RFI27007012 RFI Scope of Work.pdf

RFI - REQUEST FOR INFORMATION

TITLE: RFI27007012 Single Point of Access (SPoA) for Children's Behavioral Health

SECTION A. INTRODUCTION

The Rhode Island Department of Administration/Division of Purchases, on behalf of the

Department of Children, Youth and Families (the Department), is soliciting informational responses from qualified vendors and other interested parties to respond to the Department's intent to procure a statewide Single Point of Access (SPoA) for children's behavioral health. The SPoA is intended to serve as a consistent, statewide pathway through which children, youth and families are screened, comprehensively assessed, referred, and connected to the behavioral health services they need, and through which they are followed until that connection is made. The goal of the

Department is to support the needs of children, youth and families, in accordance with the terms of this Request for Information (RFI) and the State's General Conditions of Purchase, which may be obtained at the Rhode Island Division of Purchases website at www.purchasing.ri.gov.

Instructions and Notifications to Offerors:

1. Potential vendors are advised to review all sections of this RFI carefully and to follow instructions completely.

2. The State invites comments, suggestions and recommendations from potential vendors and other interested parties on any questions or issues raised in this RFI. Please note it is not a requirement to answer all questions.

3. Alternative approaches and/or methodologies to accomplish the desired or intended results of this RFI are solicited.

4. This is an RFI, and as such no award will be made as a result of this solicitation.

5. All costs associated with submitting responses to this RFI or with providing clarification of the content of a response shall be borne by vendors. The State assumes no responsibility for any costs.

SECTION B: REQUEST FOR INFORMATION

This RFI outlines the type of information being solicited and response structure requested from potential respondents.

A. Background

About the Department http://www.purchasing.ri.gov/

The Rhode Island Department of Children, Youth and Families is a unified state agency with combined responsibility for child welfare, children's behavioral health, and juvenile corrections.

The Department is statutorily designated (Rhode Island General Laws (RIGL) 42-72-5) as the

"principal agency of the state to mobilize the human, physical, and financial resources available to plan, develop, and evaluate a comprehensive and integrated statewide program of services designed to ensure the opportunity for children to reach their full potential." Such services shall include prevention, early intervention, outreach, placement, care and treatment and aftercare programs. The Department's mission is to partner with families and communities to raise safe and healthy children and youth in a caring environment and to engage respectfully and effectively with people of all races, ethnicities, cultures, classes, genders, sexual orientations, and faiths in a manner that recognizes, affirms, and values the worth of all individuals, families, tribes, and communities, and protects and preserves the dignity of each.

Why the Department is Considering a Single Point of Access

Today, a family's path into services depends heavily on how and where they happen to come into contact with the children’s behavioral health system. Entry points include schools, community-based providers, pediatric and primary care practices, health insurance, Kids' Link, 988, Mobile

Response and Stabilization Services (MRSS), hospital emergency departments and inpatient units, Certified Community Behavioral Health Clinics (CCBHCs), Family Care Community

Partnerships (FCCPs), the Family Court and juvenile justice system, and calls to statewide child abuse hotline or the Department’s Support and Response Unit (SRU). Each of these entry points uses its own screening practices, its own referral routines, and its own understanding of what is available. As a result, children may receive very different responses and connections to care, assessments may be duplicated or inconsistent across settings, and families may be frequently left to navigate on their own after a referral is made.

The Department is considering the procurement of a Statewide Single Point of Access to address these gaps. The SPoA is envisioned as a consistent front door with a consistent clinical decision-making process, working alongside and in partnership with existing entry points rather than replacing them.

The anticipated, upcoming RFP aims to:

• Establish one consistent way for children, youth, and families to access behavioral health services, regardless of where they first ask for help;

• Support access to a standardized, timely comprehensive clinical assessment that is available statewide and conducted by independent clinicians, replacing inconsistent and duplicative assessment practices across settings;

• Ensure that a referral results in a connection, by requiring the SPoA to remain engaged with the family until the child or youth is receiving the recommended service;

• Improve the timeliness of access, particularly for children and youth with urgent needs, and reduce reliance on emergency departments and out-of-home care as default access points;

• Create a platform capable of serving as the primary promoted access point for Mobile

Response and Stabilization Services (MRSS) within the state;

• Provide the State with reliable, real-time visibility into demand, capacity, and unmet need across the children's behavioral health service array; and

• Implement in defined phases, so that the SPoA can launch, stabilize, and then expand without disruption to families.

Population Served

The Department intends for the SPoA to serve all children and youth in Rhode Island who have, or are at risk of having, a behavioral health need, together with their families and caregivers.

Access is not intended to be limited to children and youth who meet serious emotional disturbance criteria, who are involved with the Department, or who are eligible under a particular funding stream. The Department recognizes that a broad population definition carries implications for volume, triage design, staffing, and the breadth of the service array to which the SPoA must be able to refer and is seeking respondent input on how to operationalize that breadth responsibly.

Anticipated Core Functions of the SPoA

The Department anticipates that the SPoA will be responsible for the following core functions.

