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County of Napa, CA

HHSA 081

HHSA BEHAVIORAL HEALTH TREATMENT CENTER

RELEASE DATE: September 23, 2026 RESPONSE DEADLINE: October 23, 2026, 5:00 pm

Please refer to the project timeline in this document for all important deadlines.

Request For Proposal #HHSA 081 Title: HHSA Behavioral Health Treatment Center

Table Of Contents

1. Calendar of Events

2. Definitions of Terminology

3. Scope of Work

4. Compensation

5. General Conditions

6. Questions Regarding the RFP

7. RFP Addenda

8. Proposal Submission, Due Date and Late Proposals

9. Proposal Component Requirements

10. Evaluation and Award

11. Evaluation Criteria

12. PSA and Insurance Requirements

13. Local Vendor Preference Policy

14. Protests or Objections

15. Vendor Submissions

Attachments:

Y - Napa County HHSA Standard General Terms and Conditions of the PSA

Calendar of Events

Release of Request for Proposal: September 23, 2026

Question Submission Deadline: September 30, 2026, 5:00pm

Question Response Deadline: October 7, 2026, 5:00pm

Proposal Submission Deadline: October 23, 2026, 5:00pm

Proposal Review and Selection Completion :

November 9, 2026

Notice of Intent to Negotiate: November 10, 2026

Contract Negotiations and Development Completion :

January 7, 2027

Notifications of Intent to Award: January 8, 2027

Contract Awarded: January 19, 2027

Commencement of Services: March 1, 2027

* Dates are subject to change at the sole discretion of Napa County. If dates for Questions Due or Proposals Due change, the change will be published via an Addendum attached to the RFP.

**Intent to Negotiate will be sent by RFP Administrator to all RFP respondents after Division has selected a vendor.

***Notification of Intent to Award will be sent by RFP Administrator to all RFP respondents at least 7 days prior to County signing contract or Board approval of the contract.

Definitions of Terminology

DEFINITIONS OF TERMINOLOGY

The following are definitions and acronyms that are relevant to this RFP

A. American Society of Addiction Medicine (ASAM) the criteria and established Levels of Care for persons seeking substance use treatment.

B. Behavioral Health Information Notice (BHIN)-An official policy and guidance document related to County Mental Health Plans, Drug Medi-Cal, and Managed Care Plans, which is released as policy guidance is updated and finalized. All current BHINS can be located in DHCS’s Information Notice Directory Mental Health & Substance Use Disorder Services and Behavioral Health Information Notices | DHCS

C. Department of Health Care Services (DHCS)- State Department that Administers Medi-Cal, California’s Medicaid Program.

D. Drug Medi-Cal-Organized Delivery System (DMC-ODS)- The county’s specialized managed care continuum of care specifically for addiction recovery services.

E. Health Insurance Portability and Accountability Act (HIPAA)- Federal regulation that safeguards sensitive client medical data, Protected Health Information (PHI) from unauthorized disclosure without the client’s consent.

F. Lanterman-Petris-Short (LPS) Act- A 1967 California law that governs involuntary psychiatric commitment and conservatorship for individuals with mental health disorders.

G. Medication Assisted Treatment (MAT)- The use of FDA-approved medications (such as methadone, buprenorphine, and naltrexone) combined with counseling and behavioral therapies to treat substance use disorders.

https://www.dhcs.ca.gov/forms-laws-publications/mental-health-substance-use-disorder-services-and-behavioral-health-information-notices/ https://www.dhcs.ca.gov/forms-laws-publications/mental-health-substance-use-disorder-services-and-behavioral-health-information-notices/

H. Mental Health Rehabilitation Center (MHRC)- A Mental Health Rehabilitation Center is a 24-hour program which provides intensive support and rehabilitative services designed to assist persons, 18 years or older, with mental disorders who would have been placed in a state hospital or another mental health facility to develop skills to become self-sufficient and capable of increasing levels of independence and functioning.

I. Senate Bill 43 (SB 43)- A law that went into effect January 1, 2024, expanding the definition of “gravely disabled” under the Lanterman-Petris-Short (LPS) Act. It allows for involuntary psychiatric holds and conservatorships for individuals with severe substance use disorders (SUD), in addition to mental health conditions, if someone is unable to provide for their own basic needs, personal safety, or necessary medical care.

J. Sobering Center- A short-term, non-correctional facility where publicly intoxicated individuals can safely recover from acute alcohol or drug intoxication. An alternative to emergency rooms and jails that focuses on harm reduction and health stabilization.

K. Substance Use Residential- A type of substance use disorder treatment conducted in a structured, live-in rehabilitation program where people struggling with addition may reside at a specialized facility. It includes 24/7 supervision, medical monitoring, and intensive behavioral therapy in a safe, drug-free environment distinct from a hospital setting.

L. Withdrawal Management (WM)- Refers to medically necessary, structured care designed to help individuals safely withdraw from substances. This service includes intake, observation, medication services, care coordination, and Medication-Assisted Treatment (MAT).

