RFP Jail Based Restoration-.docx

Request for Proposals Jail Based Program for Individuals Court Ordered to Forensic Evaluation and Treatment 2026000157 2/18/2026 Basic Information and Timeline

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Colorado Department of Human Services Solicitation Number: 2026000157 Division of Contracts and Procurement (v. 05/25) Page 11 of 16

Table of Contents

A. Quick Resources

1. For questions about this solicitation, contact the Single Point of Contact identified above.

2. For help with Vendor Self Service (ColoradoVSS), contact the Vendor Self Service Help Desk vsshelp@state.co.us or 303-866-6464.

3. For information about doing business with the state of Colorado generally, go to: https://osc.colorado.gov/spco/accesscolorado.

4. The Department is always interested in improving. Please take this survey at any time: https://docs.google.com/forms/d/e/1FAIpQLScIgv9lgrT3x5AGzcvT1xkvpucrRhhN5QJ23vLcbyfvc2smaw/viewform (We do actually read the responses)

B. Introduction and Background The Office of Civil and Forensic Mental Health (OCFMH) administers and oversees the State's two Mental Health Hospitals: the Colorado Mental Health Hospital in Pueblo (CMHHIP) and the Colorado Mental Health Hospital in Fort Logan (CMHHIFL) and Forensic Services. The OCFMH is responsible for policy development, service provision and coordination, program monitoring and evaluation, and administrative oversight for the State's behavioral health system.

Forensic Services within the OCFMH consists of five departments: Court Services, Forensic Community Based Services (FCBS), Jail Based Evaluation and Restoration, Forensic Support Team, and Outpatient Restoration Services. These departments are responsible for coordinating, managing, and responding to court orders for forensic evaluation and related forensic services statewide.

The State of Colorado currently provides inpatient and outpatient services for those ordered to forensic evaluation and treatment. Statutorily, inpatient locations include the State hospitals and our jail based treatment programs. The court determines whether one is ordered to inpatient or outpatient treatment and subsequently, CDHS clinicians are responsible for assessing and triaging each individual for placement to the various inpatient locations to ensure they receive the appropriate level of care. There are specific criteria utilized when determining admission into the jail based programs, which includes any facility related limitations and individual needs related to safety of self, safety of others, medical needs, medication needs, and clinical acuity. In 2019, State legislation implemented Senate Bill 19-223 (https://leg.colorado.gov/bills/sb19-223), which imposes strict timeframes related to individuals' access to forensic evaluation and treatment and includes guidelines related to length of time in restoration, directly impacting our patients’ course of treatment. Please reference, https://www.colorado.gov/pacific/cdhs/obh-forensic-services, for more information.

The OCFMH’s jail based treatment program began in 2013 and currently operates within the Arapahoe County Detention Facility and includes three separate milieus. This includes a total of eighty-two (82) patient beds, with a seventy-eight (78) bed minimum guaranteed payment with up to four (4) beds at ACDF held for high acuity individuals.

The awarded vendor shall operate the jail-based treatment program currently located at Arapahoe County Detention Facility (84 beds) and will provide restoration to competency services, forensic evaluation, and capacity for the State’s forensic mental health system. The jail-based treatment program will serve inmates with court orders for inpatient competency evaluations, inpatient competency restoration treatment, inpatient mental condition evaluations, and inpatient sanity evaluations from all 64 counties throughout Colorado.

The awarded vendor will meet the following project goals:

· Provide comprehensive mental health treatment and thorough documentation

· Provide a therapeutic and safe milieu

· Ensure quality medical care

· Provide forensic related services, including:

· -Restoring individuals to competency to stand trial

· -Mental health treatment and observation for forensic evaluations

· Minimize the number of client movements to maintain continuity of treatment;

· Provide consistent and best practice treatment based on individual needs of clients; and

· Reduce the amount of time individuals spend in jails prior to receiving services.

· The awarded vendor shall work closely with OCFMH staff to develop and implement a program compatible with OCFMH’s existing programs. Specifically, the awarded vendor will be expected to modify types, frequency, and intensity of services based on individual client needs. The actual number of beds to be provided in any year is dependent upon client populations, needs, and appropriations from the Legislature.

The department has well-established expectations regarding type and frequency of treatment. The awarded vendor will demonstrate the ability to uphold the established expectations and propose innovative ideas to enhance services. The majority of the patient population admits to the programs in order to receive competency restoration treatment and the majority of our patients discharge the program once restored to competency; however, an increasing number of individuals are now discharging to return to the community, which requires collaboration with the judicial system and community providers.

