PowerPoint - Inpatient Concurrent Review.pdf

Behavioral Health www.SBCounty.gov/dbh

Proposer’s Conference

Inpatient Concurrent Review

RFP DBH 25-61

EPro ID: DBHE26-ADMN-6093

Tuesday, January 13, 2026

Housekeeping

Please mute phones/computers

Questions Please submit any questions via email or in ePro

Audio Recording

Presenters

Misty Steffen Program Manager I, DBH Quality Management Administration

Arminda Nelson Senior Accountant/Auditor, DBH Provider Support & Accounting Services

Shane Hibbard-Miller Staff Analyst II Trainee, DBH Contracts Development Unit

Agenda

Procurement Timeline Program Requirements Fiscal information and requirements Procurement conditions eProcurement requirements Contract requirements

• Indemnification

• Employment of Former County Officials

• Public Records Act

• Subcontractor status

Proposal submission & evaluation

Procurement Timeline

Deadlines Submission of Questions

• Tuesday, January 20, 2026 by Noon (PST)

Response to Questions

• Monday, February 2, 2026 by Noon (PST)

Proposal Submission

• Tuesday, February 10, 2026 by 4 P.M. (PST)

Tentative Contract Term July 1, 2026 through June 30, 2031

The above dates are subject to change as deemed necessary

Program

Program Requirements (Pages 9-15)

Please review the following sections of the RFP document:

Period of Contract (Page 1) July 1, 2026 – June 30, 2031

Definitions (Pages 9-11)

Background (Pages 11-12)

Program Description (Pages 12-15)

DBH is seeking proposals from interested and qualified organizations and agencies to provide a proposed plan for the provision Inpatient Concurrent Review (ICR) services to evaluate authorizations for inpatient acute psychiatric hospitalization services in real-time. Proposers must be capable of implementing service provisions on July 1, 2026.

Concurrent review and authorization of psychiatric inpatient services provided to the following populations:

Medi-Cal members receiving psychiatric inpatient hospital services in any hospital within San Bernardino County.

Indigent persons receiving psychiatric inpatient hospital services in a hospital within

San Bernardino County.

Medi-Cal members with a County of Responsibility other than San Bernardino County receiving psychiatric inpatient hospital services at the County Short-Doyle/Medi-Cal hospital.

Provider must maintain strict adherence to all applicable federal, state, and local regulatory requirements, including relevant DHCS Behavioral Health Information Notices (BHIN) and compliance with the Parity in Mental Health and Substance Use Disorder Services Final Rule (42

CFR §438.910).

Program Requirements (Pages 9-15)

Program Requirements (page 12-13) Provider will work in collaboration with San Bernardino County contracted psychiatric hospitals to meet Inpatient Concurrent Review (ICR) deadlines, along with non-contracted hospitals that serve San Bernardino County Medi-Cal members.

Inpatient Concurrent Review services include all San Bernardino County Medi-Cal members to include indigent populations.

Provider shall be required to maintain adequate staffing levels and appropriate licensure for all personnel performing concurrent review and authorization functions. A licensed Medical Doctor must be designated and available for consultation regarding medical necessity.

Submit a report to the DBH Program Manager by the fifth (5th) of each month. At a minimum, the monthly report must include an overview of the total caseload, and number of Medi-Cal cases and non-Medi-Cal cases. The report is to cover changes and status of staffing, program and services that impact service delivery under the contract.

Ensure approved Treatment Authorization Requests (TARs) meet medical necessity in accordance with all applicable federal, state and county requirements. TARs are due to DBH within 5 days of completion.

Program Requirements (page 12-15)

Respond to hospital inquiries within two (2) calendar days to support real time decision-making and reduce unnecessary inpatient days.

Contractor expected to maintain ongoing collaborative meetings with DBH on a monthly basis throughout the term of the contract to facilitate communication, problem-solving, and continuous quality improvement.

Must provide DBH with direct access to data and reporting tools through the provider portal, allowing the department to run queries independently and on demand as needed for planning, monitoring, and compliance purposes.

Establish a mechanism to identify and document administrative days, ensuring DBH can process payments when patients remain hospitalized due to placement barriers.

