RFP DBH 25 165 SUDRS Perinatal Services FINAL~1.pdf

Request For Proposals for

Substance Use Disorder and Recovery Services Perinatal

Services

Joshua Dugas, Acting Director Department of Behavioral Health

San Bernardino County Department of Behavioral Health Contracts Administration 550 Hospitality Lane, 1st Floor San Bernardino, CA 92415-0026

RFP - DBH 25-165

ePro Bid ID # DBHE26-ADMN-6323

Request for Proposals San Bernardino County Department of Behavioral Health SUDRS Perinatal Services RFP DBH 25-165/ePro Bid # DBHE26-ADMN-6323 i

TABLE OF CONTENTS

I. INTRODUCTION

A. Purpose B. Period of Contract C. Proposal Conference D. Questions E. Correspondence F. Admonition to Proposers G. Proposal Submission Deadline H. Assistance to Proposers with a Disability

II. PROCUREMENT TIMELINE

III. PROCUREMENT CONDITIONS

A. Proposer B. Authorized Signatures C. Contingencies D. Term of Offer E. Required Review F. Right of Rejection G. Best Value Evaluation Process H. Amendments/Addendums to RFP I. Proposal Submission J. Local Preference Policy K. Incurred Costs L. Public Records Act M. Disclosure of Criminal and Civil Proceedings N. Debarment and Suspension O. Unsatisfactory Performance P. Clarification of Offers Q. Formal Agreement R. Independent Contractor Status S. Pre-Award On-Site Visits T. Level of Service U. Priority Population V. Iran Contracting Act of 2010 W. Executive Order N-6-22 – Russia Sanctions X. Final Authority

IV. PROGRAM REQUIREMENTS (SCOPE OF WORK)

A. Definitions B. Background C. Program Description

V. CONTRACT REQUIREMENTS

A. General B. Indemnification and Insurance Requirements C. Right to Monitor and Audit Performance and Records

VI. EQUAL EMPLOYMENT OPPORTUNITY/CIVIL RIGHTS

A. Equal Employment Opportunity Program B. Civil Rights Compliance C. Policy Prohibiting Discrimination, Harassment, and Retaliation ii

VII. EMPLOYMENT OF FORMER COUNTY OFFICIALS

VIII. IMPROPER CONSIDERATION

IX. DISCLOSURE OF CRIMINAL AND CIVIL PROCEEDINGS

X. SUBCONTRACTOR STATUS

XI. PROPOSAL SUBMISSION

A. General B. Proposal Presentation C. Proposal Format

XII. PROPOSAL EVALUATION AND SELECTION

A. Evaluation Process B. Evaluation Criteria C. Negotiations and Notice of Intent to Award D. Appeal and Award E. Final Authority

ATTACHMENTS:

A. Proposal Submission Checklist B. Table of Contents C. Statements of Certification D. Reportable Conditions E. Disclosures, Exceptions, and California Public Records Act Exemptions to RFP F. Subcontractor Information G. Financial Capability (Audited Financial Statements) H. Indemnification and Insurance Requirements Affidavit I. Budget Proposal J. Budget Cover Page K. References Form L. Licenses, Permits, and/or Certifications M. Local Preference Policy Form N. Provider Information Report O. Federal Contracting Provisions P. Recovered Materials Content For EPA-Designated Items Q. Unusual Occurrence/Incident Report” County Form QM053 (Reference Form Only)

I. INTRODUCTION

A. Purpose

The San Bernardino County (County) Department of Behavioral Health (DBH), is seeking proposals from interested and qualified organizations and agencies to provide a proposed plan for the provision of Substance Use Disorder and Recovery Services (SUDRS) Perinatal Services.

B. Period of Contract

Specific services to be provided under this RFP are outlined under Section IV. Program Requirements (Scope of Work). The Contract period will be for a five (5) year period beginning on January 1, 2027 through December 31, 2031.

The recommended SUDRS Perinatal Services providers will share an annual aggregate amount for all awards under this RFP which shall not exceed $10,000,000. The County may award contracts to one or more proposers and allocate funding at its sole discretion, subject to Board of Supervisors approval and funding availability.

Currently, the projected allocation for this (service) is approximately $2,000,000 annually or $10,000,000 for the five (5) year period.

C. Proposal Conference

1. A proposal conference will be held via Microsoft Teams on: Wednesday, July 8, 2026 @ 11:00 AM at:

https://teams.microsoft.com

Meeting ID: 252 098 134 359 437

Meeting password: zr6To7SF

Join by phone: +1 661-568-6806,,528702230# Phone conference ID: 528 702 230#

2. Attendance at the conference is strongly recommended as important information regarding this RFP will be discussed and questions will be addressed.

D. Questions

All Questions related to this RFP must be submitted in writing on or before 12 noon (local time) on July 15, 2026 and directed to the individual listed in Section I, Paragraph E, via ePro or through e-mail are acceptable. The subject line of the e-mail must read: RFP DBH 25-165.

Answers to written questions will be compiled into one (1) or more documents and posted as an Addendum on the following County website within two (2) weeks following the deadline to submit questions: https://epro.sbcounty.gov/bso.

