Inpatient_Behavioral_Health_Services.pdf

County of Orange

Health Care Agency

Request for Applications

RFA No.: RFA-042-3019403-II

Inpatient Behavioral Health Services

Released Tuesday, March 31, 2026

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TABLE OF CONTENTS

SECTION 1. INTRODUCTION AND GENERAL INFORMATION

SECTION 2. PROTEST PROCEDURES

SECTION 3. APPLICATION PREPARATION AND EVALUATION

SECTION 4. MINIMUM SUBMISSION REQUIREMENTS

SECTION 5. DESCRIPTION OF SERVICES

SECTION 6. VENDOR RESPONSES

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1 INTRODUCTION AND GENERAL INFORMATION

1.1 APPLICATION FOCUS AND BACKGROUND

The County of Orange (County) Health Care Agency (HCA) is seeking applications from qualified organizations to provide Inpatient Behavioral Health Services.

The primary goal of this program is to provide services to Medi-Cal eligible youth, adults and/or older adults, with a serious mental health condition, often a co-occurring medical/substance use disorders, or stand-alone severe substance use disorder requiring acute inpatient psychiatric treatment in a safe, secured environment to stabilize symptoms occurring as a result of their mental health condition.

The County intends to establish two (2) Master Contracts which are dependent on State licensure but have the same required services as outlined below, pursuant to which County intends to execute contracts with all applicants who meet eligibility and submission requirements. The

Master Contracts will be for one of the following service provisions:

• Inpatient Behavioral Health Services, for the facilities that are an Acute Free-Standing

Psychiatric Hospital (AFSPH)

• Medi-Cal Mental Health Managed Care Inpatient Hospital Services for the facilities that are a General Acute Care Hospital (GACH)

The County intends that the successful Applicant shall provide Inpatient Hospital Services or

Inpatient Behavioral Health Services to include but not limited to: high quality, compliant, person centered, trauma informed inpatient psychiatric services (including co-occurring

Substance Use Disorder (SUD) care or stand-alone SUD care), from admission through stabilization and transition to lower level of care, with strong coordination, discharge, and follow up as proposed in accordance with contract requirements set forth in the solicitation and Model

Contract, including Attachments.

1.2 TIME APPLICATIONS WILL REMAIN VALID

Applications will remain valid for 365 days from the solicitation due date.

1.3 TIMELINE

Timeline dates are approximations only and do not constitute any commitment or guarantee by the County.

To ensure the Services Commence date listed below can be met, applicants must submit all required materials by the Initial Application Deadline. RFA will remain open for an additional six months for rolling submissions.

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RFA Released: March 31, 2026

RFA Q&A Deadline: April 24, 2026, 4:00pm

Initial Application Deadline: April 30, 2026, 4:00pm

Final Application Deadline: March 31, 2027, 4:00pm

Board of Supervisors date (for Initial

Application Deadline):

Anticipated: August 11, 2026

1.4 WITHDRAWAL OF APPLICATIONS(S)

An application may be withdrawn by the applicant or an authorized representative, provided his or her identity is made known and he or she provides a receipt for the application, but only if the withdrawal is made prior to the application due date.

1.5 QUESTIONS REGARDING THE RFA PROCESS AND REQUIREMENTS

All questions regarding this Request for Applications (RFA) are to be posted online via The

County’s online bidding system Question and Answer (Q&A) Section and will only be accepted and answered during the Q&A period that lasts until approximately one (1) week prior to the RFA closing date.

All applicants are expected to thoroughly read through the entire RFA package before posting questions. All participating applicants will simultaneously receive a notification via The County’s online bidding system that a question has been posted related to this RFA and will be available for view by all participating applicants. The County’s responses to the questions asked will be posted as promptly as possible to The County’s online bidding system and will be available for view by all participating applicants. .

The Q&A Section will close on Friday, April 24, 2026 at 4:00 pm Pacific Time. All applicants are encouraged to post any questions regarding the RFA by this deadline. After the close of the

Q&A period, applicants may only contact the Deputy Purchasing Agent (DPA) with questions related to uploading applications to the County’s online bidding system. No other specific solicitation-related questions will be answered.

It is up to each individual applicant to determine if their organization meets the eligibility criteria stated in the RFA prior to submitting an application. The County does not provide any assistance to that effect.

Applicants are to strictly follow the directions above for questions regarding this RFA. During the entire RFA process, no County representative may be contacted for questions or information regarding this RFA with the exception of the assigned DPA, Imelda Iler at iiler@ochca.com. Any violation of this direction may be deemed non-responsive with the RFA process and shall form a basis for the rejection of the application.

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1.6 GENERAL INSTRUCTIONS FOR SUBMITTAL

A. Applicant’s application must clearly meet all of the requirements of this solicitation.

B. Applicants should review all requirements and instructions to ensure that each requirement is met. County shall not be responsible for any oral instructions given by any employees of County in regard to the application instructions, specifications, or application documents as described in this solicitation.

C. Applications and requested documents must be electronically uploaded in PDF format, via

County’s online bidding system. Hard copy applications will not be accepted.