Scope of Work

Scope of Work

SCOPE OF WORK

PROGRAM A: SOBERING CENTER

A. Target Population – Adults 18 years of age and older who present with intoxication and can safely be served at the facility. Persons may arrive at the Sobering Center by vehicle, including but not limited to law enforcement drop-offs, and/or walk-ins. The Sobering Center will be open to any adult in need of this service, regardless of Medi-Cal coverage, or other insurance type.

B. Service Provision – Respondent shall:

1. As part of admission, screen individuals to determine if the individual can be safely served in the facility.

2. Provide sufficient staff to ensure admissions can occur 24 hours a day, 7 days a week (including holidays)

3. Collect demographics and past medical history of admitted individuals, using the County’s electronic health record system.

4. Monitor signs and symptoms of intoxication per protocols established by County medical staff

5. Anticipate length of stay to last between 6 and 23 hours depending on the individual.

6. Use motivational interviewing to elicit change of behavior for individuals.

7. Provide light snacks and hydration, temporary clean clothing, toiletries and clean linen and laundering service.

8. Prior to discharge screen all individuals, using tool selected by County, for recommended level of care placement within DMC-ODS substance use treatment system. Coordinate withdrawal management and residential substance use treatment referrals within the Behavioral Health Treatment Center, when indicated by the screening tool, or elsewhere within County’s network of care for other needs as appropriate.

9. For discharge purposes, make referrals to resources such as substance use treatment, mental health services, medical services, support groups, and/or social service benefits as appropriate.

10. Facilitate available transportation as needed post discharge.

C. Performance Objectives

1. The program is expected to provide linkage through a warm handoff to ongoing behavioral health treatment, and/or physical health, as appropriate.

2. The program is expected to screen all individuals using the County’s selected placement recommendation tool.

3. Program is expected to make appropriate referrals in accordance with the placement recommendation, and to ensure effective linkages to aftercare resources.

D. Staffing Requirements – All personnel assigned to perform Sobering Center services will be closely evaluated by County. County’s evaluation of Respondent’s personnel does not take place of replace Respondent’s independent obligation to evaluate and monitor its personnel. Staffing requirements are as follows:

1. Each staff member shall be required to provide a historical background of at least two (2) years experience in the last five (5) in the field of substance use treatment and recovery

2. Medical staff must establish and maintain staffing and other protocols for the safe provision of services.

3. Staffing pattern must provide for at least two (2) staff members to be on duty twenty-four (24) hours per day, seven (7) days per week, in accordance with established protocols.

Respondent must ensure program’s safety needs are met with the staffing included in proposal.

4. Spanish (bilingual) services shall be provided to meet the needs of Napa County’s monolingual Spanish speaking population and threshold language requirement.

5. All employees shall be trained in their assigned tasks. Respondent must have a supervisory and administrative structure that will ensure staff are consistently providing services within their scope during all hours of operation, including but not limited to evening, weekend, holiday, and nocturnal shifts.

6. Staffing is required 24 hours a day, 7 days a week, including holidays

7. Staff providing case management services shall have expertise or receive training and supervision on topics that include, but are not limited to, homelessness, outreach and engagement, motivational interviewing, best practices in sobering center models of care, mental health and substance use disorder services, crisis intervention, data management, securing protected health information in accordance with 42 C Part 2, HIPAA, and all applicable state and federal privacy laws and regulations. Respondent must document and report to County the number of hours of continuing education completed each year by staff.

E. Facility Requirements – All services outlined in this RFP are to be conducted at the county-owned Behavioral Health Treatment Center, located at 2200 Napa-Vallejo Highway, Napa, CA 94558. The Sobering Center, which will be located within main building of this center, is comprised of 615 square feet of space. This includes a 3 bed male dormitory, 2 bed female dormitory, separate male and female toilet and shower rooms, staff observation and day room, and staff office. This is a smoke free facility. Sobering Center and DMC-ODS Level 3.7 Withdrawal Management ServicesThe Contractor shall develop, operate, and maintain a facility capable of providing sobering center services and medically monitored residential withdrawal management services consistent with ASAM Level of Care 3.7 under the Drug Medi-Cal Organized Delivery System (DMC-ODS).The facility shall operate in full compliance with federal and state Medicaid/MediCal managed care laws and regulations, the California Medi-Cal State Plan, applicable federal and state waivers, and all Department of Health Care Services (DHCS) Behavioral Health Information Notices (BHINs) governing specialty behavioral health and substance use disorder services.

F. Licensing, Certification, and Regulatory Compliance

1. The Contractor shall obtain and maintain all licenses, certifications, and approvals required to operate a substance use disorder treatment and withdrawal management facility. At minimum, the Contractor shall maintain:

a. Drug Medi-Cal (DMC) certification issued by DHCS for applicable services

b. Licensure for residential substance use disorder treatment services, when applicable

c. Medi-Cal provider enrollment and compliance with all Medi-Cal billing and documentation requirements

d. Local fire clearance, building occupancy approval, and zoning authorization

2. The Contractor shall ensure that all services are delivered in accordance with the American Society of Addiction Medicine (ASAM) Criteria, which establish the standards for placement, continued stay, and discharge for individuals receiving substance use disorder treatment services.

