JustifContSoleSource YBHCS.docx

CENTRAL CONTRACTS AND LEGAL SERVICES (CCLS)

Sole Source Contract Justification

TO:

CONTRACT NUMBER

2632-70897

TODAY’S DATE

07/17/2026

SELECT CONTRACT SERVICE DESCRIPTION / SUB-OBJECT CODE

Contractor Information

CONTRACTOR’S LEGAL NAME

Yale University through its Yale Behavioral Health Consulting Services

TAX IDENTIFICATION (TIN) OR UNIFORM BUSINESS IDENTIFICATION (UBI) NUMBER

ADDRESS

Contract Purpose

The Department of Social and Health Services (DSHS) is seeking a sole source contract with Yale Behavioral Health Consulting Services (YBHCS) to provide specialized consulting to support the agency’s preparation for federal Centers for Medicare & Medicaid Services (CMS) certification and state licensure survey readiness for the new forensic hospital. This certification and licensure is required for DSHS to qualify for federal Medicare and Medicaid funding.

YBHCS will provide expert guidance to ensure compliance with quality, environment of care, life safety, physical environment, and clinical guidelines. YBHCS brings demonstrated experience in forensic hospital environments, a distinct and highly regulated setting requiring knowledge beyond general healthcare consulting. In addition, the vendor will conduct a comprehensive mock survey aligned with CMS Conditions of Participation (42 CFR Part 482, Subpart E), and Joint Commission Standards and Elements of Performance for deemed status accreditation. Deliverables include an integrated package consisting of a gap analysis, an assessment of compliance readiness, identification of deficiencies, a detailed corrective action plan based on evidence-based best practices, and an executive summary report to guide leadership towards CMS certification and Joint Commission deemed status accreditation.

Contract Funding

FEDERAL FUNDING

STATE FUNDING

$ 500,664

CONTRACT TOTAL

$ 500,664

Contract Dates * Start Date must be more than 15 business days from date of request to CCLS.

*START DATE

08/10/2026

END DATE

08/29/2029

AMENDMENT OPTIONS

DSHS intends to enter into a contract with an initial term of three (3) years from the effective start date. DSHS may opt to extend the contract for an additional three (3) years in one (1) year increments, if required. Should DSHS determine to extend the contract, each optional additional one (1) year extension would result in equal (and/or slightly higher) consideration added to the total contract value.

Sole Source Definition and Guidelines What is a sole source contract?

“Sole source” means a contractor providing goods or services of such a unique nature or sole availability at the location required that the contractor is clearly and justifiably the only practicable source to provide the goods or services.

(RCW 39.26.0101)

Unique qualifications or services are those which are highly specialized or one-of-a-kind.

Other factors which may be considered include past performance, cost-effectiveness (learning curve), and/or follow-up nature of the required goods and/or services. Past performance alone does not provide adequate justification for a sole source contract. Time constraints may be considered as a contributing factor in a sole source justification however will not be on its own sufficient justification.

Why is a sole source justification required?

The State of Washington, by law and policy, believes competition is the best strategy to obtain the best value for the goods and services it purchases, and to ensure that all interested vendors have a fair and transparent opportunity to sell goods and services to the state.

A sole source contract does not benefit from competition. Thus, the state, through RCW 39.26.010, has determined it is important to evaluate whether the conditions, costs and risks related to the proposal of a sole source contract truly outweigh the benefits of a competitive contract.

Sole Source Justification

To expedite CCLS and DES review of this sole source contract, please provide clear and compelling answers to the following justification questions.

1. What is the business need or problem that requires this contract?

DSHS has a critical business need to ensure the new forensic hospital achieves CMS certification and Joint Commission deemed status accreditation. Achieving accreditation signifies compliance with CMS Conditions of Participation, demonstrating the new hospital’s clinical practices, policies, and operations meet nationally recognized standards for patient safety and quality of care, reducing risk and supporting safe and effective service delivery. Additionally, accreditation enhances the organization’s ability to recruit and retain qualified staff in an increasingly competitive behavioral health workforce. Accreditation is required for DSHS to qualify for federal Medicare and Medicaid funding.

Opening a new state hospital is a complex and multifaceted endeavor that has not been achieved in recent years by any state-operated psychiatric hospitals. According to the NASMHPD Research Institute, states are opting to increase psychiatric hospital capacity by reopening beds in existing hospitals or, in the case of Kansas, New Hampshire, and Washington, building new hospitals entirely. In the United States, there are approximately 600 psychiatric hospitals, and approximately 190 are state-operated. Of those state-operated psychiatric hospitals, approximately 70% are accredited.

