RFA Restated and Amended Respite Master Agreement 1.7.06.20.docx

The Commonwealth of Massachusetts Executive Office of Health and Human Services Department of Mental Health

Document Title: Amended and Restated Respite Services - Master Agreement Request for Applications

COMMBUYS Bid#: BD-21-1022-DMH08-8220A-53630

DMH Document Number: RFA # 2017-DMH-3048-03

DATE: July 6, 2020

Contact Name: Jerome Collins, Assistant Director Contract Administration, Audit and Systems

Address: Department of Mental Health Central Office 25 Staniford Street Boston, Ma 02114

Email: Jerome.Collins@state.ma.us

TABLE OF CONTENTS

Application Requirements Application Cover Sheet Authorized Signatory Listing Authorization for Electronic Funds Payment DMH Business Associate Terms and Conditions Definitions DMH Privacy Notice DMH Notice of Privacy Practices Acknowledgement Form DMH Standard Contract Requirements EOHHS Siting Guidelines and Operational Procedures for Siting Group Living Environments EOHHS New Group Home Request Form Listing of DMH Area and Site Offices and Communities Served List of Permitted Application Attachments MA Form W-9 OSD Instructions for Filing a Quote on COMMBUYS OSD RFR- Required Specifications for POS Services Rate Regulation 101 CMR 431.00 RFA Evaluation Tool Worksheet Standard Contract Form Instructions, Contractor Certifications and Commonwealth Terms and Conditions Supplier Diversity Plan Form for POS

Department of Mental Health Amended and Restated Respite Services – Master Agreement Request For Applications

DMH # 2017-DMH-3048-03

July, 2020

SECTION 1 INTRODUCTION AND GENERAL DESCRIPTION

1.1 Issuing Entity/COMMBUYS

Issuing Entity: Department of Mental Health

RFA File Title: Amended and Restated Respite Services - Master Agreement Request for Applications

COMMBUYS Number: BD-21-1022-DMH08-8220A-53630

DMH RFA File Number: 2017-DMH-3048-03

Date: July 6, 2020

Contact Person: Jerome Collins Assistant Director of Contract Administration, Audit and Systems Address: Department of Mental Health 25 Staniford Street Boston, MA 02114 E-Mail Address: Jerome.Collins@Mass.gov

This Bid has been released on COMMBUYS. COMMBUYS is the official source of information for this Bid and is publicly accessible at no charge at COMMBUYS. For more information on COMMBUYS, see the OSD RFR - Required Specifications included in this Bid’s COMMBUYS File. In COMMBUYS, a “Bid” refers to the solicitation, Request for APPLICATIONS (RFA) or procurement. All Attachments to this RFA are included in the Bid’s COMMBUYS File.

Applicants may not alter (manually or electronically) the Bid language or any Bid component files, except as directed in the RFA. Modifications to the body of the Bid, specifications, terms and conditions, or which change the intent of this Bid are prohibited and may disqualify an APPLICATION.

Capitalized terms not otherwise defined herein shall have the meaning ascribed to them in the Definition document which is included in the bid’s COMMBUYS file.

A list of all attachments that were included when this RFA was amended and restated is set forth at the end of the Table of Contents. The attachments are incorporated into this RFA by this reference. Bidders are strongly encouraged to review all the attachments.

1.2 Description of Procurement

The Massachusetts Department of Mental Health (DMH), through this RFA, is seeking to:

(1) Establish a pool of qualified providers from which DMH Areas can purchase Site-Based Respite (also referred to as “Site Only”) and/or Mobile Respite Services (also referred to as “Mobile Only”) on an as needed basis. Providers will be paid per day when a person is enrolled with a provider for Site and / or Mobile Only Respite. (See Section 9).

(2) Establish a pool of qualified providers from which DMH Areas can purchase a defined amount of Mobile and Site-Based respite capacity (also referred to as “Blended Capacity” or Peer Respite capacity (“Peer Respite”) for an extended period of time to allow it to effectively manage an emergency or other unexpected situation that creates the need to have respite services readily available until such time as the emergency or situation is resolved. It is anticipated that Purchase Agreements for these services will be for 6 months or longer. Providers will be paid a monthly rate for this service based on the amount of Blended Capacity or Peer Respite that is purchased. (See Section 9).

The four different models of Respite Services being procured under this RFA (Site Only, Mobile Only, Blended Capacity and Peer Respite) are more fully described in Section 4.