3. The Contractor shall comply with all applicable federal and state statutes and regulations, including but not limited to:

a. 42 C.F.R. Part 438 (Medicaid Managed Care)

b. 42 C.F.R. Part 2 (Confidentiality of Substance Use Disorder Patient Records)

c. HIPAA privacy and security regulations

d. California Code of Regulations Title 9 and Title 22

e. Applicable provisions of the Health and Safety Code and Welfare and Institutions Code

G. Facility Design and Infrastructure

1. The Contractor shall maintain a facility that is appropriately designed, staffed, and equipped to safely provide sobering and medically monitored withdrawal management services.

2. The facility shall include, at minimum:

a. Designated sobering observation areas for individuals experiencing acute intoxication

b. Residential withdrawal management beds consistent with ASAM Level 3.7 services

c. Clinical assessment and intake rooms

d. Medication storage and administration areas compliant with applicable pharmacy and medication control regulations

e. Secure storage for controlled substances and medical supplies

f. Adequate space for clinical counseling, treatment planning, and case management service

3. The facility shall maintain safety features including:

a. Clear line-of-sight observation of residents where clinically appropriate

b. Controlled access to the facility

c. Emergency response and alarm systems

d. Compliance with Americans with Disabilities Act (ADA) accessibility requirements

4. The Contractor shall maintain sufficient equipment to monitor clients receiving withdrawal management services, including equipment necessary to monitor vital signs and respond to medical emergencies.

H. Sobering Center Operations

1. The Contractor shall operate a sobering center component designed to provide short-term stabilization and monitoring for individuals experiencing acute intoxication from alcohol or other substances.

2. The sobering center shall:

a. Accept referrals and drop-offs from law enforcement, emergency medical services, hospitals, and other authorized referral sources

b. Provide safe monitoring until individuals are clinically stable for discharge or referral to treatment services

c. Maintain protocols for medical screening and emergency transfer when higher levels of care are required

3. Sobering services shall operate 24 hours per day, seven days per week, including holidays.

I. Clinical Services

1. The Contractor shall provide substance use disorder services consistent with DMC-ODS service definitions and clinical standards.

2. Services shall include, at minimum:

a. Substance use disorder assessment and diagnosis

b. ASAM level of care determination

c. Withdrawal management services

d. Individual and group counseling

e. Treatment planning and care coordination

f. Case management and referral to community-based services

g. Discharge planning and transition to lower levels of care

3. Assessments shall evaluate the member’s behavioral health status and determine the appropriate course of treatment and level of care.

J. Staffing and Clinical Oversight

1. The Contractor shall employ sufficient qualified staff to provide continuous monitoring and treatment services.

2. Minimum staffing shall include the following staff who are licensed, registered or certified in California:

a. A Medical Director, licensed physician with experience in addiction medicine or behavioral health

b. Licensed clinical staff or Licensed Practitioners of the Healing Arts (LPHAs)

c. Registered nurses or other appropriate medical staff for withdrawal monitoring

d. Certified or registered alcohol and drug counselor

e. Peer support specialists, where applicable

3. The facility shall maintain 24-hour staffing coverage sufficient to ensure safe monitoring and treatment of all clients.

K. Quality Assurance and Performance Monitoring

1. The Contractor shall maintain a quality improvement and performance monitoring system designed to ensure compliance with all statutory and regulatory requirements and continuous improvement in service delivery.

2. The Contractor shall monitor:

a. Service quality and clinical outcomes

b. Timely access to services

c. Compliance with treatment documentation requirements

d. Capacity and service availability

3. The Department of Health Care Services may conduct compliance reviews, including evaluations of service quality, access to care, and monitoring activities, as part of its oversight of county behavioral health programs.

L. Records Management and Audit Compliance

1. The Contractor shall maintain complete fiscal, clinical, and administrative records sufficient to demonstrate compliance with all applicable contract and regulatory requirements.

2. The Contractor shall allow DHCS, the Centers for Medicare and Medicaid Services (CMS), and other authorized state or federal entities to inspect records, facilities, and documentation necessary to evaluate program performance. Records shall be retained for a minimum of ten

(10) years, or longer if required due to audit or investigation.

M. Privacy and Data Security

1. The Contractor shall maintain systems and safeguards to protect confidential information and protected health information (PHI).

2. The Contractor shall comply with all applicable privacy and security laws including:

a. HIPAA privacy and security requirements

b. 42 C.F.R. Part 2 confidentiality standards

c. California confidentiality laws governing behavioral health records

3. The Contractor shall implement administrative, technical, and physical safeguards to protect confidential data and report any security incidents or breaches in accordance with DHCS reporting requirements.

PROGRAM B: SUBSTANCE USE RESIDENTIAL TREATMENT AND RESIDENTIAL WITHDRAWAL

MANAGEMENT

1. TARGET POPULATION – Adults 18 years of age and older who are enrolled in Medi-Cal, reside in Napa County, and meet medical necessity criteria for substance use disorder residential level of care in accordance with American Society of Addiction Medicine (ASAM) client placement criteria (ASAM 3.1, 3.2, and 3.5). With the exception of Residential Withdrawal Management services (ASAM 3.2), clients seeking residential substance use treatment must be authorized by HHSA-BH. Referrals will come from within the BHTC, i.e. Sobering Center or LPS designated MHRC, and will also come from the HHSA-BH directly, as well as community referrals sources (e.g. Probation, Child Welfare, Hospital, mental health and substance use programs within HHSA-BH network of care, etc.).