Respondents should assume that the exact scope, sequencing, and division of responsibility between the SPoA vendor and the State remain open, and are among the questions on which the

Department is seeking input:

• Statewide access and intake. A single, publicly promoted way for anyone to reach the

SPoA, including families and youth themselves, with the ability to receive referrals from anyone who calls, including providers, hospitals, schools, courts, State agencies, and community organizations.

• Screening and triage. A consistent process, using standardized and validated tools, to determine urgency, identify safety or crisis needs, and determine the appropriate next step.

• Comprehensive clinical assessment. Completion of a standardized comprehensive clinical assessment, statewide, using a common tool and a common process that is accessed and paid for through the SPoA vendor. Assessments, which are to be completed by qualified clinicians, will establish service needs and inform level-of-care recommendations. The

Department has determined that the comprehensive clinical assessments will be secured, when necessary, as a function within the SPoA rather than being distributed across referring or receiving providers, in order to establish a single, consistent, and objective statewide assessment process.

• Service matching and referral. Identification of the appropriate service or services

(including Intensive Care Coordination) based on assessed need, supported by current, accurate knowledge of the statewide service array and provider capacity.

• Warm handoffs and follow-through. Direct, family-inclusive handoffs to the receiving provider, and continued contact with the family until the child or youth is connected to the recommended service, including when that service is not immediately available.

• Documentation in a single system of record. Use of one system of record for all screening, assessment, referral, and follow-up activity, with the State retaining ownership of, and continuous access to, the data.

• Data, reporting, and system gap identification. Reporting on referral volume, sources, timeliness, dispositions, connection rates, unmet requests, and where families are unable to be served, so the State can see demand and capacity across the system.

• Family and youth engagement. Clear explanation of options and next steps to families and youth, meaningful family and youth choice, and culturally and linguistically responsive service delivery.

Phased Implementation

SPoA is new to Rhode Island, and the Department does not expect the SPoA to operate at full scope on the first day of the contract. The Department anticipates a phased implementation in which a defined initial scope is launched, stabilized, and then expanded over the life of the contract.

The Department expects that an initial phase will involve a defined subset of the functions described above, expanding in subsequent phases as capacity is established.

What the SPoA Is Not Expected to Be

• The SPoA is not the child protection hotline. Reports involving child safety or maltreatment concerns will continue to be handled through the Department's existing hotline, and the behavioral health access pathway will be kept clearly separate.

• The SPoA is not a gatekeeper; it is intended to function as an access point and facilitator.

The Department does not intend for the SPoA to create a barrier between a child and needed services.

• The SPoA is not intended to replace 988, Kids' Link, or other existing entry points.

Technology Platform

The Department is requesting input on whether the SPoA should operate within a State-owned platform, within a platform supplied by the selected vendor, or within some combination of the two guided by the following considerations:

• The State will own all data, records, and work product generated during SPoA operations, including all screening, assessment, referral, and follow-up documentation;

• The State will own any software, configuration, workflow, or reporting capability developed specifically for Rhode Island under the contract;

• The State will have continuous access to its data, in a usable and documented format, during the contract and after it ends; and

• A change of vendor at the end of a contract term will not require the State to rebuild its record, lose historical information, or interrupt service to children, youth, and families.

The Department is interested in how respondents would meet these expectations under each possible architecture, and in what contractual, licensing, and transition terms respondents would expect the State to include in the corresponding RFP.

Branding and Identity

The Department anticipates that the SPoA will operate under a neutral, State-owned name and identity that is not Department-branded and will be reached through a State-owned access telephone number and web presence that remain with the State across contract terms and vendors.

Continuity of the public-facing identity is a priority, so that families learn one way to get help and that way does not change when a contract changes.

Physical Presence in Rhode Island

The Department welcomes responses from national organizations as well as Rhode Island-based organizations. The Department anticipates that the selected vendor will be required to establish and maintain a physical presence in Rhode Island, with staff who know the Rhode Island service landscape and who can participate directly in community settings. The Department is seeking input on a reasonable timeline for establishing that presence and on what functions must be located in

Rhode Island as opposed to performed remotely or from a shared national operation.

Goals, Metrics and Measurable Outcomes

The Department is seeking input on what goals, metrics and measurable outcomes are essential for the State to monitor to ensure the SPoA meets the needs of children, youth and families. Responses may address, but need not be limited to, access, timeliness, connection to services, quality and fidelity of assessment, family and youth experience, and racial, ethnic, linguistic, and geographic disproportionality and disparity.

Please describe how the State can best develop these goals, metrics, and measurable outcomes so that all stakeholders, including families and youth, have a voice in their development.

Please describe how the State can assess fidelity to the SPoA model and evaluate the SPoA's impact on progress toward, and achievement of, these outcomes.

B. RFI Response

The following outline is intended to standardize and structure responses for ease of analysis.

Do NOT include a cost proposal with the RFI response as cost shall not be considered with this

RFI.

The Department recognizes the importance of stakeholder input and welcomes responses to the questions below as part of respondents’ RFI responses. Respondents may choose to reply to all or a subset of questions, based on interest and/or relevance.