D. Allow sufficient time to upload all required files. After the application deadline, County’s online bidding system will not allow any uploads. If all files are not uploaded successfully by the application deadline, your organization’s application may not be accepted.

E. Provide accurate and honest information. Information that is deliberately inaccurate may prompt an investigative review and will affect the evaluation of the application.

F. Provide documentation where necessary, including items such as forms, licenses, etc.

G. If you omit any required information or data, explain why.

H. Do not include home addresses, home phone numbers, and/or personal email addresses for any employee, volunteer, Board member, etc. in your applications.

NOTE: Electronic Bids cannot be viewed by County until after the solicitation deadline. If you encounter any problems with your registration, system, application submission, or other system issues, please contact OpenGov’s support staff via the live chat option or via email at procurement-support@opengov.com.

1.7 THE COUNTY RESERVES THE RIGHT TO:

A. Modify this RFA prior to the time applications are due, provided applicants are granted such extensions as necessary to allow sufficient time for submission of applications in response to the modified RFA.

B. Cancel this RFA at any time, but prior to award of a contract by the Board of Supervisors, in whole or in part, when it is determined that cancellation is in the best interest of the

County.

C. Reject any or all applications.

D. Reject an application at any time during the RFA process for reasons stated in this RFA or for false information submitted in response to the RFA.

E. Enter into a contract for all or some of the stated scope.

mailto:procurement-support@opengov.com

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F. Award single or multiple contracts.

G. Based on the County’s needs and availability of funds, modify the scope described herein, provided applicants are allowed to re-submit modified applications within a reasonable time.

H. Ask applicants for additional information or documentation.

1.8 USE OF LOBBYISTS

The County does not require, and neither encourages nor discourages, the use of lobbyists or other consultants for the purpose of securing business.

1.9 CONFLICT OF INTEREST

Applicant agrees that if there is a change or transfer in ownership of applicant’s organization prior to the completion of the contract, and the County agrees to an assignment of the Contract, the new owners shall be required under the terms of sale or other instruments of transfer to assume Contractor’s duties and obligations contained in the Contract and complete them to the satisfaction of the County.

The County reserves the right to immediately terminate the Contract in the event the County determines that the assignee is not qualified or is otherwise unacceptable to the County for the provision of services under the Contract.

1.10 CONFIDENTIALITY

California Public Records Act

Pursuant to California law, all information contained in an application may be public record, subject to disclosure to any member of the public who requests it through the California Public

Records Act (CPRA). Government Code section 7920 et seq.

1.11 MODIFICATIONS OF THE RFA

The County reserves the sole right to interpret or change any provision of the solicitation at any time prior to the application submission date. Any and all interpretations or changes will be in the form of a written addendum, which will be furnished to all applicants through County’s online bidding system. All addendums issued will become part of the solicitation and resultant contract.

Applicants hereby acknowledge their receipt of any addendum by being registered in County’s online bidding system and acknowledge it is the applicant’s responsibility to check for, and read all addendums posted in County’s online bidding system.

Should such addendum require information not previously requested, the County at its sole discretion, may determine that a time extension is required for the submission of applications, in which case an addendum will indicate the new application submission date.

2 PROTEST PROCEDURES

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Any actual or prospective applicant who alleges an error or impropriety in the solicitation or award of a contract may submit a grievance or protest to Imelda Iler at iiler@ochca.com, as set forth herein.

PROTEST PROCEDURES

All protests shall be typed under the protestor’s letterhead and submitted in accordance with the provisions stated herein. All protests shall include at a minimum the following information:

A. The name, address, and telephone number of the protestor;

B. The signature of the protestor or the protestor’s representative;

C. The solicitation or contract number;

D. A detailed statement of the legal and/or factual grounds for the protest; and, E. The form of relief requested.

Protest of Solicitation Specifications:

A. All protests related to solicitation specifications must be submitted to the DPA, Imelda

Iler at iiler@ochca.com, no later than five (5) business days prior to the Application

Deadline of the solicitation. Protests received after the five (5) business-day deadline will not be considered by the County.

B. In the event the protest of specifications is denied, and the protestor wishes to continue in the solicitation process, the protestor must still submit an application prior to the

Application Deadline of the solicitation in accordance with the solicitation submittal procedures provided in this solicitation.

Protest of Award of Contract:

A. Protests related to the award of a contract must be submitted to the DPA, Imelda Iler at iiler@ochca.com, no later than five (5) business days after the Notice of Solicitation

Ranking Results is provided by the DPA.

B. Protests relating to a proposed contract award received after the five (5) business day deadline will not be considered by the County.

C. If the five (5) business day period expires without the receipt of a protest, the department may move forward with the contract award or if necessary, file the item for approval by the Board of Supervisors.

Protest Process

A. In the event of a timely protest, the County shall not proceed with the solicitation or award of the contract until the DPA issues a decision on the protest.

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B. Upon receipt of a timely protest, the DPA will, within ten (10) business days of receipt of the protest, issue a decision in writing which shall state the reasons for the actions taken.