Beneficiaries may also self-refer to treatment, however in all cases HHSA-BH must prior authorize substance use residential treatment. Assessment and authorization requests must be submitted to HHSA-BH within seventy-two (72) hours of beneficiary admission. Residential withdrawal management (ASAM 3.2) does not require county authorization at this time and is subject to change. Additional characteristics of the target population for each residential level of care include:

• ASAM 3.1 - Clients served in Level 3.1 programs typically experience challenges in applying recovery skills, self-efficacy or lack connections to work, education or family life. The 24-hour structure under Level 3.1 provides clients the opportunity to develop and practice their interpersonal and group living skills, strengthen their recovery skills, reintegrate into the community and family, and begin or resume employment or academic pursuits. Clients placed in Level 3.1 also may not yet acknowledge that they have a substance use disorder. They could be living in a recovery environment that is too unstable to permit treatment in an outpatient setting, needing residential services to minimize continued substance use and/or other addictive behavior. In addition, Level 3.1 clients are often at early stages of readiness to change, requiring monitoring and motivating strategies to prevent deterioration, engage them in treatment and facilitate their progress through the stages of change to recovery.

• ASAM 3.2 - Clients may have severe intoxication and withdrawal signs and symptoms, that require a 24-hour structure and support not requiring inpatient services.

• ASAM 3.5 - Clients in Level 3.5 have addiction challenges that have escalated to the point that they need a 24-hour supportive environment to either begin or continue a recovery process that has not progressed.

Client needs across the ASAM Dimensions are of such severity that they cannot be treated safely in less intensive levels of care and require comprehensive, multi-faceted treatment approaches to address the interrelated challenges they experience. Clients demonstrate repeated inability to control impulses, or unstable and dangerous symptoms requiring stabilization. Co-occurring beneficiaries with severe and chronic mental illness are served in this setting with enhanced mental health services delivered within the program.

2. SERVICE PROVISION – HHSA-BH is seeking proposals for ASAM Level 3.1 Clinically Managed Low- Intensity Residential Treatment and ASAM 3.5 Clinically Managed High Intensity Residential Treatment in a co-located ASAM 3.2 residential withdrawal management facility.

• ASAM 3.1 Clinically Managed Low-Intensity Residential treatment provides 24-hour structure with trained and credentialed personnel providing clinically directed program activities and professionally directed treatments to stabilize and maintain substance use disorder (SUD) symptoms, develop and apply recovery skills, and preparation for outpatient treatment. Clinical services hours range from 9-19 hours per week, and they are available seven days per week.

Direct psychosocial services are provided in a therapeutic milieu.

• ASAM 3.2 Clinically Managed Withdrawal Management Residential Services include evidence-based services delivered by appropriately trained staff who provide 24-hour supervision, observation and support for clients experiencing withdrawal with an emphasis on peer and social support. Observations are to be conducted as follows:

o At least one staff member or volunteer shall be always assigned to the observation of clients and be certified in cardiopulmonary resuscitation, first aid, and Naloxone administration.

o Staff shall physically check each beneficiary for breathing by a face to-face physical observation at least every thirty (30) minutes and vital signs every six (6) hours at a minimum during the first seventy-two (72) hours following admission. The close observation and physical checks shall continue beyond the initial seventy-two (72) hour period for as long as the withdrawal signs and symptoms warrant. After twenty-four (24) hours, close observations and physical checks may be discontinued or reduced based upon a determination by a staff member trained in providing Withdrawal Management Services. Documentation of the information that supports a decrease in close observation and physical checks shall be recorded in the client's file.

o Documentation of observations and physical checks shall be recorded in a systematic manner in the Beneficiary file including information supporting a decrease in observation and physical checks and signature of staff.

o Only program staff that have been trained in the provisions of Withdrawal Management Services may conduct observations and physical checks of clients receiving Withdrawal Management Services. Training shall include information on detoxification medications, and signs and symptoms that require referral to a higher level of care. Training shall also include first aid cardiopulmonary resuscitation, and Naloxone administration. Copies of detoxification training records shall be kept in personnel files.

• ASAM 3.5 Clinically Managed High-Intensity Residential treatment provides 24-hour care with trained and credentialed personnel providing clinical directed program activities and professionally directed treatments to stabilize and maintain SUD symptoms, develop and apply recovery skills specific for individuals with co-occurring mental health disorders. Clinical services hours are no less than 20 hours per week, and they are available seven days per week. Direct psychosocial services are provided in a high-intensity therapeutic milieu.