As DSHS works towards opening the new forensic hospital, it is essential to partner with experts to meet nationally recognized accreditation standards in environment of care, life safety, physical environment, and clinical care. Yale Behavioral Health Consulting Services will provide structured support to ensure the new forensic hospital is fully prepared for the accreditation survey process, reducing the risk of delays, deficiencies, or unsuccessful survey outcomes. Yale Behavioral Health Consulting Services would supplement internal operational and clinical expertise by facilitating continuous improvement, change management, and leadership coaching to effectively guide the agency through the full accreditation process.

Consultation also provides an innovative opportunity for DSHS employees to learn from experts with a variety of experience and skills. Their insight into standards interpretation will support the quality department and executive leadership in implementing and sustaining continuous improvement that aligns with DSHS' mission to deliver safe, effective, efficient, timely, person-centered, and equitable care to modernize behavioral health. This knowledge transfer will build internal capacity, positioning DSHS to achieve accreditation and manage future survey readiness independently beyond the term of this contract.

See attached whitepaper for a detailed analysis.

2. Describe the unique features, qualifications, abilities or expertise of the contractor proposed for this sole source contract.

YBHCS is widely recognized for their expertise in assisting psychiatric hospitals and behavioral health organizations achieve and maintain compliance with accreditation standards. Consultants have direct access to Yale School of Medicine's institutional knowledge and resources for clinical and program development using evidence-based practices in trauma-informed systems in both civil and forensic patient populations.

YBHCS bridges academic research, evidence-based practices, and real-world operational implementation. Their combination of qualifications and institutional credibility stems from their dual identity as both an academic institution and a consulting practice. Psychiatric hospitals operate in one of the most regulated environments in American healthcare with hundreds of overlapping federal, state, and accreditation requirements. YBHCS has experience navigating the complexities of multiple regulatory and accrediting bodies along with managing the idiosyncrasies of state-operated and owned facilities.

YBHCS expertise is independently validated, with experience working with state licensing agencies, CMS, Department of Justice (DOJ), Joint Commission, National Council for Quality Assurance (NCQA), Utilization Review Accreditation Commission (URAC), and Council on Accreditation (COA), and their recommendations carry the credibility to drive timely, high-stakes decisions. Consultants with YBHCS have supported multiple state and private psychiatric hospitals successfully achieve full accreditation following the initial survey.

YBHCS can mitigate compliance fatigue, leadership burnout, and decision paralysis through their expert-level consulting. No other vendor identified through DSHS’ market research offers this combination of academic rigor and practical experience specifically tailored to forensic hospital settings. The breadth of regulatory experience demonstrates YBHCS is qualified to support DSHS in preparing the new forensic hospital for accreditation.

3. What kind of market research did the agency conduct to conclude that alternative sources were inappropriate or unavailable? Provide a narrative description of the agency’s due diligence in determining the basis for the sole source contract, including methods used by the agency to conduct a review of available sources such as researching trade publications, industry newsletters and the internet; contacting similar service providers; and reviewing statewide pricing trends and/or agreements. Include a list of businesses contacted (if you state that no other businesses were contacted, explain why not), date of contact, method of contact (telephone, mail, e-mail, other), and documentation demonstrating an explanation of why those businesses could not or would not, under any circumstances, perform the contract; or an explanation of why the agency has determined that no businesses other than the prospective contractor can perform the contract.

DSHS conducted a comprehensive market research effort to identify vendors capable of providing accreditation readiness consulting services for the new forensic hospital. This effort included internal expert consultation and industry research, outreach to subject matter experts and similar service providers, and a full competitive solicitation (RFQQ No. 2534-877) that yielded no responsive bids.

DSHS leveraged internal experts with behavioral health accreditation experience who conducted research using professional resources, publications, and behavioral health industry conferences. Research confirmed accreditation readiness consulting is a highly esoteric field with few practitioners, and that successful preparation for dual CMS and Joint Commission accreditation requires expertise not found amongst general healthcare consultants.

In 2025, DSHS engaged with Joint Commission Resources, an affiliate of the Joint Commission that provides independent services (e.g., advisory services, education, software and expert resources) via telephone, email, and virtual meetings. This engagement informed elements of the Request for Qualifications and Quotations (RFQQ) to include scope of work, cost, deliverables, key phases, and milestones.

