Intensive_Substance_Use_Disorder_Treatment_Services_at_the_Center_for_Addictions_Triage_and_Treatment.pdf

REQUEST FOR PROPOSAL

INTENSIVE SUBSTANCE USE DISORDER TREATMENT SERVICES AT

THE CENTER FOR ADDICTIONS TRIAGE AND TREATMENT

(NO. 2022.097-RFP)

FOR

Washington County, Oregon

RELEASE DATE: April 1, 2022 DEADLINE FOR QUESTIONS: May 20, 2022

RESPONSE DEADLINE: May 27, 2022, 3:00 pm

RESPONSES MUST BE SUBMITTED ELECTRONICALLY TO:

https://secure.procurenow.com/portal/washington-county-or

Intensive Substance Use Disorder Treatment Services at the Center for Addictions Triage and Treatment

I. Request for Proposal (RFP) w/Pre-Prop II. Introduction

III. Overview and Purpose IV. Eligibility V. Scope of Services

VI. Organization Roles VII. Funding and Estimated Timeline

VIII. Proposal Content IX. Evaluation Phases X. Evaluation and Award Process

XI. Instructions to Proposers XII. Terms and Conditions

XIII. Vendor Submissions

Attachments:

A - 2022-PP-SERVICES-SAMPLE

B - Attachment C - INSURANCE REQUIREMENTS SUMMARY FORM PP

Intensive Substance Use Disorder Treatment Services at the Center for Addictions Triage and Treatment

I. REQUEST FOR PROPOSAL (RFP) W/PRE-PROP

Washington County, Oregon is requesting proposals from qualified firms to provide Intensive Substance Use Disorder Treatment Services at the Center for Addictions Triage and Treatment.

A pre-proposal conference will be held on Friday, April 22, 2022 at 1:00 pm. More information can be found in the Introduction Section of the Procurement Portal posting under Timeline.

All applicants must hold a valid Certificate of Approval from the State Addictions and Mental Health Division to provide substance use disorder outpatient treatment in Washington County valid on July 1, 2024, and throughout the contract period.

Proposals must be received by 3:00 pm Friday, May 27, 2022.

The County may reject any proposal not in compliance with all prescribed public bidding procedures and requirements and may reject for good cause any or all proposals upon a finding by the County it is in the public interest to do so.

A copy of the Request for Proposal document is posted on https://secure.procurenow.com/portal/washington-county-or. Proposal documents can be viewed and downloaded from the site. The County’s electronic solicitation portal can also be accessed at www.washcopurch.com/biz. Proposer is responsible for checking the site for any addendums before submitting their proposals.

The Washington County Board of Commissioners reserves the right to reject any and all proposals and to waive any and all informalities in the best interest of the County.

Suzi Fulcher, Procurement Manager

Published: Friday, April 1, 2022 OregonBuys

Intensive Substance Use Disorder Treatment Services at the Center for Addictions Triage and Treatment

II. INTRODUCTION

The following instructions/terms and conditions apply to all solicitations to provide either goods or services to Washington County.

II.A Summary

Washington County is seeking proposals from qualified organizations to operate intensive substance use disorder (SUD) treatment services in a building owned and maintained by Washington County. Provider will operate under a Behavioral Health Certificate of Approval issued by the State of Oregon. The goal of this project is to add critical infrastructure to Washington County to support residents who have problem substance use. Washington County will own and maintain the physical site, this RFP is to select a provider to operate the Center for Addictions Triage and Treatment (CATT) Intensive Services. The provider will be required to lease the building from Washington County. Washington County will not be the primary funder of treatment services delivered at the CATT, most services will be paid through the provider billing OHP and other funders.

This project is currently in the development phase. A building has been selected as the site for intensive services, however the building will require extensive renovation. This building is owned by Washington County and is located at 17911 NW Evergreen Parkway in Beaverton. Washington County is seeking a provider to assist with the building and program design as well as to operate the services once the renovation work is completed. The selected provider will be required to participate in design work, assist with project implementation, hire staff and provide intensive clinical services as described in Sections 5 - Scope of Services and 6 - Organization Roles of this document. The County will provide partial funding for agency to provide staff to assist in the development work. The County may also provide start-up money to help launch the clinical services and a lease subsidy to offer the space below market rate. Start-up funding and amount of lease subsidy will be negotiated with the successful applicant.

II.B Background

The Center for Addictions Triage and Treatment (CATT) is a project led by Washington County Behavioral Health Division to add critical infrastructure for substance use treatment in Washington County. This project has been developed through a community engagement process with over 200 community members, many with lived experience of having a substance use disorder, providing input into the design. More information about the project can be found on the CATT website at: www.co.washington.or.us/CATT.