DMH will enter into a Master Agreement (MA) with all qualified providers. If and when a DMH Area determines that it needs to purchase Respite Services from a Contractor with a MA, it will enter into a Purchase Agreement with the Contractor. The Purchase Agreement will specify the Respite Service model type being purchased (i.e., Site Only, Mobile Only, Blended Capacity or Peer Respite); the number of individual(s) to be served; the number of units being purchased; maximum number of units that can be billed under the Purchase Agreement; and the DMH Office responsible for oversight of the Purchase Agreement; etc.

An Applicant may elect to qualify to provide one or more of the four models of Respite Services. An Applicant must submit a separate application for each model of Respite Services it wants to provide. A provider of Site Only, Blended Capacity and Peer Respite will be qualified by site-based location(s), meaning that a provider is being qualified to provide site based Respite at specific locations selected by the provider and approved by DMH. A provider of Mobile Only Respite will be qualified by DMH Site Office, meaning a provider is being qualified to provide services only in those communites covered by specific DMH Site Offices selected by the provider and approved by DMH. It is preferred that a provider be able to to serve all communities served by the applicable DMH Site Office(s) for which an Applicant is seeking to be qualified to serve, but this is not a requirement. Included in this Bid’s COMMBUYS file is a list of DMH Site Offices and the communities they serve. See Section 11 for more information regarding the filing of Applications.

Respite Services provide temporary short-term, community-based clinical* and rehabilitative* services that enable an individual to live in the community as fully and independently as possible. Persons Served benefit from choosing enrollment in Respite Services which:

· Assist transition from an inpatient facility, including a state hospital, with the need for a transitional living situation and/or additional support services before returning to and/or entering a stable living situation;

· Provide interventions and support to remain clinically stable;

· Develop or create solutions to help individuals increase functionality in their current living environment. Through individualized Community Service Plans (CSPs) individuals or Personal Goal Statements (Peer Respite) are empowered to make informed treatment decisions and to develop goals to manage their wellness;

· Bridge services when an individual moves from one service to another, or from one situation to another, such as from homelessness to DMH Adult Community Clinical Services; and incorporates supportive strategies that will enhance the individual’s chances for success; and

· Provides further clinical assessments including, but not limited to, functional and/or risk assessments*.

*Note: Peer Respite Services are not clinical or rehabilitative in nature and the service components and specification for Peer Respite Service vary from the other three Respite models. The Peer Respite model is discussed in detail in Section 7. However, except as otherwise noted, the provisions of this RFA apply to all four service models.

Site Only, Blended Capacity and Peer Respite Services requires Contractors to provide temporary supportive services and short-term community based living arrangements in a distinct location, away from an individual’s current living situation (site-based Respite). Applicants submitting Applications for Site Only, Blended Capacity and Peer Respite must specify the physical location(s) where site-based Respite Services will be provided and the number of beds it has available at such location(s) for purpose of the MA. To qualify for Blended Capacity and Peer Respite a provider must propose the number of beds specified in Subsection 4.1. For Site Only at least one bed must be proposed for use for the MA; otherwise there are no limits on the number of bed that can be provided for this Service Model. Mobile Only and Blended Capacity are required to provide temporary supportive services to individuals in the individuals’ current locations. Applicants submitting Applications for Mobile Only must specify the DMH Site Office(s) they are willing and able to provide Mobile Respite Services and the number of individuals they will be able to serve at one time under a Purchase Agreement with DMH. Applicants for Blended Capacity must be able to provide Mobile Respite Services to the number of individuals specified in Subsection 4.1.3, in the communities served by the DMH Area where their site-based Respite service is located. If resources are available, Peer Respite is required to provide outreach services in the DMH Area where the site-based Respite services are located. See Subsection 4.1.4 for more information.

DMH makes no guarantee that any Respite Services will be purchased from a provider as a result of the provider entering into a MA. Again, if it is necessary to purchase Respite Services from a provider with a MA, the applicable DMH Area will enter into Purchase Agreement with the provider. A provider may have more than one Puchase Agreement with a DMH Area and/or with one or more DMH Area.

Service Class Information:

1.3 Respite Services Principles

All providers of Respite Services must fully integrate the following principles into their service delivery structure:

· An understanding that growth and recovery is possible for each Person Served.

· An understanding that reasonable risks are necessary for growth and those reasonable risks can be mitigated by providing supports.

· The opportunity for peer to peer support is readily available and utilized to offer opportunities to discuss shared experiences.

· Collaborative working relationships with current DMH and other mental health providers, other relevant community organizations, and natural supports are established and maintained to help facilitate Persons Served to lead full lives in the community with the support networks of their choosing.