DSHS conducted a full competitive solicitation process (RFQQ No. 2534-877) to identify a vendor that met minimum qualifications accreditation readiness. The solicitation was posted on 10/31/2025 and closed on 12/15/2025 with no proposals meeting minimum qualifications. Feedback from vendors who reviewed the solicitation and/or participated in the pre-bid conference indicated the contract size, scope complexity, and specialized expertise exceeded their capabilities. Multiple outreach attempts to Joint Commission Resources requesting feedback on barriers to bid also yielded no response. This feedback further confirmed that the market for this specialized service is limited.

4. As part of the market research requirements, include a list of statewide contracts reviewed and/or businesses contacted, date of contact, method of contact (telephone, mail, e-mail, other), and documentation demonstrating an explanation of why those businesses could not or would not, under any circumstances, perform the contract; or an explanation of why the agency has determined that no businesses other than the prospective contractor can perform the contract.

In 2025, DSHS engaged with Joint Commission Resources, an affiliate of the Joint Commission that provides independent services (e.g., advisory services, education, software and expert resources), via telephone, email, and virtual meetings. This engagement informed elements of the Request for Qualifications and Quotations (RFQQ) to include scope of work, deliverables, key phases, and milestones.

DSHS conducted a full competitive solicitation process (RFQQ No. 2534-877) to identify a vendor that met minimum qualifications accreditation readiness. The solicitation was posted on 10/31/2025 and closed on 12/15/2025 with no proposals meeting minimum qualifications. Feedback from vendors who reviewed the solicitation and/or participated in the pre-bid conference indicated the contract size, scope complexity, and specialized expertise exceeded their capabilities.

Specific feedback from vendors is detailed below.

Western Interstate Commission for Higher Education (WICHE): “WICHE did consider submitting a proposal for RFQQ 2534-877 -Forensic Hospital Compliance Consultancy Services. However, given concerns we had about the project scope, financial resources and travel expectations, we opted not to submit a proposal. The scope was very broad and without specific deliverables for some tasks. The budget was insufficient to cover the scope of work, especially when learning that while some of the work would occur virtually, that approximately 50% would likely be onsite, and travel costs would have made this prohibitive. Additionally, as described during the pre-bid conference, the relationship of the consultant with the State for the architectural/engineering aspects, absent the design firm, contributed to our decision not to submit a bid, due to the identified communication process.”

DIOSS, LLC: “The sole factor that prevented us from submitting a response was the construction-related compliance requirement within the scope (including NFPA 101/99 and FGI 2018). While our team meets the experience requirements for CMS and Joint Commission (TJC) readiness assessments, mock surveys, and hospital and behavioral health compliance consulting, we do not currently have a consultant with the specific construction-focused compliance expertise required to fully support that portion of the scope.”

Unlike DIOSS, YBHCS’ scope explicitly includes compliance review under NFPA 101 (Life Safety Code), NFPA 99 (Health Care Facilities Code), and the 2026 FGI Facility Guidelines for Design and Construction of Hospitals (the applicable standard for this project, incorporating new requirements for wearable duress alarm systems and medical psychiatry unit standards). This breadth of expertise was not available from any competitive respondent.

5. Per the Supplier Diversity Policy, DES-090-06 and A.P. 13.27: Was this purchase included in the agency’s forecasted needs report?

The competitive solicitation was included in DSHS’ forecasted needs report. The competitive solicitation (RFQQ No. 2534-877) was posted on 10/31/2025 and closed on 12/15/2025 with no proposals meeting minimum qualifications.

6. Describe what targeted industry outreach was completed to locate small and/or veteran-owned businessman to meet the agency’s need?

DSHS followed Supplier Diversity Policy DES-090-06 to search for vendors in DES’ database that meet criteria for small, diverse, and/or veteran-owned businesses. DSHS is committed to supporting small and veteran-owned businesses. No certified vendors were identified with the specialized accreditation expertise necessary to support consultation and survey readiness for the new forensic hospital.

7. What considerations were given to unbundling the goods and/or services in this contract, which would provide opportunities for Washington small, diverse, and/or veteran-owned businesses. Provide a summary of your agency’s unbundling analysis for this contract.

DSHS determined unbundling is not feasible due to the integrated nature of the work, the critical interdependencies among deliverables, and significant risks introduced by fragmenting the work. Unbundling services across more than one vendor would create coordination challenges, increase the risk of misinterpretation of accreditation standards, and introduce gaps or overlaps in coverage. All of which could result in condition-level deficiencies or immediate jeopardy findings that would negatively impact initial accreditation. If the project fails to achieve accreditation due to unbundling-related gaps, the consequences may include operational, financial, and reputational risks for the agency as well as quality and safety concerns for the patients. For these reasons, DSHS determined that unbundling is not a viable option.

