RFP+325-23-930-091.docx

STATE OF NORTH DAKOTA

DEPARTMENT OF HEALTH AND HUMAN SERVICES

LAKE REGION HUMAN SERVICE CENTER

200 HWY 2 WEST

DEVILS LAKE, ND 58301

Solicitation Number: 325-23-930-091

Solicitation Type: Request for Proposal (RFP)

RFP Title: Crisis Residential Unit

Issued: November 20, 2023

Purpose of RFP: Requesting proposals for an entity to establish and operate a 10 bed sub-acute crisis residential unit in Devils Lake, North Dakota.

Procurement Officer: Christy Cichos

TABLE OF CONTENTS

SECTION ONE

Introduction and Instructions

1.03 RFP Schedule

1.04 Assistance to Individual with a Disability

1.05 Secretary of State Registration Requirements

1.06 Bidders List Registration

1.07 Notice Provided

1.08 Pre-Proposal Conference or Site Inspection

1.09 Deadline for Submission of Questions and Objections

1.010 Amendments to the RFP

1.011 Proposal Submission Instructions

1.012 Proposal Receipt Deadline – Late Proposals Rejected

1.013 Proposal Opening

1.014 News Releases

1.015 Attempt to Influence Prohibited

1.016 Collusion Prohibited

SECTION TWO

Scope of Work

2.01 Background Information

2.02 Budget

2.03 Scope of Service

2.04 Location of Work

2.05 Required Licenses

2.06 Federal and State Requirements

SECTION THREE

General Contract Information

3.06 Supplemental Terms and Conditions

3.07 Contract Approval

3.08 Contract Changes – Unanticipated Amendments

3.09 Taxes and Taxpayer Identification Number

3.010 Proposed Payment Procedures

3.011 Contract Personnel

3.012 Right to Inspect Place of Business

3.013 Inspection & Modification – Reimbursement for Unacceptable Services

3.014 Business Associate Agreement

SECTION FOUR

Proposal Format and Content

4.01 Proposal Format and Content

4.02 Introduction

4.03 Understanding of the Scope of Work

4.04 Management Plan

4.05 Experience and Qualifications

4.06 Cost Proposal

4.07 Required Enclosures

SECTION FIVE

Award and Proposal Evaluation

5.01 Award

5.02 Responsiveness

5.03 Proposal Evaluation

5.04 Understanding of the Scope of Work

5.05 Management Plan

5.06 Experience and Qualifications

5.07 Cost Proposal

5.08 Third-Party Security Questionnaire

SECTION SIX

Standard Proposal Information

6.01 STATE Not Responsible for Preparation Costs

6.02 Conflict of Interest

6.03 Offer Held Firm

6.04 Amendments to Proposals and Withdrawal of Proposals

6.05 Alternate Proposals

6.06 Subcontractors

6.07 Joint Ventures

6.08 Disclosure of Proposal Contents and Compliance with North Dakota Open Records Laws

6.09 Right of Rejection

6.010 Clarification of Proposals - Discussions

6.011 Best and Final Offers

6.012 Preference Laws

6.013 Negotiations

6.014 Notice of Intent to Award – Offeror Notification of Selection

6.015 Protest and Appeal

ATTACHMENTS

Attachment A – Sample Purchase of Service Agreement Attachment B – Business Associate Agreement Attachment C – Cost Proposal Attachment D – Evaluation Tool

SECTION ONE

INTRODUCTION AND INSTRUCTIONS

1.01 Purpose of the RFP

The state of North Dakota, acting through its North Dakota Department of Health and Human Services, Lake Region Human Service Center (STATE) is requesting proposals for an entity to establish and operate a 10 bed sub-acute crisis residential unit for individuals with mental illness and/or substance use disorder in Devils Lake, North Dakota.

1.02 Procurement Officer Contact Information

The procurement officer is the point of contact for this RFP. All communication regarding this RFP must be directed to the procurement officer (the preferred method of communication is e-mail). Please do not add the procurement officer to any marketing distribution lists.