The awarded vendor will employ psychiatric providers, forensic psychologists, nurses, social workers, staff to focus on community re-integration, technicians, or skilled group facilitators, recreation therapists, and peer support. Each discipline is expected to meet with patients within the first week of their admission and complete designated assessments or sessions as part of patient orientation. Each discipline is also expected to meet with patients on a weekly basis and patients should receive a daily individual session/assessment with a staff member that addresses medical needs, mental health needs, and/or matters related to competence to stand trial. Clinical rounds are expected to be held daily and treatment team meetings with the patient should be held within one week of arrival and every 30 days thereafter. Staff are expected to be trained in the functional analysis of behavior and develop behavior modification plans to support individuals in the program.

The program will utilize the curriculum established by the OCFMH (exhibit attached) and develop innovative applications that maintain best practices and national trends. Primary program hours should remain between 8:00 am and 5:00 pm with activities and staff (including deputy coverage) available for supplemental evening and weekend programming. Programming should include daily competency related sessions including education, mock trial, and rational decision making. In addition, programming should include rotating daily mental health groups such as coping skills, anger management, medication education, social skills, understanding your mental health, substance use and/or co-occurring illness, and other evidence based treatment groups such as cognitive behavior therapy (CBT) and dialectical behavior therapy (DBT). In addition, an established incentive program exists that allows our patients the opportunity to assist with improving their physical and mental health by engaging in personal wellness, milieu morale, and programming. The incentive program allows for access to items not typically found on jail commissary and although modifiable, it is expected that some iteration will remain in place.

The awarded vendor will be expected to uphold those practices and enhance existing policy and procedure, by remaining informed of national trends, innovative techniques and practices, and engage in ongoing training. Partnering with the facility security staff should remain an ongoing effort to ensure all jail needs are being met and patient needs are priority. Each site utilizes safety monitoring (welfare checks or rounds) of some sort and are to be documented in respective systems. It is important to OCFMH that deputies be specially trained and assigned to these units in order to ensure safety, consistency, and sensitivity to patient mental health needs. OCFMH feels strongly that the role of deputy staff is imperative to a successful program and expects the Offeror and jail staff to meet these expectations at a minimum and welcomes enhancements to the role.

Areas the awarded vendor will be expected to further develop include the emergency medication management and involuntary medication processes, crisis management services for acute patients, and enhanced transport services for individuals who live in various parts of the State and do not have personal means to return home. Known barriers are cited below for response consideration. Please note the following details in the proposal content section regarding each area for consideration in your respective responses:

Capacity Assessments / Involuntary Treatment (refer to #10 in section E.): To date, the Department has approved several proposed procedures to initiate involuntary medications and continues to collaborate with stakeholders to address any concerns related to Statute, liability, and details of potential procedures in order to begin successful implementation. Responses are expected to designate staff from the initial step to the conclusion of the process, including proposed methods of physical restraint, as a last resort. Please include this information in your response:

· The awarded vendor shall follow procedures for the utilization of medications over the patient’s objections at [program location], consistent with state statutes and rules (i.e. Colorado Code of Criminal Procedures Title 16, Article 8.5).

· A petition for involuntary medications will be filed with the [program location] County Courts. A copy of the certified petition will be provided to the patient’s legal representative in the involuntary medication matter, as well as his legal representative and prosecuting attorney in all open cases, the Colorado Mental Health Hospital (CMHHIP) medical-legal records department, the Director of Jail Based Restoration or designee for the OCFMH and the Civil Unit for processing.

Crisis Management (refer to #11in section E.): To date, on-call services have served as the primary mechanism to communicate and consult on any patient concern after hours and on weekends. The majority of patient needs are able to be addressed in this manner; however, the acuity of individuals requiring restoration services has increased over the recent years and OCFMH would like the Offeror to include enhanced crisis management services that includes but is not limited to on-call procedures. The role of clinical staff should be priority and consideration to the role of safety and security staff at the facility, a strong consideration when crafting a response.

Transportation (refer to #20 in section E.): It is important for Offerors to understand the current structure of transport and existing barriers. In Colorado, patients admit to our programs from across the entire State and when a defendant is ordered to inpatient evaluation or treatment, the court order includes a directive to the jail holding current custody to provide transportation to the treatment location. There are various reasons an individual may leave our program, including being opined restored to competency, completing the ordered evaluation, court closure of the case, dismissal of the case, or the need to transfer to another location for ongoing treatment. In addition, the court may convert the inpatient order to community-based treatment. When one is restored to competency, the patient will be discharged from the program back to the jail in their counties of origin. In this circumstance, the county jail will coordinate and provide transportation for the individual's return. When an individual is determined to need a higher level of care, OCFMH is able to coordinate transportation in collaboration with the State hospital’s transport team. However, when the court closes a case, dismisses a case, or allows for bond status and the court has not issued a writ of transportation, the patient may not have transportation home and may be released directly from the program location. OCFMH’s goal is to ensure all patients safely return to their designated community and expect the Offeror to propose mechanisms to ensure this occurs.

