Flexible Support Services Master Agreement RFR.doc

The Commonwealth of Massachusetts

EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

Department of Mental Health

COMMBUYS Bid#:

BD-19-1022-DMH08-8220A-33600

Assistant Director of Contract Administration, Audit & Systems

Central Office

25 Staniford Street

Boston, MA 02114

Fax (617) 626-8014

1SECTION 1

INTRODUCTION AND GENERAL DESCRIPTION

11.1 Issuing Entity/ COMMBUYS

21.2 Description of Procurement

41.3 Service Principles

41.4 Procurement Information

6SECTION 2

ESTIMATED PROCUREMENT TIMETABLE

62.1 Procurement Calendar

72.2 Written Questions via the Bid Q&A On COMMBUYS

82.3 Bid Amendment, Withdrawal, Cancellation

92.4 Physical Bidders’ Conference (In-Person)

92.5 Reasonable Accommodations

9SECTION 3

DMH MISSION STATEMENT

10SECTION 4

DESCRIPTION OF SERVICES

114.1 Clinical Services

134.2 Therapeutic Support

144.3 Young Adult Peer Mentoring

164.4 Parent/Caregiver Peer Support

174.5 Flexible Funding Administration

18SECTION 5

DESCRIPTION OF MODALITIES

185.1 Flexible Support Team

205.2 Individual Practitioners

205.3 Flexible Support Group

21SECTION 6

SERVICE SPECIFICATIONS AND STANDARDS

216.1 Access to Service

216.2 Engagement

226.3 Intake

226.4 Assessment

246.5 Community Service Plan (CSP)

256.6 Notes

256.7 Safety Plan

256.8 Discharge/Transition Plan

266.9 Collaboration with Parent/Caregiver and Youth

266.10 Collaboration with System Partners

276.11 Disenrollment from Services

27SECTION 7

ORGANIZATIONAL REQUIREMENTS

277.1 Records

287.2 Staffing

297.3 Policies, Procedures, Protocols

297.4 Data and Reporting Requirements.

307.5 Quality Measures

317.6 Quality Improvement

327.7 Meetings with DMH

327.8 Contract Management

337.9 Privacy and Data Security

337.10 Information Technology (IT) Requirements

357.11 Provider Fiscal Requirements

367.12 Intellectual Property Rights, Publicity, Publication, Reproduction

367.13 Use and Ownership of Data and Software

37SECTION 8

FISCAL SPECIFICATIONS

388.1 Unit Rate

388.2 Billable Unit of Service and Maximum Number of Billable Units

398.3 Monthly Invoicing

40SECTION 9

RESPONSE REQUIREMENTS

409.1 Submission Format

419.2 Submission Deadline

419.3 Submission Requirements

429.4 Page Limits and Attachments

429.5 Re-Bid

42SECTION 10

REVIEW AND QUALIFICATION PROCESS

4210.1 Determining Qualified Contractors

4510.2 Rejection of Responses/Quotes

4510.3 Contract Award Decision and Award Notification

47SECTION 11

TERMS AND REQUIREMENTS PERTAINING TO AWARDED CONTRACT

4711.1 Contract Contents

4811.2 Contractor’s Contact Information

4811.3 Publicity

4811.4 Contract Authorization and Effective Start Date

Attachment A Definitions Attachment B DMH Parent/Caregiver Peer Support (Family Partner) Service Core Elements Attachment C Procedures for the Use of DMH Flexible Support Services Flexible Funds

Attachment D Projected Flexible Support Teams by Area Other Associated Documents:

· OSD Instructions for Vendors Responding to Bids via Commbuys

· OSD RFR- Required Specifications for POS Services

· Authorized Signatory Listing

· Authorization for Electronic Funds Payment

· Commonwealth Terms and Conditions for Human and Social Services

· Commonwealth of Massachusetts Standard Contract Form and Instructions

· DMH Business Associate Agreement

· Flexible Support Services Response Requirements

· Flexible Support Services Evaluation Tool

· List of Permitted Response Attachments

· MA Form W-9

· RFR Cover Sheet

· Rates for Flexible Support Services

· Supplier Diversity Plan Form for POS

· WTO Government Procurement Agreement Link

SECTION 1

INTRODUCTION AND GENERAL DESCRIPTION

1.1 Issuing Entity/ COMMBUYS

Issuing Entity:

Department of Mental Health

RFR File Title:

Flexible Support Services Master Agreement Request for Response (RFR)

DMH Document Number:

DMH #2019-FLEX-3066-02

Asst. Director of Contract Administration, Audit & Systems

Address:

Department of Mental Health

Central Office

25 Staniford Street

Boston, MA 02114

Fax:

(617) 626-8014

Email:

Jerome.Collins@state.ma.us

This Bid has been released on COMMBUYS. COMMBUYS is the official source of information for this Bid and is publicly accessible at no charge at www.COMMBUYS.com. For more information on COMMBUYS, please see OSD RFR - Required Specifications for POS Services that is included in the Bid’s COMMBUYS File. In COMMBUYS, a “Bid” refers to the solicitation, Request for Response (RFR) or procurement.

