Performance Work Statement_7.16.21.docx

RFP No. 280-22-0571 ATTACHMENT 1a Pre-Decisional/Pre-Deliberative

Performance Work Statement Case Management & Behavioral Health Services for Separated Families

A. BACKGROUND INFORMATION

A.1. Purpose of the Contract The purpose of this contract is to provide effective, evidence-based, coordinated social and behavioral health services to members of the Ms. L and Ms. JP class action lawsuits. The contract shall continue the services provided by the previous contract 75P00120c00015 – Notification. Mental Health Assessments and Treatment to Members of the Released Subclass in Ms. JP, et al., v. BARR, et al., No. 18-cv-06081-JAK (C.D.Cal.) and expand the provision of case management and behavioral health services for the parents, legal guardians, and their children who were separated under the Zero-Tolerance Policy (ZTP), as are designated by the government. This contract is to continue the implementation of the Ms. JP preliminary injunction order, to support the Task Force’s reunification efforts under E.O. 14011 and to implement the upcoming settlement agreement to provide reunified families with mental health and related services.

A.2. Background and Need A. Family Separation Policy The Trump administration separated parents and legal guardians from their children at the U.S.-Mexico border as part of a deterrence policy. On April 6, 2018, the Department of Justice (DOJ) announced the Zero-Tolerance Policy, which was implemented through a memorandum issued by then-Attorney General Sessions that directed federal prosecutors along the U.S.-Mexico border to prosecute all referrals by Department of Homeland Security along the border for 8 U.S.C. § 1325 (unlawful entry), to the extent practicable. The policy was expanded on May 7, 2018.

That policy resulted in the separation of thousands of parents and legal guardians from their children at significantly greater rates than previously seen. Parents subject to criminal prosecution for unlawful entry were remanded to the U.S. Marshals Service for the duration of their criminal proceedings. Their accompanying children, who could not be detained in criminal custody, were separated from their parent(s), classified as unaccompanied children (UACs), and transferred to the custody and care of the U.S. Department of Health and Human Services, Office of Refugee Resettlement (HHS-ORR). No comprehensive, interagency process was in place at the time to track parents separated from their minor children or to ensure that they were reunited at the earliest possible time. After a national outcry, on June 20, 2018, President Trump signed Executive Order 13841, Affording Congress an Opportunity to Address Family Separation, to maintain family unity during the pendency of immigration and criminal proceedings. Despite the signing of the Executive Order, the Zero-Tolerance Policy remained in effect.

1. Ms. L Litigation The family separation policy was successfully challenged in Ms. L., et al. v. U.S. Immigration and Customs Enf’t, et al, No. 3:18-CV-00428 (S.D. Cal.) (“Ms. L”). On June 26, 2018, Judge Dana M. Sabraw enjoined the implementation of the Zero Tolerance Policy, ordered the reunification of a specified class of parents and their children, and placed specific restrictions on future separations.[footnoteRef:2] In the summer of 2018, as a result of the Ms. L preliminary injunction, approximately 2,000 children were reunited with their parents in the United States. The court later expanded the class to include those parents who entered the United States with their child(ren) on or after July 1, 2017, were separated from their children, and whose children were no longer in HHS-ORR custody on June 26, 2018. [2: Ms. L v. ICE, No. 18-428 (S.D. Cal. Sept. 4, 2019). The court defined the class as:

All adult parents who enter the United States at or between designated ports of entry who (1) have been, are, or will be detained in immigration custody by the DHS, and (2) have a minor child who is or will be separated from them by DHS and detained in ORR custody, ORR foster care, or DHS custody, absent a determination that the parent is unfit or presents a danger to the child.

Parents with a criminal history or communicable disease, as well as those apprehended in the interior, were excluded from the class. Ms. L. v. U.S. Immigration and Customs Enforcement, 310 F. Supp. 3d 1133 (S.D. Cal. 2018). The court later expanded the class of parents eligible for relief to those parents who were separated on or after July 1, 2017, to apply retroactively to include the first known pilot of this policy. ]

The court instructed Plaintiffs in Ms. L to establish a Steering Committee to focus on locating parents that had been separated and removed from the United States without their children. The Ms. L Steering Committee is made up of non-governmental organizations that have been searching for and contacting parents. The Steering Committee was tasked with contacting parents who had been removed to determine if they wanted their children returned to them in their home country or released from ORR custody to live with a sponsor in the United States. While reunifications took place in the family’s home country as a result of the Steering Committee’s efforts, very few parents were given the opportunity to return to the United States for reunification.