E. Correspondence

All correspondence, including proposals and questions, are to be submitted through ePro or to the RFP contact:

https://teams.microsoft.com/ https://epro.sbcounty.gov/bso

San Bernardino County Department of Behavioral Health ATTN: Contracts Administration

RE: RFP DBH 25-165

550 Hospitality Lane, 1st Floor San Bernardino, CA 92415-0026 Contact Person: Nathaniel Rodriguez Phone: (909) 388-0861 E-mail: dbh-contractsanalysts@dbh.sbcounty.gov

E-mail address may be used to submit questions only. Proposals will not be accepted by e-mail.

F. Admonition to Proposers

Once the RFP has been issued, the individual identified above is the sole contact point for any inquiries or information relating to this RFP. Failure to adhere to this policy may result in disqualification of the Proposer and rejection of proposal.

G. Proposal Submission Deadline

1. All proposals or bids must be received no later than 4:00 P.M. local time on Wednesday, August 5, 2026. Late or incomplete proposals or bids will not be accepted.

2. An electronic proposal or bid can be submitted through ePro (https://epro.sbcounty.gov/bso). Submittals in ePro will be opened from the system’s “encrypted lock box” after the deadline and evaluated as stated in this solicitation. If the proposal or bid is submitted through ePro, the proposal or bid may also be withdrawn OR retrieved, adjusted, and re-submitted by the Vendor at any time prior to the scheduled deadline for submission of the proposal or bid. If the proposal or bid is submitted through ePro, the proposer/bidder acknowledges that its electronic signature is legally binding.

OR

3. Hard copies of the proposal or bid containing original signatures will also be accepted at the location identified in this solicitation in Paragraph E above. Postmarks will not be accepted in lieu of actual receipt. The proposal or bid can be withdrawn at any time prior to the scheduled deadline for submission of the proposal or bid.

4. Proposals must be received by the designated date and time. All Proposers must register with the ePro system prior to the date and time to receive the proposal or they will be disqualified. Late or incomplete proposals will not be accepted.

Electronic response must be submitted through San Bernardino County Electronic Procurement Network (ePro) https://epro.sbcounty.gov/bso. System-related issues in ePro shall be directed to the Purchasing Department at (909) 387-2060. For procurement questions involving ePro, please contact the RFP Contact identified in Section I, Paragraph E-Correspondence.

H. Assistance to Proposers with a Disability

Proposers with a disability may request accommodation regarding the means of communicating this RFP or participating in the procurement process. For more information, contact the RFP Contact no later than ten (10) days prior to the Deadline for Proposal.

II. PROCUREMENT TIMELINE

The above dates are subject to change as deemed necessary by San Bernardino County.

RFP Release Date Wednesday, June 24, 2026

Proposal Conference

Wednesday, July 8, 2026 @

11:00 AM

Deadline for Submission of Questions Wednesday, July 15, 2026 by 12 noon (local time)

**Questions may be submitted in writing prior to the Proposal Conference

Deadline for Submission of Proposals Wednesday, August 5, 2026, by 4:00 p.m. (local time)

Tentative Effective/Start Date for Contract(s)

January 1, 2027

*Although Proposal Conference is not mandatory, attendance is strongly recommended as important information regarding this RFP will be discussed and questions will be addressed.

III. PROCUREMENT CONDITIONS

A. All Proposers must:

1. Be a nonprofit corporation as required by the Substance Use Prevention and Treatment Recovery Services (SUBG) Block Grant guidelines. (See United States Code (USC), Title 42, Chapter 6A, subchapter XVII, Part B, subpart ii, Section 300x-31 (a) (1) (E) and Code of Federal Regulations (CFR) Title 45, Part 96, Section 135 (a) (5).).

2. Have a current Medi-Cal Certification or have the ability to become Medi-Cal Certified.

3. Have no record of unsatisfactory performance with any government agency or County Department including DBH. Proposers who are or have been seriously deficient in current or recent [within last five (5) years] contract performance, in the absence of circumstances properly beyond the control of the Proposer, shall be presumed to be unable to meet this requirement.

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

5. Meet other presentation and participation requirements listed in this RFP.

6. Meet the standards established by the California Consortium of Addiction Programs and Professionals (CCAPP) for a sober living environment and shall be certified and maintain certification by CCAPP in good standing for as long as the facility is in operation. Clients cannot be accepted into the program until certification is completed and approved. Please see https://www.ccapp.us for more information.

B. Authorized Signatures

All proposals must be signed by an individual authorized to bind the Proposer to the provisions of the RFP.

C. Contingencies

Funding for this program is contingent on funding from the appropriate office of the State of California and is subject to reimbursement under Federal and State laws. This RFP does not commit the County to award a Contract. Cost, while not necessarily the primary factor used in the selection process, is an important factor. The County will award a Contract based on the proposal that best meets the needs of the County.

D. Term of Offer

Proposals shall remain open, valid, and subject to acceptance anytime within nine (9) months after the proposal submission.

E. Required Review

Proposers should carefully review this RFP for defects and questionable or objectionable material.