Responders may not alter (manually or electronically) the Bid language or any Bid component files, except as directed in the RFR. Modifications to the body of the Bid, specifications, terms and conditions, or which change the intent of this Bid are prohibited and may disqualify a Response.

Capitalized terms not otherwise defined herein shall have the meaning ascribed to them in Attachment A of the RFR that is included in the Bid’s COMMBUYS File. All attachments to this RFR are included in the Bid’s COMMBUYS file. A list of all attachments included when this RFR was issued is set forth at the end of the Table of Contents. The attachments are incorporated into this document by this reference.

1.2 Description of Procurement

1.2.1 Purpose. The Massachusetts Department of Mental Health (DMH), through this RFR, is seeking to establish a pool of qualified Provider organizations that can provide one or more of the following Flexible Support Services: (a) home and community-based Clinical Services, (b) Parent/Caregiver Peer Support, (c) Young Adult Peer Mentoring, and (d) Therapeutic Support; within the context of one or more of the following modalities: (i) a Flexible Support Team, (ii) Flexible Support Group or (iii) Individual Practitioner. Sole proprietors will not be considered. Services will be provided to children, youth, and young adults from birth through 21 years old (hereinafter referred to as “Youth”) authorized for DMH Flexible Support Services, and their families.

Providers will be qualified by Service Type(s); Modality(ies) and DMH Area. See Subsection 10.1 for more information.

1.2.2 Service Class Information. DMH Flexible Support Services is a service within the EOHHS “Family Stabilization” Service Class. This Service Class is defined as services that provide supports to Youth and their families with the purpose of promoting stability, whether this involves preventing out-of-home placement, supporting transition between placements, or independent living.

Overview. Flexible Support Services include Clinical Services, Therapeutic Support, Young Adult Peer Mentoring, and Parent/Caregiver Peer Support. These services are provided through three modalities: through a Flexible Support Team, Flexible Support Group, and Individual Practitioner.

A Responder may bid to provide one or more of the four Flexible Support Services through one or more of the Flexible Support Service modalities to one or more DMH Site Offices and the cities and towns served by that Site Office. A listing of DMH Area and Site Offices and their geographic locations can be found here: https://www.mass.gov/locate-department-of-mental-health-offices-and-facilities.

Based on the needs of the target population, available resources in the local communities, and DMH Area financial allotment, each DMH Area will determine the number and configuration of Flexible Support Teams, Flexible Support Groups, and Individual Flexible Practitioners it needs. This is expected to be fluid over the duration of this RFR.

Flexible Funds Administration. Flexible Funds Administration is an additional Flexible Support Service. Under Flexible Funds Administration, a Provider is responsible for managing Flexible Funds. Flexible Funds are used to purchase goods and services needed to maximize the benefit a Youth derives from mental health interventions and activities delivered through DMH Services. Examples of purchases made with Flexible Funds include Youth and family activities (such as therapeutic recreational activities) that support self-care and/or achievement of treatment goals; specialty consultations; respite care; etc. All expenditures must be made in accordance with the “Procedures For The Use of DMH Flexible Support Services Flexible Funds” (Attachment C). Flexible Funds may only be expended as authorized by DMH and in accordance with Attachment C. All Flexible Support Providers must provide Flexible Funds Administration and attest to their ability to provide Flexible Funds Administration in accordance with the “Procedures For The Use Of DMH Flexible Support Services Flexible Funds”. A Responder may not submit a Response solely for Flexible Funds Administration. Similarly, DMH will not enter into a contract for Flexible Funds Administration only.

Master Agreement. This is a Master Agreement (MA) RFR. As such, any number of Bid Responders may qualify to provide the services. DMH will enter into contracts with all qualified Responders. All Responders awarded contracts will be included on the MA for the Flexible Support Service(s) and the modality(ies) for which they qualify and the DMH Area/geographic catchment area where they commit to providing the services. To qualify for the Flexible Support Team, a Responder at a minimum must qualify for the following services: Clinical Services and one of the other Flexible Support Services (Parent/Caregiver Peer Support, Young Adult Peer Mentoring, Therapeutic Support). Responders interested in providing Flexible Support Service though a Flexible Support Service Team are advised to review Attachment D to the RFR which is included in the Bid’s COMMBUYS File. This Attachment indicates the Flexible Support Services Teams the Areas anticipate purchasing as of the estimated Service Start Date, January 1, 2019.

If and when a DMH Area determines that it needs to purchase Flexible Support Services, it will do so from a Contractor on the MA. Once the Contractor is selected from the MA, the Area will enter into a Statement of Work (SOWs) with the Provider. The SOW will specify the following:

· Flexible Support Services to be delivered: Clinical Services, Therapeutic Support, Young Adult Peer Mentoring, and/or Parent/Caregiver Peer Support

· Specific service interventions/activities listed in Section 4 for each Flexible Support Service to be delivered

· Modality through which the Flexible Support Services are to be delivered: Flexible Support Team, Flexible Support Group and/or as an Individual Practitioner

· Effective Time Period (beginning and end dates of the SOW)

· Expected number of individual(s) to be served, i.e., maximum size of the cohort a Flexible Support Team will serve; number of individuals served by Flex Groups, and/or the number of individuals to be served by Individual Practitioners

· For Flexible Support Teams, the staffing structure and Full Time Equivalent (FTE) billable amount per staff

· For Flexible Support Groups and Individual Flexible Practitioners, the number of service units being purchased

· Total Estimated Amount of Flexible Funds allocated for the Effective Time Period

· Maximum Number of Billable Units allowed for each Flexible Support Service Modality

· DMH Area Office responsible for oversight of the SOW.