The successful Offeror’s program will be required, by contract, to accept all clients referred for placement by OCFMH. OCFMH staff will refer individuals who, based on a review of the individual’s competency evaluation, criminal charges, and other clinical and administrative information, appear appropriate for treatment in a jail environment.

Individuals admitted to this program, but later determined to need psychiatric hospitalization after review and consultation by the OCFMH Director of Jail-Based Evaluation and Restoration and program staff, will be transferred to another OCFMH designated facility, when possible.

An OCFMH psychologist will conduct the evaluation of competency, mental condition, and/or sanity by statutory requirement. If the program reports to OCFMH that an individual is believed to be restored to competency, they will be referred for an early evaluation of competency to proceed.

Financial Audit: The successful Offeror shall have an annual financial audit, prepared at Offerors’ expense performed by an independent Certified Public Accountant. The audit must conform to the guidelines included in the Federal Government OMB Circular A-133. The Offeror shall submit a copy of the audit report to OCFMH, including financial statements, management letter, and auditor’s opinion letter, for the most recent fiscal year ending June 30th, on or before November 30th.

Sub-Contractors: The Department reserves the right to contribute, review, inspect, or otherwise approve any services delivered by any sub-contractor.

The State reserves the right to add any related services that may enhance or modernize its operations in the future.

C. How to Submit a Proposal

1. In General. Email the proposal, Signature Page, and any other required documents in one zip file as an attachment to this email address: JG_2026.cq4ruho16jmux6uu@u.box.com Please be aware of email server file size limitations. The maximum file size the Department can accept is 15 GB.

2. Only Attachments. Only the zip file goes through. The Department cannot see any text or messages sent to the email address identified above. Written questions may be emailed to the Single Point of Contact.

3. File Names. The zip file name should start with the solicitation type, solicitation number, and vendor name (e.g., “RFP 2026000157 Vendor Name…”). Vendors may include additional information in the zip file name.

4. Timing. The zip file typically uploads within five minutes; however, vendors should submit zip files at least thirty minutes prior to any deadline to ensure the file is received.

5. Confirmation. Vendors will receive an email confirmation from box.com that the zip file was uploaded correctly. If not, please contact the Single Point of Contact.

6. No Encryption. Do not encrypt emails sent to the submission email as it may prevent full submission.

7. Pre-bid Conference. There will not be a pre-bid conference.

8. Questions. Vendors may submit questions by email to the Single Point of Contact prior to the Questions Due Date identified in the Basic Information and Timeline above. The Department may answer some, all, or none of the questions asked by posting them publicly.

9. Late Proposals will not be accepted unless specifically allowed by rule and at the Department’s sole discretion.

D. Proposal Format

1. Maximum Length. Proposals should not exceed 30 pages. The Department may evaluate proposals negatively if this page limit is not followed.

2. Requirements/Criteria. Requirements be stated in Section E. Proposal Content followed by the criteria. In you response, please restate the requirement

3. Respond to the requirements in the same sequence as outlined as above and restate the requirement followed by your response. Proposals that do not follow the sequence, outline, and response format of this RFP, may be deemed non-responsive and disqualified from further consideration.

E. Proposal Content

1. Proposal Substance. Please answer or address the following questions or issues:

1. Demonstrated Experience and Capabilities:

· Company Overview and Business Experience: Offeror’s experience in providing services to incarcerated individuals requiring behavioral health treatment services, including treatment of severe and persistent mental illness, evaluation of competency to stand trial, mental condition evaluations, sanity evaluations, and restoration to competency to stand trial.

Criteria: Please describe your agency and the services that you have provided to adult male populations in jails or correctional facilities that require behavioral health services. Include years of experience and specific programs and services offered by your agency specific to this population. You should disclose which agencies your company has contracted with in performing similar work in the past five years.

Criteria: Briefly describe the services (including annual average number of beds, daily rate charged per client per day), include the address, and phone number of a contact person at the agency with which you have contracted.