CATT will consist of two separate buildings that offer services and supports to those struggling with substance use. One building, the Intensive Services Building, will be in Beaverton and will offer residentially based intensive treatment. The other building, the Community Services http://www.co.washington.or.us/CATT

Intensive Substance Use Disorder Treatment Services at the Center for Addictions Triage and Treatment

Building, is planned to be in Hillsboro and will offer a variety of co-located outpatient supports and services. This RFP is to select a provider for the Intensive Services Building only.

Washington County is located in the northwest portion of Oregon, covering over 726 square miles of urban, suburban, agricultural, forest, and mountain terrains. Over 600,000 people live within the county boundaries, which extend north and west from the City of Portland to the Northern Oregon Coast Range, and south to the Nehalem Mountains. The more densely populated eastern half of Washington County contains the largest cities- Beaverton and Tigard-and is a mix of suburban residential, light industrial and technological manufacturing, and commercial activity. The county seat, Hillsboro, is in the western half of the county, which is primarily rural, with farmland, forests, and mountains.

Washington County has experienced substantial population and economic growth over the last several years, principally in the electronics and high-tech industries. Over half of Oregon’s population growth in the last five years occurred in Washington County.

Washington County is a home rule county, governed by five elected Commissioners who appoint a County Administrator as the chief executive officer. There are approximately 2,300 employees in all areas of County government engaged in providing the multitude of services required by its member cities, businesses, and general population.

II.C Contact Information

Suzi Fulcher Procurement Manager Email: suzi_fulcher@co.washington.or.us Phone: (503) 846-8734 Department:

HHS

II.D Timeline

The County reserves the right to modify this schedule at the County's discretion. Proper notification of changes to the due date will be made to all parties that have received the proposal from the County's Procurement Portal.

Date of Legal Advertisement April 1, 2022

Pre-Proposal Meeting (Non-Mandatory) April 22, 2022, 1:00pm This pre-proposal conference will be in person at Elam Young Building (5240 NE Elam Young Parkway, suite 150, Hillsboro) conference room 40.

Question Submission Deadline May 20, 2022, 5:00pm mailto:suzi_fulcher@co.washington.or.us tel:(503)846-8734

Intensive Substance Use Disorder Treatment Services at the Center for Addictions Triage and Treatment

Submittals Due May 27, 2022, 3:00pm

Contractor Selection Date June 21, 2022

Intensive Substance Use Disorder Treatment Services at the Center for Addictions Triage and Treatment

III. OVERVIEW AND PURPOSE

III.A Philosophy

At the center of the CATT project is the understanding that substance dependence is a medical condition, and that people can recover with the right supports and services. Services must be rapidly accessible, culturally responsive and client driven. Staff with lived experience of having a substance use disorder must be integrated throughout the program for it to be truly responsive to our community members.

Key philosophies for the CATT include:

• Lead with race and equity throughout the project development and implementation.

Prioritize culturally specific service providers and service models to ensure the program is responsive to our whole community. Include community members who represent a variety of cultures in planning, implementation and service delivery.

• Prioritize rapid access to substance use disorder services and work to significantly reduce barriers to care.

• Prioritize serving community members with lowest access to care including those on OHP, Medicare or without coverage. While individuals with commercial insurance may be served in the program, the program must center on serving low-income community members.

• Mental health supports must be available for program recipients as part of the service model.

• Strive for no wrong door, with multiple avenues to enter services at CATT. Use a client centered approach with a focus on engagement into care, however many times needed.

• Focus services on meeting clients’ self-stated goals with a philosophy of hope and resiliency.

• Use a model where peers are active and integrated in all components of the program.

Peer Based Recovery Support Services are designed to help individuals seeking substance use services increase recovery capital and develop recovery pathways that support them in leading healthy, self-directed lives.

• Coordinate care across service systems with an emphasis on seamless transitions of care.

• Operate as a collaborative member of the local Behavioral Health Resource Network.

• Participate in Oregon’s Medicaid 1115 substance use disorder waiver to expand services and care provided to community members. Collaborate with the local Coordinated Care Organizations (CCOs) to develop and implement new opportunities to support community members who struggle with substance use disorders.

Intensive Substance Use Disorder Treatment Services at the Center for Addictions Triage and Treatment

• Value natural supports (i.e., family, friends, community) and engage these wherever possible.

• Ensure that harm-reduction approaches are prevalent throughout the service array.

• Establish the center using trauma informed care principles. Utilize design features that promote safety, health and a trauma-informed treatment environment.

• Design space with flexibly in mind to accommodate changes in services and community need over time.

• Adopt best practices for design and operations including the use of medication supported recovery throughout all services.

III.B Goals

There are several goals for the CATT project. The primary goal is to increase treatment infrastructure in Washington County. The county is significantly lacking in intensive SUD service;

the CATT is designed to add significant new capacity to the system of care. Services should be integrated with the newly established Behavioral Health Resource Network in Washington County.