2. Ms. JP Litigation In addition to Ms. L, Ms. J.P. Order, the parents filed another class action lawsuit, Ms. JP., et al., v. BARR, et al., No. 18-cv-06081-JAK (C.D. Cal.),alleging that they suffered “life-altering” trauma that could “continue to affect their mental and emotional well-being for years to come,” because they were separated from their children at the Mexican border pursuant to the Department of Justice’s Zero Tolerance Policy (ZTP).

On November 5, 2019, the judge in J.P., Judge Kronstadt, certified a class of separated migrant parents, and ordered the Government to locate and provide notice and mental health assessments and treatment to class members requiring appropriate mental health services. The district court certified the following class:

All adult parents nationwide who entered the United States at or between designated ports of entry, who (1) on or after July 1, 2017, were, are or will be detained in immigration custody by DHS; and (2) have a minor child who has been, is, or will be separated from them by DHS and detained in DHS or [HHS Office of Refugee Resettlement (ORR)] custody or foster care, absent a demonstration in hearing that the parent is unfit or presents a danger to the child.

The district court certified two subclasses: (i) the Custody Subclass, which is defined as all members of the class who are currently or will be detained in immigration custody by DHS; and (ii) the Released Subclass, which is defined as all members of the class who were previously detained in immigration custody by DHS, but who have since been released. The district court “exclude[d] from the class definition – without prejudice to later request do redefine the class based on new information – parents with a criminal history or communicable disease, or those apprehended in the interior of the country.”

The district court then issued a preliminary injunction requiring the Government to “work collaboratively and promptly to establish a process to provide members of both the Custody and Release Subclasses with notice of the available mental health screenings and treatment.” The Government shall deliver “[m]edically appropriate” mental health assessments and treatment to the members of both subclasses. And it shall deliver the mental health assessments and treatment from locations that are “reasonably convenient to [the Released Subclass members] given their current locations and restrictions on travel under respective terms and conditions of release.” Ms. J.P. Order at pp. 45-46.

Consistent with its mission to enhance and protect health and well-being, HHS is committed to complying with the Court’s preliminary injunction and ensuring that the services the Court has ordered are delivered in an effective, efficient, and professional manner. On March 11, 2020, HHS awarded a sole-source contract to Seneca Family of Agencies (Seneca) to implement the preliminary injunction order in the Ms. JP Litigation, using its authority under section 6.302 of the FAR to award the contract based on unusual and compelling urgency. The Seneca contract was initially set to expire on January 10, 2021, but HHS has twice issued a contract modification that extended the contract’s expiration date to January 10, 2022.

Presidential Task Force On February 2, 2021, President Biden signed Executive Order 14011 (E.O. 14011), Establishment of Interagency Task Force on the Reunification of Families (Task Force), with a mandate to locate and reunify all separated families, as well as provide additional services and support to the children and their families, including trauma and mental health services. The Task Force is headed by the Secretary of Homeland Security, and the Attorney General, the Secretaries of State and HHS serve as vice chairs. In fulfilling its mandate, the Task Force has established a mechanism for processing the return of eligible parents and family members, and is well on its way to reunifying hundreds of parents who remain separated from their children.

In addition, the Task Force is pursuing a global settlement of the family separation cases, including Ms. L and Ms. JP. On March 11, 2021, the litigating parties informed the Ms. L court that they were interested in resolving these cases, and the litigating parties are actively engaging in court-supervised settlement negotiations.

B. GOALS AND OBJECTIVES

The goal of this contract is to establish contact with families (parents, legal guardians, and children) separated at the United States-Mexico border under the ZTP and related policies between January 20th, 2017 and January 20th, 2021 and to inform them of and facilitate their access to: 1) child-centered pre-reunification counseling; and 2) post-reunification behavioral health and social services, if desired. To that end, the Contractor shall convene a coalition of child and family-serving organizations as well as organizations providing services to migrant families and youth. The Contractor shall convene and coordinate the activities of coalition-member organizations to ensure unity of effort, and capacity to deliver all the described services to reunified families in all relevant geographic areas of the United States.

The objectives of the contract are:

1. To successfully organize and coordinate a system for establishing contact with families separated at the United States-Mexico border under the ZTP and related policies as identified by the United States Government (USG) between January 20th, 2017 and January 20th, 2021.

2. To subsequently inform the families of available child-focused pre-reunification counseling as well as post-reunification social and behavioral health services and solicit their interest in those services;

3. To facilitate access for those families to available pre-reunification counseling, post-reunification social and behavioral health services;

4. To successfully organize and coordinate a system for child-centered pre-reunification counseling;

5. To successfully organize and coordinate trauma-informed, culturally competent case management service delivery for these families in all relevant geographic areas of the United States;

6. To successfully organize and coordinate trauma-informed, culturally competent psychoeducation and parenting support services for these families in all relevant geographic areas of the United States.; and

7. To successfully organize and coordinate trauma-informed, culturally competent and evidence-based (and evidence-informed) behavioral health service provision for these families in all relevant geographic areas of the United States.