A Provider may have a SOW with one or more DMH Areas. A Provider may hold several SOWS at one time with one or more Areas. A SOW may be amended during its duration. The number of Flexible Support Teams, Flexible Support Groups, and Individual Practitioners purchased by DMH and their staffing composition are subject to change throughout the duration of the RFR.

Providers are expected to directly employ all Flexible Support Staff. Any request to waive this requirement by using a subcontractor must be approved by the DMH Deputy Commissioner of Child, Youth and Family Services in writing.

1.3 Service Principles

Providers must fully integrate the following principles into their service delivery structure. Clinical Services, Young Adult Peer Mentoring, Parent/Caregiver Peer Support and Therapeutic Support services are:

· Family driven and youth guided

· Culturally relevant and linguistically accessible

· Trauma informed

· Strength-based

· Evidence-based or a promising practice

· Fully accessible regardless of physical disability, auditory or visual impairment.

Additionally, Flexible Support Services must be provided in a manner consistent with the DMH Family Collaboration Principles, as described in Section 3 below.

1.4 Procurement Information

1.4.1 Applicable Procurement Law. This Bid is issued under the following law(s): authorizing legislation, MGL c. 29, § 29B, st.1993, c.110, S.274 as amended; MGL c. 7, § 22; 801 CMR 21.00; 808 CMR 1.00, ; federal Single Audit Act, OMB A-133; The American Reinvestment and Recovery Act (ARRA) of 2009.

1.4.2 Acquisition Method(s). The acquisition method for this Bid, including Flexible Fund Administration, is fee for service, based on prescribed Unit Rates. See Subsection 8.1 for information on the Unit Rates. The Unit Rates applicable to any one Contract depend on the modality through which the Services will be provided. See Subsection 8.2. A Statement of Work (SOW) will specify the Flexible Support Services to be provided, the modality through which they will be provided, and the Maximum Number of Billable Units allowed for each Flexible Support Service/Modality being purchased under the SOW. Unless an amendment is made to a SOW, a Provider may not bill DMH for more units than specified in the applicable SOW. The Unit Rates applicable to any one Contract cover all services required to be delivered by the Contractor with the exception of Flexible Funds. A Provider will be reimbursed on a cost reimbursement basis for the Flexible Funds they expend (see Subsection 8.3).

The estimated Annualized Spending Amount that each DMH Area has for Flexible Support Services is set forth in Subsection 1.4.3.

Federal funds MAY be used to fund part/all of Contract(s)

Federal funds X WILL NOT be used to fund part/all of Contract(s)

1.4.3 Estimated Annualized Spending Amount. The estimated annualized spending amount that each Area has for Flexible Support Services is as follows:

Fiscal Year 2019 Estimated Annualized Spending Amount

*The actual expended Flexible Fund amount will be less than or equal to the Estimated Annualized Spending Amount, depending on the needs of the Youth and families being served in the Fiscal Year.

1.4.4 Master Agreement Duration. The duration of a contract awarded as a result of this RFR will depend on when a particular contract is awarded. The duration of a contract issued under this RFR will be from its Effective Date (as defined in Subsection 11.4) up to the termination date of the RFR, June 30, 2028. The duration of any SOW entered into by a DMH Area to purchase services from a Provider with a contract will be negotiated at the time of execution; provided, however, that the duration of a SOW cannot extend beyond June 30, 2028, the termination date of the RFR.

1.4.5 Ownership of Submitted Responses. DMH shall be under no obligation to return any Responses or materials submitted by a Responder in response to this Bid. All materials submitted by Responders become the property of the Commonwealth of Massachusetts and will not be returned to the Responder. The Commonwealth reserves the right to use any ideas, concepts, or configurations that are presented in a Responder’s Response, whether or not the Response is selected for Contract award.

Responses stored on COMMBUYS in the encrypted lock-box are the file of record. Responders retain access to a read-only copy of this submission via COMMBUYS, as long as their account is active. Responders may also retain a paper copy or electronic copy on a separate computer or network drive or separate media, such as CD or DVD, as a backup.

1.4.6 Prohibitions. Responders are prohibited from communicating directly with any employee of DMH regarding this RFR except as specified in this RFR, and no other individual Commonwealth employee or representative is authorized to provide any information or respond to any question or inquiry concerning this RFR. Responders may contact the DMH Contact Person if this RFR is incomplete or information is missing (see Subsection 1.1 for contact information). Responders experiencing technical problems accessing information or attachments stored on COMMBUYS should contact the COMMBUYS Help Desk COMMBUYS@state.ma.us or 1-888-627-8283 or 617-720-3197.

