HSS26018-CERCOMBHCS-appA.pdf

Appendix A – Scope of Services

I. BACKGROUND

A. Delaware Division of Substance Abuse and Mental Health

DSAMH is a division of the Department of Health and Social Services (DHSS) and is responsible for promoting health and recovery by ensuring that Delawareans have access to quality prevention and treatment for mental health, substance use, and gambling conditions. DSAMH carries out this work through contracts and partnerships to provide a variety of community-based mental health and substance abuse treatment programs as well as operation of the Delaware Psychiatric Center.

In recent years, DHSS has taken several steps to create a more favorable clinical, operational, and reimbursement environment such as the implementation of a treatment and referral network, development of targeted billing guidance for key initiatives, and the provision of technical assistance.

B. Background The CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINICS (CCBHC) model is designed to ensure access to high-quality, coordinated, comprehensive behavioral health services in a timely manner to individuals across the lifespan. Modeled after the Federally Qualified Health Center (FQHC) prospective payment system, CCBHC is a way for states to explore new approaches to deliver and reimburse community behavioral health services.

CCBHCs are required to provide nine core services to children, youth, and adults and to ensure that services are delivered in a manner that is person-and family-centered, trauma-informed, and focused on the whole person.

The CCBHC initiative is operated through a partnership across the Substance Abuse and Mental Health Services Administration (SAMHSA), the Center for Medicare & Medicaid Services (CMS), and the Office of the Assistant Secretary for Planning and Evaluation (source).

Delaware was awarded its first CCBHC Planning Grant in 2023 and was awarded a subsequent Planning Grant in 2025. Through this funding opportunity, Delaware has gained a better understanding of its providers, the needs of its population, and how CCBHCs will improve the system, and ultimately the outcomes, of individuals served.

DSAMH seeks information with the necessary expertise, experience, and interest to implement Certified Community Behavioral Health Clinics (CCBHCs) in Delaware, thus expanding access to high-quality behavioral health services for Delawareans.

https://www.samhsa.gov/communities/certified-community-behavioral-health-clinics

C. Eligibility DSAMH welcomes any provider who is capable of providing the scope of services and any additional services which potentially includes, but is not limited to, current DSAMH vendors, DE FQHCs, behavioral health providers operating in DE, and behavioral health providers currently operating outside of DE with an interest in expansion. CCBHC services must be located in Kent and/or Sussex counties.

II. SCOPE OF SERVICES

The information you provide in this Request for Information will help us determine what is needed by a prospective Vendor who will incrementally build capacity to serve as a CCBHC as demonstrated by its ability to meet required SAMHSA criteria for CCBHCs.

The Vendor that will be needed should focus initial efforts on building capacity to provide the nine core services, with priority toward outpatient mental health and substance use disorder services for children, families, and adults across the lifespan.

A. Program Description

a. Principles

CCBHCs are designed to ensure access to coordinated, comprehensive behavioral health care. Services must be trauma-informed, person- and family-centered, and recovery-oriented.

b. Target Population CCBHCs are designed to serve all Delawareans in their service area experiencing mental health disorders, substance use disorders, or both, regardless of age, ability to pay, or place of residence. For those individuals who require a higher level of care than that provided by the CCBHC, CCBHC staff will assist the individual in accessing the appropriate services.

c. Access As part of the capacity building process, the CCBHC will complete a community needs assessment to inform specific access needs, ensuring that hours of operation and location(s) support accessibility and meet the needs of the population served.

i. Location: Kent and/or Sussex counties

ii. Hours: Must include some evening and weekend hours

d. Services CCBHCs must provide nine core services directly, or through partnership with a Designated Collaborating Organization:

• Outpatient mental health and substance use services

• Crisis behavioral health services including prevention, 24-hour mobile crisis teams, emergency crisis intervention, and crisis stabilization1