Services must be:

· Strength Based and Person Centered. Services are based on the choices, strengths and vision of recovery of the individual receiving services.

· Trauma Informed. This includes an understanding of an individual’s symptoms in the context of the individual’s life experiences, current experiences and environment, history, social identity, and culture. All staff understand the impact of trauma and deliver services in a manner that is supportive and avoids re-traumatization.

· Culturally and Linguistically Competent. This includes being sensitive and responsive to cultural, ethnic, linguistic, sexual orientation, gender identity, parental status, and other individual needs of the Persons Served; age and developmentally appropriate, including services for transitional age youth and elders.

· Accessible. The Services provided must be fully accessible regardless of physical disability, auditory or visual impairment.

1.4 Service Goals

Respite Services provide interventions that are intended to:

· Be temporary and time limited.

· Assess service needs and facilitate transition to community based services.

· Enable a Person Served to remain in or transition back to a stable living situation.

· Divert or transition a Person Served from acute or continuing care hospitalization.

1.5 Procurement Information

1.5.1 Applicable Procurement Law. This Bid is issued under the following law(s): MGL c. 29, § 29B, st.1993 c.110, S.274 as amended; MGL c. 7, § 22; 801 CMR 21.00; 808 CMR 1.00; Federal Single Audit Act, OMB A-133; the American Reinvestment and Recovery Act of 2009 (ARRA).

1.5.2 Single or Multiple Contractors.

____ Single Contractor __X__ Multiple Contractors

1.5.3 Eligible Entities.

1.5.4 Acquisition Method. The acquisition method to acquire services from this Bid is fee for service, based on prescribed Unit Rates (described in more detail in Section 9).

The Unit Rates covers all services required to be delivered by Contractors. MAs will not have a Maximum Obligation Amount; however, Purchase Agreements will specify the maximum number of units that can be bill DMH under them.

Federal funds _X__ MAY be used to fund part/all of the Purchase Agreements Federal funds __ WILL NOT be used to fund part/all of the Purchase Agreements

1.5.5 MA Duration. The duration of an MA awarded as a result of this RFA may potentially be for 9 years and 9 months. The duration will depend on when a particular MA is awarded. The duration of a MA issued under this RFA will be from its Effective Date (as defined in Subsection 11.4) up to the termination date of the RFA, June 30, 2027. The duration of any Purchase Agreement entered into by DMH to purchase services from a provider with a MA will be negotiated at the time of execution; provided, however, that the duration of a Purchase Agreement cannot extend beyond June 30, 2027, the termination date of the RFA.

All MAs and Purchase Agreements made as a result of this RFA are subject to appropriations and the performance of the Contractor on an on-going basis.

1.5.6 Ownership of Submitted Applications. All materials submitted by Applicants become the property of the Commonwealth of Massachusetts and will not be returned to the Applicants. DMH shall be under no obligation to return any Applications or materials submitted by an Applicant in response to this Bid. The Commonwealth reserves the right to use any ideas, concepts, or configurations that are presented in an Application, whether or not the Application is deemed qualified for the MA.

Applications stored on COMMBUYS in the encrypted lock-box are the file of record. Applicants retain access to a read-only copy of this submission via COMMBUYS, as long as their account is active. Applicants may also retain a traditional paper copy or electronic copy on a separate computer or network drive or separate media as a backup.

1.5.7 Prohibitions. Applicants are prohibited from communicating directly with any employee of DMH regarding this RFA, except as specified in this RFA; and no other individual Commonwealth employee or representative is authorized to provide any information or respond to any question or inquiry concerning this RFA. Applicants may contact the contact person using the contact information provided in the Header Information of this RFA in the event that this RFA is incomplete or information is missing. (See Subsection 1.1 for DMH contact information). Applicants experiencing technical problems accessing information or attachments stored on COMMBUYS should email the COMMBUYS Helpdesk at COMMBUYS@state.ma.us or call during normal business hours (8AM – 5PM Monday – Friday) at 1-888-627-8283 or 617-720-3197.

In addition to the certifications found in the Commonwealth’s Standard Contract Form, by submitting an Application, the Applicant certifies that the Application has been arrived at independently and has been submitted without any communication, collaboration, or without any agreement, understanding or planned common course of action with, any other Applicant of the services described in the RFA.

SECTION 2 ESTIMATED PROCUREMENT TIMETABLE

2.1 Procurement Calendar

Restated and Amended July 6, 2020

Questions may be submitted up to December 31, 2026, 4 p.m.