In addition, by submitting a response, a Responder certifies that the Response has been arrived at independently and has been submitted without any communication, collaboration, or without any agreement, understanding or planned common course or action with any other Responder of the services described in the RFR (see the Standard Contract Form).

SECTION 2

ESTIMATED PROCUREMENT TIMETABLE

2.1 Procurement Calendar

Physical Bidders’ Conference

There will be one Bidders’ Conference on the following Date, Time and Location:

Date: August 16, 2018 Time: 10:00 a.m. to 11:30 a.m.

DMH Hadley Building

167 Lyman Street

Westborough, MA 01581

Questions may also be submitted after January 1, 2019 on an ongoing basis.

Thereafter questions will be responded to at a minimum each fiscal quarter, starting January 1, 2019.

Thereafter, a Bid Response may be filed any time on or after January 1, 2019, 4:00 PM EST up to March 31, 2028 4:00 p.m.

Thereafter qualifications will be announced each fiscal quarter, starting January 1, 2019.

All responses must be submitted via COMMBUYS.

*Responses will be reviewed within ninety (90) days of receipt (or sooner). Qualified Contractors will be added to the Master Agreement and their names will be posted on COMMBUYS as contracts are executed. SOWs will be negotiated and executed as needed.

2.2 Written Questions via the Bid Q&A On COMMBUYS

The “Bid Q&A” provides the opportunity for Responders to ask written questions and receive written answers from DMH regarding this Bid. All Responders’ questions must be submitted through the Bid Q&A found on COMMBUYS (see below for instructions). Questions may be asked within the timeframe specified in the Procurement Calendar located in Subsection 2.1. DMH reserves the right not to respond to any questions asked. It is the Responder’s responsibility to verify receipt of questions.

Please note that any questions submitted to DMH using any other medium (including those that are sent by mail, fax, email, or voicemail) will not be answered. To reduce the number of redundant or duplicate questions, Responders are asked to review all questions previously submitted to determine whether the Responder’s question has already been posted.

Responders are responsible for entering content suitable for public viewing since all of the questions are accessible to the public. Responders must not include any information that could be considered personal, security sensitive, inflammatory, incorrect, collusory, or otherwise objectionable, including information about the Responder’s company or other companies. DMH reserves the right to edit or delete any submitted questions that raise any of these issues or that are not in the best interest of the Commonwealth or this Bid.

All answers are final when posted. Any subsequent revisions to previously provided answers will be dated.

It is the responsibility of the Responders/Qualified Providers to maintain an active registration in COMMBUYS and to keep current the email address of the prospective Responder’s/Qualified Provider’s contact person and prospective contract manager, if awarded a Master Agreement contract, and to monitor that email inbox for communications from the DMH Area or if applicable, other Purchasing Department(s), including requests for clarification. The Purchasing Department and the Commonwealth assume no responsibility if a Responder’s/Qualified Provider’s designated email address is not current, or if technical problems, including those with the Responder/Qualified Provider’s computer, network or internet service provider (ISP) cause email communications sent to/from the Responder/Qualified Provider’s Purchasing Department to be lost or rejected by any means including email or spam filtering.

Locating Bid Q&A: Log into COMMBUYS, locate the Bid, acknowledge receipt of the Bid, and scroll down to the bottom of the Bid Header page. The “Bid Q&A” button allows Responders access to the Bid Q&A page.

Note: Generally, any other communications with DMH about the Bid are prohibited. For more information, see the OSD RFR Required Specifications for POS Services, which is included in the Bid’s COMMBUYS file, “Bidder Communications”.

2.3 Bid Amendment, Withdrawal, Cancellation

DMH reserves the right to make amendments to the Bid after initial publication. It is each Responder’s responsibility to check COMMBUYS for any amendments, addenda or modifications to this Bid, and any Bid Q&A records related to this Bid. DMH and the Commonwealth accept no responsibility and will provide no accommodation to Responders who submit a Response based on an out-of-date Bid or on information received from a source other than COMMBUYS.

This RFR does not commit DMH to award any contracts or to pay any costs incurred in the preparation of a Responder’s Response. DMH reserves the right to accept or reject any and all Responses received as a result of this RFR, to negotiate with any or all qualified Responders and to cancel in part or in its entirety the RFR if it is in the best interest of DMH to do so.

2.4 Physical Bidders’ Conference (In-Person)

There is one Bidders’ Conference being offered as a physical in-person conference conducted by DMH for the purpose of informing prospective Responders about general Bid information and answering questions from prospective Responders. Attendance is optional. The current place and date for the Bidders’ Conference is set forth in the Procurement Calendar in Subsection 2.1. Please refer to the COMMBUYS website for any updated information.

2.5 Reasonable Accommodations

Responders with disabilities or hardships that seek reasonable accommodations should submit a written request by email, fax or mail to the DMH Contact Person named in Subsection 1.1. For information that needs to be included in the request and more information on Reasonable Accommodations, please see the OSD RFR-Required Specifications for POS Services included in the Attachment Section of this Bid’s COMMBUYS file.