Procurement Officer: Christy Cichos E-Mail: ckcichos@nd.gov Phone: 701-665-2224 TTY Users Call: 7-1-1

Engaging in unauthorized communication or seeking to obtain information about an open solicitation with any state employee or official other than the responsible procurement officer or designee is sufficient grounds for suspension or debarment. [N.D.A.C. § 4-12-05-04(7)]

1.03 RFP Schedule

This schedule of events represents STATE’s best estimate of the schedule that will be followed for this RFP. If a component of this schedule, such as the Deadline for Receipt of Proposals, is delayed, the rest of the schedule will be shifted by the same number of days. The estimated RFP Schedule is as follows:

1.04 Assistance to Individual with a Disability

Contact the procurement officer, as soon as possible, if an individual with a disability needs assistance with this RFP, including any events in the RFP Schedule, so reasonable accommodations can be made.

1.05 Secretary of State Registration Requirements

The North Dakota Secretary of State has registration requirements for individuals and businesses transacting business in North Dakota. If the successful Offeror is determined to have a registration requirement with the North Dakota Secretary of State, they must be registered before the contract award and registration must remain active for the duration of the contract period (N.D.C.C. § 54-44.4-09.1).

· See the OMB Guidelines to Vendor Registry for more information.

Visit the Secretary of State's Vendor Registration webpage for information on registration requirements and fees. Visit FirstStop, the Secretary of State's business and licensing software, for online form options.

· Check the Business Records database to see if a business is registered.

· Contact Secretary of State's office by email or call 701-328-2900 (choose menu item 2, then option 1).

· If you need to register, fees apply.

· Vendors may need to obtain businesses licenses. See the list of licenses required of businesses in the State of North Dakota. The link includes information on who to contact, application fees, renewal dates, and the legal reference.

1.06 Bidders List Registration

Individuals or business entities desiring to be notified of bidding opportunities may apply to be placed on the Bidders List. (N.D.C.C. § 54-44.4-09) Bidders Lists are used to notify vendors when solicitations are issued on the State Procurement Office Online system (SPO Online). Placement on the Bidders List does not guarantee a vendor will receive notice of every solicitation (N.D.A.C. § 4-12-05-01). There are no fees to register as a bidder. The online application form requests contact information for the receipt of solicitation notices. The Bidders List application and SPO Online system use commodity codes to identify categories of goods, services, and information technology.

The commodity code used for this solicitation is: 952 – 62.

Visit the OMB website for instructions and the online Bidders List Application: Bidders List Registration Website

For assistance with Bidders List Registration, contact State Procurement Help Desk at 701-328-1728 or infospo@nd.gov.

1.07 Notice Provided

This RFP, and any related amendments and notices, will be posted on North Dakota’s OMB’s website using SPO Online. Offerors are responsible for checking this website to obtain all information and documents related to this RFP:

https://apps.nd.gov/csd/spo/services/bidder/main.htm

Select “Recent Solicitations”. Recent Solicitations are listed by close date (see Deadline for Receipt of Proposals date in Section 1.03 RFP Schedule).

Notices related to this RFP will be sent to the Bidders List for the needed commodity or service and other known potential offerors.

Offerors not having completed the Bidders List registration may request to receive notices related to this RFP by contacting the Procurement Officer, in writing, with the following information: RFP title, business name, contact person, mailing address, telephone number, and email address.

This RFP will also be posted on the North Dakota Department of Health and Human Services website: Solicitation Notice | Health and Human Services North Dakota

1.08 Pre-Proposal Conference or Site Inspection

No pre-proposal conference or site inspection will be held for this RFP.

1.09 Deadline for Submission of Questions and Objections

Offerors should carefully review this RFP, including all attachments. Offerors may ask questions to obtain clarification and request additional information, or object to material in the RFP. Questions and objections must be submitted to the procurement officer, in writing, by the deadline identified in the RFP Schedule. The procurement officer may elect to respond to questions received after the deadline.

Questions and objections should include a reference to the applicable RFP section or subsection. Email is the preferred method of submission with the RFP number cited in the email subject line.

Responses to questions will be distributed as a Solicitation Amendment, unless the question can be answered by referring the offeror to a specific section of the RFP.

1.10 Amendments to the RFP

If an amendment to this RFP is issued, it will be provided to all offerors on the Bidders List for the solicitation and to those prospective offerors who have contacted the procurement officer to receive notices related to the RFP. An offeror shall include in its proposal any required acknowledgements of amendments to the RFP.