An associated goal is to increase rapid access to care for all community members but especially those who are low income and have difficulty accessing care. Services must be available to an individual at the moment they are seeking care. CATT strives for rapid connection to client-centered services.

Finally, the CATT strives to reduce system inequalities. Many of our community members of color or within culturally specific communities receive substance use treatment services at rates that are less than the majority population. The CATT project seeks to reduce this disparity by involving culturally specific communities in the design and implementation of the program.

Intensive Substance Use Disorder Treatment Services at the Center for Addictions Triage and Treatment

IV. ELIGIBILITY

IV.A Proposer Eligibility

Washington County is seeking an experienced provider of substance use treatment services to operate the Intensive Services Building for the CATT project. To qualify as the provider for these services through this RFP, provider must:

• Have experience providing intensive substance use disorder treatment services to adults.

• Be able to provide Dual Diagnosis Capable (DDC) services as defined by the American Society of Addiction Medicine: The primary focus is on substance use disorders, but the program is capable of treating patients with sub-threshold or diagnosable but stable Axis I or II disorders. Psychiatric services are available on-site or by consultation; at least some staff are competent to understand and identify signs and symptoms of acute psychiatric conditions.

• Have experience providing residentially based services including withdrawal management and residential treatment.

• Demonstrate experience employing, training, and supervising peer mentors or have a formal, established partnership with a peer-run organization to provide peer delivered services.

• Demonstrate a history of successfully partnering with other organizations and stakeholders including but not limited to counties, Coordinated Care Organizations, community corrections, child welfare, Department of Human Services, local behavioral health providers and emergency responders.

• Have experience providing medication supported treatment services.

• Demonstrate strong knowledge of and full compliance with applicable Oregon Administrative Rules and must remain in full compliance throughout the contract period.

• Maintain General Liability ($500K), Automobile Liability w/ additional insured endorsement ($1M/$2M), Professional Liability ($1M/$3M), and Sexual Abuse & Molestation Liability ($3M coverage required when providing services to vulnerable populations).

Proposer may, with agreement from Washington County, subcontract elements of the service delivery such as peer services to another organization; however, proposer will retain responsibility for all service delivery and center outcomes including all subcontracted services.

The County reserves the right to approve any subcontract relationship.

Any public or private organization is eligible to submit a proposal. Applicants must be able to demonstrate expertise in the provision of the proposed services. They must be in full compliance

Intensive Substance Use Disorder Treatment Services at the Center for Addictions Triage and Treatment with applicable Oregon Administrative Rules and must remain in full compliance throughout the contract period.

All applicants must hold a valid Certificate of Approval from the State Addictions and Mental Health Division to provide substance use disorder outpatient treatment in Washington County valid on July 1, 2024, and throughout the contract period.

IV.B Equity

Washington County is committed to addressing system inequities that exist for our culturally specific communities. Preference will be made for applicants that demonstrate the following characteristics, in order of priority:

• Provider is a culturally specific service provider with a majority of the board reflecting that culture. Provider serves one or more of the following populations:

o Native American o Hispanic/Latino o Pacific Islander o Asian o LGBTQIA2S+ o African American

• Proposer demonstrates strong, formalized, established partnerships with local culturally specific service providers. This may include contractual relationships for shared service delivery, memorandums of understanding or collaborative work on a shared program.

• Provider demonstrates successful outreach and engagement of underserved populations including communities of color, LGBTQIA2S+ population and/or individuals with disabilities.

• Provider demonstrates a history of inclusion of people with lived experience of having a substance use disorder in organizational leadership.

• Provider is an established member of the Washington County Behavioral Health Resource Network.

IV.C Client Eligibility

A. Those eligible to receive services at the CATT will include adult individuals who have problem substance use or are diagnosed with a substance use disorder. This includes individuals recovering from a substance use disorder and individuals who currently use substances but are interested in achieving and maintaining recovery, however that is defined by the individual.

B. While this program is intended to primarily serve low-income Washington County residents, individuals from other areas of the state may receive services at the CATT.

Intensive Substance Use Disorder Treatment Services at the Center for Addictions Triage and Treatment

However, provider may not intentionally recruit from outside the local area or deploy strategies to encourage service delivery to residents of other states. Provider must actively develop strategies to be most responsive to the local community and prioritize serving local community members with lowest access to care including those on OHP, Medicare or without coverage. While individuals with commercial insurance may be served in the program, the program must center on serving low-income community members.

Intensive Substance Use Disorder Treatment Services at the Center for Addictions Triage and Treatment

V. SCOPE OF SERVICES

V.A Intensive Services

A. Intensive Services will be offered out of the Intensive Services Building and provided by a single provider, though the provider may subcontract some elements of care such as peer services with approval by Washington County. Most of these services are residentially based, meaning a person will check in to the program for a period of time and assigned a space (bed) for the duration of their service delivery. The only service that is not residential in nature is the assessment and triage component of the program.