C. The County may, after providing written justification, make the determination that an immediate award of the contract is necessary to protect the substantial interests of the

County. The award of a contract shall in no way compromise the protester’s right to the protest procedures outlined herein.

D. If the protestor disagrees with the decision of the DPA, the protestor may submit a written appeal to the County Procurement Officer requesting an appeal to the

Procurement Appeals Board, in accordance with the process stated below.

APPEALS PROCESS

A. If the protestor wishes to appeal the protest decision of the Deputy Procurement Agent, the protestor must submit, within three (3) business days from receipt of the Deputy

Procurement Agent’s decision, a written appeal to the Office of the County Procurement

Officer.

Written appeals must be sent by mail to the address below with a courtesy copy by email;

County of Orange/County Executive Office

County Procurement Office

400 W. Civic Center Drive, 5th Floor

Santa Ana, CA 92701

Attn: County Procurement Officer

CPOAppeals@ceo.oc.gov

B. Within fifteen (15) business days, the County Procurement Officer will review all materials in connection with the appeal, assess the merits of the protest and provide a written determination that shall contain his or her decision on whether the appeal shall be forwarded to the Procurement Appeals Board.

C. The decision of the County Procurement Officer on whether to allow the appeal to go forward will be final and there shall be no right to any administrative appeals of this decision.

3 APPLICATION PREPARATION AND EVALUATION

Applicants should review all requirements and instructions to ensure that each requirement is clearly addressed in the application.

mailto:CPOAppeals@ocgov.com

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3.1 ELIGIBILITY TO SUBMIT APPLICATIONS

To be eligible to submit an application for these services, the applicant must:

A. Be a facility located within Orange County, California

B. Demonstrate direct experience in the last two years providing care for individuals with serious mental disorder, dually diagnosed patients (mental health and substance use disorders) and individuals with severe substance use disorders in an acute psychiatric setting or acute medical setting.

C. At the time of responding to this RFA, be: licensed by the California Department of Public

Health (CDPH) as either a General Acute Care Hospital (Health & Safety Code §1250(a)), or an Acute Psychiatric Hospital (Health & Safety Code §1250(b)); be designated by the

Orange County Behavioral Health Director or obtain LPS Designation within six months of application and approved by the California Department of Health Care Services (DHCS) as an LPS-designated facility authorized for involuntary detention and treatment under

Sections 5150 and 5585 of the Welfare & Institutions Code.

D. Be Medicare and/or Medicaid certified as a psychiatric hospital provider at the time of responding to this RFA and be Medi-Cal certified for reimbursement.

County will not review any application submitted by an individual or entity found not to be eligible to submit an application.

In addition, to be eligible to contract with the County, an individual or entity must not be listed on the current Cumulative Sanction List of the Office of the Inspector General (U.S. Department of

Health and Human Services), the General Services Administration’s list of parties excluded from federal programs, or the California Medi-Cal Suspended and Ineligible Provider List.

Accordingly, County will not review any application submitted by an individual or entity found to be on any of these lists and the application will automatically be rejected. County will notify the applicant of this determination in writing.

The County plans to use the following databases to identify individuals and entities that are not eligible to contract with the County:

• https://exclusions.oig.hhs.gov/

• https://sam.gov/search/

• Medi-Cal Suspension Search Database

It is the sole responsibility of all applicants to verify that they are not on any of these lists prior to preparing and submitting an application in response to this RFA. Correction of any errors found on any of the lists, above, is the sole responsibility of the applicant and must be made prior to submission of the application.

https://exclusions.oig.hhs.gov/ https://sam.gov/search/

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In addition, to be eligible to contract with the County, an individual or entity must not have any pending charge(s) or conviction(s) for violation of criminal law(s) and/or any sanction(s) or disciplinary action(s) imposed or taken against them by any federal or state law enforcement, regulatory or licensing agency or body, including exclusion from Medicare and Medicaid programs. Accordingly, all applicants must self-disclose with explanation, or deny the existence of this information pertaining to their principals, executives, and managers directly involved with the performance of the services solicited herein in Attachment II. Form C “Applicant

Certifications”.

3.2 REJECTION OF APPLICATION(S)

The County reserves the right to reject any application at any time during the RFA process on the basis of any substantiated actual and/or apparent conflict of interest regarding the performance of the proposed services solicited under this RFA. All applicants must self-disclose any potential and/or actual conflict of interest(s) in Attachment II. Form C “Applicant’s Certifications”. Any applicant submitting an application herein waives any right to object to County’s exercise of this right, now or at any future time, before anybody or agency including, but not limited to, the County

Board of Supervisors or any court of competent jurisdiction.

As soon as the County has determined that an applicant has a conflict of interest as stated herein, County will provide written notification of such conflict and rejection of the application.

The County also reserves the right to reject any application at any time during the RFA process on the basis of any one or more of the following substantiated grounds:

1. Evidence of collusion amongst applicants;

2. Lack of such business skills and/or financial resources necessary and appropriate to successfully operate the services solicited in this RFA, as revealed by either the financial statement or experience statement;

3. Default on, or unpaid, County debt;

4. Default on any obligation to County;

5. Current or past failure to perform to County standards any obligation of a contract with

County, as determined by County; and

6. Ineligible to enter into a contract with the County, as set forth in Section 3.1 Applicants’

"Eligibility to Submit Application".