1.11 Proposal Submission Instructions

UPLOAD RESPONSE THROUGH THE STATE PROCUREMENT ONLINE SYSTEM (SPO ONLINE):

Offeror must electronically submit proposals through the State Procurement Office Online system (SPO Online) by the Deadline for Receipt of Proposals.

DO NOT WAIT UNTIL THE “LAST MINUTE” TO SUBMIT A RESPONSE. It is recommended that proposals be uploaded 24 hours prior to the Deadline for Receipt of Proposals.

Offeror must begin the electronic submission process well in advance of the Deadline for Receipt of Proposals to allow for transmission and resolution of any technical difficulties. Be advised that the STATE is not responsible for an offeror’s failure to timely submit a proposal due to any technical difficulties. If you experience any technical difficulties contact the Procurement Officer or the State Procurement Office at infospo@nd.gov or 701.328.2740.

If documents are in the process of being uploaded when the Deadline for Receipt of Proposals occurs, the upload process will stop. The attempted submission will not be uploaded successfully and is ineligible for consideration. The STATE takes no responsibility for electronic submissions that are captured, blocked, filtered, quarantined, or otherwise prevented from uploading by any anti-virus or other security software.

1. This solicitation is posted on SPO Online at: https://apps.nd.gov/csd/spo/services/bidder/main.htm

2. Select “Recent Solicitations” and find this solicitation. Solicitations are listed by close date.

3. Use “Upload Response” to upload a maximum of five (5), clearly labeled documents before the Deadline for Receipt of Proposals provided in the RFP Schedule.

4. Offeror must upload their Technical Proposal and Cost Proposal in separate files.

5. The maximum file size allowed is 50mb per file.

6. There is a 50-character file name limitation for the document being uploaded.

7. There is a 75-character limit in the TITLE field within SPO Online.

8. All SPO Online field entries must be alphanumeric. Dashes and underscores are allowed; however, the system DOES NOT accept other special characters, such as apostrophe, & symbol, quotation marks, etc..

9. DO NOT submit documents that are embedded (zip files), movies, wmp, encrypted, or mp3 files.

10. Offeror will receive an email confirmation from infospo@nd.gov that the upload response was received including the “File Description” for the uploaded files. Review this email to ensure all files were successfully uploaded. If offeror DOES NOT receive an email confirmation, the upload was NOT successful, and the files will need to be uploaded again. If offeror does not receive an email confirmation after the reattempt, contact the Procurement Officer or the State Procurement Office at infospo@nd.gov or 701.328.2740.

Visit https://www.omb.nd.gov/sites/www/files/documents/doing-business-with-the-state/procurement/spo-electronic-response-external-job-aid.pdf for the SPO Electronic Response Job Aid which describes how to submit an electronic response.

1.12 Proposal Receipt Deadline – Late Proposals Rejected

An offeror is responsible for ensuring its proposal is received by STATE prior to the Deadline for Receipt of Proposals identified in Section 1.03 RFP Schedule. A Solicitation Amendment will be issued if this deadline is changed. An offeror may contact the procurement officer to inquire whether its proposal has been received. Offerors assume the risk of the method of dispatch chosen. STATE assumes no responsibility for delays caused by any delivery service. Postmarking by the Deadline for Receipt of Proposals shall not substitute for actual proposal receipt by STATE. Proposals delivered late will be rejected pursuant to N.D.A.C. § 4-12-08-13.

1.13 Proposal Opening

This is a formal sealed RFP process. Proposals will be secured and held unopened until the Deadline for Receipt of Proposals. A public opening will not be held.

1.14 News Releases

An offeror shall not make any news releases related to this RFP without prior approval of the procurement officer.

1.15 Attempt to Influence Prohibited

Offerors must not give or offer to give anything to a state employee or official anything that might influence, or appear to influence, procurement decisions. Suspected attempt to influence will be handled in accordance with N.D.A.C. § 4-12-04-05.

1.16 Collusion Prohibited

Offerors must prepare proposals independently, without collusion. Suspected collusion will be handled in accordance with N.D.A.C § 4-12-04-06.