Intensive services include:

1. Assessment and Triage: The entry point into services where an individual meets with program staff to discuss their substance use, service needs and desire for treatment.

Initial engagement and support by a Peer Specialist are crucial, with clinical assessment provided by Certified Alcohol and Drug Counselors. The goal is to provide immediate support and rapid connection to care. This service will be closely aligned with the Hawthorn Walk-In Center which offers urgent behavioral health care to Washington County residents. Provider will perform multidimensional, biopsychosocial assessments based on OAR 309-018-0140 and American Society of Addiction Medicine (ASAM) for Individuals Receiving Substance Use Disorder Services.

2. Sobering: Services designed to support an individual who is acutely intoxicated while they are processing the substance from their body. Services include monitoring of vital signs, providing fluids and nutrients and offering a safe and supportive environment until the individual is ready to transition to a different level of care.

Length of stay is typically very short, generally ranging from 4-12 hours. This service will initially focus on supporting individuals who can safely be served in a voluntary environment. The provider must be willing to participate in larger system planning to provide services to more agitated, involuntary individuals in the future.

3. Withdrawal Management (aka Detoxification): Provides medically monitored support to individuals who have developed a physiological dependence on various substances. This is typically a short-term service, often with transition to residential services upon discharge. Average length of stay is 3-5 days.

4. Stabilization: A flexible, short-term program (1-4 days) that provides immediate services to individuals in a safe environment while they are waiting to access other care. This program may also be used for short term stays to support individuals as they are transitioning from one service to another.

5. Residential: Adult substance use disorder residential treatment consists of services delivered to Individuals 18 years of age or older who are unable to live independently in the community, cannot maintain even a short period of abstinence from substance

Intensive Substance Use Disorder Treatment Services at the Center for Addictions Triage and Treatment use, need 24-hour supervision, treatment and care, and meet the treatment placement criteria indicated in the American Society of Addiction Medicine (ASAM) Level 3.1.

B. All services must incorporate staff who have lived experience of having a substance use disorder. The role of peer mentors will be valued and fully integrated into the treatment team. Additionally, provider must offer medication supported recovery services throughout all residentially based treatment and supports.

C. The Intensive Services program is part of the larger CATT project and will occupy one of the two proposed CATT sites. The Intensive Services program will be expected to be integrated with the CATT community services program, described in the next section.

Integration includes cross-site referrals and coordination of care. A formalized relationship with the other CATT service providers will be required.

V.B Community Services (out of scope) - Informational Only

The CATT project will also include expanding community-based services provided out of a Community Services Building, proposed to be in Hillsboro. At the Community Services Building, services will be provided by several different organization that are co-located into a single building, creating a service mall of supports for individuals who have a behavioral health condition. The provider of Intensive Services will be expected to refer and coordinate with the providers offering services out of the Community Services Building to create a comprehensive substance use services program. Community Services include:

• Outpatient substance use and mental health treatment: Treatment that occurs in a clinic setting that includes a variety of treatment interventions focused on reducing mental health symptoms or substance use while improving community functioning. Services may include evidence-based interventions, peer supports, medication management and counseling.

• Peer drop-in center: A space where individuals in recovery and their friends, family and other supports can congregate. Drop-in centers provide opportunities for socialization, mutual support, and development of peer networks, all of which are critical to recovery.

The space can also be used for support groups, affinity group activities and self-help groups such as Alcoholics Anonymous and Dual Diagnosis Anonymous.

• Health Services: Physical and dental care for individuals who have co-occurring health needs along with their behavioral health conditions.

• Supportive Housing Services: An entry point into the Washington County Supportive Housing Services program offering services and supports to those who are low income and who have housing instability.

• Crisis Services: The Hawthorn Walk-In Center is a behavioral health urgent care program that provides crisis intervention, safety planning, connection to services and brief treatment. This center is open 7 days per week and does not require appointments. Most other Washington County crisis services are located out of Hawthorn, including the

Intensive Substance Use Disorder Treatment Services at the Center for Addictions Triage and Treatment mobile crisis team, peer crisis services and intensive transitional services. These services will be relocated to the Community Services Building.

Community services are not included in this RFP. A separate process will be used to select the providers to be located within the Community Services Building.

Intensive Substance Use Disorder Treatment Services at the Center for Addictions Triage and Treatment

VI. ORGANIZATION ROLES

Both County staff and the selected provider will participate in the implementation of the intensive services portion of the CATT project. The roles and responsibilities of each are described below.