Comments from Proposers concerning defects and objectionable material in this RFP must be made in writing and received by the RFP contact prior to the deadline for submission of questions identified in Section II or at least ten (10) calendar days before the Deadline for Proposals (whichever occurs last). This will allow issuance of any necessary amendments or addendums to the RFP. It will also help prevent the opening of a defective Proposal and exposure of Proposals upon which an award could not be made. Protests based on any omission or error, or on the content of this RFP, may be disallowed if not submitted in writing to the attention of the RFP Contact, prior to the deadline for submission of questions identified in Section II or at least ten

(10) calendar days before the Deadline for Proposals (whichever occurs last).

F. Right of Rejection

Offers must comply with all of the terms of the RFP, and all applicable local, State, and Federal laws, codes, and regulations. The County may reject as non-responsive any proposal that does not comply with all of the material and substantial terms, conditions, and performance requirements of the RFP.

Further, the County may reject a proposal from any entity that is a parent, affiliate, or subsidiary, or that is under common ownership, control, or management with any other entity submitting a Proposal in response to this RFP.

Proposer may not qualify the proposal nor restrict the rights of the County. If Proposer does so, the proposal may be determined to be a non-responsive counter-offer and the proposal may be rejected.

No proposal shall be rejected, however, if it contains a minor irregularity, defect or variation and if the irregularity, defect or variation is considered by the County to be immaterial or inconsequential, the County may choose to accept the proposal.

Minor informalities may be waived by the County when they:

https://www.ccapp.us/

1. Do not affect responsiveness;

2. Are merely a matter of form or format;

3. Do not change the relative standing or otherwise prejudice other offers;

4. Do not change the meaning or scope of the RFP;

5. Are trivial, negligible, or immaterial in nature;

6. Do not reflect a material change in the work; or

7. Do not constitute a substantial reservation against a requirement or provision;

In such cases the Proposer will be notified of the deficiency in the proposal and given an opportunity to correct the irregularity, defect or variation or the County may elect to waive the deficiency and accept the proposal.

This RFP does not commit the County to award a contract. The County reserves the right to reject any or all proposals if it is in the best interest of the County to do so. County also reserves the right to terminate this RFP process at any time.

G. Best Value Evaluation Process

As established in this RFP, the County realizes that criteria other than price are important and will award contract(s) based on the proposal that best meets the needs of the County. The County seeks the optimal combination of quality, price, and various qualitative elements of the required Services that will provide the County the greatest or best value for its money.

H. Amendments/Addendums to RFP

The County reserves the right to issue addenda or amendments to this RFP if the County considers that additional clarifications are needed. Only those proposers registered in ePro will receive addenda or amendments issued after the Conference.

Changes to a Proposal or withdrawal of a Proposal will only be allowed if a request is received prior to the Deadline for Proposals. No amendments or withdrawals will be accepted after the Deadline for Proposals.

I. Proposal Submission

To be considered, all proposals must be submitted in the manner set forth in this RFP. It is the Proposer’s responsibility to ensure that its proposal arrives on or before the specified deadline. All proposals and materials submitted become the property of the County.

J. Local Preference Policy

The San Bernardino County has adopted a preference for Vendors whose principal place of business is located within the boundaries of the County. A five percent (5%) preference may be applied prior to approval of any purchase or acquisition of services, equipment, goods, or supplies. In a best value evaluation, five percent (5%) of the awardable points for cost will be added to the local vendor’s score. If the local vendor’s overall score is equal to or lower than that of an otherwise successful non-local vendor, the local vendor will be recommended for award.

Due to the evaluation of qualitative elements in a best value evaluation, application of local preference for cost proposals may not result in award to a local vendor with the lowest cost after applying local preference.

For purposes of the application of the Local Preference Policy (County Policy 11 – 10) a vendor is considered a local vendor when it meets the following requirements:

1. Vendor’s main office (headquarters) or a major regional office is located within the County;

2. Vendor employs a minimum of 25% of the vendor’s full-time management employees and 25% of its full time regular employees working from San Bernardino County location(s);

3. Vendor employs one full-time or two part-time employees with primary residence in the County;

4. Vendor’s “point of sale” for purposes of reporting sales tax to the State Board of Equalization is within the boundaries of the County. The payment of any local share of sales tax must go to the County or a city within the County. If the local business has more than one sales office in the State of California, the office located in the County shall be the point of sale for sales tax calculation;

5. Vendor is not delinquent in any taxes or other payments to the County;

6. Vendor possesses a valid and verifiable business license (if required);

7. Vendor has been open and established for at least six months prior to the issuance of the solicitation;

8. Vendor can demonstrate on-going business activity in the field of endeavor on which they are proposing from that office during the preceding six months;

9. Vendor has not within five years prior to the solicitation admitted guilt or been found guilty by any court or state or federal regulatory enforcement agency of violation of any criminal law or any law or regulation regarding fraud;

10. Vendor is not federally debarred; and

11. Vendor is not suspended or debarred from participation in doing business with the County, in the scope of work that is the subject of the solicitation.

Any vendor requesting a local preference shall complete Attachment M certifying to DBH under penalty of perjury that they meet all of the criteria listed above. If, at any time after being certified as a local vendor, a change in status occurs rendering a vendor no longer eligible for such status, the vendor must notify DBH prior to responding to a solicitation or accepting an award. Failure to certify the above information shall result in the proposal or bid being evaluated by the County without any adjustment for a local vendor.