Times are Eastern Standard/Daylight Savings (US), as displayed on the COMMBUYS system clock displayed to Applicants after logging in. If there is a conflict between the dates in this Procurement Calendar and dates in the Bid’s Header, the dates in the Bid’s Header on COMMBUYS shall prevail. Applicants are responsible for checking the Bid record, including Bid Q&A, on COMMBUYS for Procurement Calendar updates.

*Applications will be reviewed within ninety (90) days of receipt (or sooner). Provider names will be added to the Master Agreement List posted on COMMBUYS as MAs are executed. Purchase Agreements will be negotiated and executed as needed.

2.2 Written Questions Via the Bid Q&A on COMMBUYS

The “Bid Q&A” provides the opportunity for Applicants to ask written questions and receive written answers from DMH regarding this Bid. All Applicants’ questions must be submitted through the Bid Q&A found on COMMBUYS (see below for instructions). Questions may be asked as specified in Subsection 2.1. DMH reserves the right not to respond to any questions asked. It is the Applicant’s responsibility to verify receipt of questions.

Please note that any questions submitted to DMH using any other medium (including those that are sent by mail, fax, email or voicemail) will not be answered. To reduce the number of redundant or duplicate questions, Applicants are asked to review all questions previously submitted to determine whether the Applicant’s question has already been posted.

Applicants are responsible for entering content suitable for public viewing, since all of the questions are accessible to the public. Applicants must not include any information that could be considered personal, security sensitive, inflammatory, incorrect, collusory, or otherwise objectionable, including information about the Applicant’s company or other companies. 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.

All answers are final when posted. Any subsequent revisions to previously provided answers will be dated.

It is the responsibility of the prospective Applicant/Contractor to maintain an active registration in COMMBUYS and to keep current the email address of the prospective Applicant’s contact person and prospective contract manager, if awarded a MA, and to monitor that email inbox for communications from the DMH, including requests for clarification. DMH and the Commonwealth assume no responsibility if a prospective Applicant/Contractor’s designated email address is not current, or if technical problems, including those with the prospective Applicant/Contractor’s computer, network or internet service provider (ISP) cause email communications sent to/from the prospective Applicant/Contractor and DMH to be lost or rejected by any means including email or spam filtering.

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 Applicants access to the Bid Q&A page.

Note: Generally any other communications with DMH about the Bid are prohibited. See OSD RFR - Required Specifications, “Applicant Communications,” for more information. The OSD Required Specifications are included in the COMMBUYS file for this Bid.

2.3 Physical Applicants’ Conference (in person)

There will be no Applicants’ Conference for purposes of the Amended and Restated Request for Application.

2.4 Bid Amendments, Withdrawal, Cancellation

DMH reserves the right to make amendments to the RFA after initial publication. It is each Applicant’s responsibility to check COMMBUYS for any amendments, addenda or modifications to this Bid, and any Bid Q&A records related to this RFA. DMH and the Commonwealth accepts no responsibility and will provide no accommodation to Applicants who submit an Application based on an out-of-date Bid or on information received from a source other than COMMBUYS.

This RFA does not commit DMH to enter into a Master Agreement or to pay any costs incurred in the preparation of an Application. DMH reserves the right to accept or reject any and all Applications received as a result of this RFA, to negotiate with any or all qualified Applicants and to cancel in part or in its entirety the RFA if it is in the best interest of DMH to do so.

SECTION 3 DMH MISSION STATEMENT

Contractors will be responsible for ensuring that the mission and values of DMH, the Respite Services Standards, and when applicable DMH policies, directives, procedures, and initiatives, are integrated and adhered to in all contract activities and by all staff members. DMH’s vision and mission statements are as follows:

Vision

Mental health is an essential part of health care. The Massachusetts Department of Mental Health, as the State Mental Health Authority, promotes mental health through early intervention, treatment, education, policy, and regulation so that all residents of the Commonwealth may live full and productive lives.

Mission Statement

The Department of Mental Health, as the State Mental Health Authority, assures and provides access to services and supports to meet the mental health needs of individuals of all ages, enabling them to live, work, and participate in their communities. The Department establishes standards to ensure effective and culturally competent care to promote Recovery. The DMH sets policy, promotes self-determination, protects human rights, and supports mental health training and research. This critical mission is accomplished by working in partnership with other state agencies, individuals, families, providers, and communities.

SECTION 4 RESPITE SERVICES DESCRIPTION

Respite Services are intended to be a short term Service. The goal of these Services is to assist Persons Served to remain in or transition back to community settings, including permanent or other stable living situations, and community based mental health services. Also, Respite Services provide supportive interventions to help facilitate a Person’s Served successful transition to a new service or living situation.