Provider Support & Accounting Services

Financial details

Funding Type of funding

10% 1991 Realignment 35% 2011 Realignment 55% Medi-Cal Quality Assurance

Contract Term Contract period is five years totaling $11,983,620

Period of Contract – July 1, 2026 to June 30, 2031

(Fiscal submission requirements—RFP Page 48, & Attachments G, I & J)

PSAS Submission Requirements

Financial Statements In accordance with CDSS MPP Section 23-610(L), submit the three most recent and complete annual audited financial statements; the most recent must be completed within the past 18 months.

-OR-

If you do not have audited financial statements, please submit unaudited financial statements for the three most current years (including balance sheet, income statement, and statement of cash flow).

If the business has been in existence for less than three years, provide the most recent financial statements.

These statements shall be audited by an independent, certified public accountant. (If the business is less than three years old, information on the rest of the proposal should support the reported time frame.)

Rate Proposals Submit complete rate proposals for each fiscal year for cost analysis purposes.

Failure to submit correct/complete rate proposals & financial statements will result in disqualification.

Contract Requirements

Single Audit Requirement (Pages 36-38) A single audit must be performed for contractors expending the threshold amount ($1,000,000 or more) in federal funds annually.

Indirect Admin. Costs Indirect admin. costs cannot exceed 15% of the modified direct costs.

Contract Reimbursement (Pages 19-20)

• Fiscal Year – July 1 to June 30

• Contractors bill County monthly in arrears for services provided

• Must accept all payments via electronic funds transfer (EFT)

• In applicable, the deadline to submit budget modification requests is February 1st of the fiscal year needing the budget adjustment.

Contract Requirements

Right to Monitor and Audit

Audit requirements Right to monitor

Right to review and audit all records.

Availability of records Maintain all fiscal, statistical, and management books and records pertaining to the program.

All records shall be complete and current and comply with all contract requirements.

Fiscal Records shall be kept in accordance with GAAP.

Retain all service and financial records for a period of at least 10 years.

Contracts Development Unit

Proposal Conditions

Proposers must:

(Section III “Proposal Conditions”, Paragraph A – Page 3)

Be a non-profit, for-profit organization or other legally constituted business entity.

Have no record of unsatisfactory performance with any government agency or County Department including DBH in the twenty-four (24) month period immediately preceding the date of issuance of this RFP. Proposers who are or have been seriously deficient in contract performance during this period, in the absence of circumstances properly beyond the control of the Proposer, shall be presumed to be unable to meet this requirement.

Register in the County’s Electronic Procurement Network (ePro) system.

Meet other presentation and participation requirements listed in this RFP.

eProcurement Conditions

All proposers must register in ePro prior to the submission deadline regardless of the method of submission or they may be disqualified:

https://epro.sbcounty.gov/bso/ eProcurement Conditions

For information on how to register and respond to an RFP go to:

http://wp.sbcounty.gov/purchasing/wp-content/uploads/sites/3/2021/07/How-to-do-Business-wi-San-

Bernardino-County-7_9_21.pdf

See: https://wp.sbcounty.gov/purchasing/vendor-registration/ and https://wp.sbcounty.gov/purchasing/commodity-codes-3/

For system related issues involving ePro, contact the Purchasing Department at (909) 387-2060.

Late proposals WILL NOT be accepted.