False certification shall be immediate grounds for rejection of any proposal or bid or if the proposal or bid is awarded, grounds for voiding the proposal or bid, terminating any agreement, and seeking damages thereto. Any vendor that falsely obtains certification shall be ineligible to transact business with the County for not less than one year and not more than three years, at the discretion of the County. This penalty shall also apply to any vendor that previously obtained proper certification and, because of a change in its status would no longer be eligible for certification, and fails to notify DBH of this information prior to responding to a solicitation or accepting an award.

The County's Local Preference Policy means for example, if two Vendors are responding to this RFP and if quality, service and ability to meet the County's needs are equal, County staff must determine if one of the Vendors is a local Vendor. If one of the Vendors is a local vendor, and its quoted price or cost for services, equipment, goods or supplies does not exceed five percent (5%) of the other Vendor's quoted price or cost, unless it is determined that an exemption applies, staff should recommend the local Vendor for the contract award.

K. Incurred Costs

The County is not obligated to pay any costs incurred by Proposer in the preparation of a proposal in response to this RFP. Proposer agrees that all costs incurred in developing this proposal are the Proposer’s responsibility.

L. Public Records Act

All proposals and other material submitted become the property of the County and are subject to release according to the California Public Records Act (Government Code § 7920.000). All Proposal information, including cost information, will be held in confidence during the evaluation and negotiation process. Thereafter, Proposals are subject to becoming a non-exempt public record.

If a Proposer believes that any portion of its Proposal is exempt from public disclosure, it must indicate the specific portions believed to be confidential and not subject to disclosure on Attachment E – Disclosures, Exceptions, and Public Records Act Exemptions to RFP. The Proposer also must include a brief description that sets out the reasons for exemption from disclosure. Each stated exemption must include a citation to supporting legal authority, including statutory authority or case law, to support exemption from the Public Records Act. Requested exemptions that do not meet the requirements of this section will not be considered.

The County will use reasonable means to ensure that such information is safeguarded, but will not be held liable for inadvertent disclosure of the information. Proposals marked “Confidential” in their entirety will not be honored, and the County might not deny public disclosure of any portion of Proposals so marked.

By submitting a Proposal with portions identified in Attachment E as “Confidential,” Proposer represents that it has a good faith belief that such portions are exempt from disclosure under the California Public Records Act. Proposer may be requested to obtain legal protection from disclosure should a Public Records Act request be received. In the event the County does not disclose the information marked “Confidential,” Proposer agrees to reimburse the County for, and to indemnify, defend (with counsel approved by County) and hold harmless the County, its officers, employees, agents, and volunteers from and against any and all claims, damages, losses, liabilities, suits, judgments, fines, penalties, costs and expenses, including without limitation, attorneys’ fees, expenses and court costs of any nature arising from or relating to the County’s non-disclosure of any such designated portions of a Proposal.

M. Disclosure of Criminal and Civil Proceedings

The County reserves the right to request the information described herein from the Proposer selected for Contract award. Failure to provide the information may result in a disqualification from the selection process and no award of Contract to the Proposer. The County also reserves the right to obtain the requested information by way of a background check performed by an investigative firm.

The selected Proposer may also be asked to provide information to clarify initial responses. Negative information provided or discovered may result in disqualification from the selection process and no award of Contract.

The selected Proposer may be asked whether the firm, or any of its partners, principals, members, associates or key employees (as that term is defined herein), within the last ten years, has been indicted on or had charges brought against it or them (if still pending) or convicted of any crime or offense arising directly or indirectly from the conduct of the firm’s business, or whether the firm, or any of it partners, principals, members, associates or key employees, has within the last ten years, been indicted on or had charges brought against it or them (if still pending) or convicted of any crime or offense involving financial misconduct or fraud. If the response is affirmative, the Proposer will be asked to describe any such indictments or charges (and the status thereof), convictions and the surrounding circumstances in detail.

In addition, the selected Proposer may also be asked to disclose whether the firm, or any of its partners, principals, members, associates or key employees, within the last ten years, has been the subject of legal proceedings as defined herein arising directly from the provision of services by the firm or those individuals. “Legal proceedings” means any civil actions filed in a court of competent jurisdiction, or any matters filed by an administrative or regulatory body with jurisdiction over the firm or the individuals. If the response is affirmative, the Proposer will be asked to describe any such legal proceedings (and the status and disposition thereof) and the surrounding circumstances in detail.

For purposes of this provision “key employees” includes any individuals providing direct service to the County. “Key employees” do not include clerical personnel providing service at the firm’s offices or locations.

N. Debarment and Suspension; California Secretary of State Business Entity Registration.

Proposer certifies that neither it nor its principals or subcontractors are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency. (See the following United States General Services Administration’s System for Award Management website https://www.sam.gov). Proposer also certifies that if it or any of the subcontractors listed in the Proposal are business entities that must be registered with the California Secretary of State, they are registered and in good standing with the Secretary of State.