Respite is a closed referral Service with the exception of Peer Respite. A closed referral Service means only individuals referred by DMH may be enrolled into the Service. Individuals who are referred will often times be in locations such as hospital emergency departments and acute inpatient services. In these instances the rapid response that is required of Respite Services is vital to engage the Person Served to address immediate needs and to divert him/her from more intensive, longer term services. See Section 7 for who may enroll in Peer Respite Services.

Respite Services, other than Peer Respite, may also be used to conduct clinical and/or functional assessments to inform DMH of the Person’s Served service needs pending a final DMH Service Authorization decision. Additionally, Applicants should note that referrals from DMH may include individuals who face open criminal charges, CORI issues and have SORI requirements, and require court-ordered evaluation, but who have been deemed by the court suitable for release to the community while undergoing a criminal court process. The need for the court-ordered evaluation will not be the reason why a Person Served is referred to Respite Services, and the forensic evaluation will not be done by the Respite Services Contractor.

Respite Services are not intended to be used as a substitute for the intensive level of evaluation, observation and treatment furnished by an acute crisis stabilization service when that level of service is clinically indicated.

Respite Services are delivered by four different service models as outlined below. Respite Services may be provided in the two settings. Only the Blended Capacity provides services in both settings. Although, Peer Respite does provide some outreach work in the community. The two settings are as follows:

1. Site-Based: Respite Services are provided to individuals in a short-term, community based living arrangement in a distinct physical site provided by the Respite provider and approved by DMH. The site is away from an individual’s current living situation.

2. Mobile: Respite Services are provided to individuals who are in their current living situation (e.g., own apartment, group living environment, with family) or are in transition from other settings (e.g. hospital, shelter).

All Respite Services components and specifications must be delivered by a provider regardless of the setting.

4.1 Respite Service Models

4.1.1 Site Only. Respite Services are provided to individuals in a short-term, community based living arrangement in a distinct physical site, away from an individual’s current living situation. Services are site-based only. Contractors must have a physical site that accommodates one or more individuals. The physical site must meet the specification set forth in Subsection 6.11. An Applicant must specify the specific location(s) of its physical site(s) and the capacity of such site(s) for providing site-based Respite Services under a Purchase Agreement. A MA for Site Only Respite Services will be awarded to a Contractor specifying the physical site(s) where the Contractor has been determined qualified to provide services.

4.1.2 Mobile Only. Respite Services are provided to individuals who are in their current living situation (e.g., own apartment, group living environment, with family) or are in transition from other settings (e.g. hospital, shelter). An Applicant must specify the DMH Site Office(s) where it wants and is able to provide Mobile Respite Services and the capacity for providing such services at any one time. A MA for Mobile Only Respite Services will be awarded to a Contractor specifying the DMH Site Office(s) to which the Contractor has been determined qualified to provide Mobile Respite Services.

4.1.3 Blended Capacity. Contractors provide both site-based and mobile Respite service. Persons Served may be enrolled in one or both settings during their tenure in Respite Services. However, at no time will a Person Served be enrolled in both site-based and mobile simultaneously. Contractors must have a physical site to accommodate a set number of individuals and the ability to provide mobile Respite at any time for a set number of individuals. The number of individuals it needs to accommodate in both settings depends on what rate a Contractor is determined qualified to provide and what is agreed to in the MA.

There are two rate models applicable to Blended Capacity:

· Model A is for a total capacity of 13 individuals of which 4-6 must be served in site-based and the remainder (7-9) in mobile;

· Model B is for a total capacity of 20 individuals of which 7-9 must be served in site-based and the remainder (13-11) mobile.

See Section 9 - for more information on the Rate Models.

An Applicant must specify the rate model it intends to use; the specific location(s) of its physical site(s) and the capacity of such site(s). The capacity must be within the range set for site-based in the applicable rate model. The Applicant must also have the capacity to provide mobile Respite Services to the remaining population specified in the applicable rate model. The mobile Respite services are to be provided in the towns and communities served by the DMH Area responsible for the town(s) where the physical site(s) is located. A MA for Blended Capacity will specify the applicable rate model; the site-based and Mobile capacities and the location of the physical sites.

4.1.4 Peer Respite. Peer Respite must include a physical site at which individuals in emotional distress and/or emergent crisis can stay overnight for up to seven (7) nights (program site). This program site must offer a homelike environment with 3-5 beds and be operated as a Peer-Run program consistent with Section 7. If resources are available, the Contractor may also provide Peer support through other means such as mobile outreach, telephone, text, or other personal interactions outside the Peer Respite Program’s physical site.