· Corporate Support and Management: The Offeror should have agency / corporate level resources, services, and functions that are indirectly involved in the day-to-day functioning of the program. OCFMH values corporate strength, support, and management that provide effective leadership, direction, quality control and assurance, crisis intervention, and resources to ensure successful program implementation.

Criteria: Describe your practices, experiences, and evidence as to why your company’s approach to support and management will lead to successful outcomes in this program.

Criteria: Describe how your company will manage this project.

· Indicate “key personnel”:

Criteria: Please identify who will be assigned to the project and describe their experience. Key personnel are defined as any and all personnel who are not employed at the program site but who are responsible for ensuring the program operates successfully.

Criteria: Please explain how you will ensure that equally qualified key personnel are assigned to the project if key personnel leave the company or the project. The State expects that the awarded Offeror will continue to make the key project personnel available through the life of the contract as long as they remain in Offeror’s employ. The state reserves the right to approve any replacement personnel.

Criteria: Please explain any performance incentives offered by the agency to key personnel.

2. Program Requirements / Work Plan:

· Referral and Admission Process: Admissions to the program will be coordinated through OCFMH, with initial priority given to those individuals most likely to respond positively to treatment in the jail program. It is recognized that treatment in a State hospital may be a more appropriate placement for some individuals.

· Upon admission, OCFMH will provide the following documents to the program:

2..1. The commitment order, including a specification of the charges;

2..2. The commitment order, including a specification of the charges;

2..3. Any arrest reports prepared by the police department or other law enforcement agency;

2..4. Any court ordered psychiatric examination or evaluation reports, including the competency evaluation(s) leading to treatment in the program; and, 2..5. Records of any findings of prior mental incompetence.

2..6. The awarded vendor’s program will accept referrals of individuals housed in county jails statewide, including the program site’s jails. The awarded vendor will not have a right of refusal.

Criteria: Please describe the process for receiving, prioritizing and responding to program referrals. Include specific timelines and describe the process for reviewing referral packets, responding to referrals, and admitting clients into the program. Please note, timelines may not exceed 24 hours from the time of referral. The proposed program should acknowledge the ability to accept referral packets in PDF format.

· Pre-Admission Transition: Transition processes are those designed to enhance positive transition from the individual’s county jail or state hospital location prior to admission to the program. The goal is to improve communication between jails, reduce anxiety of individuals and families, improve treatment service transition, and establish program engagement to reach successful outcomes.

Criteria: Please discuss willingness and ability to contact mental health and custody and control staff in the jails served by this program prior to admission to this program to obtain information beneficial to the individual’s treatment (i.e., medications administered, etc.) and your willingness to schedule and conduct program pre-placement visits as deemed appropriate.

2..7 Initial Assessment within 24 Hours of Admission: New admissions must be assessed by nursing and psychiatry within 24 hours of admission for appropriateness for the program, current mental status, suicidal ideation, and the possibility of violent behavior. Currently, nursing and psychiatric staff assess the following:

· Mental status;

· Vital signs;

· Pain;

· Skin color and condition;

· Nutrition;

· Rest and sleep;

· Suicide and self-injury risk;

· Homicide and assault risk;

· Substance abuse;

· Escape risk;

· Maladaptive behaviors;

· Vulnerability;

· Medical needs;

· Psychotropic medication needs.

Criteria: Please describe the admission assessment processes and tools to be used.

2..8 Intake Evaluation Period and Program Orientation: Individuals need time to become orientated to the program's rules and expectations and the clinical staff need to evaluate the individual’s level of functioning in order to inform housing needs and develop an individualized treatment plan. All disciplines should be involved in the orientation and assessment period to include formal assessments by nursing, psychiatry, social work, psychology, and recreation therapy staff. A well-defined orientation process for admittance and integration of clients into the Offeror’s program is required. The successful Offeror’s program will develop and implement policies and procedures for the process. The process includes orientation to program goals, review of a client handbook, which details information about the program and expectations for clients while in the program, objectives, procedures, and client rights including grievance procedures.

Criteria: Please describe the intake evaluation period, including length, assessment processes, and tools to be used. Describe the process that will be used to inform OCFMH of potential referrals to a higher level of care. Describe the individual orientation process. The description should include the intent of the orientation program, length of the program, and what criteria are involved in moving beyond the orientation program. Include a complete explanation of the orientation process that includes program goals, expectations for clients, client rights, and a description of the materials and practices that you will use during the orientation process.

Assessments: Comprehensive assessments of each individual admitted to the program shall be conducted within ten (10) days of admission. The assessments shall be completed by each discipline, including psychiatry, psychology, social work, nursing, and recreational therapy. A psychologist with forensic experience must complete the psychological assessment. The established time frames are listed below for reference.