VI.A Provider Role - Pre-Opening

The provider, selected through this procurement process, will have key responsibilities throughout the development of intensive services. The roles and responsibilities will vary depending on the stage of the project.

Prior to services being delivered, the selected provider will appoint staff to join the CATT project leadership team and provide input and support to project planning and service development.

The provider will be required to:

• Participate in work to develop the physical building design.

• Develop clinical services that are compliant with: OAR 415-012-0000 to 415-012-0090 and OAR 415-050-0000 to 415-050-0095 (medically managed withdrawal management);

OAR 309-018-0135 to 309-018-0160 and OAR 309-018-0170 to 309-018-0200 (residential treatment); and OAR 944-001-0000 to 944-001-0040 (behavioral health resource networks).

• Develop peer support services that are incorporated throughout all levels of care. Peer Support Specialists are Individuals as defined in OAR 309-019-0105(77), as such rules may be revised from time to time. Peer Support Specialists must comply with all requirements in accordance with OAR 410-180-0300 through 410-180-0380.

• Develop culturally responsive service programming in collaboration with community subject matter experts.

• Develop services that are consistent with CATT key program philosophies as described in Section 3 - Overview and Purpose, Article 1 - Philosophy of this RFP.

• Partner with the County to engage with community members to establish positive neighbor relations and good neighbor agreements as indicated.

• Establish and/or expand contracts with the Coordinated Care Organizations (CCOs) covering Washington County to provide funding for services provided to OHP members.

• Pursue funding arrangements with other payors to cover the cost of clinical services delivered to non-OHP covered individuals.

• Enter into Memorandum of Understanding(s) with other Washington County Behavioral Health Resource Network participants and CATT Community Services providers.

• Develop operational policies and procedures.

Intensive Substance Use Disorder Treatment Services at the Center for Addictions Triage and Treatment

• Assist County staff in applying for grant funding as needed to fill operational funding gaps.

• Recruit, hire and train staff to provide clinical services.

• Assist in the establishment of protocols and agreements involving first responders.

• Execute a space lease and full-service package agreement with Washington County Facilities and Parks Division to establish payment and use of space agreements.

• Work with Washington County and the CCOs on developing, tracking and reporting outcome measures.

• Obtain all necessary approvals from the Oregon Health Authority to operate the services as described previously.

All activities will be done in collaboration with county staff. The timing and extent of participation in each focus area will be negotiated between County and provider. The goal is to form a mutually supportive partnership between the County and the provider to create a comprehensive treatment center that provides quality services to Washington County residents and is responsive to county systems and supports.

VI.B Provider Role - After Opening

Once the facility has been deemed ready for occupancy, provider will implement the intensive services program located within the County-owned building. Provider shall implement services using promising and best practices and incorporating culturally relevant supports to be responsive to residents of Washington County. In addition, provider will:

• Bill OHP (Medicaid), Medicare and commercial insurance where available. Provider will make continued good faith attempts to execute agreements with commercial insurance companies and not cost-shift expenses to other funding sources.

• Execute a general fund contract (if not already awarded) with the Washington County Behavioral Health Division to serve Washington County residents who are not eligible for the Oregon Health Plan, or are underinsured, with income at or below 200% of federal poverty guidelines.

• Coordinate services with system partners to support development of referral pathways and mechanisms to connect clients with the local provider that is the best clinical and cultural match to their service needs, even if this is not the provider operating CATT.

• Incorporate culturally responsive service delivery throughout all direct services.

• Incorporate peer delivered supports throughout all direct services.

• Provider must maintain a certificate of approval for the duration of the contract.

• Maintain all relevant licensures required for service delivery within the scope of this RFP.

• Regularly convene, in partnership with Washington County Behavioral Health, an advisory committee to ensure services are delivered in a manner that is responsive to Washington

Intensive Substance Use Disorder Treatment Services at the Center for Addictions Triage and Treatment

County service systems including public safety, public health, crisis services, the local Behavioral Health Resource Network (BHRN), CCOs and county behavioral health.

• Coordinate service delivery with other Behavioral Health Resource Network participants in accordance with the established MOU.

• Provide in-person prescriber services. Telehealth will be offered as an alternative only when in-person prescribing is not available. Provider will make a good faith effort to provide in-person care whenever possible.

• Provide mental health supports to individuals with co-occurring mental health conditions.

Provider shall not decline to admit a client solely based on the presence of a co-occurring mental health condition.

• Partner with the County to engage with hospitals and first responders regarding the responsiveness of CATT to community needs with the understanding that some services may need to be expanded in scope or intensity in the future to meet system needs.

• Notify County if there are any disruptions to service delivery.

• Work with County and CCOs to develop an ongoing funding model for non-funded services such as sobering.

• Notify County of critical incidents that occur within the facility. The definition of “critical incident” shall be mutually developed and included in contract.