The Intentional Peer Support (IPS) Model or a similar model must be adopted by the Contractor to guide service delivery. See Subsection 7.2 for more information on the IPS Model.

All direct care staff must be Certified Peer Specialists and trained in the service model used by the Contractor. Individuals staying at the Peer Respite program site may come and go to work, school, or to participate in other activities.

An Applicant must specify the specific location(s) of its physical site and the capacity of such site must be within the above stated range for Peer Respite. A MA for Peer Respite will be awarded to a Contractor specifying the physical site where the Contractor has been determined qualified to provide services.

4.1.5 Additional Site-Based or Mobile Capacity After Initial Qualification. If a Contractor with a MA wants to qualify for an additional Service Model, it must submit an entirely new application for that Model. If a Contractor wants to add a Physical Site to its Site Only, Blended Capacity or Peer Respite Contracts or increase capacity at its existing sites, or if it wants to add a new DMH Site Office(s) to its Mobile Only Contract or increase capacity to its existing Mobile Only Contract, it must file a new Application, that updates the material from its last application for such service model and which specifically addresses the new Physical Site(s) or DMH Site Office(s) and/or capacity it wants to add to its MA.

4.1.6 Special Attributes of Peer Respite. Although the goals for Respite Services are essentially the same for all four service models, the way services are provided in the Peer Respite Service Model differ from the other three models. For this reason the service components and specifications for Peer Respite Services are set forth separately in Section 7. Sections 5 and 6 apply only to Site Only; Mobile Only and Blended Capacity Respite Service Models.

SECTION 5 RESPITE SERVICES COMPONENTS FOR SITE ONLY; MOBILE ONLY AND BLENDED CAPACITY

This Section sets forth the service components for Site Only; Mobile Only and Blended Capacity Service Models. When Contractors are providing services pursuant to a Purchase Agreement, the Contractors must provide the Service Components included by this Section 5 in accordance with the terms of the MA, the applicable Purchase Agreements and the needs of the Persons Served. In doing so, the Specifications and Standard set forth in Section 6 also must be met. For Blended Capacity the components apply to both site-based and mobile Respite.

5.1 Consultations and Assessments

For each person referred to a Contractor, the Contractor must conduct and document consultation(s) and assessment(s) that may be required as a result of the reason(s) for the referral including, but not limited to, clinical, medication, functional skills, and/or risk. The consultation(s) and assessment(s) must be completed by staff appropriately trained to conduct such consultation(s) and assessment(s). The consultation(s) and assessment(s) will be used to inform DMH of the service needs of the individual referred, to assist in referral and transition to community based services.

5.2 Crisis Management

Contractors must have and implement written plans for 24 hours/day 7 days/per week support in the event of a psychiatric crisis. The Contractors must have the staff capacity to provide crisis intervention and stabilization support to meet the needs of a Person(s) Served. This shall include the availability of both face-to-face and telephone contact. When clinically appropriate, intervention and stabilization support should be provided prior to referral to a separate crisis stabilization or psychiatric emergency service.

5.3 Symptom Management

As to the Persons Served, Contractors must address their problems associated with their mental health conditions; assist them with symptom self-management skills in order to maximize recovery and reduce the risk of relapse.

In addition, Contractors must encourage each Person Served to use evidence based and best practice Recovery tools and techniques as well as self-management strategies. This is to be done by:

· Providing the Person Served with information and options about Recovery tools and techniques and self-management strategies.

· Providing the Person Served with support by staff, including peer staff and, when desired, assistance in developing a recovery plan.

· Incorporating Persons’ Served self-management plans and tools into his or her crisis plans.

· Incorporating family members, friends and other individuals as chosen by the Person Served, in the development of self-management plan(s) and the Recovery process.

5.4 Medication Education and Self-Management

Respite Services provide the necessary support and training for Persons Served to self-administer and monitor their own medication whenever possible. Persons Served are supported in developing self-advocacy and decision making skills regarding their medications. Contractors as part of the Assessment process (see Subsection 6.5) must complete and document the evaluation of the ability of Persons Served to self-administer medications. For Persons Served unable to self-administer medications, medication administration must be consistent with the regulations and policies of DMH and the Department of Public Health that currently allow only staff certified under the Medication Administration Program (MAP), or staff who are appropriately licensed to administer medication. See Subsection 6.12.