A. Evidence Based Practices - The DMC-ODS requires the use of evidence-based practices for SUD treatment to improve client outcomes. Respondents must demonstrate their experience in the provision of evidence-based practice and the capacity to provide at least two (2) of the approved DMC-ODS evidence-based practices (EBPs) through the following at a minimum in their proposals:

1. Motivational Interviewing: A client-centered, empathic, but directive counseling strategy designed to explore and reduce a person's ambivalence toward treatment. This approach frequently includes other problem solving or solution-focused strategies that build on clients' past successes. The approach also has had success in supporting client engagement and harm reduction for clients not yet motivated to abstain from substance use www.motivationalinterviewing.org.

2. Cognitive Behavioral Therapy: Based on the theory that most emotional and behavioral reactions are learned and that new ways of reacting and behaving can be learned. This therapeutic approach has been effective in preventing relapse.

3. Relapse Prevention: A behavioral self-control program that teaches individuals with substance addiction how to anticipate and cope with the potential for relapse. Relapse prevention can be used as a stand-alone substance use treatment program or as an aftercare program to sustain gains achieved during initial substance use treatment.

4. Trauma-Informed Treatment: Services must take into account an understanding of trauma and place priority on trauma survivors’ safety, choice and control.

5. Psycho-Education: Psycho-educational groups are designed to educate clients about substance abuse and related behaviors and consequences. Psycho-educational groups provide information designed to have a direct application to clients’ lives; to instill self-awareness, suggest options for growth and change, identify community resources that can http://www.motivationalinterviewing.org/ assist clients in recovery, develop an understanding of the process of recovery, and prompt people using substances to take action on their own behalf.

B. Operating Hours: Services to beneficiaries in this program will be provided on a twenty-four (24) hours per day, seven (7) days per week basis. Contractor’s holiday schedule will be consistent with County’s schedule unless otherwise approved by County.

C. Admissions hours must adhere to the following schedule:

1. Substance Use Residential Treatment– Admissions hours shall be between the hours of 8:00 am and 5:00 pm Monday through Sunday. Contractor will also maintain the ability to accept an admission outside of these hours as requested.

2. Residential Withdrawal Management– Admissions to this service must be available twenty-four (24) hours per day, seven (7) days per week. Withdrawal Management services are urgent and admissions shall be conducted within 48 hours of request for services.

D. Electronic Health Record and Data Collection - Under DMC-ODS, counties and their treatment providers are required to enter timely and accurate data to support DMC-ODS evaluation activities and other quality improvement activities. Respondents must demonstrate they have the organizational capacity to collect and report data to HHSA-BH on a monthly basis or within five (5) business days of a request and in compliance with all other State and County data system reporting requirements. This includes employing trained staff who are capable and knowledgeable about collecting, analyzing and reporting data for the following systems:

a. SmartCare electronic health record (EHR) system or a different EHR of comparable capabilities

b. State Drug and Alcohol Treatment Access Report data system (DATAR)

c. State CalOMS Treatment data system

d. ASAM Level of Care data, including initial assessments and reassessments

Respondents must demonstrate that they have program capacity to support data collection and evaluation activities, including the necessary hardware, software, and information technology (IT) resources to support these activities. This includes, at a minimum, demonstrated organizational capacity to:

a. Effectively interface with DHCS and County data collection systems such as SmartCare, CalOMS Treatment and DATAR:

b. Submit client information and treatment records directly into the County’s electronic health record, SmartCare, as well as complete required surveys and assessments to meet all billing, documentation, outcomes, quality improvement, and performance measurement and reporting requirements;

c. Comply with all federal, state, and County systems, laws and regulations;

d. Identify and train staff required to provide registration and eligibility verification functions within the electronic health record, in order to meet billing, reporting, quality management, program evaluation, and monitoring requirements; and

e. Provide for other required data collection including client satisfaction surveys, ASAM level of care determinations, as well as other data collection requirements not yet identified.

All Respondents must demonstrate that they have sufficient information technology capacity and resources including:

a. Hardware including a computer on each workstation or desk with sufficient processing power to support real time use of highly complex scheduling, electronic healthcare record and eligibility verification applications;

b. Software including current internet browser software, Microsoft Office applications to support practice management functions, and VPN or Token share of cost;

c. Connectivity including high speed internet and local area networking within facilities; and

d. Information Technology (IT) support services sufficient to the level of IT resources within programs and facilities including desktop support, computer break fix, networking support, and basic computer training.

E. Gender Appropriate Services. The program shall deliver evidence-based services to all genders with elements designed to address the unique issues of all genders.

F. Culturally and Linguistically Competent Services. For all levels of care offered, the program shall demonstrate ability to deliver culturally and linguistically competent services in alignment with Culturally and Linguistically Appropriate Services (CLAS) standards developed by the U.S.

Department of Health and Human Services. Because Spanish is a threshold language in Napa County, the program must employ bilingual English-Spanish speaking staff during day and evening hours in order to effectively serve Napa County’s Spanish speaking beneficiaries. For beneficiary language needs beyond the county’s threshold languages, Contractor may use interpretation services, obtained through its own interpreter services agreement, when Contractor’s own staff cannot effectively communicate in the client’s primary language.