• Coordinate with providers operating out of the Community Services building to implement the comprehensive CATT services model.

Services may be phased in as staffing/workforce allows. Implementation timeline will be negotiated with County Behavioral Health staff to develop a mutually agreeable timeline.

Provider shall prioritize opening withdrawal management and residential services first, with additional services added as hiring/workforce allows.

VI.C Washington County Role - Pre-Opening

The County will retain a primary leadership role in the CATT development which includes the following activities:

• Convening workgroups to inform program design and systems integration.

• Funding the capital costs associated with owning and renovating the buildings used to provide CATT services.

• Leading and participating in community engagement activities to assist in developing positive relationships with neighbors and good neighbor agreements where indicated.

• Selecting design and build organizations for the physical site renovation.

• Primary coordination and collaboration with the architect and general contractor.

Intensive Substance Use Disorder Treatment Services at the Center for Addictions Triage and Treatment

• Funding building furnishing and initial start-up costs (as detailed in the funding section) related to opening the physical site. Start-up costs related to staffing shall be negotiated with the provider and based on both provider need and available resources.

• Informing county leadership of the project’s progress and receiving and incorporating input into ongoing planning.

• Executing a lease and space use agreement with the selected provider.

• Executing a full-service agreement that includes security, utilities, maintenance, janitorial services and groundskeeping.

As the owner and funder of the physical site, County staff will have final say in all aspects of the project that involves the physical site and capital construction costs. However, County staff will ensure input is sought from the provider throughout the design phase and will strive for consensus for all major decisions.

VI.D Washington County Role - After Opening

Upon opening, the county’s role will shift from project development and management to being a landlord (Facilities Division), functioning as the local mental health authority, and providing system oversight and coordination (Behavioral Health Division). County staff will not direct CATT clinical services beyond ensuring the program is aligned with the broad goals and philosophies of the CATT project and continues to carry out the array of agreed upon programs and deliverables.

The county acknowledges that the treatment provider must have discretion to develop and implement clinical services within their policies, procedures, and accepted practices for the clinical services as long as such discretion aligns with all applicable contracts, rules and regulations. As such, the primary role for the county will include:

• Providing responsive support to the provider around building issues.

• Providing continued support to the provider around maintaining positive neighborhood relations.

• Supporting the Behavioral Health Resource Network and ensuring the CATT services are integrated and coordinated with the larger system.

• Continued advocacy with the state and payors to fund services in a manner that covers the true and actual cost of care.

• Facilitating broader discussions with first responders around program capacities and future design.

• Providing state general fund dollars to support Washington County indigent individuals seeking services.

The county shall make a continual good faith effort within its role and responsibilities to support the provider in mitigating any service disruption due to loss of funding, changes at the state level or challenges with workforce. This does not obligate the county to fill any service funding gaps;

Intensive Substance Use Disorder Treatment Services at the Center for Addictions Triage and Treatment however, the county will partner with the provider to identify funding options and provide advocacy to address system challenges.

Intensive Substance Use Disorder Treatment Services at the Center for Addictions Triage and Treatment

VII. FUNDING AND ESTIMATED TIMELINE

VII.A Commitment

Washington County Behavioral Health endeavors to support the selected provider in successfully implementing the Intensive Services portion of the CATT project. As such, the County will provide funding for provider staff to join County staff and assist with the development and implementation of the program. If available, the County may offer additional funds to help support the initial start-up period prior to opening and for a period after opening. In addition, the County will offer to lease a design-built Intensive Services Building to the selected provider at a negotiated rate.

VII.B Staffing for Project Development

Design and construction are anticipated to take approximately two years to complete, from the time the provider is selected through this RFP. Washington County Behavioral Health will provide funding for provider to assist with completing the tasks described in Section 6 - Organization Roles, Article 1 - Provider Role - Pre-Opening of this proposal. The expectation of the county is that the provider will work in close partnership with the county in development of the project.

Provider must be responsive to county requests for participating in community meetings, meetings with the architectural firm, work group activities, project planning, leadership briefings and other pre-opening activities as identified. While time is expected to vary, the estimated type of staff and hours are described below:

• Program leadership and direction (5 hours per week)

• Clinical service planning and community engagement (5 hours per week)

• Space design (10 hours per week)

• Policy development, workforce planning and implementation (20 hours per week)

The County will be lead in the building design and construction, the selected provider will be primarily offering input from a clinical and workflow perspective. Funding for project development staff is intended to be general support to the organization during implementation, with the understanding that the number of hours and type of staff may vary over the course of the project. Provider will have discretion and flexibility across staff and number of hours dedicated to the project as to how to operationalize this work within their organization but must accomplish the pre-opening scope of work as described in section Section 6 - Organization Roles, Article 1 - Provider Role - Pre-Opening of this proposal. Payments for staffing will be made in equal monthly payments for two years from the time of award.