5.5 Substance Use Services

Contractors must provide and/or coordinate with community based clinical, self-help and peer, medication assisted treatment, and psycho-educational services that address substance use treatment and related issues such as HIV/AIDS/Hep C and relapse prevention that reflects the need(s) of a Person Served as identified in the assessment(s) (see Subsection 5.1 and 6.5) and the Person Served Community Service Plan (CSP) (see Subsection 6.6). These services may be provided through individual and group interventions, as well as medication assisted treatment as needed. Contractors must also maintain relationships with the full continuum of substance use treatment services.

5.6 Coordination and Communication with Healthcare System

Contractors must know when Persons Served are enrolled in healthcare coordination resources (e.g., Behavioral Health Community Partner, Accountable Care Organization, One Care) and must collaborate, to the extent authorized, with the resources to assure full access to identified treatment services. If Persons Served are not enrolled in healthcare coordination resources, Contractors must evaluate the individuals’ eligibility for third party resources for healthcare coordination and with authorization provide linkage as needed.

Until linkage is made with the healthcare coordination resource, Contractors must seek to obtain authorizations to communicate (and communicate) with individuals’ healthcare providers including psychiatric and general medical hospitals prior to discharge as part of the enrollment into Respite Services and other treatment providers as applicable.

5.7 Support Services

Contractors must provide Support Services as are appropriate to ensure individuals to whom they are providing Respite Services have the following, as needed:

· Medical and dental services.

· Safe, affordable housing.

· Health insurance and other entitlements and benefits.

· Psychiatric and other community mental health services.

· Community resources such as self-help, home care.

· Legal advocacy and representation.

· Transportation.

5.8 Skill Building Activities

Contractors must address the activities of daily living and community living skills needs of each Person Served as reflected in his or her assessment and CSP (see Subsections 6.5 and 6.6).

5.9 Peer Support Services

Contractors must provide peer counselling and support through Certified Peer Specialist staff. In addition, Contractors must make linkages to consumer self-help programs and advocacy organizations that promote Recovery (e.g., Recovery Learning Communities). The goal is to help Persons Served to actively participate in their own Recovery and develop strategies to combat stigma and discrimination associated with mental illness.

5.10 Community Inclusion and Social Connection

Contractors must assess each Person’s Served current social network to identify opportunities to strengthen access and utilization of natural supports. The goal is to expand and maintain positive social networks, reduce social isolation and promote community integration. Contractors must ensure each Person Served has reasonable access to family and/or other significant individuals of his or her choice to support meaningful connections and to encourage his or her participation in all stages of Respite Services.

SECTION 6 RESPITE SERVICES SPECIFICATIONS AND STANDARDS FOR SITE ONLY; MOBILE ONLY AND BLENDED CAPACITY

This Section sets forth the service specifications and standards for Site Only, Mobile Only, and Blended Capacity Respite Service Models.

6.1 Delivery of Services

These Respite Services Models utilize a multi- disciplinary team to deliver Services. Respite Services they provide must be flexible to meet the needs of the Persons Served.

In Blended Capacity Only, a single multi- disciplinary team must be utilized to deliver Services in both site-based and mobile settings. All team members are expected to perform Respite Services activities regardless of the setting. For Persons Served who are in need of short term community-based living arrangements, Respite Services will be provided in a site-based setting. For Persons Served who choose to remain in their current living situation or are in transition from one setting to another Respite Services will be provided in a mobile-setting.

Respite Services must be flexible and portable, in that staff must have the ability to deliver Respite Services in a variety of settings, and to meet with individuals in different settings including, but not limited to, acute and continuing care inpatient hospitals, shelters, and skilled nursing facilities.

Contractors must have a service delivery structure that meets the cultural and linguistic needs of Persons Served. Services are to be available and provided either directly or on call 7 days a week, 24 hours a day (see Subsection 6.12.1).

6.2 Enrollment Criteria for Respite Services

To be eligible for enrollment in these Respite Services an individual must be 18 years of age or older and have been authorized for Respite Services through the DMH Service Authorization process. For the purposes of this RFA, a Person Served may also be an individual who has not yet been authorized for DMH Services but has been authorized to receive Respite Services by the Area Director/Designee for the purposes of assisting DMH in determining a service authorization request by gathering information and assessing service needs.

6.3 Referral to Respite Services

These Respite Services will operate on a closed referral basis with all referrals generating from the applicable DMH Area and/or Site Office. All individuals referred will be authorized for Respite Services in accordance with Subsection 6.2. A Referral to a Blended Capacity Contractor will indicate if the referral is initially for Mobile or Site Based. If there is no capacity available in a site-based setting, DMH may refer the individual for Respite Services in a mobile setting until such time a bed becomes available in the site-based setting.