SECTION 3

DMH MISSION STATEMENT

The Provider will be responsible for ensuring that the DMH mission, vision, family collaboration principles, and applicable DMH regulations, policies, directives, procedures, and initiatives are integrated into the Flexible Support Services approach and adhered to by all staff. DMH’s vision, mission, and family collaboration principles are as follows:

Vision

Mental health is an essential part of health care. The Massachusetts Department of Mental Health, as the State Mental Health Authority, promotes mental health through early intervention, treatment, education, policy and regulation so that all residents of the Commonwealth may live full and productive lives.

Mission

The Department of Mental Health, as the State Mental Health Authority, assures and provides access to services and supports to meet the mental health needs of individuals of all ages, enabling them to live, work and participate in their communities. The Department establishes standards to ensure effective and culturally competent care to promote recovery. The Department sets policy, promotes self-determination, protects human rights, and supports mental health training and research. This critical mission is accomplished by working in partnership with other state agencies, individuals, families, Providers, and communities.

DMH Family Collaboration Principles DMH recognizes that mental health services are most effective when parents/caregivers, Youth, and Providers work collaboratively as partners in a Youth’s treatment. Youth need every opportunity to be involved with and stay connected to their parents/caregivers and family members. Parents/caregivers are essential sources of support for their children throughout their lives and need to be actively involved with their children and their services. Parents/caregivers also need timely and accurate information about their children’s conditions and the range of available interventions and services. While parents/caregivers, Youth, and professionals bring different perspectives, each benefit from understanding the other’s vantage point. Policies, services and supports must be designed and evaluated collaboratively and be family-driven, Youth-guided, strength-based, culturally and linguistically competent, individualized, informed by best practices and evidence, and consistent with the research on sustained positive outcomes.

DMH also recognizes that a variety of factors can impact a Youth and/or family’s engagement and participation in services, including but not limited to:

· the needs of siblings

· caregiving responsibilities related to other family members’ physical and/or mental health needs

· parent/caregiver’s own physical and/or mental health needs

· access to transportation to/from services

· parent/caregiver’s work responsibilities

· community dynamics, and

· other social determinants of health.

DMH works with Youth and families to understand these factors and manage services with these factors in mind. DMH also recognizes that successful services must be grounded in a trusting therapeutic relationship between Youth, families, and Providers; and that these relationships can take time to develop. DMH services allow the time needed to establish positive therapeutic relationships. They provide flexible scheduling of services to accommodate Youth and family schedules and allow for fluctuations in how often a Youth/family meets with service Providers. They assist families in understanding and accessing the array of services and supports that may be available to them in their local communities, through their insurance benefits, and through a Youth’s school.

SECTION 4

DESCRIPTION OF SERVICES

The goal of DMH Flexible Support Services is to strengthen the well-being of Youth and their families; build family cohesion; and prevent the need for more intensive services. Services are designed to be individualized to meet the varying needs of Youth and their families. Throughout the service process, all Flexible Support Services staff work with the Youth and family to develop and sustain a positive, respectful, and collaborative therapeutic relationship. This on-going engagement process is responsive to changes in the needs and preferences of the Youth and family, and works to mitigate the factors that may limit a Youth and family’s access to and participation in services. Flexible Support Service staff engage the Youth and family members in culturally-informed therapeutic interventions that build autonomy and self-efficacy as well as strengthen permanency of important relationships in the Youth’s life (parents/caregivers, family members, peers, other individuals important to the Youth).

Flexible Support Service staff working with transition-age Youth, on an on-going basis, assess the Youth’s unique physical, relational, and possible legal permanency needs; and partner with the Youth and/or their family of origin or identified “chosen family” to develop strategies for addressing these needs.

Services are delivered to the Youth, parent/caregiver and/or siblings in their home and community primarily during after-school, evening and weekend hours. Transportation is arranged or provided, as needed to support the Youth and family in meeting their Community Service Plan goals. Flexible Support Services provide ongoing in-person, phone and email support to the Youth and family as needed and link them to needed services, supports, community resources and opportunities that the Flexible Support Service Provider is unable to provide.

DMH Flexible Support Service Providers collaborate with the Youth and family to plan for transitions between services and the impact of significant changes in life events. As requested by DMH, Flexible Support Services may be provided concurrently with other services to allow for the active and seamless transition between services or to promote engagement in another service. Additionally, as requested by DMH, services may be provided outside the Provider’s identified catchment area for an extended period of time in order to maintain continuity of care when youth and family experience a transition (e.g. entrance to college, homelessness, move, etc.).

Flexible Support Services include:

· Clinical Services

· Therapeutic Support

· Young Adult Peer Mentoring

· Parent/Caregiver Peer Support

· Flexible Funds Administration Clinicians, Therapeutic Support Specialists, Young Adult Peer Mentors, and Family Partners provide interventions and activities specific to the Flexible Support Service they provide. These activities and interventions are tailored to meet the individual needs of the Youth and family while remaining commensurate with the practitioner’s qualifications outlined in Subsections 4.1-4.4.

All staff demonstrate safe, professional, and ethical behavior by adhering to practices that promote integrity, dignity, and emotional health centered on communication, accountability, and learning opportunities as well as rigorous attention to professional boundaries and the rights and self-determination of others.