Intensive Substance Use Disorder Treatment Services at the Center for Addictions Triage and Treatment

VII.C Start-Up Funds

The successful proposer may be offered start-up funding for the program to help cover agreed upon expenses. Initial start-up costs may include expenses related to hiring, staffing, and training personnel to operate the center as well as initial supplies. These funds may be used to help fill gaps in funding for the program during the period where billing revenue is either not available (i.e., prior to client service delivery) or to cover expenses during initial claims lag. Provider will not be required to use these funds for durable equipment and furnishings such as desks, beds, kitchen appliances, service ware, etc. These initial costs will be covered separately by the county.

Clarification on what will initially be covered by the county and what may be requested as part of provider start-up funding is provided in the chart below:

The availability and amount of funding is not determined at this time. Provider will be asked to estimate the amount requested as part of the RFP response. The actual amount of start-up funding provided will be negotiated between the County and the provider and is subject to availability of funding.

Intensive Substance Use Disorder Treatment Services at the Center for Addictions Triage and Treatment

VII.D Lease Subsidy:

A. Provider will be offered a county-owned space to operate services within the scope of this RFP. This space is located at 17911 NW Evergreen Parkway in Beaverton and consists of approximately 35,500 sq ft. The space will be renovated substantially prior to opening and designed in a manner to support the intensive services as described earlier. The selected provider will assist in the physical space design and selection of furnishings. All costs for renovation and furnishing will be covered by Washington County.

B. Provider will be required to both lease the space from the County as well as enter into a full-service contract that covers the cost of janitorial, security, utilities, maintenance, depreciation and yard service.

C. The lease and full-service contract rates will be negotiated between the successful proposer and the County prior to opening. The lease may be offered below market rate, effectively subsidized by Washington County.

VII.E Estimated Project Timeline

Below is a sample timeline for the project. This schedule is subject to change depending on many factors and is for illustrative purposes only. Construction delays may result in the services opening later than this schedule identifies.

Intensive Substance Use Disorder Treatment Services at the Center for Addictions Triage and Treatment

VIII. PROPOSAL CONTENT

VIII.A ORGANIZATIONAL QUALIFICATIONS & EXPERIENCE TO CONDUCT THE SCOPE

OF WORK

A. Describe your agency’s mission and organizational goals. Discuss how these align with the CATT project.

B. Describe your organization’s qualifications and experience providing intensive services including whether your organization is currently licensed by the State of Oregon to provide these different service types. Please provide information specific to each of the following service types: Sobering, Residential treatment, Withdrawal management, Assessment and triage, and Stabilization services.

C. Is your organization a culturally specific organization? If so, how does your organization define what makes it a culturally specific organization?

D. If your organization is not a culturally specific organization, describe any formal partnerships your organization has with culturally specific organizations that will assist you in providing responsive services at the CATT.

E. Does your organization employ people with lived experience of having a substance use disorder in organization leadership roles? How is this perspective incorporated into your agency’s design and operations?

F. Has your organization ever lost its license or been placed on a corrective action plan on order to retain a license, certification or contract? If so, please describe the circumstances and outcome.

G. Among the supervisors, managers, and clinical directors proposed for your project, are any listed on the Exclusion List posted by the US Office of the Inspector General? What processes does your organization use to ensure no employees are on the exclusion list?

Evaluation Criteria: In the Organizational Qualifications and Experience section the proposer:

Describes the agency’s mission and organizational goals, and alignment with Washington County’s CATT project.

Demonstrates substantial organizational qualification and experience providing intensive SUD treatment services.

Proposer is a culturally specific organization based on a well-considered definition and concrete examples.

Proposer has established partnerships with culturally specific organizations and provides evidence of formal relationships such as contractual arrangements or memorandum of understandings.

Intensive Substance Use Disorder Treatment Services at the Center for Addictions Triage and Treatment

Proposer demonstrates that lived experience is critical to developing services responsive to clients with substance use disorders.

Proposer offers candid information about any prior loss of licensure or corrective actions. When significant issues were identified, the proposer responded with effective actions to address the concern.

Proposer validates that staff members associated with the Center are not prohibited from federal Medicaid participation and has processes to monitor staff for exclusion.

VIII.B CULTURALLY RESPONSIVE SERVICE DEVELOPMENT

A. How does your organization embrace the provision of culturally responsive services?

Please provide specific examples.