All applications that are irregular, incomplete, conditional, ambiguous and/or obscure and not minor irregularities and/or immaterial or inconsequential variations from the RFA requirements will be rejected. The County will provide a written notification of the grounds upon which an application is rejected.

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3.3 MINOR IRREGULARITIES AND DEFICIENCIES IN APPLICATION(S)

The County reserves the right at its sole discretion, to accept an application containing a minor irregularity or when a defect or variation is immaterial or inconsequential.

The County reserves the right to waive any and all minor irregularities in lieu of seeking corrections thereof. All requests for correction of minor irregularities or notification of waiver thereof will be given to applicants in writing.

3.4 NON-RESPONSIVE APPLICATION(S)

Any application which fails to conform to the essential requirements of this RFA, such as specifications, may be rejected as non-responsive.

The County will provide a written notification of rejecting non-responsive applications, which will state the specific grounds for the rejection. Therefore, it is the sole responsibility of the applicants to ensure their applications are conforming and responsive to all requirements of this RFA.

3.5 EVALUATION OF APPLICATIONS AND SELECTION OF PROVIDERS

The County plans to review all applications received and may enter into contract negotiations with applicants that meet all eligibility and submission requirements for one of the following service provisions:

• Inpatient Behavioral Health Services, for the facilities that are an Acute Free-Standing

Psychiatric Hospital

• Medi-Cal Mental Health Managed Care Inpatient Hospital Services for the facilities that are a General Acute Care Hospital

The County has the right to conduct a compensation plan analysis to review and audit all business records and related documents of any and all applicants (including an affiliated or parent company), determine the adequacy, fairness, and reasonableness of the application, and to contact any and all client references.

The County’s determination as to whether an applicant is qualified and responsive will be based on the information furnished by the applicant in this solicitation, interview(s) with the applicant

(if applicable), as well as from other sources determined to be valid by County. Award will not be made until after such investigations, as are deemed necessary, are made by the County regarding the experience and financial responsibility of applicant, which each applicant agrees to permit by submitting its application.

4 MINIMUM SUBMISSION REQUIREMENTS

The following are the submission requirements for an applicant to be considered as an eligible candidate to be considered for the requested services described in this RFA. Should any of this information be missing, the applicant may be deemed non-responsive.

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Provide the information requested below in one (1) file labeled [Solicitation Name]-[Applicant

Name] per the instructions in Section I. “General Instructions for Submittal”. Failure to provide and/or disclose requested information and/or documents may result in disqualification of your application.

A. Cover Page/Executive Summary

All Applications must be accompanied by a cover letter of introduction and executive summary of the application (include what license your organization has if your organization is bidding on multiple services). The cover letter must be signed by person(s) with authority to bind the applicant together with the main office address, and telephone number (including area code). If the applicant is a corporation, two (2) signatures are required: one (1) signature by the Chairman of the Board, the President or any Vice

President; and one (1) signature by the Secretary, any Assistant Secretary, the Chief

Financial Officer or any Assistant Treasurer. The signature of one (1) person alone is sufficient to bind a corporation, as long as he or she holds corporate offices in each of the two (2) categories described above. For County purposes, proof of such dual office holding will be satisfied by having the individual sign the instrument twice, each time indicating his or her office that qualifies under the above described provision. In the alternative, a single corporate signature is acceptable when accompanied by a corporate resolution demonstrating the legal authority of the signatory to bind the corporation. An unsigned or improperly signed application submission is grounds for rejection of the application and disqualification from further participation in this RFA process.

B. Complete all required questions and upload all required documents in Section 6. Vendor

Responses of the RFA.

C. Provide a copy of staffing schedule with classifications and hours to meet LPS Designation staffing requirements.

D. Provide a copy of valid license or certification for each staff member allocated to the program, including those for any registered nurse, nurse practitioner, licensed vocational nurse, licensed psychiatric technician, certified nursing assistant, licensed clinical social worker, licensed marriage and family therapist, peer support specialist, psychologist, and/or MD, as well as any other type of staff member not mentioned above, working under a licensing board to complete their job duties.

E. Provide Provide copies of the following as they become available:

a. DHCS Medi-Cal Certification;

b. Centers for Medicare & Medicaid Services (CMS) approval;

c. California Department of Public Health (CDPH) facility license;

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d. Signed statement noting that all LPS-Designated Facility requirements have been met and required documents have been submitted to HCA for review;

e. Copy of the Orange County LPS-Designation approval or copy of the Orange

County Designation Application;

f. Copy of LPS-Designation approval once received. (Contract will not be executed until HCA receives LPS-Designation approval);

g. Copy of the most recent settled or audited CMS 2552 Cost Report.

F. Provide copies of the documents below. Include an index of all the documents included, and an explanation for any document requested but not provided.