O. Unsatisfactory Performance

Proposer affirms that it has no record of unsatisfactory performance with the County in the twenty-four (24) month period immediately preceding the date of issuance of this RFP.

P. Clarification of Offers

In order to determine if a Proposal is reasonably susceptible for award, communications by the Facilitator for the evaluation panel are permitted with a Proposer to clarify uncertainties or eliminate confusion concerning the contents of a Proposal. Clarifications may not result in a material or substantive change to the Proposal. The evaluation by the panel may be adjusted as a result of a clarification under this section.

https://www.sam.gov/

Q. Formal Agreement

Proposer will be required to enter into a formal agreement with the County. This RFP sets forth some of the general provisions which will be included in the final contract. In submitting a response to this RFP, Proposer will be deemed to have agreed to each clause unless the proposal identifies an objection and County agrees to a change of language in writing. All objections to any provisions of the final contract should be listed on Attachment E – Disclosures, Exceptions, and Public Records Act Exemptions to RFP, or any exception thereto shall be waived.

R. Independent Contractor Status

Any Proposer that is awarded a Contract will be considered an independent Contractor(s), wholly responsible for the manner in which it performs, and will assume exclusively the responsibility for the acts of its employees who will not be entitled to any rights and privileges of County employees nor be considered in any manner to be County employees.

S. Pre-Award On-Site Visits

Site visits may be conducted to verify information submitted in the RFP and to determine if the proposed facilities are appropriate for the proposed services to be provided.

T. Level of Service

For any Contract awarded as a result of the RFP, no minimum or maximum number of referrals or enrollments can be guaranteed by the County.

U. Priority Population

The priority populations to be served are pregnant and parenting women. All treatment providers must treat the family as a unit and admit both women and their child(ren) into treatment services.

Treatment providers must serve the following individuals with a SUD:

• Women who are pregnant;

• Women with dependent children;

• Women attempting to regain custody of their children;

• Postpartum women and their children; and/or

• Women with substance exposed infants.

V. Iran Contracting Act of 2010

(Only applicable for all procurements of one million dollars ($1,000,000) or more).

In accordance with Public Contract Code Section 2204(a), the Proposer certifies that at the time the proposal is submitted, the Proposer signing the proposal is not identified on a list created pursuant to subdivision (b) of Public Contract Code Section 2203 (https://www.dgs.ca.gov/PD/Resources/Page-Content/Procurement-Division-Resources-List- Folder/List-of-Ineligible-Businesses) as a person [as defined in Public Contract Code Section 2202(e)] engaging in investment activities in Iran described in subdivision (a) of Public Contract Code Section 2202.5, or as a person described in subdivision (b) of Public Contract Code Section 2202.5, as applicable.

Proposers are cautioned that making a false certification may subject the Proposer to civil penalties, termination of existing contract, and ineligibility to bid on a contract for a period of three

(3) years in accordance with Public Contract Code Section 2205. Proposer agrees that signing the Proposal shall constitute signature of this Certification.

W. Executive Order N-6-22 – Russia Sanctions

On March 4, 2022, Governor Gavin Newsom issued Executive Order N-6-22 (the EO) regarding Economic Sanctions against Russia and Russian entities and individuals. “Economic Sanctions” refers to sanctions imposed by the U.S. government in response to Russia’s actions in Ukraine (https://home.treasury.gov/policy-issues/financial-sanctions/sanctions-programs-and-country-information/ukraine-russia-related-sanctions), as well as any sanctions imposed under state law (https://www.dgs.ca.gov/OLS/Ukraine-Russia). By submitting a bid or proposal, Proposer represents that it is not a target of Economic Sanctions. Should it be determined Proposer is a target of Economic Sanctions or is conducting prohibited transactions with sanctioned individuals or entities, that shall be grounds for rejection of the Proposer’s bid/proposal any time prior to contract execution, or, if determined after contract execution, shall be grounds for termination by the County.

X. Final Authority

The final authority to award a Contract as a result of this RFP rests solely with San Bernardino County Board of Supervisors.

IV. PROGRAM REQUIREMENTS (SCOPE OF WORK)

A. Definitions

1. The terms Proposer, Contractor, Provider, or Vendor/Applicant are used interchangeably throughout this document referring to the entity submitting a response and may subsequently become a Contractor.

2. The terms beneficiary, client, consumer, customer, participant, or patient are used interchangeably throughout this document and refers to the individual(s) receiving services.

3. Definition of May, Shall, and Should. Whenever in this document the words “may”, “shall”, and “should” are used, the following definitions shall apply: “may” is permissive; “shall” is mandatory; and “should” means desirable.

4. American Society of Addiction Medicine (ASAM) – ASAM is a professional society representing over 4,000 physicians and associated professionals dedicated to increasing access and improving the quality of addiction treatment; educating physicians, other medical professionals and the public; supporting research and prevention; and promoting the appropriate role of physicians in care of patients with addictions.

5. American Society of Addiction Medicine (ASAM) Criteria – The ASAM Criteria is a set of guidelines for placement, continued stay, and transfer/discharge of patients with SUD and co-occurring conditions. The ASAM criteria provide separate placement criteria for adolescents and adults to create comprehensive and individualized treatment plans.