· Nursing assessment is completed within 24 hours.

· Psychiatric assessment is completed within 24 hours.

· Biopsychosocial assessment is completed within three (3) business days and will include at a minimum information regarding the individuals:

Family history, developmental history, medical history, psychiatric history, legal history, intellectual and emotional functioning, substance use including valid screening tools, religious preferences, support systems, and community resource needs.

· Recreation assessment is completed with five (5) business days.

· Psychological assessment is completed within ten (10) business days and will include at a minimum:

2.9 A thorough clinical interview, mental status exam, and testing, as clinically indicated. Consideration to diagnosis of mental illness, cognitive limitations, malingering, and risk should be thoroughly considered. The assessment must also include a review of the evaluation of competency to proceed that led to the individual being placed in the program, with specific reference to barriers to competency that were identified in the competency evaluation. These barriers to competency shall be listed individually on the individualized treatment plan and targeted specifically in the defendant’s treatment.

Criteria: Describe the comprehensive assessments administered by each of the disciplines listed above, including specific tests and tools to be used, as applicable. The established time frames listed above should be considered as benchmarks in your proposal.

3. Treatment Planning: The individual shall receive services in accordance with a treatment plan that meets the needs of the individual. The initial treatment plan shall be completed within seven (7) business days from admission and informed by the initial assessments completed during the intake and orientation period. Subsequent treatment plan reviews will be updated based upon the monthly assessments completed by psychology and the contributions of all treatment team members. Monthly treatment plan reviews will be held. The plan shall:

· Be developed by an interdisciplinary team and based on the psychiatric, medical, social behavior, and developmental aspects of the individual as identified through assessments. The interdisciplinary team shall complete the care plan within seven days of admission and review the plan at least monthly for appropriateness. Plans should be revised as needed; particularly to incorporate change in clinical acuity and/or safety, and team meetings should be held more frequently if clinically indicated.

· Include short and long-term goals with measurable outcomes, active treatment modalities to be used, and the responsibility of each member of the treatment team.

· Reflect individual and family participation to the extent possible.

· Address any maladaptive behaviors and include monitoring of any behavior modification plans.

· Deficits in competency-related functional abilities that were identified in the evaluation that led to the individual’s admission to the program shall be listed in the individual treatment plan and addressed by specific treatment interventions. This should be modified as new evaluations are completed and strengths and/or barriers change.

· Daily rounds to re-assess defendants’ progress toward restoration of competence shall be conducted or as needed to allow the treatment teams to measure whether their treatment interventions are working, and whether additional treatment elements need to be incorporated into individuals’ treatment plans.

Criteria: Please describe treatment planning to be provided for individuals utilizing assessment and collaborative information. Describe the process of treatment plan review, including frequency or review, participants in the review. Provide any sample documentation created.

4. Psychological Assessment Protocol: Within ten (10) days of admission, and every 60 days thereafter, each defendant will undergo a competency screening to include areas of strength and continued barriers for competency restoration, and psychological assessment and testing, if clinically indicated. At admission, standardized psychological tests may be utilized to complete a preliminary assessment of the individual’s current functioning and likelihood of malingering.

· If preliminary assessment findings suggest presence of malingering, additional malingering-specific tests shall be completed, integrating additional observable data reported by various disciplines.

· If deficits in cognitive functioning are identified in the preliminary assessment, then further cognitive functioning tests shall be administered, depending on the specific cognitive deficit identified.

· Additional instruments assessing personality and neuropsychiatric symptoms are to be administered to complete further assessment of psychological functioning.

Criteria: Please describe the psychological assessment protocol to be completed for each individual admitted to the program. Measures should be standardized, reliable, and valid. Consideration should be given to the psycholegal context of treatment.

5. Daily Restoration and Other Treatment Services:

· The awarded vendor must provide a robust forensic treatment program that meets individual needs as identified in the treatment plan. Treatment services must include individual contacts and group sessions. Each individual shall be educated by being provided materials presented in multiple learning formats by multiple staff, e.g., a simple lecture format may be replaced with learning experiences involving discussion, reading, video, and experiential methods of instruction, such as role-playing or mock trial. Treatment services will focus on the various reasons for court ordered treatment, specifically competency restoration. Treatment services shall also focus on comprehensive mental health treatment including topics intended to support individuals' insight into their mental health, treatment needs, coping skills, and safe behaviors. Treatment services must extend to Saturday programming and access to on-call clinicians after hours.