C. GENERAL REQUIREMENTS

The Contractor shall account for project funding necessary to meet all requirements specified in Section C, including but not limited to activities supporting IT security and privacy, Section 508 compliance, and web content development, management, and migration.

1. Independently, and not as an agent of the Government, the Contractor shall furnish the necessary personnel, labor, equipment, software, services, materials, and supplies, except as otherwise noted specifically herein to perform the work set forth below.

2. All work under this contract shall be monitored by the Contracting Officer’s Representative (COR).

The Contractor is required to follow the general information technology requirements – the DTM and OC Requirements – please see Attachment 1b.

D. SPECIFIC REQUIREMENTS

Task 1: Plan of Performance Task 1.1: Transfer of Activities (if applicable):

The Contractor shall coordinate an orderly transition of the project from the previous contractor or the Government during the time between award of this contract and expiration of the previous contract, for which the final period of performance is scheduled to end on January 10, 2022. The Contractor shall ensure that all activities are transitioned smoothly and with no interruption or break in any services.

a) The Contractor shall, at the Contracting Officer’s (CO’s) discretion, participate in up to three (3) meetings with the previous Contractor or COR to effect a smooth transition and to receive detailed information on the operation of the previous contract.

b) Within the transition period, the Contractor shall ensure the following:

i. Ensure receipt from the previous Contractor, or SAMHSA, complete documentation and all government furnished property, hardware, software, materials and data necessary to support continuation of full services, capabilities and outstanding technical and related work inherited from the previous Contractor(s), and promptly notify the COR of any omissions or deficiencies.

ii. Ensure that during a three (3)-week transition period, the Contractor’s personnel receive training from the previous Contractor’s senior personnel in all system operation and maintenance functions.

Task 1.2: Kick-off Meeting & Plan of Performance Within two (2) weeks of the CED, the contractor shall conduct a virtual kick-off meeting with the COR, Alternate COR, task leads, and other relevant federal staff to review the PWS, including the purpose, goals, objectives, tasks, protocols, activities, deliverables, schedule of project meetings, and timelines. The meeting shall also include discussion of education around the government role in the recovery of reunified families, targeted at helping to bridge advocacy and government work.

In all years, within two (2) weeks of the kick-off meeting, present a Draft Plan of Performance to the COR, Alternate COR, and task leads for feedback.

In all years, within three (3) weeks of receiving feedback on the draft, deliver a revised Draft Plan of Performance for the upcoming year. The COR/Alternate COR shall either approve the revised draft or ask for further revision.

Submit the Final Plan of Performance one (1) week after COR/Alternate COR approve or ask for further revision. The Final Plan of Performance shall serve as the guide for work requirements to be performed.

Update the final Plan of Performance as necessary and with the approval of the COR/Alternate COR. Detail any variances from the plan, reason for such variances and methods used or proposed to make mid-course corrections.

Initiate meetings with the Department of Health and Human Services Substance Abuse and Mental Health Services Administration (SAMHSA) IT Department:

IT Work Plan

· Within four (4) weeks after the CED, the Contractor shall create and submit draft system’s Privacy Impact Assessments, Entity Relationship Diagrams, Physical and Logical diagrams, information types along with data types and related relationship diagrams for the data that is being stored, processed and transmitted within the system. The above information shall be submitted to SAMHSA Security through the COR for approval and validation.

· Within four (4) weeks after the CED, the Contractor shall meet with the COR and Chief Information Security Officer at a Privacy and Security Kick Off meeting to plan an implementation schedule that attains an ATO prior to system entering the production stage. (This meeting can be held virtually.)

· The Contractor is responsible for submitting all required materials 30 days prior to the ATO anniversary date for review by the SAMHSA Security team, and contractor shall follow SAMHSA continuous monitoring schedule.

Data Classification Note: Based upon preliminary review of the PWS the data residing within this system shall be categorized as a “[Moderate]” and shall obtain Authorization to Operate (ATO) before system gets deployed into the production environment. Please see Security and Privacy Requirements section of Attachment 1b for example deliverables for the ATO.

Task 1.3: Meetings and Calls The Contractor shall meet with the COR/ACOR, as well as federal staff, service Contractors, and other stakeholders at least one (1) time per year and within two (2) weeks submission of the Final Plan of Performance. The Contractor shall work with the COR/ACOR, establish the timing of the meeting and the agenda. The Contractor shall provide a call summary that includes decisions made; agreed upon action steps; individuals responsible for each action step; due dates identified during the meeting; and items for future discussion that are identified during the call.