SECTION TWO

SCOPE OF WORK

2.01 Background Information

STATE is one of eight regional human service centers in North Dakota and is designed to provide a wide range of human services to the residents of Ramsey, Benson, Eddy, Cavalier, Towner, and Rolette counties in North Dakota.

There is a need for a sub-acute crisis residential care to meet the needs of Region III, which consists of the above listed counties. The target population of this service is adult (age 18+) clients of STATE who have serious and persistent mental illness and/or substance abuse disorder and require crisis intervention not available in the community. This is a higher level of care than outpatient care, yet not serious enough to constitute psychiatric inpatient hospitalization. Individuals that are served within the crisis residential units are in the midst of a behavioral health crisis and may be in active withdrawal from substances. STATE may also find that the clients will have the need to continue to be housed to maintain a safe and sober environment while involved in treatment services with STATE. Therefore, there potentially could be individuals in the following levels of care: crisis residential, withdrawal management, and/or low-intensity residential. Level of supervision will vary person to person, depending on risk.

The population served by this facility includes STATE, both male and female, adult age clients participating in center programming. STATE will retain the authority to determine placements and discharges and will retain the formal treatment portion of this service. Admissions to the facility and the duration of enrollment in the facility and program are determined by STATE’s designated staff.

This program will accept all referrals from STATE and will provide a safe, structured, therapeutic environment for up to the maximum of 10 participants at any one time. This program will target serving individuals who have serious and persistent mental health issues and/or substance abuse issues.

2.02 Budget

The budget shall be for the period of June 1, 2024, through June 30, 2025. The successful offeror must submit a detailed Cost Proposal of the monthly projection, to include regional staffing patterns based on the current regional market, to substantiate the requested amount. This amount will be prorated based on the official start date.

The successful offeror will be responsible for all start-up costs, including, if needed, remodeling a facility to meet compliance with local codes. STATE may assist the successful offeror, upon proof of actual costs, with start-up costs.

STATE intends to enter into a contract with the successful offeror for the monthly projection cost.

2.03 Scope of Service

STATE desires to contract for sub-acute crisis residential services for all referred adult (age 18+) citizens of North Dakota. Sub-acute crisis residential services are designed to resolve the presence of acute or crisis behavioral health symptoms or the imminent risk of onset of acute or crisis behavioral health symptoms for individuals experiencing a decreased level of functioning due to a behavioral health concern. The sub-acute treatment setting provides a protective environment that includes stabilization, support, risk assessment, crisis-psychotherapy, wellness, and connection to ongoing services provided 24 hours a day, seven days a week. These facilities are intended to be short-term, intensive, and recovery-oriented.

STATE will have the authority to determine placements and discharges and will retain the formal treatment portion of the services, which includes providing direction for skills integration services delivered by the successful offeror’s staff. Admission to the program and the duration of enrollment in the program are determined by STATE. An individual’s length of stay will be based on the individual’s needs and crisis resolution, although the average length of stay is anticipated to be between two-five days.

This program will accept all referrals from STATE and will provide a safe, structured, therapeutic environment for up to the maximum of 10 individuals at any one time.

An offeror must provide a detailed response for each of the following sections:

The successful offeror shall provide sub-acute crisis residential services to all referred North Dakota citizens in a self-defined behavioral health crisis.

The successful offeror shall adhere to the following principles, in accordance with the Department of Health and Human Services (DHHS) Field Services defined core values:

1. Person-Centered Care

2. Recovery-Oriented

3. Trauma-Informed

4. Integrated

5. Transparent

6. Accountability

7. Evidence-Based Practice

8. Data Driven

The successful offeror shall apply the following Substance Abuse Mental Health Services Administration (SAMHSA) Practice Guidelines and Guiding Principles in operating crisis services: avoid harm, intervening in person-centered ways, shared responsibility, addressing trauma, establishing feelings of personal safety, based on strengths, the whole person, the person as a credible source, recovery, resilience and natural supports, and prevention.

The successful offeror shall implement the six SAMHSA guidelines for Trauma-Informed Care in their practices, which include:

1. Safety - throughout the organization, staff and the clients served feel physically and psychologically safe.

2. Trustworthiness and transparency - organizational operations and decisions are conducted with transparency. The goal is to build and maintain trust among clients and their family members, staff, and others involved in the organization.