http://wp.sbcounty.gov/purchasing/wp-content/uploads/sites/3/2021/07/How-to-do-Business-wi-San-Bernardino-County-7_9_21.pdf http://wp.sbcounty.gov/purchasing/wp-content/uploads/sites/3/2021/07/How-to-do-Business-wi-San-Bernardino-County-7_9_21.pdf http://wp.sbcounty.gov/purchasing/wp-content/uploads/sites/3/2021/07/How-to-do-Business-wi-San-Bernardino-County-7_9_21.pdf http://wp.sbcounty.gov/purchasing/wp-content/uploads/sites/3/2021/07/How-to-do-Business-wi-San-Bernardino-County-7_9_21.pdf http://wp.sbcounty.gov/purchasing/wp-content/uploads/sites/3/2021/07/How-to-do-Business-wi-San-Bernardino-County-7_9_21.pdf http://wp.sbcounty.gov/purchasing/wp-content/uploads/sites/3/2021/07/How-to-do-Business-wi-San-Bernardino-County-7_9_21.pdf http://wp.sbcounty.gov/purchasing/wp-content/uploads/sites/3/2021/07/How-to-do-Business-wi-San-Bernardino-County-7_9_21.pdf http://wp.sbcounty.gov/purchasing/wp-content/uploads/sites/3/2021/07/How-to-do-Business-wi-San-Bernardino-County-7_9_21.pdf http://wp.sbcounty.gov/purchasing/wp-content/uploads/sites/3/2021/07/How-to-do-Business-wi-San-Bernardino-County-7_9_21.pdf http://wp.sbcounty.gov/purchasing/wp-content/uploads/sites/3/2021/07/How-to-do-Business-wi-San-Bernardino-County-7_9_21.pdf http://wp.sbcounty.gov/purchasing/wp-content/uploads/sites/3/2021/07/How-to-do-Business-wi-San-Bernardino-County-7_9_21.pdf http://wp.sbcounty.gov/purchasing/wp-content/uploads/sites/3/2021/07/How-to-do-Business-wi-San-Bernardino-County-7_9_21.pdf http://wp.sbcounty.gov/purchasing/wp-content/uploads/sites/3/2021/07/How-to-do-Business-wi-San-Bernardino-County-7_9_21.pdf http://wp.sbcounty.gov/purchasing/wp-content/uploads/sites/3/2021/07/How-to-do-Business-wi-San-Bernardino-County-7_9_21.pdf http://wp.sbcounty.gov/purchasing/wp-content/uploads/sites/3/2021/07/How-to-do-Business-wi-San-Bernardino-County-7_9_21.pdf http://wp.sbcounty.gov/purchasing/wp-content/uploads/sites/3/2021/07/How-to-do-Business-wi-San-Bernardino-County-7_9_21.pdf http://wp.sbcounty.gov/purchasing/wp-content/uploads/sites/3/2021/07/How-to-do-Business-wi-San-Bernardino-County-7_9_21.pdf http://wp.sbcounty.gov/purchasing/wp-content/uploads/sites/3/2021/07/How-to-do-Business-wi-San-Bernardino-County-7_9_21.pdf http://wp.sbcounty.gov/purchasing/wp-content/uploads/sites/3/2021/07/How-to-do-Business-wi-San-Bernardino-County-7_9_21.pdf https://wp.sbcounty.gov/purchasing/vendor-registration/ https://wp.sbcounty.gov/purchasing/vendor-registration/ https://wp.sbcounty.gov/purchasing/vendor-registration/ https://wp.sbcounty.gov/purchasing/commodity-codes-3/ https://wp.sbcounty.gov/purchasing/commodity-codes-3/ https://wp.sbcounty.gov/purchasing/commodity-codes-3/

Important Deadlines

Important Deadlines

Submission of Proposals:

DUE: TUESDAY, FEBRUARY 10, 2026

Must be by electronic submission in ePro or hard copy submission per RFP instructions by 4:00 p.m., Local Time (PST).

Late proposals will NOT be accepted.

Proposal Conditions, Pages 3-9

Contingencies

Right of Rejection

Best value evaluation process

Amendments/Addendums

Proposal submission

Negotiations

Pre-award on-site visits

Level of service

Termination of awarded contract

Proposals MUST be submitted on or before TUESDAY, February 10, 2026 by 4 p.m. (Local Time)

Contract Requirements

General Requirements (Pages 15-38)

Pages Licenses, Permits and/or Certifications 20-21

Department of Justice (DOJ) Clearance 22

System for Award Management (SAM)* 22-23

Trafficking Victims Protection Act of 2000 23-24

Privacy and Security (HIPAA) – Covered & Non-Covered Entities 24-27

Cultural Competency 28-29

* DBH Office of Compliance will do an Exclusion Check to the recommended provider(s) prior to contract award.

Final contract may contain additional requirements/terms

Indemnification and Insurance, Pages 30-34

Type of Insurance Limits Aggregate Worker’s Compensation $250,000 General Liability $1,000,000/occurrence $2,000,000 aggregate

Automobile Liability $1,000,000/occurrence $2,000,000 aggregate If transporting clients

Cyber Liability $1,000,000/occurrence $2,000,000 aggregate Professional Liability and/or Errors & Omissions $1,000,000/occurrence $2,000,000 aggregate

Abuse/Molestation $1,000,000/occurrence $2,000,000 aggregate

• Evidence of ability to obtain insurance to be submitted with proposal (Attachment H)

• Proof of insurance required within 15 days of contract start date

Employment of Former County Officials, Page 39

• Provide information on former San Bernardino County administrative officials who terminated county employment within the last five (5) years and who are now employed by or represent your business as an officer, principal, partner, associate or member.