B. Describe how your organization will assist in the development of culturally responsive and/or culturally specific intensive services at the CATT. How will your organization ensure recovery services are available, mutually accessible, and responsive to participants from non-dominant cultures? Please discuss considerations for:

1. Referral pathways to ensure clients from various cultures feel safe and welcomed in accessing services

2. Staffing – recruit, retain and promote at all levels of the organization

3. Service delivery to overcome barriers you specifically identify for each non-dominant population group

4. Physical environment design – including materials and signage

5. Conflict and grievance resolution processes that identify, prevent, and resolve cross-cultural conflicts or complaints

C. How will your organization ensure that treatment services are available to non-English speaking participants in a manner that is proactive, meaningful, responsive and accessible for the individual?

D. How will cultural awareness be included in training of staff and peers?

E. Describe current relationships your organization has with other culturally specific providers/agencies/organizations, and how these relationships will be used to improve cultural responsiveness to participants of the Center.

Evaluation Criteria: In the Culturally Responsive Service Delivery section the proposer:

Demonstrates the organization’s commitment to providing culturally specific/culturally responsive services with specific examples.

Demonstrates that recovery services will available, mutually accessible, and culturally responsive to participants from non-dominant cultures.

Describes how recovery services will be made available to non-English speaking participants in a way that facilitates meaningful engagement in the treatment program.

Intensive Substance Use Disorder Treatment Services at the Center for Addictions Triage and Treatment

Demonstrates that cultural awareness is a part of program design and training; and, Shows relationships with local culturally specific providers and shows how relationships will improve cultural responsiveness.

VIII.C PROGRAM DESIGN

A. Describe your organization’s theoretical framework that serve as the basis of your approach to the client and their family. Why has your organization chosen this framework?

B. How will your program specifically meet the unique needs of Washington County residents? How will you ensure services primarily support the target population as described in Section 4 - Eligibility, Article 3 - Client Eligibility?

C. Describe the process your organization will use to create the clinical service design (i.e., how the Center will operate), including:

1. How services will be delivered in a manner that is based in research and best practices.

2. How services will be delivered as part of a continuum of care that includes other service providers.

3. How clients will move through the treatment continuum offered at the CATT.

D. What natural participant support systems will be encouraged/facilitated, and how will they be developed?

E. Will your organization subcontract with other organizations to provide the services? If so, describe the arrangement and how you will provide oversight of the subcontracted entity.

F. What challenges does your organization anticipate during the implementation process and how do you propose to respond to these challenges?

Evaluation Criteria: In the Program Design section the proposer:

Describes and offers concrete examples of a theoretical framework that is client centered, focused on harm reduction and engagement, and ensures services are delivered with dignity and respect to the client. Emphasizes recovery as a journey with a focus on continued client engagement and support.

Demonstrates a sophisticated understanding of Washington County and the needs of residents.

Specifically describes strategies to ensure the program is most responsive to the target population.

Describes an effective process for developing the service design that is based in research and best practices, is integrated with the larger system of care and considers opportunities to keep individuals engaged in services throughout the service continuum.

Intensive Substance Use Disorder Treatment Services at the Center for Addictions Triage and Treatment

Values natural supports and has concrete actions to facilitate family engagement in service delivery.

If the proposer plans to subcontract elements of service delivery, the proposer already has a formalized relationship with the subcontractor and a plan to provide oversight to the subcontractor to ensure services are aligned with CATT philosophies.

Anticipates areas that will be challenging during program implementation and offers a strategic and approach to responding to the challenges that is likely to be effective.

VIII.D PARTNERSHIP/SERVICE COORDINATION

A. Outline the important connections/collaborations needed with other agencies/systems to operate the Center in Washington County.

B. How will the center specifically collaborate with first responders and health care systems to ensure clients are directed to the service most appropriate to their needs? What are specific actions your organization has taken in the past to coordinate with these systems?

C. Describe how these important connections/collaborations will be developed.

D. Describe how you will develop and support an advisory board for the center. Who will be on the board? How will board members inform the services provided at the CATT?

E. Describe how you will form positive relationships with nearby neighbors and address any concerns they may have about a treatment center being located near their homes and businesses.

Evaluation Criteria: In the Partnership/Service Coordination section the proposer:

Identifies key agencies and systems with which to coordinate service delivery and referrals.

Acknowledges the important role of first responders and hospitals as both a key entry point and support for center operations. Proposer has a well-developed plan for engaging and coordinating with these systems and demonstrates success in partnering with first responders and hospitals.

Details a plan for developing formalized relationships with other systems.

Describes a plan for developing an advisory committee to the center that is thoughtful and values input from community stakeholders.

Describes how neighborhood relationships will be developed and a plan for addressing neighborhood concerns that is respectful and centered on partnership.

VIII.E STAFFING/TRAINING PLAN

A. Describe actions your organization will take to recruit and hire staff to support the center to ensure stability of operations.

B. Describe how proposed Center staff will be trained, specifically addressing these key areas:

Intensive Substance Use Disorder Treatment Services at the Center for Addictions Triage and Treatment

1. Client centered care

2.…