The Contractor shall meet with the COR, ACOR, task leads, and other relevant federal staff on a weekly basis via tele-conference to discuss progress on existing tasks and deliverables, emerging trends, and to discuss and resolve challenges. On an ongoing basis and in a proactive and collaborative manner, the Contractor shall provide expert and project management input to the COR on all content and management areas of the contract. The Contractor shall develop a draft agenda for weekly meeting and submit it to the COR for input and approval no later than two (2) days before the meeting or call is to take place. The final agenda shall be completed no later than one (1) day before the meeting or call. The Contractor shall prepare brief call summaries of each meeting and submit them to the COR within one (1) week of the call. The call summaries shall include decisions made; agreed upon action steps; individuals responsible for each action step; due dates identified during the meeting; and items for future discussion that are identified during the call.

Task 1.4: Project Tracking System & Electronic Health Records System The Contractor shall establish and maintain an efficient electronic method to facilitate the management and tracking of individuals as they are contacted and referred for services. The system shall house information including, but not limited to, number of times outreach was attempted, methods of contact, contacts, services received, etc.

Additionally, this tracking system shall have capacity to track outcomes and quality of services delivered, the types of promising and best practices, evaluation results of treatment modalities and services received, barriers to treatment and services. The system shall be able to generate reports in response to COR requests throughout the life of the contract within 48 hours from time of request. The Contractor shall assume no more than 10 short reports, no more than 5 pages each. Examples of such reports could be “What treatment modalities are the most effective/commonly used for this population? What is the rate of completed referrals? What is the rate of treatment completion? What challenges and barriers are reported by the families and individuals in relation to receiving mental health services? What is the rate of satisfaction of services provided to the individual/families?”

Regarding the provision of case management and behavioral health services, the Contractor shall use an existing electronic record system that complies with HIPAA and National Patient Data Standards. All patient records for the basis of this contract shall be stored and updated in the electronic record provided by the contractor. Although the creation of such a system shall not be covered by contract costs, maintenance costs may be covered.

The Contractor shall be able to provide de-identified data to the USG and provide secure transfer of data to the next Contractor, if relevant, in a way that is HIPPA compliant and compliant with data standards consistent with National Information Exchange Model (NIEM) human services or other accepted social services data standard.

NOTE TO OFFEROR: For Tasks 2, 3, and 4, the government anticipates 6,000 individuals per year will require some or all of these services (contact, engagement, pre-unification and post-unification services, case management services, and behavioral health services).

NOTE TO OFFEROR: For travel under Tasks 2, 3, and 4, assume that 25 percent of class members and 10 percent of staff may need to travel per task.

NOTE TO OFFEROR: For travel under Tasks 2, 3, and 4, assume no more than $750 for airfare, $250 per day for lodging, $77 per diem, and $100 for ground transportation. When paying for class members to travel to appointments, assume $400 per month for local ground transportation per person.

Task 2: Establishing Contact and Engagement of Class Members When appropriate, the Contractor shall collaborate with other providers, contractors, and stakeholders to help ensure a “wraparound” approach to services. Services include but are not limited to: housing, primary health care, nutrition assistance, legal assistance, immigration and travel processes. Approximately 25 percent of class members and 10 percent of staff may have to travel under this task. The Contractor shall perform two critical functions: 1) establish contact (from a contact list provided by the USG) with parents, legal guardians, and children that have been identified by the USG as separated under zero tolerance and related policies, and who are members of the Ms. L or Ms. JP class; 2) then make available the following services to those families:

· Establish contact with families in the US who were separated at the border The Contractor shall attempt to contact parents, legal guardians, and children from ongoing lists of contact information received from the USG. Again, these shall be individuals identified by the USG as separated at the United States-Mexico border under the zero tolerance and related policies between January 20th, 2017 and January 20th, 2021. Pre-reunification contact shall be established with the goal of providing child-centered pre-reunification counseling. Post-reunification contact shall be established with the goal of facilitating their access to behavioral health and social services, if the services are desired. The Contractor (via outreach staff) shall educate families as to the availability of social and behavioral health services and solicit their interest in receiving services. For families expressing interest, the Contractor shall connect the family with culturally and linguistically appropriate case management and behavioral health services to address mental health issues or related concerns that were caused by or worsened by the trauma of forced separation. Regarding all outreach, for those children residing with sponsor families who are engaged in ORR-funded post-release services, coordination with their Post Release case worker is also strongly recommended.