A Contractor must accept all referrals as agreed to in the applicable Purchase Agreement it holds with a DMH Area.

Referrals will be made using the standardized DMH Respite Referral Form and/or through the Purchase Agreement itself. Upon referral, a Contractor must review the Respite Referral Form and attachments or the Purchase Agreement and rapidly respond to enroll the individual or as soon as possible.

DMH reserves the right to modify the Referral Form in whole or in part and to modify the method by which it is sent to a Contractor.

6.4 Enrollment in Respite Services

6.4.1 Respite Services in a Site-Based Setting. Upon receiving a referral, a Contractor must rapidly respond by obtaining written consent from the individual to participate in Respite Services and make arrangements for the individual to take occupancy of the available bed on the same day the referral is received. Within twenty four (24) hours of an individual taking occupancy of the available bed, the Contractor shall notify the applicable DMH Area Office that the individual has agreed to participate in the service and the date he or she first occupied the bed. An individual shall be considered “enrolled” in site-based Respite as of the date he or she first occupied the bed and he/she shall remain enrolled until and including the day he/she is disenrolled pursuant to Subsection 6.9.

6.4.2 Respite Services in a Mobile Setting. Upon receiving a referral, a Contractor must rapidly respond by making contact with the referred individual within twenty four (24) hours of receipt of the referral, obtaining written consent from the individual to participate in Respite Services and begin providing services to the individual within the next twenty-four (24) hours. Within twenty four hours (24) of the Contractor starting to provide services to the individual, the Contractor shall notify the applicable DMH Area Office that the individual has agreed to participate in the service and the date he or she first received services from the Contractor. An individual shall be considered “enrolled” in Mobile Respite as of the day he or she first started receiving services from the Contractor and he/she shall remain enrolled until and including the day he/she is disenrolled pursuant to Subsection 6.9.

6.4.3 Time limit For Making an Enrollment. If a Contractor is unable to Enroll an individual within forty-eight (48) hours from the date of the referral, the Contractor must notify the applicable DMH Area or Site Office so next steps can be determined. A Contractor must document all attempts to contact the Individual and the reason(s) why contact attempts failed.

6.4.4 30 Day Enrollment Limit and Waiver. The enrollment of a Person Served in Respite Services cannot exceed 30 days unless the Area Director, or designee, approves of such in writing. An approval may only be for a period of up to an additional 30 days; provided, however, that multiple approvals for additional days may be given. If an extension is approved, the CSP of the Person Served must be reviewed and modified as appropriate (see Subsection 6.6).

6.4.5 Orientation. Upon enrollment into Respite Services, Persons Served are provided with an orientation to Respite Services. If a Contractor determines the Person Served cannot participate in the orientation, the Contractor must document in the record of the Person Served its good faith efforts to provide such orientation and the reasons why the orientation was not provided (e.g., the individual refused, individual experiencing symptoms of mental illness) and the plan to provide the orientation at a later date. The written information, in the Person’s Served and LAR’s primary language, if feasible, is presented to and reviewed with the Person Served and LAR, if applicable. If the written information cannot be provided in the primary language of the Person Served or LAR, an interpreter must be used.

The written information must include:

· Description of Respite Services, including expected length of stay and expectations for involvement in active partnership in discharge planning,

· Hours of operation,

In addition for Blended Capacity, the Contractor must provide the Person Serviced with the name and responsibilities of the Services’ Human Rights Officer and the Officer’s contact information.

6.5 Assessment

Within 24 hours of enrollment, a Contractor must complete an assessment. The assessment must be completed by and/or reviewed and signed by a Respite Services clinical staff person and must include an assessment of the following areas as applicable based on the reason for referral:

· Immediate critical needs which impact the health and safety of the Person Served

· Mental status

· Risk factors

· Medical and psychiatric needs, symptom management

· Substance use/abuse

· Ability to self-administer medication

· Housing and benefits

· Need for financial and/or legal assistance

· Community resources available

· Family Involvement

· Discharge barriers

· Personal strengths and resources

· Cultural and ethnic needs

· Eligibility for third party resource(s) (e.g. Behavioral Health Community Partner, One Care, Accountable Care Organization)

· Need for language/communication assistance

The findings of the assessments are to be used when developing Persons Served CSPs and shall be updated and modified as the needs and circumstances of the Persons Served change or additional information becomes available.

6.6 Community Service Plan (CSP)

A Contractor in partnership with the Person Served and the LAR of the Person Served, if any, must complete and document a CSP within 72 hours following the completion of the assessment.