1. If incorporated:

a. Articles of Incorporation executed by the Secretary of State, including all amendments.

b. By-laws, including all amendments.

c. Board of Directors resolution empowering a Corporate Officer either by title or individual name, to act on behalf of the organization by his/her signature alone.

2. If not incorporated, documentation empowering an Authorized Representative to act on behalf of the organization by his/her signature alone.

3. Fictitious Business Name statement filed with the County Clerk and proof of publication.

4. Partnership papers and/or joint venture contracts.

5. Evidence of federal/state tax status.

6. IRS W-9 Form: Request for Taxpayer Identification Number and Certification.

7. Business License/Certifications/Conditional Use Permit (CUP).

8. Table of contents from the organization’s policies and procedures manual covering daily operations and emergency procedures (medical, fire, etc.). If a policies and procedures manual does not exist, provide a plan and time frame for development.

9. Corporate organizational chart that includes all programs, identifies the relationship of the proposed program to the overall organization, and identifies the reporting relationship of each proposed staff position.

10. Unique Entity Identifier (UEI): A unique twelve-character identification number required by the federal government as part of their financial request and reporting

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(https://sam.gov/content/entity-registration) Every applicant is required to provide a

UEI number regardless of the funding source of this solicitation.

11. Good Neighbor Policy: The intent of this Policy is to identify community impacts and measures to mitigate those impacts so as to be an integral part of the neighborhood and community the County serves.

G. Recent financial statement prepared by an independent Certified Public Accounting (CPA) firm.

H. Any audits, reviews, or inspection reports completed by a CPA firm, regulatory agency

(e.g., Occupational Safety and Health Administration), or other government agency within the last 12 months.

I. Provide a description of any active litigation and resolution, performance issues and/or audit or review of any contractual documents (e.g., invoices, units of service reports, etc.)

within the last five (5) years that resulted in a corrective action plan, reimbursement of money to funder, investigation, and/or termination of any agreements or contracts between your organization and the County of Orange, other government entity, and/or private organization. Provide a copy of a letter from your attorney and/or in-house legal counsel concerning the status of lawsuits and pending litigation for the most recent year. IF THERE

ARE NONE, PLEASE STATE SUCH IN THE SUBMITTAL RESPONSE. For each litigation and or performance issue include:

1. The type of contracts, contract term (dates), funding amount and services provided.

2. The issues and circumstances.

3. How and when the issues were resolved.

4. Your plans to ensure that the issues will not re-occur in future contracts.

J. Attach detailed information regarding past, current, or threatened litigation, liens, or claims

(including claims filed or pending with Financial Industry Regulatory Authority and/or with the Security Exchange Commission) within the past five (5) years involving your company, or any company your company holds a controlling interest in, or any company that holds an interest in your company, or any of the principal officers of your company that has also involved the County of Orange or any of its officers or agencies.

5 DESCRIPTION OF SERVICES

https://sam.gov/entity-registration

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5.1 TARGET POPULATION

Inpatient Behavioral Health Services shall be provided to residents from all areas of Orange

County who require this highly restrictive level of care to ensure their safety and/or the safety of others. Many individuals served may present with co-occurring medical conditions and/or substance use disorders. In some instances, adults and older adults may present with a primary severe substance use disorder, necessitating involuntary treatment. Services shall be provided to

Orange County residents, ages 13 - 17 living with a serious emotional disturbance; adults ages

18-64; and older adults ages 65 and older living with a serious mental health and/or severe substance use disorder and who meet criteria for involuntary acute inpatient psychiatric care under Sections 5150 or 5585 of the Welfare and Institutions Code. Services shall also be provided to individuals who voluntarily seek treatment. These individuals may be considered a danger to themselves or others or may be gravely disabled.

5.2 SERVICES TO BE PROVIDED

The successful Applicant shall provide high quality, compliant, person-centered, trauma-informed inpatient psychiatric services (including co-occurring SUD care and/or care for medical conditions or stand-alone severe substance use disorder care), from admission through stabilization and transition to lower level of care, with strong coordination, discharge and follow-up.

A. Certification/Accreditation: Applicant shall be certified for participation under 42 CFR

Part 482. If not certified, applicant must hold accreditation from a nationally recognized accrediting body and meet all applicable State licensure and/or accreditation requirements.

B. Quality Standards: Applicant shall meet all quality standards required by County, State, and Federal entities.

C. Care Model: Services shall be person-centered, recovery-oriented, non-coercive, trauma-informed, medically necessary, co-occurring capable and time-limited to achieve psychiatric stabilization sufficient for discharge or transfer to a lower level of care.

D. Assessment & Level of Care: Applicant shall utilize a standardized assessment tool approved by the Behavioral Health Plan (BHP) to determine appropriate level of care and length of stay, used in conjunction with the concurrent review process.

E. Psychiatric Evaluation: A licensed psychiatrist shall complete a psychiatric evaluation within 24 hours of admission, including psychiatric history, diagnosis, and initial plan of treatment. This evaluation must be completed in accordance with the current Diagnostic and Statistical Manual of Mental Disorders (DSM).