· The treatment program shall include the following educational elements:

5..1. Forensic related education:

· Strong emphasis on rational decision making skills, particularly in the context of legal proceeding.

· Criminal charges.

· Severity of charges, namely felony vs. misdemeanor.

· Sentencing.

· Pleas, including: Guilty, not Guilty, Nolo Contendre/No Contest, and Not Guilty by Reason of Insanity (NGRI).

· Plea bargaining.

· Roles of the courtroom personnel.

· Adversarial nature of trial process.

· Evaluating evidence.

· Courtroom behavior.

· Probation and Parole.

5..2. The awarded vendor will provide additional learning experience through increased lecture time, as well as individual instruction to defendants who are incompetent due to specific knowledge deficits caused by intellectual disabilities or cognitive disorder, but who may be restored to competence with additional exposure to the educational material.

Criteria: Please describe the required services in detail, including curriculum, number of staff providing the service, and daily and weekly hours of service. Describe any curriculum (in addition to the OCFMH curriculum provided for reference) and evidence-based principles and theory of the treatment program.

6. Psychiatric Services: The awarded vendor must provide psychiatric services for each individual, to include assessment and treatment with psychotropic medications and prompt response to psychiatric emergencies after hours, including weekends. A licensed psychiatrist employed by the awarded vendor must provide these services and be licensed to practice in Colorado.

Criteria: Please describe your plan for providing psychiatric services, including services after hours, on weekends, and in emergencies.

7. Medical Services: The awarded vendor must ensure each patient receives appropriate medical care while in the program. This may be provided by staff designated to the program and/or staff employed through partnerships with jails or other vendors. Currently, Arapahoe is contracted with RecSol to provide medical services to the entire jail, including patients admitted to our jail based restoration program.

Criteria:: Please describe your plan to ensure adequate medical services are provided, including how the program will track staff referrals/requests for care and patient requests for care, services after hours, on weekends, and in emergencies. Include what medical services would be provided by program staff and cite the designated staff, what services would be provided by another partnership, and detail the expectation of care monitoring (i.e., frequency of vitals, labs, appointments, etc.). Also, include any foreseen barriers to maintaining this expectation and potential solutions.

8. Psychotropic Medications: The awarded vendor must ensure individuals are provided with all psychotropic medications as needed. The awarded vendor will be required to assess individuals upon admission for a current medication regimen, including interviewing the individual and contacting the individual’s last residential facility or jail. The awarded vendor will be required to use this information and maintain current medication regimens. Medications not on the current “Preferred Medication List,” but beneficial to the individual and the individual’s psychiatric stability, are to be prescribed. The awarded vendor will also be required to utilize practices to encourage medication compliance and adherence.

Criteria: Please describe your plan for providing psychotropic medications and meeting individual treatment needs. In addition, describe the practices you will use to encourage medication compliance and adherence.

9. Capacity Assessments / Involuntary Treatment: Defendants court ordered to receive evaluations and treatment may also lack the capacity to give informed consent with regard to treatment / medication issues. Since an important component of restoration to competence and general psychiatric health is medication treatment, it is essential that clinicians obtain proper authorization/consent for medication administration as soon as possible after admission. In addition, the awarded vendor will be expected to propose a plan for pursuit and administration of emergency medications and court ordered medications. Currently, the program within Arapahoe County Detention Facility has established relationships with the Court, specific Magistrate, and attorney to continue court ordered medications for patients who admit to the program with existing orders. It is expected the awarded vendor will work to expand upon this by collaborating with the necessary stakeholders to offer and initiate court ordered medication in our programs.

10.1 The awarded vendor will develop internal implementation plans that include designated staff, use of restraint and/or seclusion, the role of deputy staff, and administration of medication with consideration given to confidentiality and trauma informed care. The awarded vendor will also develop an appropriate strategic plan, outlined in the proposal to secure initiation of involuntary medications in the program.

Criteria: Please describe the process that will be used to obtain authorization/consent for medication administration. Please include any foreseen barriers and potential solutions.

10. Crisis Management: The awarded vendor must ensure individuals receive an adequate level of care to support basic safety needs. The awarded vendor will be required to have robust crisis intervention plans in place that includes clinical intervention and safety intervention.

Criteria: Please describe your plan for providing crisis services, including services after hours, on weekends, and in emergencies. This plan should account for various levels of intervention, designate specific staff, and cite any potential barriers.

