Request for Information MMHC Primary Care Clinic.pdf

RFI Department of Mental Health (DMH) Massachusetts Mental Health Center (MMHC)’s co-located Primary Care Clinic April 2025

Commonwealth of Massachusetts Department of Mental Health

Request For Information Massachusetts Mental Health Center

Primary Care Clinic

COMMBUYS # BD-25-1022-DMH08-8220A-115003

Issued: April 4, 2025

Individuals and entities responding to this Request for Information (RFI) are invited to respond to any or all the requests for information set forth in Section C of this document. Responses will serve to assist the Department of Mental Health (DMH) in understanding viable program design options for a primary care clinic at its Massachusetts Mental Health Center in Boston. Responding to this RFI is entirely voluntary and will not affect the Department’s consideration of any proposal submitted in response to any subsequent solicitation.

A. INTRODUCTION

The purpose of this Request for Response (RFI) is to elicit the advice and analysis regarding the DMH’s Massachusetts Mental Health Center (MMHC) desire to continue having a third party operate a Primary Care Clinic onsite at MMHC. MMHC is located at 75 Fenwood Road in Boston.

The Primary Care Clinic is open only to DMH clients served by MMHC and the Area.

B. BACKGROUND

MMHC is a Harvard Medical School-affiliated mental health center providing outpatient integrated behavioral health services for transition-age youth and adults authorized for services through DMH.

MMHC serves individuals with persistent mental health challenges and significant comorbidities, including substance use and medical conditions. Many of these individuals face complex psychosocial challenges such as homelessness, economic instability, and social isolation, and have struggled to access healthcare due to racism, stigma, and discrimination.

MMHC severs Allston, Back Bay, Brighton, Brookline, Fenway, Hyde Park, Jamaica Plain, Roslindale, Roxbury, West Roxbury, and several DMH authorized individuals who reside throughout the Commonwealth.

MMHC serves approximately 1,300 clients. Approximately 60-80% of those served by MMHC have one or more chronic medical conditions, and a similar percentage struggle with substance use.

MMHC clients have cardiovascular disease risk factors 1.6 to 2.8 times higher than the general Massachusetts population. The primary goal of having a Primary Care Clinic on-site at MMHC is to

RFI Department of Mental Health (DMH) Massachusetts Mental Health Center (MMHC)’s co-located Primary Care Clinic April 2025 enhance the physical health of MMHC clients by providing convenient access to and seamless integration of primary care services. Key objectives include:

Effectively treating medical conditions related to the chronic use of alcohol, opiates, and other substances.

Addressing medical conditions associated with psychiatric medications.

Coordinating medication-assisted treatment with mental health care.

Reducing cardiovascular disease risk factors.

Improving the quality and accessibility of care.

Controlling healthcare costs by minimizing unnecessary acute care utilization.

Brigham and Women’s Hospital (Brigham) has been operating an outpatient Primary Care Clinic on-site at MMHC for the past twelve years, currently serving 425 enrolled clients. The Primary Care Clinic staff contribute to several MMHC initiatives aimed at promoting wellness and supporting the health of the population, including:

Wellness Coaching: Personalized wellness guidance.

Dental and Vision Screenings: Organizing screenings for clients.

General Health Screenings: Offering screenings for all MMHC clients.

Subspecialty Referrals: Facilitating access to specialized care as needed.

Population Health Management: Using data to address broader health needs.

Care Coordination: Collaboration with mental health teams.

Risk Review Meetings: Consulting on health and wellness issues.

Resident Training: Training primary care and psychiatry residents.

Grand Rounds Lectures: Educational lectures on health and wellness.

The Clinic has been provided by Brigham under a contract with DMH. DMH needs to reprocure the Clinic and in doing so wants to update the service model and assess what changes, if any, are needed and are feasible within DMH’s budgetary restraints. The following is key information about the current contract to help inform your comments:

DPH Licensed. The Clinic is licensed by the Department of Public Health (DPH) to provide clinical services. The Clinic bills Medicaid and other third-party payers directly for services rendered at the Clinic.