F. Daily Rounds: Daily rounds shall be conducted by licensed psychiatrists or advanced psychiatric providers (Psychiatric Nurse Practitioners or Psychiatric Physician Assistants) under the supervision of a licensed psychiatrist.

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G. Medical Health and Physical (H&P): A medical history and physical examination shall be completed within twenty-four (24) hours of admission.

H. Comorbidity Screening and Capacity: Applicant shall screen for comorbid physical health conditions, SUD and suicidal ideation and demonstrate capacity to address comorbid needs during short-term stay via on-site staff, telemedicine, and/or partnerships with local physical health providers.

I. Psychosocial Assessment: A Psychosocial Assessment shall be completed within seventy-two (72) hours of admission by a Licensed or Licensed Waivered Practitioner of the

Healing Arts (LPHA).

J. Laboratory/Diagnostics: Provide laboratory and diagnostic services as clinically indicated.

K. Medication Services: Provide psychiatric medication evaluation and monitoring, including ongoing laboratory testing as clinically necessary.

L. Medication for Addiction Treatment (MAT): Initiate, continue, and link clients to continued MAT for substance use disorders as appropriate.

M. Therapy—Individual & Group: Provide individual and group therapy.

N. Substance Use Interventions: Deliver substance use treatment interventions.

O. Collateral Interventions: Provide collateral therapy and interventions (including provision or supervision of family therapy sessions as indicated for youth).

P. Activity Therapy: Provide activities therapy as clinically appropriate.

Q. Care Coordination Documentation: Document coordination of care with the Managed Care

Plan (MCP) and community-based providers.

R. Pre-discharge Planning and Aftercare: Implement extensive pre-discharge planning using the Model Care Coordination Plan or an equivalent tool containing the same requirements.

S. Provide each patient with an aftercare plan prior to discharge that includes, to the extent known:

1. Nature of illness, required follow-up, and expected course of recovery.

2. Medications, side effects, and dosage schedules.

3. Notation that informed consent for medications was obtained.

4. Confirmation that informed consent includes information on medication side effects.

5. Expected course of recovery.

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6. Treatment recommendations relevant to the patient’s care.

7. Documented referrals to medical and behavioral health providers using a closed-loop referral process through a BHP-determined application or vendor.

8. Housing assessment for members at risk of homelessness or returning to unsafe/unstable housing, with documented referrals to community-based housing providers using closed-loop/e-referrals when available.

T. Post-discharge Outreach: Contact members within seventy-two (72) hours of discharge to ensure follow-up care is accessed, using the most effective means (e.g., email, text messaging, telephone). Report outcomes to County BHP via the closed-loop referral method designated by the plan.

U. Assertive Discharge Planning (Suicide Risk): Provide person-centered, tailored, participatory discharge planning for any member at risk of death by suicide, which may include:

1. Immediate access to structured clinical interventions within a stepdown level of care.

2. Appointments with primary care or other medical follow-up.

3. Arranged access to prescription medications.

4. Family/support system engagement and psychoeducation.

5. Peer support engagement.

6. Vocational or educational support.

7. Crisis response planning.

8. Risk factor analysis and safety contracting.

9. Strategies to address social determinants of health.

10. Preferred methods for proactive outreach within the first hours or days post-discharge.

V. Continuing Care and Coordination: Provide continuing care planning and coordinate behavioral health services, including:

1. Admission, discharge, and transfer notifications from acute care hospitals, psychiatric hospitals, state hospitals, and skilled nursing facilities.

2. Data sharing among Medi-Cal Partners, including BHPs and MCPs.

3. Service coordination with all applicable providers regardless of Medi-Cal participation.

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W. Administrative Services Organization (ASO) Coordination: Notify the County appointed

ASO within 24 hours of admission and maintain ongoing coordination for utilization management.

X. Aftercare Linkage: Provide referral and linkage to mental health and substance use treatment providers and other support services prior to discharge.

Y. Individualized Treatment Plan (ITP): Initiate an ITP within twenty-four (24) hours of admission; obtain signatures from the treatment team and client (or document why signatures could not be obtained) within seventy-two (72) hours. All services must be compatible with ITP.

Z. Voluntary/Involuntary Treatment: Assess for voluntary and involuntary treatment needs and proceed in accordance with applicable laws and policies.

AA. Crisis Intervention: Provide crisis intervention services.

BB. Education & Support: Deliver education and support to clients and families/caregivers as appropriate.

CC. Transportation: Arrange or provide transportation services as needed to support access to care.

DD. Psychological Services: Provide psychological services as clinically indicated.

EE. Psychometrics: Conduct psychometric testing upon admission to establish clinical baseline, inform treatment decision-making, and support evidence-based practices.

FF. 24/7 Psychiatric Coverage: Ensure on call psychiatric coverage 24/7, supported by other qualified personnel.

GG. Interdisciplinary Interventions: Provide nursing, psychological, and social interventions consistent with the ITP.

HH. Aftercare Scheduling: Arrange dates and times for aftercare appointments to

County programs within 24 business hours of discharge.