4.1 Clinical Services

Flexible Support Clinical Services provide home and community-based clinical interventions that support the Youth and family in achieving specific treatment goals that lead to improved functioning in identified areas of their life. These services include comprehensive assessment; Community Service Plan development and implementation; monitoring and tracking goal achievement; risk and safety planning and support; and transition and discharge planning and support. All clinical interventions are designed to enhance emotional well-being, self-regulation, symptom management, social skills, family resiliency, and self-efficacy in response to challenges posed by SED, peers, school, and associated stressors on the family system. Clinical services must be coherent and integrated with other services and supports in the life of a DMH involved Youth.

4.1.1 Staff Credentials: Clinical Services are provided by a Clinician with the following credentials:

A Clinician holds a Master degree in a human services field, is trained in psychology, social work, or other clinical disciplines, and has at least 1 year of experience working directly with Youth who have experienced serious emotional disturbance or other mental and emotional challenges to well-being.

· Level 1: Master’s level clinician

· Level 2: Independently licensed clinician

4.1.2 Service Interventions/Activities: Clinical Services are provided to the Youth and their family and may include but are not limited to the following interventions/activities:

· Engage in a comprehensive and on-going assessment process that assesses the following: life functioning (e.g., family, school, social, medical, etc.); mental health needs; risk behaviors; diagnosis; cultural considerations; Youth strengths; caregiver needs and strengths; transitions to/from other services systems and/or providers; and transition to adulthood. This may also include a specialized assessment to address the unique needs of individuals with co-occurring substance use or other co-occurring complex conditions.

· Co-create a Community Service Plan with the youth and family and develop treatment approaches that reflect and target the needs identified in the comprehensive assessment.

· Implement home-based individual and family therapy interventions that are evidence-based or grounded in promising practices and utilize techniques that have proven effective for the presenting issues such as but not limited to: Trauma-informed Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), Collaborative Problem Solving, Multisystemic Therapy, Attachment Regulation Competency, Adolescent Community Reinforcement Approach (A-CRA), Functional Behavioral Assessment, Positive Behavioral Support, and relevant practice profiles, etc. Interventions may also include treatment approaches modified to respond to the unique capabilities of individuals with co-occurring disorders or complex diagnoses.

· Provide ongoing safety assessment, planning, and on-call crisis support that includes on call telephonic support 24 hours a day, seven days a week.

· Coordinate services to assure that they are integrated and clinically coherent across all treatment providers and supports to the Youth. This includes coordinating continuity of approaches across providers, school, state agencies, and other supports.

· Conduct collateral contact with third parties on behalf of a DMH involved Youth or with the Youth, parents/caregivers, or other family members. These can occur through face-to-face meetings, by phone, e-mail, or other technology and/or direct observation (e.g., in classroom) with school staff, pediatricians, or other formal and informal services and supports to the Youth and their family. Authorizations must be obtained by the Provider as needed.

· Support the parent/caregiver and the Youth in developing strategies for self-care, identifying respite care providers (both formal and informal), and accessing respite care.

· Other interventions commensurate with clinician’s credentials, experience, and training.

4.2 Therapeutic Support

Therapeutic Support Services provide therapeutic interventions to assist the Youth, parent/caregiver, siblings, and/or other family members in practicing and applying life-skills such as but not limited to self-regulation, coping skills, self-care, and daily living skills.

4.2.1 Staff Credentials: Therapeutic Support is provided by a Therapeutic Support Specialist with the following credentials:

A Therapeutic Support Specialist holds an Associate or Bachelor degree in a human services field and one or more year(s) of experience working with Youth who have experienced serious emotional disturbance or other mental and emotional challenges to well-being.

· Level 1: Bachelor degree with one year of experience working with the target population or Associates degree with two years of experience working with the target population

· Level 2: Bachelor degree with two years of experience working with the target population 4.2.2 Service Interventions/Activities:

Therapeutic Support is provided to a Youth and their family and may include but is not limited to the following interventions/activities:

· Provide strengths based and resiliency building activities that support:

· Social and recreational engagement

· Development and maintenance of friendships

· Maintaining personal boundaries

· Stress management, relaxation, and mindfulness

· Daily living skills such as money management and the use of public transportation

· Secondary education/pre-vocational/career planning and preparations (completing job or college applications, appropriate dress, practicing interviewing for jobs or college, etc.).

· Strategies to prevent and address bullying of others and being bullied.

· Collaborate on goal development, crisis planning, and problem solving in partnership with the Youth, parent/caregiver and other service and support persons as necessary.

· Collaborate with the family, treatment providers, supports, school, and other service providers to ensure that there is continuity of the Therapeutic Support Service approach with other services and that services are integrated and clinically coherent. Authorizations are obtained by the Provider as necessary.

· Support implementation of a clinician’s treatment/behavior plan.

· Support the Youth and family to participate in community, recreational, cultural, artistic, or social events/activities.

· Support the youth and parent/caregiver in developing strategies for self-care, identifying respite care providers (both formal and informal), and accessing respite care.