11. Milieu and Behavior Management: It is important the awarded vendor have an integrated and responsive system for managing the behaviors and the daily treatment milieu so that the program and living environment is safe, organized, supportive, and conducive to treatment across all functional areas and offers specific programs and services.

OCFMH requires that all new program staff, including jail staff assigned to the jail pod, receive twelve initial hours of training and ongoing training in continuum of therapeutic intervention skills and eight hours of training in verbal judo skills. In addition, training is required every two years for current staff, including twelve hours of training in continuum of therapeutic intervention skills and two and a half hours of training in verbal defense skills. Program staff may receive this training at the Colorado Mental Health Hospital in Fort Logan.

The awarded vendor shall include any expected collaboration between treatment team staff and security staff in milieu management and safety. Please use the aforementioned deputy staffing as reference.

Criteria:: Please describe your milieu and behavior management system. Describe how you will utilize proven practices to ensure safe environments and treatment outcomes in dealing with this population. Identify how issues related to escapists’ behaviors, mental health needs, relational needs, trauma informed care, and aggressive behaviors will be addressed within the milieu.

12. Staffing: The awarded vendor must provide appropriate staff to ensure an environment that values the physical and emotional safety of the individuals and provides high quality services as described above. Retention, relief and employee quality of life plan - The intense environment to which direct care staff is exposed requires that the awarded vendor have a plan to retain qualified staff and support its employees so that there is adequate staff and support to cover training, sick leave, vacation, sick call ins, and any other situation where the provider is short staffed

Criteria:

List each position and respective titles, including contracted staff positions and intern positions, as well as full and part time staff positions (including client to staff ratio) for each shift. Specify if there are parameters around various positions’ ability to conduct forensic related work outside of this role and what conflicts of interest may be present. Specify any positions that are licensed or certified and include minimum qualifications for each position. Provide a sample-staffing schedule, for a week, indicating how many staff will be on duty, at what times and their roles. Be sure to include administrative staff responsible for human resources and the management of documentation related to new admissions, current patients, and those who have discharged. Discuss staff turnover ratios and the incentive program in place to encourage staff retention.

· Provide a position description for each position, to include minimum educational, licensure and experience requirements, and a salary range. (This does not include staff employed by the jail or other jail contract employees.)

· Provide a comparative analysis ranking your proposed salary ranges with current healthcare salary ranges in Colorado, including State of Colorado health care positions. Your response should discuss a salary schedule, indicating beginning salaries for each position, basis, and frequency for incremental increases, and fringe benefits.

· Provide your agency’s most recent annual turnover rate for identical or similar direct care positions.

· Please describe how your agency will cover vacancies to maintain funded staffing levels and provide the treatment services included in this RFP.

· Describe the background checks that are performed on employment candidates and employees.

· Describe your plan for retaining qualified staff and how you will support your employees by actively mitigating “staff burnout.” Also, include if there are any agency performance incentives or tuition reimbursement/stipend programs.

· Detail the desired safety and security coverage across all shifts.

13.1 Staff Development: A staff-training plan and professional development opportunities for new and existing staff. All newly hired staff and security personnel shall have initial and annual in-service training on effective methods to de-escalate various states of agitation associated with emotional disturbed behaviors. In addition, training specific to forensic related treatment and documentation should be incorporated upon hire and on an ongoing basis.

Criteria: Describe and quantify initial and on-going staff training that will ensure preparedness in meeting the challenges of the Offeror’s program. Discuss any special training that staff may receive for Offeror’s programmatic services offered throughout the proposal.

13. Policies and Procedures(subject to be reviewed and approved by Colorado Department of Human Services : The Offeror shall adhere to certain OCFMH policies and procedures as well as ensuring the adherence from any subcontractor. The awarded vendor will be expected to develop and implement policies and procedures regarding:

· Staffing and New Employee Orientation.

· Death of a Patient.

· Duty to Warn.

· Critical Incident Reporting.

· Medical Retention.

· On Call Practices.

· Patient Grievances.

· Patient Rights.

· Right to Refuse Treatment.

· Medication capacity assessments, medication monitoring, pursuit and implementation of emergency medications, and pursuit and implementation of court ordered medications.

· Victim Notification.

· Safety and security precautions for the prevention of suicide, assault, and individual injury at all hours. This shall include, but not be limited to protocols for:

13..1. Systematic assessments and elimination of environmental risks, to include periodic checking of breakaway hardware;

13..2. Systematic summoning immediate assistance for staff and individuals;

13..3. Opening locked or barricaded doors in the event of an emergency, using methods that do not cause harm to individuals;

13..4. Use of restraint and seclusion, 13..5. Sexual assault, 13..6. Behavior management techniques ranging from the least to most restrictive and when techniques that can result in harm to the individual are authorized; and, 13..7. Safety and security checks/welfare checks.