II. Court-Related Services: Prepare required court documents and provide expert witness testimony services, including but not limited to writs of habeas corpus, capacity hearings, conservatorship, probable cause hearings, court ordered evaluations, and appeal/post certification proceedings.

JJ. Juvenile Court Documentation: Prepare documentation required by Juvenile Court to authorize psychotropic medication for youth under court jurisdiction (JV220).

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KK. Recovery and Trauma-Informed Focus: All services shall be recovery oriented, and trauma informed, promote client empowerment, and be tailored to individual needs.

LL. Peer Mentor Collaboration: Collaborate with County contracted Peer Mentors, as available, to provide direct support, education, advocacy, and resource/linkage assistance.

MM. Orange County (OC) Medi-Cal Admission Notification: Provide next day notification to HCA for each OC Medi-Cal admission.

NN. SUD Treatment Capacity and MAT: Demonstrate capacity to treat severe standalone SUD or cooccurring SUD using harm reduction or abstinence-based models, including MAT therapy. Facilities must initiate, continue, and refer for MAT as approved by the Food and Drug Administration (FDA) and/or updated DHCS requirements.

OO. Resource Familiarity: Be familiar with County and community resources to support

SUD treatment and recovery.

PP. SUD Therapies and Expertise: Include SUD therapies and ensure access to SUD experts.

QQ. Bed Capacity Tracking: Maintain capacity to participate in statewide tracking of inpatient and crisis stabilization bed availability in accordance with State and Federal

Health IT (HIT) Plan standards/regulations upon DHCS launch of a bed capacity data solution.

RR. Average Length of Stay (ALOS): Monitor and report monthly on ALOS, with a goal of ≤30 days across all treatment episodes. Report ALOS by County Health Plan, including unfunded clients.

SS. Readmission Monitoring and ALOS Integrity: Monitor readmission rates for all treatment episodes.

Under no circumstances shall a facility discharge a member for the purpose of readmitting them to meet the ALOS goal.

TT. Electronic Notification Compliance: Comply with Electronic Notification requirements under 42 CFR 482.61(f), as specified in the CMS Interoperability and Patient Access Final

Rule.

UU. County Access and Rights Advocacy: Allow facility access, as requested, to County

Contract Monitors and Patient Rights Advocates to conduct chart reviews and meet with clients and staff within seventy-two (72) hours’ of the facility receiving notice

Unannounced inspections, evaluations, or requests for information may be made in those situations where arrangement of an appointment beforehand is not possible or is inappropriate due to the nature of the inspection or evaluation.

VV. Information Systems and Data Exchange: Maintain effective Information Systems, including use of an Electronic Medical Record (EMR), Health Information Exchange

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(HIE), and data exchange capabilities to support care coordination and compliance with performance measures as determined by HEDIS (Healthcare Effectiveness Data and

Information Set) and NCQA (National Committee for Quality Assurance).

WW. Public Guardian Notification: Facilities must notify Public Guardians’ office immediately, twenty four (24) hours a day/ seven (7)-days per week/ three hundred sixty five (365) days per year, at Main Line (714) 567-7600 or After Hours Line (714) 628-7000, of changes in placement, emergencies, or changes of the client’s condition, for any publicly conserved client, in addition to notifying OC HCA contract monitor.

XX. Regional Center Coordination: Facilities shall make reasonable efforts to notify the

Regional Center Service Coordinator and Nurse Consultant of a Regional Center Client’s admission within twenty-four (24) hours of admission or within twenty- four (24) hours of identifying that a Client is a Regional Center Client.

5.3 PERFORMANCE OBJECTIVES

The selected applicant shall be required to meet the following performance objectives by the end of each Term.

A. Aftercare Scheduling (Timeliness): One hundred percent (100%) of clients discharged to the community shall have a follow-up outpatient appointment scheduled within 24 business hours of discharge.

B. Recidivism Tracking (7 & 30 Days): Track the number and percentage of clients re-hospitalized at any psychiatric hospital within seven (7) calendar days and thirty (30) calendar days of discharge.

C. Average Length of Stay: Track and report monthly the length of stay for all clients discharged in the previous month.

D. Contact members within seventy-two (72) hours of discharge to ensure follow-up care is accessed reporting linkage rates, on a monthly basis, to County BHP via the closed-loop referral method designated by the plan.

E. 7-Day Rehospitalization Prevention: Greater than or equal to ninety percent (≥90%) of clients will not require rehospitalization within seven (7) calendar days of discharge.

F. 30-Day Rehospitalization Prevention: Greater than or equal to eighty percent (≥80%) of clients will not require rehospitalization within thirty (30) calendar days of discharge.

G. Seclusion/Restraint Monitoring: Track and report seclusion and restraint rates on a monthly basis.

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H. Admissions Reporting: Track and report monthly admissions by referral source and population age groups (Youth 13 through 17, Adults 18 through 64, and Older Adults 65+ years.)