Adolescent and adult treatment plans are developed through a multidimensional patient assessment over five broad levels of treatment that are based on the degree of direct medical management provided, the structure, safety and security provided, and the intensity of treatment services provided. ASAM’s criterion uses six dimensions to create a holistic, bio-psychosocial assessment of an individual to be used for service planning and treatment across all services and levels of care.

6. Care Coordination – Care Coordination consists of activities that organize and integrate substance use disorder (SUD), mental health, physical health, and ancillary services for a member, with the goal of restoring the member to their best possible functional level. Care Coordination must be provided with all levels of SUD treatment and may also be delivered and claimed to be a standalone service.

7. Case Management – Case management services assist clients access needed medical, educational, social, prevocational, vocational, rehabilitative, or other community services.

Case management services may be provided by a Licensed Practitioners of the Health Arts (LPHA) or a certified counselor. Case management services may be provided face-to-face, by telephone, or by telehealth with the client and may be provided anywhere in the community.

8. Certified Peer Support Services – Culturally responsive, recovery-oriented, strength-based services delivered by certified peer support specialists with lived experience of mental health and/or substance use challenges. Services promote recovery, resiliency, engagement, socialization, self-sufficiency, self-advocacy, and development of natural support through structured individual and group activities. Peer Support Services may be delivered and claimed as a standalone service or in conjunction with other Drug Medi-Cal Organized Delivery System (DMC-ODS) services and levels of care, in clinical or non-clinical settings.

9. Client – The San Bernardino County resident who will be receiving the services as described in the RFP.

10. Client Education – Client education provides research-based education on SUD, treatment, recovery, and associated health risks.

11. Collateral Services – Sessions with therapists or counselors and significant persons in the life of the client, focused on the treatment needs of the client in terms of supporting the achievement of the client’s treatment goals. Significant persons are individuals that have a personal, not official or professional, relationship with the client.

12. Co-Occurring Disorders – Concurrent substance use and mental health disorders.

13. Cultural Competency – The acceptance and understanding of cultural mores and their possible influence on the participant’s issues and/or behavior, i.e., using the understanding of the differences between the prevailing social culture and that of the participant’s family to aid in developing individualized supports and services.

14. Department of Behavioral Health (DBH) – DBH under state law provides mental health and/or substance use disorder treatment and prevention services to County residents. In order to maintain a continuum of care, DBH operates or contracts for the provision of 24-hour residential treatment, non-medical withdrawal management (detoxification) services, Outpatient Treatment services, Intensive Outpatient Treatment (IOT), case management, recovery centers and crisis and referral services. Community services are provided in all major County metropolitan areas and are readily accessible to County residents.

15. Drug Medi-Cal (DMC) Program – The DMC Program is the state system wherein beneficiaries receive covered services from DMC-certified substance use disorder treatment providers.

16. Drug Medi-Cal Organized Delivery System (DMC-ODS) – DMC-ODS is a Medi-Cal benefit in counties that choose to participate, delivered either through county operated programs or contracts with DMC certified providers . DMC-ODS shall be available as a Medi-Cal benefit for individuals who meet the medical necessity criteria, in accordance with DHCS requirements and reside in a county that opts into the program. The county shall, in turn contract with DMC certified providers or provide county-operated services to provide all services outlined in the DMC-ODS.

17. DMC-ODS Services – DMC-ODS services are those services authorized by Title XIX or Title XXI of the Social Security Act; Title 22 Section 51341.1; WIC 14124.24; and California's Medicaid State Plan, including the DMC ODS 1115 Demonstration Waiver special terms and conditions.

18. Evidence-Based – Evidence-based programs are programs that have been shown to have positive outcomes through high quality research. An evidenced-based program shall demonstrate the use of a minimum of two evidenced-based practices.

19. Family Therapy – Therapy that includes the client’s family members and loved ones in the treatment process, and education about factors that are important to the client’s recovery as well as their own recovery can be conveyed. Family members may provide social support to beneficiaries, help motivate their loved ones to remain in treatment, and receive help and support for their own family recovery as well.

20. Group Counseling – Counseling in which one or more therapists or counselors treat two or more clients at the same time with a maximum of twelve (12) in the group. A client that is seventeen (17) years of age or younger shall not participate in-group counseling with any participants who are eighteen (18) years of age or older. However, a client who is seventeen

(17) years of age or younger may participate in group counseling with participants who are eighteen (18) years of age or older when the counseling is at a provider's certified school site.

21. Problem List – A written list, included in the client record, that identifies and tracks the beneficiary’s clinical problems and treatment needs, including SUD and any co-occuring physical or mental health conditions, that are addressed in the treatment plan.

22. Individual Counseling Session – Contact between a client and a therapist or counselor.

Services provided in-person, by telephone or by telehealth qualify as Medi-Cal reimbursable units of service, and are reimbursed without distinction. The Problem List will be completed upon intake and updated on an ongoing basis within a reasonable time.These may be written by a substance use counselor or LPHA.

23. Intake – Process of determining that a client meets medical necessity criteria and a client is admitted into a SUD treatment program. Intake includes the evaluation or analysis of the cause or nature of mental, emotional, psychological, behavioral, and SUD; and the assessment of treatment needs to provide medically necessary services. Intake may include a physical examination and laboratory testing necessary for SUD treatment.