• Complete Attachment D: Reportable Conditions – indicate if there are “none to disclose” by initialing and/or indicate if there are disclosures (if there are “Reportable Conditions”, fill out Attachment E: Disclosures, Exceptions and Public Records Act Exemptions to RFP).

California Public Records Act, Page 7

• All information submitted is subject to disclosure under the provisions of the California Public Records Act.

• Confidential information should be properly marked and enclosed in a separate envelope marked “PROPRIETARY.”

• The County assumes no responsibility for disclosure of unmarked data.

Note: Do not include personal information in the submitted proposal. (SSN, home addresses, etc.)

Proposal Submission, Pages 41-48 ePro Submission

• By submitting online proposer acknowledges electronic signature is legally binding.

Hard copy submission

• One original with original signatures

• Package sealed and marked with:

“CONFIDENTIAL – Inpatient Concurrent Review – RFP DBH 25-61”

Proposal Submission - Format

Proposal Format Cover Page with AUTHORIZED SIGNATURE Proposal Submission Checklist (Attachment A) Table of Contents (Attachment B) Statements of Certification (Attachment C) Reportable Conditions (Attachment D) Proposal/Narrative Description Statements of Experience Disclosures, Exceptions, and Public Records Act Exemptions to RFP (Attachment E) Subcontractor Information (Attachment F) Financial Capability (Attachment G) Indemnification and Insurance Requirements Affidavit (Attachment H) Rate Cover Page with appropriate rate submissions (Attachment J) References (Attachment K) Local Vendor Preference Self-Certification (Attachment N)

References, Page 48 & Attachment K

Provide three (3) references from other entities, preferably public agencies, of same or similar size as the county, with whom you have established a contract on a project of the same nature as this RFP. Provide Contact Name, Address, Phone Number, and dates Services were provided. (Attachment K).

Proposal Evaluation and Selection, Pages 49-54

Components Value

Program Component (Pages 49-50) 65%

Financial Component (Pages 50-52) 35%

Total 100%

Final Authority, Page 54

The San Bernardino County Board of Supervisors have final approval of any/all contract(s) that may be awarded as a result of this RFP.

Contact and Proposal Submission

Sole Contact Person:

Shane Hibbard-Miller, Staff Analyst II Trainee

(909) 386-8264 Shane.Hibbard-Miller@dbh.sbcounty.gov

Submit Proposal Packets to:

• Online Packet submission:

https://epro.sbcounty.gov/bso/

• Hard copy packets via Mail or Hand Delivery:

San Bernardino County Department of Behavioral Health Attention: Contracts Development Unit Re: CONFIDENTIAL – Inpatient Concurrent Review – RFP DBH 25-61 303 East Vanderbilt Way San Bernardino, CA 92415-0026 mailto:Shane.Hibbard-Miller@dbh.sbcounty.gov mailto:Shane.Hibbard-Miller@dbh.sbcounty.gov mailto:Shane.Hibbard-Miller@dbh.sbcounty.gov

Important Reminders

Late proposals WILL NOT be accepted

• Be sure to submit questions via email or ePro by Noon, Tuesday, January 20, 2026.

• Be sure to submit your proposal no later than 4 p.m. (PST) Tuesday, February 10, 2026.

• Be sure to include financial statements.

• Be sure to follow the Proposal Submission Checklist (Attachment A).

• Be sure to follow the proposal format.

Questions

Email and ePro are the only acceptable methods to submit questions.

See RFP Page 2, Paragraph E. Correspondence for more details and for your

Sole Contact Point – Shane Hibbard-Miller

Important Deadline Submission of Questions: Tuesday, January 20, 2026 by Noon, Local Time (PST)

Questions

Where will the questions and answers be posted?

The questions and the answers will be posted in the County’s ePro system as an Addendum to the RFP.

All registered Vendors to this RFP will receive and email notification, once the Addendum is uploaded.

Thank you

Shane Hibbard-Miller, Staff Analyst II Trainee

(909) 386-8264

Shane.Hibbard-Miller@dbh.sbcounty.gov