Health Home Model. The Clinic follows the "Health Home Model," of service delivery where primary care and behavioral health professionals are co-located and, with proper authorization(s), collaborate to ensure the coordination of care.

Practice: The Clinic provide physical exams, diagnostic tests, and supportive care for medical conditions. Clinic patients are referred to nearby laboratories and other ancillary services and subspecialists, as is appropriate.

RFI Department of Mental Health (DMH) Massachusetts Mental Health Center (MMHC)’s co-located Primary Care Clinic April 2025

Administrative functions: The Clinic, independent of DMH, performs all necessary administrative functions for the Clinic, including, but not limited to, the scheduling and registering of patients, maintaining medical records, and billing services (including billing Medicaid, Medicare and other third-party payors).

Hours of Operation. The Clinic is opened a minimum of 36 hours a week during the normal hours MMHC is open, which are Monday through Friday (not including State holidays) 9 am to 5 pm EST.

Space: DMH provides 16 square feet of space at MMHC (75 Fenwood Rd, Boston) for the exclusive use of the Clinic. This includes two dedicated exam rooms, three designated offices, and one supply closet. Additionally, the primary care clinic has access to a shared waiting room area, a separate shared exam room, and shared conference room space. The clinic does not pay rent or utilities.

Staffing: Currently the staff at the Clinic consist of the following staff provided by Brigham:

i. 0.75 FTE Physician (1 FTE is equal to 37.5 hours per week).

ii. 1.0 FTE Practice Manager.

The Practice Manager, in collaboration with the Nurse Care Manager and Lead Internist is responsible for the overall management of the practice, assuring that quality services are provided to patients in an environment that maximally fosters healing relationships between those patients and their health care team and provides administrative assistance and secretarial support for the Primary Care Clinic.

DMH provides the Clinic with a 1.0 FTE Nurse Practitioner. The Nurse Practioner reports dually to Brigham and DMH.

When it reprocures the Clinic, DMH intends to add funding (approximately $106,500) to allow the Clinic to add a Register Nurse to the practice.

Financial. Currently the annual amount that DMH budgets for the contract is $336,000.

Amounts collected by the Clinic from third parties are used to offset the DMH funding. The amount of offsets for the last few years has totaled approximately $39,000, resulting in DMH funding around $297,000 annually. Funding covers staffing, medical and program supplies and administrative costs.

C. INFORMATION REQUESTED

DMH is seeking input in the following areas:

1. Service Model. Based on the amount of available funding described above (including the additional amount for a nurse and after applying any offsets, $403,500) what do you think would be the most appropriate service and staffing models for the Clinic and based on such model what would be maximum number of hours and days of the week the Clinic could fully function.

RFI Department of Mental Health (DMH) Massachusetts Mental Health Center (MMHC)’s co-located Primary Care Clinic April 2025

2. Third Party Billing. If the Clinic was permitted to retain third party billing to offset costs and to only offset DMH funding if the third-party billing exceeded costs, do you believe this could allow for an increase in staffing and/or hours of operation?

3. Client Enrollment. Based on the amount available for funding, and that most DMH clients are Mass Health members, what is the maximum number of patients you believe could be enrolled in the Clinic described in your response to number 1, above. If you cannot answer this, what additional information would you need to do so.

4. Continuity of Services. Given the anticipated limited clinic staff, what proposed strategies can be put in place to minimize service disruptions in the event of unexpected absences, terminations, or healthcare professionals being unavailable? How can the continuity of services be maintained, and client staffing needs be met without interruption?

5. Outreach Strategies. Do you have any specific outreach strategies or activities you would recommend for MMHC and/or the Clinic to encourage more clients to use the Primary Care Clinic?

D. GENERAL RFI INFORMATION AND HOW TO SUBMIT RESPONSES

1. Questions Concerning the RFI.

There is an opportunity for individuals and entities to ask written questions about this RFI.