Criteria: Please state Offeror’s commitment to develop program policy and procedures and the date by which they will be developed.

14. Accreditation: The location of the program must meet American Correctional Association and National Commission on Correctional Health Care standards for mental health services.

Criteria: Please attest and describe your process and timeline to meet these standards and compliance with these standards.

15. Adjunct Services: The awarded vendor’s program must also provide solutions for instances where there are language barriers, which may include instances where English is a second language or a client is hearing impaired.

Criteria: Describe the types and frequency of these services and the qualifications of staff providing services. Please take into consideration ADA requirements.

16. Daily Schedule: A daily schedule of individual activities must be posted in the jail pod.

Criteria: Provide a detailed proposed daily schedule of individual activities.

17. Recreation and Social Activity: Recreational programming provides the opportunity for individual and group recreation activities that assist clients in learning how to use leisure time in a pro-social manner. These include physical activities and other programs that promote relaxation, relieve stress, and promote a healthy lifestyle. In addition, wellness is addressed through recreational services that focus on lifetime physical fitness and affordable pro-social use of leisure time. Services will provide education regarding the connection of nutrition, food, exercise, self-image, and positive relationships.

Criteria: Describe how your program will provide both active and passive recreational opportunities and both structured and non-structured recreation, including any evening and weekends.

18. Continuity of Care after Restoration: Individuals restored to competency or those that completed the court ordered evaluation are typically returned to a detention facility to await respective next legal steps. In addition to returning to jails, patients may return directly to the community. The awarded vendor is expected to identify patient needs, assist in communicating those needs to the judicial system, make appropriate referrals, and begin applications for assistance or outreach when appropriate (i.e., benefits, referrals to community treatment, referrals to mental health centers and community housing, etc.). In addition, maintaining adherence to medications is often critical to preventing the individual from decompensating after restoration to competency. Medication adherence is related to provision of information to the program or facility where the individual is housed prior to trial.

Criteria: Provide a description of continuity of care services that the program will provide to individuals leaving the program. Additionally, provide a detailed process that the program will use to identify, refer, and transition patients to the community throughout the course of their time in the program. Include a process for outreach to the courts and coordination with the jails. Please include any proposals to address potential barriers.

19. Transportation: Individuals leaving the program for reasons other than having been opined restored or transferring to another OCFMH treatment location may require transportation assistance in order to return to their home community.

Criteria: Describe how your program will ensure the safe return of all patients leaving the program. Proposals should consider the use of cab services, transport services, or partnerships with jails and other entities.

20. Data Reporting Requirements: The awarded vendor shall have a system of data collection allowing for the examination and continuous improvement of the program. The awarded vendor shall deliver to OCFMH a written report and an electronic file within 10 days of the last day of the prior month to include:

· Individuals referred, by name, referral date and committing county.

· Individuals admitted by name, admission date and committing county.

· Primary diagnosis of each individual admitted.

· Average Daily Census.

· Lowest Single Day Census.

· Highest Single Day Census.

· For evaluations, average length in treatment, shortest length in treatment, longest length in treatment.

· For restored individuals, average length in treatment, shortest length in treatment, longest length in treatment.

· For transfers, average length in treatment, shortest length in treatment, longest length in treatment.

· Of those discharged, percent restored in less than 90 days and less than 60 days.

· Primary diagnosis at time of discharge and frequency of each diagnosis.

· Use of interpretive services.

· Critical incidents involving individuals.

· Number of discharges.

· Number of individuals transferred to other OCFMH locations.

· Number of individuals diagnosed as malingering.

· Number and percentage of individuals prescribed medications and percentage and number fully med compliant, intermittently med compliant and refusing medications.

· Number of and hours of group sessions held daily and total sessions in the month.

· Amount of assessment time per individual in hours and average amount of assessment time for new admissions in hours.

· Number and percent of individuals refusing to participate in treatment.

· Staff turnover information including departures, offers, hires, and percentage of occupied and vacant employee positions.

· In addition, the program must provide a monthly written report to the Department summarizing program activity and outcomes during the preceding month.

Criteria: Describe your program’s ability and willingness to provide the data elements listed above within 10 days of the last day of the preceding month. Describe the monthly report and the outcome and performance measures that will be included in the monthly report.

21. Transition Planning: The awarded vendor is expected to flexibly accommodate the changing needs of the patient population as well as OCFMH.