Provide other interventions commensurate with the Therapeutic Support Specialist’s credentials, experience, and training.

4.3 Young Adult Peer Mentoring

Young Adult Peer Mentoring Services provide strength-based, peer-to-peer education, coaching, modeling, guidance, and support to Youth in a variety of settings, including home, school, community, group home, and other out-of-home settings. Young Adult Peer Mentoring is a specialty expertise based on sharing one’s lived experience of mental health challenges with purpose and intent to inspire hope and motivation in a youth who is struggling with similar concerns. Successful Young Adult Peer Mentoring is built on developing a healthy relationship with the Youth which includes listening from a peer perspective, encouraging the Youth’s unique gifts, and fostering their communication with family, friends, natural supports, providers, and others.

4.3.1 Staff Credentials: Young Adult Peer Mentoring is provided by a Young Adult Peer Mentor or Senior Young Adult Peer Mentor with the following credentials:

A Young Adult Peer Mentor/Senior Young Adult Peer Mentor is a young adult who has personal experience living with and recovering from mental health needs, substance use, and/or traumatic life concerns which caused challenges in one or more areas of life. A Young Adult Peer Mentor is trained to share their lived experience of these challenges with purpose and intent to benefit the Youth.

· Level 1 (Young Adult Peer Mentor): Has 1 year of experience working with the target population and has successfully completed the Core Elements of Young Adult Peer Mentoring Training. Individuals enrolled/waitlisted for this training may be considered in partnership with DMH on a case by case basis.

· Level 2 (Senior Young Adult Peer Mentor): Meets the Young Adult Peer Mentor qualification and (a) has 2 years of experience as a Young Adult Peer Mentor, or (b) has successfully completed an advanced peer to peer training program (such as Certified Peer Specialist training), or (c) has 1 year of experience providing supervision, or (d) has a Bachelor degree in a human services field.

4.3.2 Service Interventions/Activities:

Young Adult Peer Mentoring is provided to Youth and may include but is not limited to the following interventions/activities:

· Share personal experiences with purpose and intent to inspire hope and motivation. Young Adult Peer Mentors show through their own example that recovery is within reach.

· Support Youth to communicate effectively and foster their communication with family, friends, allies/natural supports, providers, and others.

· Support Youth to identify their strengths in order to develop their vision, treatment goals, and life goals.

· Work with the Youth’s team or other supports to ensure that the Youth’s vision and goals guide treatment decisions; focus on aspirational life goals (such as education, employment, healthy relationships, and independence); and support Youth in building the skills that they need.

· Role model and support youth on discerning when and how to share lived experience effectively and safely in order to support Youth in knowing when/how to share their experiences (e.g., sharing hospitalization upon return to school).

· Promote self-care through modeling healthy habits and sharing resources and strategies that have been helpful to the Young Adult Peer Mentor and may be of help to the Youth.

· Collaborate with the Youth, family, treatment providers, supports, school, and other service providers to ensure that there is continuity of the Young Adult Peer Mentoring service approach with other services and that Young Adult Peer Mentoring services are integrated and clinically coherent. This also includes collaborating on goal development, crisis planning, and problem solving in partnership with the Youth, parent/caregiver, and other service and support persons as necessary. Authorizations are obtained by the Provider as necessary.

· Link young adults to peer support services such as Young Adult Resource Centers.

· Provide other interventions commensurate with the Young Adult Peer Mentor’s credentials, experience, and training.

Young Adult Peer Mentoring is guided by (but not limited to) the Young Adult Peer Mentoring Practice Profile located here http://www.cbhknowledge.center/young-adult-peer-mentoring-overview/

4.4 Parent/Caregiver Peer Support

Parent/Caregiver Peer Support Services provide parents/caregivers (inclusive of mothers, fathers, grandparents, etc.) strength-based, peer-to-peer education, coaching, modeling, guidance, and support. Parent/Caregiver Peer Support Services can be provided in a variety of settings utilized by the Youth and family, such as home, school, community, and out-of-home treatment settings. Parent/Caregiver Peer Support is a specialty expertise based on having provided caregiving to a Youth with mental health challenges. This service offers multiple opportunities for parents/caregivers to practice skills related to networking, informed decision making, collaborative decision making, and leadership. Parent/Caregiver Peer Support provides three distinct levels of individualized assistance based on the parent/caregiver’s needs. They include modeling skills (“Do For”), providing assistance to support a parent/caregiver practicing a skill (“Do With”), and encouraging a parent/caregiver who’s engaging in skills independently (“Cheer On”).

4.4.1 Staff Credentials: Parent/Caregiver Peer Support is provided by a Family Partner or Senior Family Partner with the following credentials:

A Family Partner/Senior Family Partner is an individual with lived experience as a parent/caregiver of a Youth with significant social, emotional, behavioral health, medical or trauma-related needs and who is also experienced in navigating child and family-serving systems (especially the DMH system of care).

· Level 1 (Family Partner): Has an Associate Degree in a human services field and 1 year of experience working with the target population; or has a high school diploma/GED and 2 years of experience working with the target population.