G. Licensing and Certification of the Program. The provider shall be licensed by the State Department of Health Care Services (DHCS) as a “Residential Alcoholism or Drug Abuse Recovery or Treatment Facility” with a detox service authorization pursuant to Title 9 California Code of

Regulations, Section 10500, et Seq. The provider is required to obtain a Drug Medi-Cal (DMC) Residential Certification using the application process prescribed by the DHCS through the Provider Enrollment Division (PED). Licensure and certification, with an ASAM designation for 3.2, 3.1, and 3.5, shall be maintained in good standing at all times and meet all additional requirements of state and federal statute, including counselor certification.

H. Documentation of Services. All services shall be documented in accordance with the DHCS licensing and certification standards for detoxification and substance use residential treatment programs and such documentation standards as the County may reasonably establish for services to be reimbursed by Napa County HHSA-BH. Documentation must comply with all Drug Medi-Cal requirements pertaining to residential substance use treatment and withdrawal management services delivered in the DMC-ODS. All services must be documented in the County’s electronic health care record, SmartCare.

I. Written Treatment Protocols. The program shall be operated in accordance with comprehensive written policies and procedures developed by the program which meet the requirements for licensure and certification and that describe the DMC-ODS residential treatment modalities and activities. Without limiting this, the policies and procedures shall describe the program standards for admission, continued stay and discharge; staffing levels and credentials;

client schedules; individual and group education and treatment protocols; group curricula;

assessment and treatment planning protocols; documentation standards; protocols for medical assessment and medication services, including but not limited to Medication Assisted Treatment;

and protocols for dealing with client crises and emergencies.

J. Program Capacity. The program shall be operated in a manner that will accommodate not less than forty-six (46) clients in residence at a time, with ten (10) withdrawal management and thirty-six

(36) short term residential SUD treatment slots in total. Of the 36 residential treatment slots, 12 are reserved for female-identified clients and 24 for male-identified clients.

K. Treatment Tracks and Lengths of Stay. At a minimum, the program shall operate three tracks or levels of service.

a. Residential Treatment ASAM 3.1. An intensive, short term residential treatment track and therapeutic milieu will prepare clients for “step down” or transfer to outpatient treatment from other providers. The length of stay in this track will generally be made within increments of 30 calendar days. Total length of stay will vary according to the clinical need as assessed by the program and determined by HHSA-BH utilization review. Admission and length of stay must be prior authorized by HHSA-BH based upon a clinical review of medical necessity as documented by the program. “Step down” or transfer to Outpatient Treatment as well as a comprehensive discharge planning shall be determined at regularly scheduled multi-disciplinary team meetings with representatives from the program operator and the county Alcohol and Drug Services Division.

b. Residential Withdrawal Management (Detoxification) ASAM 3.2. A detoxification track will serve beneficiaries who are engaged in the withdrawal from the physical and psychological symptoms of addiction. Average length of stay in this track will range from two to six days. No prior authorization is needed for this service.

c. Residential Treatment ASAM 3.5 A high intensity therapeutic milieu providing 24-hour care with trained and credentialed personnel who deliver clinical directed program activities and professionally directed treatments to stabilize and maintain substance use disorder symptoms, develop and apply recovery skills specific for individuals with co-occurring mental health disorders. The length of stay in this track will generally be made within increments of 30 calendar days. Total length of stay will vary according to the clinical need as assessed by the program and determined by HHSA-BH utilization review.

L. Confidentiality. The program shall at all times abide by applicable federal and state laws and regulations relating to the confidentiality of client information, including, without limitation, the Health Insurance Portability and Accountability Act of 1996 and 42 C.F.R. Part 2.

M. Reporting of Critical Incidents and Sentinel Events. The program shall comply with County and State reporting standards. Program shall report any unusual occurrences to the county. An unusual occurrence is any event which jeopardizes the health and/or safety of clients, staff and/or members of the community, including but not limited to physical injury and death. Unusual occurrences are to be reported to the county immediately via telephone (within 24 hours after becoming aware of the event) followed with a written report within five calendar days of the event.

Residential SUD treatment facilities licensed by DHCS shall also comply with reporting unusual incidents as outlined in Title 9 CCR, Chapter 5, Subchapter 3, Article 1.

N. Client Grievances. Contractor shall make County grievance forms readily available to clients and provide these to clients directly when clients express a concern regarding services. Program shall work with County to address any concerns brought forth and document these in a Grievance Log. Program shall provide assistance to clients in completing grievance forms, including interpreter services as needed.

3. Performance Objectives - For clients whose treatment is funded under this agreement, the Program shall be evaluated on the basis of the criteria set forth below. The Contractor shall collect and maintain any data necessary to show the extent of compliance with these criteria. The criteria shall be subject to revision in the normal contract negotiation and renegotiation process.

A. Adherence to Documentation Standards. HHSA-BH shall have the right to review client records to determine their compliance with applicable documentation standards, and to determine that the services reflected in the documentation are reviewed by supervisory staff and adhere to the Basic Program Specifications. Evidence of ongoing training on documentation standards is required.

B. Adherence to Licensure Standards. HHSA-BH shall have the right to evaluate program activities to measure their adherence to applicable licensure and certification standards, including counselor certification.