· Direct outreach efforts shall be made through the following:

· Pre-Reunification Outreach:

· Pre-reunification outreach shall be provided for the purposes of offering child-centered counseling to those children residing in the United States.

· The outreach staff shall reach out to the parents who are class members in their home countries within 24 hours of receiving the appropriate contact information from the USG, and notice that parole is approved, and location of parents is confirmed. Lastly the outreach staff shall also receive notice from the USG when/if the general consent for all Contractor services has been signed by the parents. USG shall offer and obtain a general consent for all Contractor services, which shall include consent to provide care to the children in the United States, beginning with pre-reunification counseling. USG shall review consent with parents and outline all services, from which parents may choose to opt out of. USG shall also remind parents to review the pre-reunification handouts for parents provided to them by the government. Then, and only then, may the outreach staff contact the parents. At least two (2) attempts shall be made to contact the parents prior to their own flight departure.

· When parents are contacted, the outreach staff shall complete an introductory and orientation call (with the use of appropriate interpretive services when relevant) regarding Contractor services, with a focus on explaining pre-reunification counseling for their children currently residing in the United States with sponsors, including a discussion of the purpose, means, and expected outcomes of pre-reunification counseling.

· Outreach staff shall then reach out to the sponsors and attorneys of children residing in the US to engage them proactively to support reunification and services delivery. Sponsor and attorney of record information shall be provided to the Contractor by the USG.

· This may also include in-person counseling support during the reunification process if directed by the needs of the individual families.

· Outreach staff shall provide daily reports to the supervisory case managers containing the necessary information for case management to contact the children of class members who expressed interest in pre-reunification counseling for their children.

· Post-Reunification Outreach:

· All class members shall be contacted post-reunification in order to offer services, even if they were contacted pre-reunification.

· The contractor shall be provided the last known contact information by the USG, however the contractor shall make further attempts to establish contact with the families in the following ways:

· Mail class notice to the newly paroled parents to at least one (1) address provided by the government, or found through public records searches

· Attempt at least one (1) verified phone number for class member, sponsor, or relative. This does not include outreach attempt to unverified or inaccurate phone numbers.

· Contact class member’s attorney via email or phone.

· Attempt to reach someone in person using at least one verified address for class member, relative or sponsor. This option shall be reserved for a) Special populations with unique needs such as indigenous populations that may require in person interpretation; b) for individuals who may not be comfortable with virtual contact, or c) as a last resort if class members are unreachable through the above options.

· Search public records for class member and sponsor contact information.

· Terms of establishing contact for pre-reunification and post-reunification include:

· Informing the class member that all of the services being offered are voluntary and they shall not be penalized in any way for rejecting them.

· Informing the class member that this effort is NOT for DHS, HHS or any government entity to track them, but rather to aid in their recovery from traumatic separation.

· Informing the class member that engaging in these support or mental health services, or even reaching out for more information shall not affect any efforts they may have been making towards obtaining legal status, their housing, any current or future social services, any work they may be engaged in for their livelihood (whether authorized or unauthorized) and their right to obtain a work permit when authorized.

· The terms shall also include a clear explanation about their right to privacy and that their health and case management records would under no circumstances be shared with DHS or law enforcement for immigration purposes. General privacy and confidentiality limits for mandated reporters shall be applicable in behavioral health service provision, however it shall be clarified that there is no mandated reporting around immigration; only for securing the safety of individuals.

· Most importantly each class member when contacted shall be assured that engaging in social and/or behavioral health services shall not result in any re-separation from their children for immigration purposes.

· Outreach Staffing and Transition to Case Management Services

· The Contractor shall establish a supervisory outreach coordinator, whose primary responsibility shall be to coordinate and manage the outreach staff.

· Personnel Requirements: The supervisory outreach coordinator shall have at least a Bachelor’s degree and at least 5 years of experience relevant to the position, including past supervision, and expertise in working with forced migrant families. Outreach staff shall have a minimum of a bachelor’s degree or at least 3 years of experience relevant to the position, including some background in working with forced migrant families. It is strongly recommended that outreach staff be highly proficient in Spanish and/or indigenous languages, or another second language. In the case that outreach staff are qualified however not proficient in a second language or the family’s preferred language, they shall have access to qualified interpreters for all languages.

· Special Note: The Contractor can use Community Health Workers, Promotoras de Salud, or Peer Support Workers as engagement and outreach staff as their functions and responsibilities are in alignment with this task. Community Health Workers and/or Promotoras or peer support workers for this function shall have a minimum of a bachelor’s degree, have at least 3 years of behavioral health experience in the field.

· All initial and ongoing attempts to establish contact with families by the outreach staff shall be documented.