5.4 STAFFING REQUIREMENTS

The Applicant shall maintain a staffing pattern and administrative personnel that meet all applicable State, Federal, and County regulations, including Title 9, California Code of

Regulations (CCR), Lanterman-Petris-Short (LPS) Act Facility Designation Interim Regulations, and Senate Bill 43 (SB 43) mandates. If staffing ratio requirements conflict, the highest client to staff ratio will be followed. At a minimum, the following shall be provided:

A. Clinical Staff must comply with Title 9 CCR, Section 663, which requires:

1. A psychiatrist (if the administrative director is not a psychiatrist) who assumes medical responsibility as defined in Section 522.

2. A psychologist, social worker, registered nurse, and other nursing personnel under supervision of a registered nurse.

3. Nursing personnel present 24/7, Physicians, Psychiatrists, and mental health personnel available at all times.

B. Administrative Director must qualify under Title 9 CCR Sections 620(d), 623, 624, 625, or 627, which include licensed physicians with psychiatric training, licensed psychologists, licensed clinical social workers, or licensed marriage/family counselors with required administrative experience.

C. Clinical Program Director must meet qualifications under Sections 623–627, consistent with professional discipline (psychiatrist, psychologist, social worker, or marriage/family counselor).

D. Psychiatric Medical Director must be a licensed psychiatrist per Section 623, assuming medical responsibility as defined in Section 522.

E. Adequate Clerical Support to support documentation, reporting, and coordination requirements.

F. All Staff shall reflect the linguistic and cultural patterns of the population served and complete training in cultural competency and diversity.

G. Assigned Staff for Concurrent Review Compliance to ensure notification to the County

ASO of client admission within 24 hours and participation in utilization management processes.

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H. All clinical staff shall demonstrate competence in treating severe mental health disorders, severe emotional disorders, co-occurring conditions, and stand-alone severe substance use disorders. Staff shall complete any additional training required by the Administrator or

County.

I. Staffing must support expanded criteria for grave disability under SB 43, which includes severe substance use disorder as a basis for involuntary detention or placement. Staff shall be trained on SB 43 requirements and updated LPS facility regulations.

J. All staff shall be trained and knowledgeable in treatment issues reflecting the diversity of

Orange County residents, including individuals with severe substance use disorders, as required by Health & Safety Code §1799.111 and Welfare & Institutions Code § 5008, 5350, 5354, 5402, and 5122, as amended by SB 43.

5.5 FACILITY REQUIREMENTS

The selected applicant shall maintain a facility that meets the following minimum requirements:

A. Location and Security: Services must be provided in a locked inpatient facility located within Orange County, California, to ensure client safety and regulatory compliance.

B. Certification: Facility must be certified as meeting the conditions for participation in 42

CFR 482 or be accredited by a nationally recognized entity in addition to meeting State licensure and/or accreditation.

C. Licensure: Facility must be licensed by the CDPH as either:

1. A General Acute Care Hospital (GACH) as defined in Health & Safety Code

§1250(a), as a health facility having a duly constituted governing body with overall administrative and professional responsibility and an organized medical staff that provides 24-hour inpatient care, including the following basic services: medical, nursing, surgical, anesthesia, laboratory, radiology, pharmacy, and dietary services;

or

2. An Acute Free-Standing Psychiatric Hospital (AFSPH) as defined in Health & Safety

Code §1250(b) as a health facility having a duly constituted governing body with overall administrative and professional responsibility and an organized medical staff that provides 24-hour inpatient care for persons with mental health disorders or other patients referred to in Division 5 (commencing with Section 5000) or Division 6

(commencing with Section 6000) of the Welfare and Institutions Code, including the following basic services: medical, nursing, rehabilitative, pharmacy, and dietary services.

https://california.public.law/codes/health_and_safety_code_section_5000

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D. LPS Designation: Facility must be designated by the Orange County Behavioral Health

Director or obtain designation within 6 months of application and approved by the DHCS as a Lanterman-Petris-Short (LPS) facility authorized for 72-hour treatment and evaluation pursuant to Sections 5150 or 5585 of the Welfare & Institutions Code before a contract will be fully executed.

E. Physical Space Requirements: In addition to semi-private patient rooms, the facility shall include, at a minimum:

1. Dining area

2. Group therapy and activity rooms

3. Day room/visitor room

4. Seclusion room for clinical use as required by law and safety standards

F. Licensure and Certification Maintenance: Provider must maintain all facility licenses, certifications, and designations in full compliance with State and Federal regulations, including any updates issued by CDPH, DHCS, and County Behavioral Health.

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5.6 REIMBURSEMENT RATES:

In accordance with BHIN-25-038 and State Plan Amendment (SPA) 23-0045, Fee-for-Service/Managed Care (FFS/MC) contract hospitals providing acute psychiatric inpatient services to Medi-Cal (FFS and managed care) members are reimbursed under a standardized rate methodology and using the Centers for Medicare & Medicaid Services (CMS) Market Basket

Index for inpatient psychiatric facilities.

A hospital and Mental Health Plan (MHP) may negotiate a per-diem reimbursement rate.

However, this negotiated rate must not exceed the hospital’s usual and customary…