C. Adherence to other Contract Requirements. HHSA-BH shall evaluate program performance to measure its adherence to other requirements of the service contract.

D. Client Satisfaction. In compliance with DMC-ODS and County requirements, the program shall administer the Treatment Perception Survey annually, and, in addition shall use its best efforts to survey all clients at the time of discharge to determine satisfaction with the treatment services. Program staff shall consult with HHSA-BH representatives in the development of the survey instrument. The program will strive to achieve the outcome of 80% of all clients admitted rating themselves as “satisfied” or better with services provided. Client Satisfaction Survey results should be compiled quarterly and submitted to HHSA - BH within 30 days of the end of the quarter.

4. Staffing Requirements

A. Contractor shall include bilingual/bicultural services to meet the needs of threshold languages as determined by County. Whenever possible, bilingual/bicultural staff should be retained. Any clinical vacancies occurring at a time when bilingual and bicultural composition of the clinical staffing does not meet the above requirement must be filled with bilingual and bicultural staff unless minimum qualifications are not met.

B. Contractor shall make its best effort to provide services pursuant to the Agreement in a manner that is culturally and linguistically appropriate for the population(s) served. Contractor shall maintain documents of such efforts which may include, but not be limited to: records of participation in applicable training; recruitment and hiring policies and procedures; literature in multiple languages and formats, as appropriate; and descriptions of measures taken to enhance accessibility for, and sensitivity to, individuals who are physically challenged.

C. Contractor shall use an interpreter service when a caller speaks a language not spoken by staff, as well as the California Relay Service for hearing impaired members.

D. Contractor shall ensure that all staff are trained and have a clear understanding of all policies and procedures. Subcontractor shall provide signature confirmation of the policies and procedures training for each staff member and place in their personnel files.

E. Contractor shall ensure that all new clinical and supervisory staff complete the County’s New Provider Training.

F. Contractor shall ensure that all staff complete the County’s Annual Compliance Training.

G. Contractor shall ensure that all staff are trained and have a clear understanding of all Personnel Requirements as stated in CCR tit. 22 § 81065 and that continuing education is provided.

Contractor shall document the number of hours of continuing education completed each year by direct care staff. The continuing education may include such topics as the following:

1. Basic knowledge of mental disorders;

2. Counseling skills, including individual, group, vocational and job counseling skills

3. Crisis management;

4. Developing and updating of needs and services plan;

5. Discharge planning;

6. Medications, including possible side effects and signs of overmedicating;

7. Knowledge of community services and resources; and

8. Principles of good nutrition, proper food preparation and storage, and menu planning.

H. Contractor shall have a supervisory and administrative structure that will ensure high quality, and cost effective service provision including initial and on-going staff training.

I. Contractor shall maintain personnel files for each staff member, including the Executive Director and other administrative positions, which will include, but not be limited to, an application for employment, qualifications for the position, documentation of bicultural/bilingual capabilities (if applicable), pay rate and evaluations justifying pay increases.

5. Facility Requirements - All services outlined in this RFP are to be conducted at the county-owned Behavioral Health Treatment Center, located at 2200 Napa-Vallejo Highway, Napa, CA 94558.

1. Substance Use Residential Treatment portion of the BHTC, includes three housing dormitories comprised of 5,040 square feet of living space, 18 beds for male participants within two dormitories, and 9 beds for female participants in one dormitory. A separate dedicated treatment space for the residential program is located within the main building at the BHTC, and consists of 3,967 square feet of classrooms and counseling space and 2,460 square feet of shared kitchen, dining room and support staffing areas.

2. Residential Withdrawal Management will be located in a dedicated dormitory, adjacent to the residential treatment dormitories. This dormitory, consisting of 1,420 square feet, includes 5 beds for females and 5 beds for males, and a staff station area for staff observation during the withdrawal management process. Clients served in withdrawal management will have access to the shared kitchen and dining room referred to above, as well as the treatment space within the main building when appropriate.

PROGRAM C: LPS SB43 MENTAL HEALTH REHABILITATION CENTER

A. Target Population - Adults 18 years of age and older who are enrolled in Medi-Cal, and diagnosed with a disabling co-occurring psychiatric and substance use disorder -or- severe substance use disorder (SB 43) who meet the following conditions:

1. Voluntary and Lanterman-Petris-Short (LPS) conservatees;

2. Clients who are in need of MHRC services;

3. Clients who require supervision, rehabilitation, life enrichment, and other care and treatment;

4. Clients with a history of evaluation and treatment at any of the following facilities: acute psychiatric hospital, crisis stabilization unit, psychiatric health facility, withdrawal management delivered in a inpatient hospital or residential setting.

5. Clients diagnosed as having a disabling psychiatric disorder such as schizophrenia, bi-polar, major affective disorder, &/or a severe substance use disorder.

