission date is May 3, 2021 at 2 pm.

34. Question: Since the requirement for providers to restrain youth is contained in the main RFR document, is DCF suggesting that restraint be utilized for Young Parent Living Programs? The CSEC Program Model? Models that serve ages 18+?

· Answer. There is no requirement to restrain youth. Having staff who are well-trained to administer skilled and humane physical interventions, if needed to ensure safety when there is threat of serious, imminent physical harm, should not be misinterpreted as a requirement to restrain youth. The Department’s expectation is that programs will work to eliminate the need for physical restraints as well as reduce calls to law enforcement for involvement with behavioral health issues.

· 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.

35. Question: What is the data and research informing DCF's shift away from restraint reduction/elimination?

· Answer: DCF has not shifted away from restraint reduction/elimination. 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.

· See the response to question 34 above for instructions on submitting a proposal for a program in which staff will not be trained 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.

36. Question: Understanding that if we are proposing the same program model at different addresses (i.e. Community Treatment residence in the same community, in different buildings) we only need to complete one Response Sheet 1. Do we also only need to complete one Response Sheets 2 and 3? If we only need to complete one Response sheet 3, do we indicate the total number of beds across all sites at the top of the sheet where it asks for number of beds or do we indicate the number of beds per site?

· Answer: Submit one Program Model Response Package to propose the same model at different addresses that have same number of beds and serve the same clinical profile of youth. On Response Sheet 3, indicate the number of beds per site.

37. Question: If we are submitting for two locations for the same model, same number of beds, but one location is latency aged mixed gender and one location is adolescent male, do we need two program model response packages?

· Answer: See Section 10.07(E)(ii) for a description of when a single Program Model Response Package may be used. The example in this question does not qualify for a single Program Model Response Package because the clinical profiles of the youth to be served are different. The submittal described in the question would require two Program Model Response Packages.

38. Question: If we are submitting for four sites for the same model, all serving latency age, all mixed gender, but two sites are 12 bed and two sites are 6 bed, do we need two separate program model response packages?

· Answer: Yes, two separate Program Model Response Packages must be submitted because the programs have a different number of beds. One of the Program Model Response Packages would be for the 12 bed proposals and the other Program Model Response Package would be for the 6 bed programs.

39. Question: Our campus has multiple houses under one license; however we intend to have each house apply for in separate proposal/program, what is the plan/intention of DCF and EEC for license, does each program need a separate licenses or may they fall under the facility/property license? For example, Property A has three houses that are applying for three unique programs, do they each need their own license?

· Answer: There is not a requirement that each program must have a separate license.

40. Question: Are we only allowed to submit requested attachments? Or can we include others?

· Answer: Only requested attachments are allowed.

41. Question: Can we use 10-point font in tables?

· Answer: Please maintain the 12 point font in responses.

42. Question: Does DCF have an anticipated length of stay for different program models?

· Answer: A length of stay has not been set for each program model.

43. Question: What is the definition of "profiles of youth"? What factors are included, e.g. age, gender? (in reference to pg 103 of RFR, 10.07(E)ii(2)a)

· Answer: “Different profile of youth,” refers to different clinical profiles, which includes age and gender. A Program Model Response Package includes a Bidder’s responses describing a program model that will mee the needs of a certain profile of youth.

44. Question: When are contract award notifications anticipated? In the RFR, are there updates to Sections 7.12(D) - 7.12(H)?

· Answer: The estimated date ranges in Section 7.12 are still applicable.

45. Question: Can you clarify whether site control is required? If not, how can we best respond to Sections B (Community Connections and Relationships) and Section L (List of Locations and Community Integration) without losing any points?

· Answer: If a site has not been finalized, 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.

46. Question: Regarding this question which is in Section F. Safety on Response Sheet 1 (any/all models): Describe the routine process(es) that will be implemented to gather and document staff members’ concerns and comments about youth safety, maintenance of healthy physical and emotional boundaries between youth and staff, and supervision of youth. We are seeking clarity on the meaning of the question due to punctuation. Are these three separate processes (1-process to gather and document staff concerns about safety, 2-process to gather and document maintenance of healthy physical and emotional boundaries between youth and staff, 3-processes for supervision of youth) OR- Our process to document staff members’ concerns and comments about safety, boundaries between staff and youth, and supervision of youth?

· Answer: The task is to collect information about three aspects of safety. The task could be completed with one process. Or, two or three different processes could be used to collect the information.

· Respond to the question by describing how the task of collecting information about three aspects of safety will be completed in the program you are proposing.

47. Question: What is the additional revenue for providing QRTP programs intended to cover? Is it intended to pay for the cost of accreditation and providing a trauma informed model? Is it intended to pay for additional salary expense to cover nursing and clinical on-call coverage as well as aftercare? Does a provider have an obligation to use contract resources for aftercare or is this a service that can be exclusively provided through outpatient/CBHI resources without using program resources. This impacts staffing model proposals as well as considerations regarding where to apply for QRTP service.

· Answer: A provider has discretion in how to use the additional revenue in the QRTP rate, applying it to any of the costs associated with providing a program that meets QRTP requirements. All program models in the RFR are required to provide a trauma-informed therapeutic milieu.

· It may be possible to arrange external resources for aftercare. A Bidder considering such an arrangement may submit a proposal for the Department’s review. The requirement is for aftercare support for at least 6 months post-discharge for youth who reunify or transition to a home-based setting, such as a kinship or foster home. A referral to a service that is not delivered or not delivered for the entire 6 months would not qualify as aftercare for QRTP. The requirement is for actual delivery of aftercare support for 6 months post-discharge.

48. Question: Is there an issue with Appendix S – Additional Resources? It does not open.

· Answer: DCF recommends that bidders attempt to open this file from multiple browsers and on multiple devices in order to ensure access. For any technical issues accessing documents on COMMBUYS, please contact the COMMBUYS Help Desk from 8:00a.m.-5:00p.m. (Eastern) Monday-Friday by calling 1-888-627-8283 or by emailing COMMBUYS@state.ma.us.