· Outreach staff shall provide daily reports to the supervisory case managers containing the necessary information for case management to contact class members who expressed interest in services.

· Case management shall contact class members to follow up on services within 48 hours of receiving their contact information from the outreach staff.

Task 3: Case Management & Support Services The Contractor shall provide case management and behavioral health services in a manner that is conducive to the population being served. Due to the breadth and scope, the Contractor shall propose the best ways to establish contact and engage class members impacted by the ZTP, offer case management and behavioral health services to address recovery from traumatic separation and related life difficulties that stemmed from that separation. Services provided to the child are to include anyone necessary to facilitate the best treatment for that child in line with behavioral health standards for treatment of any child under ordinary circumstances. All services are expected to be available virtually or in person, depending on whichever method fits the needs of the families. The contractor shall ensure that adequate administrative support is provided for all levels of service. Approximately 25 percent of class members and 10 percent of staff may have to travel under this task. When relevant, the Contractor shall collaborate with other providers, contractors, and stakeholders to help ensure a “wraparound” approach to services. Services include but are not limited to: housing, primary health care, nutrition assistance, legal assistance, immigration and travel processes.

Task 3.1: Case Management.

· Recipients must utilize third party reimbursements and other revenue realized from the provision of services to the extent possible and use SAMHSA contract funds only for services to individuals who are not covered by public or commercial health insurance programs, individuals for whom the services available through their insurance plan are not sufficient or appropriate to treat their condition, individuals for whom coverage has been formally determined to be unaffordable, or for services that are not sufficiently covered by an individual’s health insurance plan. Recipients are also expected to facilitate the health insurance application and enrollment process for eligible uninsured clients. Recipients should also consider other systems from which a potential service recipient may be eligible for services (for example, the Veterans Health Administration or senior services), if appropriate for and desired by that individual to meet his/her needs. In addition, recipients are required to implement policies and procedures that ensure other sources of funding are utilized first when available for that individual.

· For those children residing with sponsor families who are engaged in ORR-funded post-release services, coordination with their Post Release case worker is strongly recommended.

Pre-Reunification Counseling:

· Case Managers shall also reach out to children of class members to provide pre-reunification counseling. These counseling sessions shall be short term until reunification occurs, however the case manager shall subsequently offer to continue all post-reunification services for the entire family to ensure a smooth transition between counseling and social and behavioral health services.

· In the case that any child requires more than counseling and requires formal mental health services due to concerning symptoms, the case manager shall connect the child immediately to the behavioral health service coordinator, who shall then coordinate placement into the appropriate level of assessment and care.

Post-Reunification Case Management:

· Once contact has been established, the Contractor shall assign each family a case manager that shall serve as the point of contact for further information about the role of the Contractor, referral to health and behavioral health services, and coordination of social support and interpretation services. Case managers shall conduct age-appropriate comprehensive assessments of family’s unmet needs and goals, and work to link the families with resources in their communities to address those needs at the appropriate level (e.g., crisis, vulnerable, stable, safe). One primary role for case managers shall be to help orient the families to their new environments and provide psychoeducation on social determinants of health and mental health. They shall discuss on a regular basis with families, potential solutions to foreseeable stressors and barriers to successful reunification and resettlement. Case managers, based on the needs identified in the assessment, shall assist with connection to pro bono legal services, financial support resources, assistance with employment, assistance with housing, health care and health care access, enrollment in public school, connection with community youth and family serving organizations, support appropriate for families’ personal belief system, healthy relationships, food and material goods security (e.g. adequate clothing for each season), transportation, and any special circumstance, using identified public, private, and nonprofit resource Contractors. All case management services shall be free of charge to the families.

· Personnel Requirements: Case managers shall be at least 21 years of age. It is strongly recommended that case managers be highly proficient in Spanish and/or indigenous languages, or another second language. In the case that case managers are qualified however not proficient in a second language or the family’s preferred language, they shall have access to qualified interpreters for all languages. Case managers shall have a minimum of a Master’s degree in the behavioral sciences, human services or social services field; or a Bachelor’s degree with at least three years of progressive employment experience that demonstrates case management experience with forced migrant or immigrant populations. They shall also have a strong background and understanding of trauma informed and strengths-based case management approaches. Case management services are consistent with culturally and linguistically appropriate services standards (CLAS). It shall be the responsibility of the contractor to do their due diligence towards ensuring the safety of the families by confirming that any Contractor/staff that has telephonic or in-person contact with children has the appropriate license in good standing and/or background checks.