· Level 2 (Senior Family Partner): Meets the Family Partner qualification and (a) has 1 year of experience providing supervision; or (b) has 1 additional year working as a Family Partner.

4.4.2 Parent/Caregiver Peer Support is provided to parents/caregivers and may include but is not limited to the following interventions/activities:

· Share lived experiences (of parenting a youth with mental health challenges) with purpose and intent in order to encourage hope and inspiration.

· Educate parents/caregivers on effective ways to: navigate systems of care; maximize effective treatment; and build supportive relationships with provider and others working with the Youth and family around mental health, behavioral, and emotional needs.

· Educate parents/caregivers about formal and informal community-based resources, and supporting parents/caregivers in finding, accessing, and utilizing these resources.

· Foster the conditions for empowerment of parents/caregivers in all aspects of Community Service Planning (treatment planning) and implementation.

· Model and coach problem-solving and advocacy skills with parents/caregivers.

· Collaborate with the Youth and family, treatment providers, supports, school, and other service providers to ensure the cohesive inclusion of the Parent/Caregiver Peer Support Service with all other services.

· Collaborate on goal development, crisis planning, and problem solving in partnership with the Youth, parent/caregiver and other service providers and support persons as necessary. Authorizations are obtained by the Provider as necessary.

· Develop and implement an activities/intervention plan (Family Action Plan) in partnership with the Youth and parent/caregiver that outlines activities/objectives and measurable progress/transition indicators that the family and Family Partner have prioritized to work on together in support of the Youth/family's needs and goals.

· Support the parent/caregiver in developing strategies for: self-care, identifying respite care providers (both formal and informal), and accessing respite care.

· Provide other interventions commensurate with the Family Partner’s credentials, experience, and training.

Family Partners adhere to the Family Partner Service Core Elements listed in Attachment B and other guiding documents that DMH may issue relative to Parent/Caregiver Peer Support Service practice.

4.5 Flexible Funding Administration

Under Flexible Funds Administration, a Provider is responsible for managing Flexible Funds. Flexible Funds are used to purchase goods and services needed to maximize the benefit a Youth derives from mental health interventions and activities delivered through DMH Services. Examples of purchases made with Flexible Funds include Youth and family activities (such as therapeutic recreational activities) that support self-care and/or achievement of treatment goals; specialty consultations; respite care; etc. All expenditures must be made in accordance with the “Procedures For The Use Of DMH Flexible Support Services Flexible Funds” (Attachment C). All Flexible Support Services Providers must provide Flexible Funds Administration and attest to their ability to provide Flexible Funds Administration in accordance with the “Procedures For The Use Of DMH Flexible Support Services Flexible Funds”. Flexible Funds may only be expended as authorized by DMH and in accordance with Attachment C.

SECTION 5

DESCRIPTION OF MODALITIES

Flexible Support Services include Clinical Services, Therapeutic Support, Young Adult Peer Mentoring, and Parent/Caregiver Peer Support. These four Flexible Support Services (described in Section 4) can be delivered via three distinct modalities: a Flexible Support Team, a Flexible Support Group, or as Individual Practitioners. Specific expectations associated with each of these modalities are described below (Subsections 5.1 - 5.3).

5.1 Flexible Support Team

Flexible Support Teams deliver Flexible Support Services (as described in Section 4) to a cohort of DMH-authorized Youth. The actual staff composition and type of Flexible Support Services provided by a Team are designed to meet the particular needs of the Team’s cohort. A Flexible Support Team may provide some or all Flexible Support Services, but at a minimum must provide Clinical Services and at least one other Flexible Support Service (Parent/Caregiver Peer Support, Young Adult Peer Mentoring, Therapeutic Support). A Flexible Support Team is designed to ensure staffing capacity to meet the clinical needs of a maximum number of youth in the cohort. There may be circumstances where the acuity and/or intensity of clinical needs of the youth/family in the cohort are such that DMH authorizes the Flexible Support Team to serve less than the maximum number in the cohort. In these circumstances, DMH will work in collaboration with the Provider to assess the team’s capacity to meet the clinical needs of the cohort. The maximum number of Youth in the cohort will be described in the SOW. Unless agreed to as stated in this paragraph, a Provider must accept all referrals from DMH up to the maximum number in the applicable cohort.

Responders interested in providing Flexible Support Services through Flexible Support Team(s) should review Attachment D. Attachment D describes the Flexible Support Teams that each DMH Area anticipates purchasing in the first year of this procurement based on the needs of the youth and families in the Area; available resources in the local communities; and DMH Area budgets. DMH will collaborate and negotiate with qualified Contractors to determine the final structure of the Flexible Support Teams to be purchased (i.e., staffing composition, service intervention(s)/activities and maximum cohort size). DMH may contract for additional teams at any time or utilize fewer teams than listed.

The duration, intensity, and type of service delivered to each Youth in the cohort and their family is determined in collaboration with DMH and the Youth/family served. Service utilization varies based on the complexity of the Youth’s and family’s needs, resources, and available supports. Some Youth and families will not need all services for which the Team is contracted to provide in accordance with the applicable SOW, while others will use all services for which the Team is contracted to provide.