8. Provide a detailed and compelling description that includes qualification of the costs and risks mitigated by contracting with this contractor (i.e., learning curve, follow-up natures)..

A significant challenge for the new forensic hospital is to ensure it is recognized by CMS as a separate entity from Western State Hospital. The existing Western State Hospital cannot meet current CMS standards due to aged facilities and infrastructure. Due to the similar scopes of service, shared BHHA policies, and proximity between the two institutions, there is a risk that CMS determines both hospitals operate as a single entity, resulting in the new hospital not receiving accreditation. Another challenge is the forensic patient population that will be served at the new forensic hospital. CMS generally excludes forensic hospitals from the Medicare payment due to them serving individuals who are in custody of penal authorities. However, many hospitals across the country, including many organizations within the Western Psychiatric State Hospital Association (WPSHA) have been successful with certification and accreditation for facilities serving forensic patients.

YBHCS has expertise in psychiatric or behavioral health to help develop evidence-based strategies aligned with best practices to help DSHS navigate complexities associated with these challenges. Contracting with YBHCS mitigates significant costs and risks that DSHS would incur in preparing the new forensic hospital for CMS certification and Joint Commission accreditation. These include the cost of rework and remediation, the cost of internal learning curve and trial-and-error, and the risk of condition-level deficiencies or immediate jeopardy findings.

9. Is the agency proposing this sole source contract because of special circumstances such as confidential investigations, copyright restrictions, etc.? If so, please describe.

|_| Not applicable.

10. Is the agency proposing this sole source contract because of unavoidable, critical time delays or issues that prevented the agency from completing this acquisition using a competitive process? If so, please describe. For example, if time constraints are applicable, identify when the agency was on notice of the need for the goods and/or service, the entity that imposed the constraints, explain the authority of that entity to impose them, and provide the timelines which work must be accomplished.

|_| Not applicable.

11. The agency proposing this sole source contract because of a geographic limitation? If the proposed contractor is the only source available in the geographical area, state the basis for this conclusion and the rationale for limiting the size of the geographical area selected.

|_| Not applicable.

12. What are the consequences of not having this sole source filing approved? Describe in detail the impact to the agency and to services it provides if this sole source filing is not approved.

The new forensic hospital project is a $947M investment and plays a critical role in meeting Washington State’s obligations under the Trueblood consent decree, which requires timely expansion of forensic behavioral health capacity. If the sole source filing is not approved, DSHS lacks the specialized expertise needed to prepare for accreditation survey. While the new forensic hospital can begin operations and admit patients prior to accreditation, achieving certification is essential for long-term operational, financial, and regulatory stability. Without accreditation, the new forensic hospital will not be eligible to bill Medicaid, resulting in lost reimbursement. Support from a consultant also mitigates risks in misinterpretation and application of CMS Conditions of Participation and Joint Commission standards. Incomplete or inconsistent interpretation of these standards could result in condition-level deficiencies impacting the agency’s ability to demonstrate compliance with nationally recognized quality and safety standards, potentially compromising patient safety and quality. Without structured guidance, DSHS would incur significant rework under compressed timelines. YBHCS’ approach includes a mock survey and corrective action plan designed to identify and address deficits before the official survey, reducing the risk to last-minute remediation.

13. Since competition was not used as the means for procurement, how did the agency conclude that the costs, fees, or rates negotiated are fair and reasonable? Please make a comparison with comparable contracts, use the results or a market survey, or employ other appropriate means calculated to make such a determination.

DSHS conducted a full competitive solicitation for these services with an established contract value based on market research. The proposed contract value reflects the full suite of deliverables including gap analysis, mock survey, deficiency identification, corrective action plan, and executive summary report. As part of its market research, DSHS consulted with organizations that provide accreditation readiness services. These consultations informed the development of the scope of work and provided insights into market rates for specialized consulting.

Based on the alignment with the original competitive solicitation, consultation with other service providers, and analysis of market rates for specialized accreditation consulting, DSHS has determined the proposed costs, fees, and rates are fair and reasonable.

SOLE SOURCE CONTRACT JUSTIFICATION Page 4 of 4

DSHS 27-231 (REV. 02/2025)

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