24. Intensive Outpatient Treatment (IOT) (ASAM Level 2.1) – Structured programming services are provided to the beneficiaries (a minimum of nine (9) hours with a maximum of nineteen

(19) hours a week for adults, and a minimum of six (6) hours with a maximum of nineteen

(19) hours a week for adolescents) when determined by a Medical Director or a LPHA to be medically necessary and in accordance with an individualized client plan. Lengths of treatment can be extended when determined to be medically necessary. Services consist of counseling and education about addiction-related problems. Services can be provided by a licensed professional or certified counselor in any appropriate setting in the community.

25. Licensed Practitioner of the Healing Arts (LPHA) – LPHA includes: Physicians, Nurse Practitioners, Physician Assistants, Registered Nurses, Registered Pharmacists, Licensed Clinical Psychologist (LCP), Licensed Clinical Social Worker (LCSW), Licensed Professional Clinical Counselor (LPCC), and Licensed Marriage and Family Therapist (LMFT) and licensed-eligible practitioners working under the supervision of licensed clinicians.

26. Medical Necessity and Medically Necessary Services – SUD treatment services that are reasonable and necessary to protect life, prevent significant illness or significant disability, or alleviate severe pain through the diagnosis or treatment of a disease, illness, or injury consistent with 42 CFR 438.210(a)(4) or, in the case of Early Periodic Screening, Diagnostic and Treatment (EPSDT), services that meet the criteria specified in Section 1905(r) of the Social Security Act. Medical Necessity Criteria - means adult beneficiaries must have one diagnosis from the Diagnostic and Statistical Manual of Mental Disorders (DSM) Fifth Edition for Substance-Related and Addictive Disorders with the exception of Tobacco-Related Disorders and Non-Substance-Related Disorders, and must meet the ASAM Criteria definition of medical necessity for services based on the ASAM Criteria. Adults shall meet the ASAM Adult Dimensional Admission Criteria. Beneficiaries under age twenty-one (21) are eligible to receive Medicaid services pursuant to the EPSDT mandate. Under the EPSDT mandate, beneficiaries under age 21 are eligible to receive all appropriate and medically necessary services needed to correct and ameliorate health.

27. Medications for Addiction Treatment (MAT) – Treatment that includes the use of all FDA-approved medications and biological products to treat SUD provided with accompanying clinical services appropriate to the member’s needs. MAT may be provided in clinical or non-clinical settings and may be claimed as a standalone service or as part of another DMC-ODS level of care.

28. Medication Services – The prescription or administration of medication related to SUD treatment services, or the assessment of the side effects or results of that medication conducted by staff lawfully authorized to provide such services.

29. Memorandum of Understanding (MOU) – An official statement outlining a mutual understanding between parties as to their working relationships.

30. National Culturally and Linguistically Appropriate Services (CLAS) Standards – National CLAS in Health and Health Care are issued by the U.S. Department of Health and Human

Services Office of Minority Health, which establish a framework for health care organizations to provide effective, equitable, understandable, and respectful quality care and services responsive to individuals’ diverse cultural health beliefs and practices, preferred languages, health literacy levels, and communication needs.

31. Perinatal – The term “Perinatal” means treatment services designed for pregnant women and women with dependent children pursuant to Title 45 Code of Federal Regulations (CFR) Part 96, Section 96.124(c).

32. Perinatal DMC Services – Covered services including mother/child habilitative and rehabilitative services; services access (i.e., provision or arrangement of transportation to and from medically necessary treatment); education to reduce harmful effects of substance use on the mother and fetus or infant; and coordination of ancillary services (Title 22, Section 51341.1(c) 4).

33. Perinatal Practice Guidelines (PPG) – The PPG includes core competencies for programs serving perinatal women. These core competencies are included in an effort to promote integrated programming approaches based on theories that fit the psychological, social, and developmental needs of women. The core competencies are not required services but rather standards of care guidelines for women’s services.

34. Physician Consultation Services – Include DMC physicians’ consulting with addiction medicine physicians, addiction psychiatrists or clinical pharmacists. Physician consultation services are not with DMC-ODS beneficiaries; rather, they are designed to assist DMC physicians with seeking expert advice on designing treatment plans for specific DMC-ODS beneficiaries.

a. Physician consultation services are to support DMC providers with complex cases which may address medication selection, dosing, side effect management, adherence, drug-drug interactions, or level of care considerations.

b. Counties may contract with one or more physicians or pharmacists in order to provide consultation services. Physician consultation services can only be billed by and reimbursed to DMC providers.

c. Providers shall create progress notes for the provision of all medi-Cal behavioral health delivery system services. Each progress note shall provide sufficient detail to support the servie code selected for the service type(s) as indicated by the service code description.

35. Postpartum – As defined for DMC purposes, the postpartum coverage period for individuals receiving postpartum care services begins after the last day of pregnancy through the last day of the month in which the 365th day occurs. Individuals will maintain coverage through their pregnancy and the 12 month postpartum coverage period regardless of income changes, citizenship, immigrations status, or how the pregnancy ends.