· Frequency and Timeliness of Contact: Case managers shall be required to contact families within two days of the Contractor establishing contact and at least twice a week for the first month, and thereafter at least once a week until it is mutually determined that families are more stable. For families with special needs or who are in crisis (e.g. facing homelessness, targets of crime or violence, medical or psychological challenges), the Contractor shall have the capacity to provide intensive case management services multiple times a week. The option for in-home case management visits shall also be present and utilized in cases where there are particular challenges which make it difficult to adequately provide services virtually or in the case manager office. If the case manager is unable to reach the families by phone or in person through reasonable attempts or if they decline contact at any point, the case manager shall document all attempts made and the reasons, if known, for why contact was not made (e.g., child/family is safe and secure and no longer requires services, etc.).

· Case management service delivery may be delivered utilizing virtual HIPPA compliant platforms, including telephone. Where Spanish is not the primary language of the family, and the case manager is not proficient in the family’s preferred language, they shall use in person or virtual interpreters.

· Behavioral Health Distress Assessment: In addition to providing psychoeducation on what behavioral health services entail, case managers shall also engage in initial behavioral health distress screening utilizing non re-traumatizing, non-triggering instruments such as the RHS-15 or equivalent validated and translated instrument to aid in determining when an individual shall be referred for behavioral health services. The results of any distress screening and screening tools shall be clearly explained to the individuals. The assessment shall also entail an exploration of contributing factors to the distress and education on steps that may aid to reduce distress, including but not limited to referral to behavioral health services, parental support services, school based support, or other social services. Importantly the case managers themselves shall NOT conduct a full behavioral health assessment or ask for families to divulge any trauma history more than what is the minimum necessary to provide families with services they need.

· Guidance for Referrals: All referral information shall be presented to families in a culturally responsive, trauma-informed, and strengths-based way, ensuring strong two-way communications to ensure trust and a sense of safety for the families. When making a referral, case management shall provide the following information in a clear, culturally sensitive fashion:

· why the referral is being made;

· the case manager’s role in the referral and connection process;

· time and date of the service appointment;

· what to expect during the appointment;

· directions to the service location;

· how to contact the Contractor directly;

· the importance of being on time for appointments; and

· the child’s rights within the context of the service area (e.g., HIPAA).

· Case managers shall facilitate referrals in a way to ensure families shall be able to contact the service Contractor directly; make appointments; communicate effectively with their Contractor; ask for interpretation services, if needed; and understand the service’s costs, if applicable. All referral information shall be clearly documented in the individual’s case file.

· Referral Follow Up: Once individuals have been referred for social or medical services, case managers shall check in with the individuals regarding follow up at 30 days and again at 60 days. If a new referral is needed due to issues such as poor rapport, access, etc., the case manager shall supply a new referral and follow the same process regarding follow up.

· Case managers shall assist the individuals in determining if they are in need of immigration legal services or other legal services. Case managers shall then supply families with a referral for low or pro bono legal services.

· When relevant, the Contractor shall also assist in finding and referring individuals for low or pro bono medical and psychological forensic evaluations if required by their attorney for their immigration cases.

· Case managers shall assist with referral to a Federally Qualified Health Center (FQHC) for health screening and establishment of care with a pediatrician and/or primary care physician. The case managers shall facilitate any necessary communication between medical and behavioral health Contractors. Additionally, case managers shall assist with determining eligibility for and enrolling families in health insurance, if applicable.

· Documentation and Follow up: Each case management encounter and attempt at reaching patients shall be documented in the Electronic Medical Record (EMR). After a missed appointment, case managers shall make at least three attempts in a two-week period to contact individuals prior to documenting they are not interested in services. Importantly there shall be no policies around involuntary termination and/or limits to no-shows, however this shall be addressed during service provision in sessions with the patient. If a family or individual initially reported interest in receiving services and then was unreachable for more than 30 days, a Notice of Concern (NOC) shall be submitted (see below under Reporting guidelines) and future attempts at reaching the family/individual shall continue at a rate of at least once per month or until they express they are no longer interested in services.

Task 3.2: Psychoeducation and Parenting Support This service shall be offered to all families. The Contractor shall establish a resource for evidence-based and evidence-informed supports for parents who have experienced separation, including making available culturally and linguistically appropriate psychoeducational supports to support effective parenting and promote reintegration of the family system following the disruption of separation. This complements clinical behavioral health treatment, but is separate from it, so that parents who do not elect to receive behavioral health treatment may still benefit from psychoeducation and parenting support. The Contractor may develop a proposed solution to provide such psychoeducation and parenting support, including but not limited to:

· Preparation of a brief brochure for parents in home country regarding pre-reunification psychoeducation. This shall be given to USG to distribute to parents in home country prior to reunification.

· A phone line staffed by bilingual staff, appropriate accessible interpretation for non-Spanish speaking individuals, and options to leave messages for those that do not want to call, such as text.