Questions must be submitted through the Bid Q&A section found on COMMBUYS. DMH will respond to questions as appropriate using the Bid’s Q&A section on COMMBUYS.

Locating Bid Q&A: Log into COMMBUYS, locate the Bid, acknowledge receipt of the Bid, and scroll down to the bottom of the Bid Header page. The “Bid Q&A” button allows Bidders access to the Bid Q&A page.

Questions must be submitted on COMMBUYS by April 18, 2025, by 3:00 pm to be considered for a response. To reduce the number of redundant or duplicate questions, respondents are asked to review all questions previously submitted to determine whether their question has already been posted. It is estimated that DMH’s responses to questions will be posted on COMMBUYS by DMH on April 25, 2025.

Those submitting questions are responsible for entering content suitable for public viewing, since all the questions are accessible to the public Information that is personal, security sensitive, inflammatory, incorrect, collusory, or otherwise objectionable, should not be included in any question. DMH reserves the right to edit or delete any submitted questions that raise any of these issues or that are not in the best interest of the Commonwealth or this Bid.

2. Informational Sessions.

There will be no informational sessions associated with this RFI.

3. Responses Due Date and Submission Format. Responses to this RFI are due no later than May 9, 2025, by 3:00 pm. A response must be submitted though COMMBUYS and be in the http://www.commbuys.com/bso

RFI Department of Mental Health (DMH) Massachusetts Mental Health Center (MMHC)’s co-located Primary Care Clinic April 2025 format submitted described in Section D.4. If there are questions about how to respond through COMMBUYS, they should be direct to the COMMBUYS Help Desk at COMMBUYS@state.ma.us or call during normal business hours (8AM – 5PM Monday – Friday) at 1-888-627-8283 or 617-720-3197.

Useful Links:

Job aid on how to submit a quote: http://www.mass.gov/anf/docs/osd/commbuys/create-a-quote.pdf Webcast: How to Locate and Respond to a Bid in CommBuys, will familiarize bidders with COMMBUYS terminology, basic navigation, and provide guidance for locating bid opportunities in COMMBUYS and submitting an online quote.

4. Response Instructions and Format. Individuals or Entities are invited to respond to any or all of the Requests for Information set forth in Section C of this RFI; please respond to as many as you feel appropriate. The response must be typed using 12 pt. font using 81/2 by 1 inch paper.

The response shall not exceed five pages. At the beginning of the response, please indicate:

Title of RFI: MMHC Primary Care Clinic RFI.

Name or individual or entity submitting the response.

Business affiliation (if any).

A contact name, mailing address, and email. (DMH may contact a respondent for clarification purposes.)

If responding to more than one Request for Information, the responses must be in chronological order (based on the order of the Requests for Information in the RFI) and for each response provided, the applicable request number and header must be inserted before the response (e.g., 1.

Service Model , 2. Third Party Billing.)

5. Costs Any cost incurred in responding to this RFI, or in support of activities associated with this RFI, are the sole responsibility of respondents. DMH shall not be held responsible for any costs incurred by respondents in preparing their respective responses to this RFI.

6. Review Rights Responses to this RFI may be reviewed and evaluated by any person(s) at the discretion of DMH, including independent consultants retained by Department now or in the future.

7. Public Record All responses to this RFI will be public record under the Commonwealth’s Public Records Law, Mass. Gen. L. c. 66, §10, regardless of confidentiality notices set forth on such writings to the contrary.

http://www.commbuys.com/bso mailto:COMMBUYS@state.ma.us?Subject=COMMBUYS%20Question http://www.mass.gov/anf/docs/osd/commbuys/create-a-quote.pdf http://www.mass.gov/anf/docs/osd/commbuys/create-a-quote.pdf http://www.mass.gov/anf/docs/osd/commbuys/create-a-quote.pdf https://www.youtube.com/watch?v=UhUTNokbhfY