36. Recovery Services – Recovery Services are non-time-limited, recovery-oriented services designed to support ongoing recovery, prevent relapse, and restore the member to their best possible functional level. Recovery Services may be delivered and claimed as a standalone service, concurrently with other DMC-ODS services, or as components within other levels of care. They may be provided in clinical or non-clinical settings, including community-based locations. Members may access Recovery Services based on self-assessment or provider assessment of relapse risk and do not need to be in remission or enrolled in another level of care.

37. Registrant Alcohol and Other Drug (AOD) counselor – An individual who provides counseling services. An individual registered with any certifying organization to obtain certification as an AOD counselor.

38. Standalone Services Under DMC-ODS – DMC-ODS standalone services, as defined in DHCS Behavioral Health Information Notice (BHIN) 24-001, are reimbursable Medi-Cal services that may be delivered and claimed independently of another DMC-ODS level of care, consistent with medical necessity, documentation, and claiming requirements.

The following services may be delivered and claimed as standalone services under DMC

ODS:

a. Medications for Addiction Treatment (MAT)

b. Certified Peer Support Services

c. Recovery Services

d. Care Coordination

39. Substance Use Disorder and Recovery Services Block Grant (SUBG) – Federal funds awarded to US States and the District of Columbia, Puerto Rico, the U.S. Virgin Islands, 6 Pacific jurisdictions, and 1 tribal entity through the Substance Use and Mental Health Services Administration (SAMHSA). Grantees use the funds to plan, implement, and evaluate activities that prevent and treat SUD and promote public health.

40. Substance Use Disorder (SUD) – SUD includes substance use and substance dependence.

Substance abuse is a maladaptive pattern of substance use manifested by recurrent and significant adverse consequences related to the repeated use of substances. Substance dependence is a cluster of cognitive, behavioral, and physiological symptoms indicating that an individual continues use of substances despite significant substance related problems.

SUD service is the provision of services to prevent or reduce the harm of alcohol and other drugs throughout the County through community action, education, support, and collaboration.

41. Substance Use Disorder Diagnoses – Diagnoses set forth in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, published by the American Psychiatric Association.

42. Substance Use Disorder and Recovery Services (SUDRS) – The term “SUDRS” refers to the San Bernardino County Department of Behavioral Health Substance Use Disorder and Recovery Services.

43. The State – The “State and/or applicable State agency” as referenced in this RFP may include the Department of Health Care Services (DHCS), the Department of State Hospitals (DSH), the Department of Social Services (DSS), the Mental Health Services

Oversight and Accountability Commission (MHSOAC), the Department of Public Health (CDPH), and the Office of Statewide Health Planning and Development (OSHPD).

44. Unduplicated Client – A client who presents for the first time at a treatment facility during the fiscal year.

45. Unit of Service – Refers to the time spent by Provider staff to SUD program services to the client(s). With respect to SUD treatment services, a unit of services include staff time spent conducting client visits, collateral visits, and group treatment sessions. Other services, including time spent staffing client charts and documenting treatment sessions in the charts, should be included in the Provider’s cost of the unit of service.

a. For case management, intensive outpatient treatment, outpatient services, Naltrexone treatment services, and recovery services contact with a beneficiary in 15-minute increments on a calendar day.

b. For additional medication assisted treatment, physician services that includes ordering, prescribing, administering, and monitoring of all medications for substance use disorders per visit or in 15-minute increments.

c. For physician consultation services, consulting with addiction medicine physicians, addiction psychiatrists or clinical pharmacists in 15-minute increments.

d. For residential services, providing 24-hour daily service, per beneficiary, per bed rate.

For withdrawal management per beneficiary per visit/daily unit of service.

e. For withdrawal management per beneficiary per visit/daily unit of service.

B. Background Information

DBH is responsible for providing mental health and/or SUD services to County residents who are experiencing major mental illness and/or SUD. DBH-SUDRS provides a full range of SUD prevention, treatment services and education for communities and residents of the County through contracts with community-based organizations and County-operated clinics with the goal of promoting prevention, intervention, recovery and resiliency for individuals and families.

All Perinatal Services Network programs, regardless of funding source, are required to comply with the Perinatal Practice Guidelines as specified in the DMC-ODS and SUBG combined contracts between the state and the counties.

Program requirements specific to Perinatal Drug Medi-Cal (DMC) are contained in the California Code of Regulations (CCR), Title 22, Division 3, Health Care Services.

C. Program Description

1. Program Objective

DBH-SUDRS Perinatal Services are designed to achieve progressive changes in an individual's thinking and substance misusing behavior in order to prevent relapse. This must be accomplished by using evidence-based SUD treatment services. The objective of DBH's Perinatal Services is to provide or arrange SUD treatment services and other therapeutic interventions to substance misusing pregnant and parenting women, providing a planned regiment of treatment, consisting of regularly scheduled sessions within a structured program, for a minimum of nine (9) hours of treatment per week for adults provided at minimum three (3) hours per day, three (3) days per week.

a. Perinatal Eligibility:

• Women who are pregnant;

• Women with dependent children;

• Women attempting to regain custody of their children;

• Postpartum women and their…