· Partnership with and/or use of non-clinical supports such as promotoras, community support workers, peer support, etc., when relevant.

· A comprehensive plan for providing orientation and assistance with community integration, coping skills, problem solving, and parenting skills as it relates to mental health and wellness.

· Personnel Requirements: Community Health Workers and/or Promotoras or peer support workers providing this particular service shall have a minimum of a bachelor’s degree, have at least 5 years of behavioral health experience in the field. It is strongly recommended that those providing psychoeducation and parenting support be highly proficient in Spanish and/or indigenous languages, or another second language. In the case that they are qualified, however not proficient in a second language or the family’s preferred language, they shall have access to qualified interpreters for all languages.

Task 4: Provision of Behavioral Health Services

· Recipients must utilize third party reimbursements and other revenue realized from the provision of services to the extent possible and use SAMHSA contract funds only for services to individuals who are not covered by public or commercial health insurance programs, individuals for whom the services available through their insurance plan are not sufficient or appropriate to treat their condition, individuals for whom coverage has been formally determined to be unaffordable, or for services that are not sufficiently covered by an individual’s health insurance plan. Recipients are also expected to facilitate the health insurance application and enrollment process for eligible uninsured clients. Recipients should also consider other systems from which a potential service recipient may be eligible for services (for example, the Veterans Health Administration or senior services), if appropriate for and desired by that individual to meet his/her needs. In addition, recipients are required to implement policies and procedures that ensure other sources of funding are utilized first when available for that individual.

· When appropriate, the Contractor shall collaborate with other providers, contractors, and stakeholders to help ensure a “wraparound” approach to services. Services include but are not limited to: housing, primary health care, nutrition assistance, legal assistance, immigration and travel processes.

· Approximately 25 percent of class members and 10 percent of staff may have to travel under this task.

· The Contractor shall be responsible for behavioral health service provision. The Contractor shall establish a network of trauma informed, culturally competent behavioral health Contractors, including licensed professional counselors, nurse practitioners, clinical social workers, clinical psychologists and psychiatrists. The network shall be established through a salary time-buy out (% FTE) to then be able to offer free of charge mental health assessments and services for families.

· All services are expected to be available virtually or in person, depending on whichever method fits the needs of the families. It shall be the Contractor’s responsibility to ensure that Contractors are following the telehealth guidelines set forth by their licensing bodies and states.

· Clinician Requirements: Licensed behavioral health practitioners shall have a Master’s degree in social work, psychology, or other relevant behavioral science in which direct clinical experience is a program requirement; supervising clinicians shall have a PhD in psychology, or other relevant behavioral science in which direct clinical experience is a program requirement. Psychiatrists shall possess an M.D. or a D.O. All clinicians shall have had at least five years of clinical experience, three of which was direct clinical experience with forced migrants or immigrant populations. All clinicians shall possess an active license to provide behavioral health treatment and be in good standing with their licensing boards. All clinicians shall have some background in trauma-informed, culturally responsive, and strengths-based care.

· Frequency and Timeliness of Contact: The behavioral health Contractor shall establish contact with the referred individual(s) within two days of receiving the referral from the case manager. The ongoing contact and frequency of clinical appointments shall be mutually determined by the health Contractor and the individual receiving services and based on the type of service being delivered.

· Mode of Services: Both in-person clinical services and virtual/tele-behavioral health services are to be utilized as appropriate and in compliance with national recommendations regarding the COVID-19 pandemic, due to geographic limitations of access to linguistically appropriate clinical behavioral health services. Services available to families shall include both individual psychotherapy and if relevant, pharmacotherapy services for separated children and parents, and/or couples and family therapy. For in person visits, onsite child care shall be available (e.g. play room with staff supervision while parent or guardian is receiving services). Importantly, the Contractor shall refer families to facilities with trauma informed and culturally appropriate Contractors who have the capacity to provide ongoing follow up behavioral health services in addition to the initial assessment.

· Interpretation: Clinicians with high proficiency in Spanish and/or indigenous languages shall be prioritized. In cases where this is not possible, the use of certified medical interpreters is warranted, including in-person or telephonic. Importantly interpretation services being used for behavioral health service provision shall come from a reputable source that is certified for medical interpretation and comply with HIPAA privacy and confidentiality standards.

· Evidence-based and evidence-informed clinical interventions: Clinicians shall utilize culturally appropriate, trauma-informed and evidence based and evidence-informed clinical interventions. Clinical interventions shall be delivered through a strengths-based model. For psychiatry, this includes the use of Food and Drug Administration approved medications, off label medications if they are supported by expert consensus or with substantial literature documenting their utility.