B. Licensing, Certification, or Accreditation and Regulatory Compliance

1. As part of delivering services in accordance with this agreement, Contractor’s proposal shall comply with all requirements under the LPS Facility Designation Interim Regulations published by the California Department of Health Care Services on February 24, 2026, LPS Facility Designation Interim Regulations, as may be subsequently amended and all applicable federal and state laws and regulations including but not limited to:

a. 42 C.F.R. Part 438 (Medicaid Managed Care)

b. 42 C.F.R. Part 2 (Confidentiality of Substance Use Disorder Patient Records)

c. HIPAA privacy and security regulations

d. California Code of Regulations Title 9 and Title 22

e. California Code of Regulations (CCR) Title 9, Division 1, Chapter 3.5

f. Applicable provisions of the Health and Safety Code and Welfare and Institutions Code

2. Contractor shall ensure they maintain an active license to operate from the Department or State Department of Public Health.

a. Contractor shall also maintain any required Medi-Cal certifications.

3. Contractor shall notify the Napa County HHSA Director, and the behavioral health director in writing:

https://www.dhcs.ca.gov/wp-content/uploads/2026/05/LPS-Facility-Designation-Interim-Regulations.pdf https://www.dhcs.ca.gov/wp-content/uploads/2026/05/LPS-Facility-Designation-Interim-Regulations.pdf

a. No later than 24 hours after the suspension, revocation, or termination of its license, certification, or accreditation.

b. Within 10 calendar days of any other change to the facility’s license, certification, or accreditation, including but not limited to the facility’s name, location, or mailing address.

c. Within 10 calendar days of a change to the professional person in charge of the facility.

d. The notice required by subsection (3)(B) shall include a copy of the designated facility’s license, certification, or accreditation reflecting the change, or documentation the professional person in charge of the facility is qualified in accordance with Section 6, Staffing Requirements as applicable.

C. Facility and Environment

1. Bed Capacity: Maintain exactly 7 licensed beds in a secure, sub-acute, homelike environment.

D. Service Provision

1. Contractor shall provide the following behavioral health treatment services, as clinically appropriate, 24 hours per day:

a. Assessment;

b. Evaluation;

c. Crisis intervention;

d. Medication treatment;

e. Therapy; and

f. Care coordination, in accordance with the requirements set forth in Welfare and Institutions Code sections 5152 and 5257.5.

2. Contractor shall provide the behavioral health treatment services required by subsection (A) seven days per week, unless the Department of Health Care Services (DHCS) approved an exemption for the facility under Welfare and Institutions Code section 5151.

3. Contractor shall individually determine a client’s length of stay based on evidence-based clinical standards and the client’s assessed need for behavioral health treatment.

4. Contractor shall directly provide all medications for addiction treatment to clients on site, as indicated.

5. Contractor shall implement an effective process for initiating or continuing a client’s treatment with methadone for opioid use disorder. Contractor’s process shall include all of the following:

a. Procedures for initiating or continuing a client’s treatment with methadone while admitted to the facility, which shall include a documented formal agreement with a narcotic treatment program, unless locally unavailable;

b. Procedures for transporting clients to a narcotic treatment program, if clientss are transported offsite, or procedures for obtaining and distributing methadone in the facility;

and

c. Procedures for referring discharged clients to narcotic treatment programs, community health centers, or other providers of medications for addiction treatment.

5. When Contractor admits clients who are presently intoxicated or experiencing withdrawal symptoms, or at risk of experiencing withdrawal symptoms are admitted, Contractor, shall do the following:

a. Assess a client’s need for observation at admission; and

b. Conduct client observation checks in accordance with the client’s assessed need for observation.

c. A designated facility shall document the name of the staff conducting client observation checks and the date and time of each observation check in a client’s chart.

6. Contractor shall maintain a suicide prevention policy addressing all of the following elements of care for clients expressing suicidal ideation or engaging in self harming behavior.

a. Risk assessments.

b. Safety precautions.

c. Visual observation policies and staffing to maintain compliance with visual observation policies.

d. Incident documentation requirements.

e. Methods by which hazardous objects, including plastic bags and

f. trash can liners, are kept inaccessible to clients.

7. The contractor must ensure delivery of structured treatment tailored to complex behavioral and chemical dependency needs, guaranteeing an average of at least 27 hours per week of direct program services per client.

a. Intake & Assessment: Complete comprehensive psychiatric, psychosocial, functional nursing, and standardized SUD screenings (e.g., ASAM criteria aligned metrics) within mandated state timelines following placement.

b. Individualized Recovery Plans: Formulate goal-oriented, multidisciplinary care plans updated at minimum every four months to evaluate ongoing functional tiers, integrated mental health stabilization, and substance use relapse prevention.

c. Therapeutic Interventions: Provide regular evidence-based individual therapy, group therapy, crisis intervention, and specialized SUD counseling (e.g., Medication-Assisted Treatment, Motivational Interviewing, CBT for substance use).

d. SB 43 Basic Needs Framework: Tailor rehabilitation goals to address the expanded definition of basic personal needs, focusing heavily on a client's capacity to maintain personal safety and access necessary medical care, alongside food, clothing, and shelter.

e. Rehabilitation & Life Skills: Train residents in Activities of Daily Living (ADLs), symptom management, communication, and community re-integration pathways.

f. Medication Management: Ensure strict physician-led psychiatric evaluation, safe dispensing, cross-functional tracking for…