Although these questions have been designed as a guide, respondents are encouraged to provide additional feedback that may be helpful. Any assumptions that respondents are making with respect to comments or recommendations should be included. It is hoped that clear, innovative, and concrete ideas will be provided. Please respond as succinctly as possible to communicate information and recommendations as requested below. Please refrain from including marketing materials or other content not directly responsive to the questions below.

Respondent Information and Capacity

1. Please describe the capacity in which you are responding to this RFI (for example, prospective vendor, current Rhode Island provider, family or youth advocate, national organization, technology vendor, or other interested party).

2. If applicable, please describe your organization's knowledge and experience operating a centralized access, intake, triage, assessment, or referral function for children's behavioral health, including the states or jurisdictions served, the population size, the duration of the engagement, and your role. Please also describe how that system was structured, what worked well, and what you would design differently if you were starting again.

Model Design and Phased Implementation

3. If/as applicable based on prior organizational experience and within the context of industry standards, what are the essential operational components of a SPoA that must be in place at launch, and which components can reasonably be added later without undermining credibility with families and providers?

4. Assuming a phased approach, what does industry and/or best practice recommend for the initial phase, and what are the specific milestones that should be met before the SPoA expands to a subsequent phase?

5. Based upon industry standards, what are the phases of implementation within the first three to 12 months for establishing an SPoA and what is the optimal sequencing for operational implementation and timeframe for each phase?

Access, Intake, and Family Engagement

6. What hours of operation are recommended at program launch, and what would be required to reach 24 hours per day, seven days per week, 365 days per year? What are the staffing and clinical coverage implications of each?

7. What access channels should be available (telephone, web form, chat, text, secure provider portal, in person), and in what order should they be implemented?

8. What is the minimum information necessary to initiate a referral, and how should the SPoA handle incomplete referrals so that families are not turned away or asked to start over?

9. How should consent be obtained and documented, including for youth who contact the SPoA directly, and how should consent travel with the referral?

10. What family and youth engagement requirements should the Department include in the RFP, and how should family and youth voice be built into SPoA operations, quality improvement, and governance? Please also describe how the SPoA should reach and serve families who are not connected to any provider or system.

Screening, Comprehensive Assessment, and Referral

11. What screening, triage, and comprehensive assessment tools does the industry recommend for statewide use, and why? Please identify tools that are validated for children and youth and appropriate for use across a wide age range and level of acuity, and describe the training, certification, supervision, and fidelity monitoring that would be required to use them.

12. How should the SPoA maintain current, accurate information on the statewide service array, including provider capacity, openings, waiting times, and specialty capabilities? What is required of providers, and what technology supports this?

13. What should a warm handoff consist of, operationally, and how should it be documented and verified? What should the SPoA do while a child or youth is waiting for the recommended service to become available, including how often it should contact the family and what interim supports it should arrange or provide?

Coordination with Existing Systems

14. What are best practices regarding SPoA coordination with existing entry points and system partners, including 988 and Kids' Link, schools, the Family Court and juvenile justice system, CCBHCs, Family Care Community Partnerships, primary care, and the Department itself, so that children and youth are routed appropriately without duplicating the roles of those partners?

15. What data-sharing agreements, memoranda of understanding, escalation pathways, and shared protocols are necessary to make these coordination relationships function, and who should be responsible for establishing them?

Technology, Data, and Reporting

16. The Department has not determined whether the SPoA will operate within a State-owned platform, within a platform supplied by the vendor, or within a combination of the two.

Which approach aligns best with industry standard and why?

17. What integration and interoperability capabilities are required for the Department to implement a successful SPoA, including a health information exchange, Medicaid systems, provider electronic health records, 988 platforms, and State agency systems?

18. How should referral status, assessment results, and service connection information be made visible to referring parties, receiving providers, and families, while protecting privacy?

Staffing, Workforce, and Rhode Island Presence

19. What staffing model is recommended or industry standard for a state of Rhode Island's size, including positions, licensure requirements, ratios, supervision structure, and coverage across hours?

20. What training and orientation would SPoA staff require, and how would you ensure consistency of practice across staff over time?

21. What language capacity and lived-experience representation, including family partners and youth peer support, should be built into the staffing model?

22. The Department anticipates requiring the vendor to establish and maintain a physical presence in Rhode Island as part of the corresponding RFP requirements. What would be an industry reasonable timeline for establishing that presence, and what would it consist of?

Goals, Metrics, and Measurable Outcomes

23. Please describe best practice and/or industry recommended goals, metrics, and measurable outcomes.

24. Please describe best practice and/or industry recommended processes for establishing goals, metrics, and outcomes so that all stakeholders, including families and youth, have a voice in their development.

Market Feedback and Procurement Design

25. Reiterating that cost information is not considered in the context of an RFI, what elements of the anticipated scope create the greatest cost, risk, or uncertainty from an implementation perspective?

26. What reimbursement or payment structure is recommended for this function, recognizing that cost proposals are not being solicited through this RFI?

27. Are there any additional considerations, models, cautions, or recommendations the

Department should be aware of that are not addressed in this RFI?