• Screening, assessment, and diagnosis including risk assessment

• Person-centered and family-centered treatment planning

• Primary care screening and monitoring

• Targeted case management

• Psychiatric rehabilitation services

• Peer supports, Peer counseling, and family/caregiver supports

• Intensive community-based mental health care for members of the Armed Forces and veterans

e. Staffing

Staffing is informed by the community needs assessment and must include:

• CEO or equivalent/Project Director

• Psychiatric Provider as Medical Director

• Clinical and non-clinical staff that is appropriate for the population receiving services in terms of size, composition, and service mix

f. Outcomes Collecting information regarding interested/potential CCBHC providers who may be interested in developing a CCBHC within the state and understanding their existing models and potential alignment with federal and state criteria. This information will also support Delaware with understanding potential influx of CCBHC providers under potential Demonstration grant.

III. TECHNICAL RESPONSE REQUIREMENTS

Responses to the question below must describe how it will fulfill the requirements outlined in the scope of work. The information provided should ensure that all proposed solutions are consistent with DSAMH policies and procedures, and applicable regulations, standards, procedures, and best practices. In addition, the proposal must demonstrate how the organization will

1 SAMHSA CCBHC criteria allows certifying states to request approval from HHS to certify CCBHCs that have or seek to have a DCO relationship with a state-sanctioned crisis system. It is the intent in DE to pursue this approval.

meet applicable state licensing and certification standards associated with each proposed service line.

A. Experience and Reputation

These criteria relate to the qualifications and experience of the organization and person assigned to the project.

• Describe the organization’s mission and values.

• Describe the organization’s current service lines and areas of clinical expertise including treatment modalities, populations of focus, and ages served.

• Provide a map showing where the organization currently has physical and administrative sites.

• Provide a current organizational chart, including current roles, functions, and credentials of staff and a description of how individuals with lived experience are an integral part of service delivery and organizational governance.

• If the organization currently operates in Delaware, describe staff qualifications and experience working with individuals with substance use disorders and mental health conditions across the lifespan including current staff who are credentialed in specific Evidence-Based Practices.

• If the organization does not currently operate in Delaware, describe staff qualifications and experience implementing new sites and.

• Describe the organization’s experience implementing new licensed or accredited programs.

• Describe the organization’s experience implementing services in Delaware. Include a description of any known risks and mitigation strategies.

B. Expertise

• Present any evidence of experience and success as a CCBHC in other states.

• Present any evidence of experience and success providing each of the nine core services required of CCBHCs.

C. Capacity to meet Requirements

• Include a statement of the organization’s leadership’s dedication and support of CCBHC.

• Describe how the program will involve people served, families, and community stakeholders in the planning, delivery, and ongoing events and activities of the proposed CCBHC.

• Describe organizational strengths and challenges that will affect the ability of the organization to implement the CCBHC within the specified timeframes.

• Identify the health information technology infrastructure that the organization will leverage and/or build to meet the requirements for CCBHC service delivery and reporting.

D. Plan for Program Design & Approach to Implementation

a. Staffing Requirements

• Describe the proposed approach to hiring, training, and supervising all necessary staff.

b. Nine Core Services

• Describe the proposed approach to implementing the nine core services including considerations for prioritization, hours, and location(s).

c. Timeline

• Describe the steps and milestones from award to full implementation of the nine core services.

d. Partnerships

• List and describe existing community partnerships with other providers.

• Identify how these existing partnerships will be leveraged to determine the success of the proposed CCBHC, including any potential Designated Collaborating Organizations (DCOs).

• Identify new community partnerships that will be developed within the county to meet the needs of people served by the CCBHC.

e. Risks & Mitigation Strategies

• Identify potential challenges and planned strategies to prevent and/or mitigate them.

E. Budget

Provide a budget which includes start-up costs related to physical plant, licensing and certification; training; technology; and staffing as well as revenue projections.

a. Sustainability

• Describe projected revenue to include the timeline and potential for profit or loss in a fee for service model should a Prospective Payment Structure (PPS) not be in place at the time of implementation.