3. Peer support and mutual self-help - these are integral to the organizational and service delivery approach and are understood as a key vehicle for building trust, establishing safety, and empowerment.

4. Collaboration and mutuality - there is true partnering and leveling of power differences between staff and clients and among organizational staff from direct care staff to administrators. There is recognition that healing happens in relationships and in the meaningful sharing of power and decision-making. The organization recognizes that everyone has a role to play in a trauma-informed approach. One does not have to be a therapist to be therapeutic.

5. Empowerment, voice, and choice - throughout the organization and among the clients served, an individual’s strengths are recognized, built on, and validated and new skills are developed, as necessary. The organization aims to strengthen the staffs’, clients', and family members' experience of choice and recognize that every person's experience is unique and requires an individualized approach. This includes a belief in resilience and in the ability of individuals, organizations, and communities to heal and promote recovery from trauma. This builds on what clients, staff, and communities have to offer, rather than responding to perceived deficits.

6. Cultural, historical, and gender issues - the organization actively moves past cultural stereotypes and biases (e.g., race, ethnicity, sexual orientation, age, geography), offers gender responsive services, leverages the healing value of traditional cultural connections, and recognizes and addresses historical trauma.

The successful offeror shall ensure all staff are trained (in collaboration with STATE) on the usage of Narcan nasal spray and ensure availability of Narcan nasal spray onsite for use in opioid overdose emergencies.

The successful offeror shall establish and maintain the necessary facility within the city limits of STATE’s accompanying human service center. The facility must be a pleasant, safe, healthy environment, and meet all applicable local codes relating to building structure, health, and safety. The successful offeror shall:

1. Provide a minimum of three meals per day for clients, which adhere to national nutritional standards.

2. Provide housekeeping, janitorial, and other support services.

3. Follow established check-in systems to ensure that dangerous materials or items are monitored and not allowed in the facility.

4. Inspect the service delivery site and provide any additional furnishings, technology (phone/computer/etc.), and residential supplies that are necessary to adequately operate the program. This shall include:

i. Any substance use screening and testing equipment and supplies.

ii. Vital sign measurement equipment and basic first aid medical supplies.

iii. All necessary items to adequately provide a therapeutic environment to meet clients’ needs, such as bedding, cleaning equipment, medication monitoring equipment, etc.

5. Utilize and improve facilities to meet the following objectives:

i. The layout is maximized to aid in easy visual observation of clients by staff, without compromising client dignity and respect.

ii. Ligature and other safety risks are minimized via the use of specialized hardware and fixtures with special attention to bathrooms, as these are the highest risk areas within behavioral health facilities.

iii. Furniture is comfortable, heavy (hard to throw), and easy to clean.

iv. Safety risks are minimized via the use of secure entry/exit.

v. Quiet rooms are separate from the common milieu where clients can de-escalate.

vi. Interview areas that permit privacy while permitting safe exit if agitation occurs.

vii. Cameras to enhance the ability to provide real-time monitoring and allow video review of safety incidents for quality improvement process review.

The successful offeror shall adhere to the following:

1. General/Policy Expectations:

i. The successful offeror shall develop and demonstrate consistent compliance with the Subacute Residential Unit Policy and Procedure Manual. Successful offeror will receive the Subacute Residential Unit Policy and Procedure Manual for this program from STATE within 30 days of signing the Purchase of Service Agreement. Any updates or changes to the policies and procedures will be submitted to the successful offeror within 30 days of the update and/or change. Policies and procedures will be subject to and must adhere to licensure and/or Council on Accreditation Standards.

ii. The successful offeror shall provide general maintenance of the work area, complete minor repairs, and schedule and report more complex repairs.

iii. The successful offeror shall maintain safety protocols, including, but not limited to, conducting fire drills and recording incident reports.

2. Staffing Expectations and Training:

The unit must be staffed and able to provide the services above, 24 hours per day, seven days per week, 365 days per year (24/7/365). The successful offeror shall ensure that staffing is adequate to meet service demand within a timely manner for all crisis services. Minimum staffing requirements shall be a 1:5 ratio that includes certified mental health technicians, who are certified in medication administration, and a unit supervisor. For safety purposes, there must be a minimum of two staff on each shift. The minimum staffing ratio of 1:5 shall be provided at any given time of day, except for those situations that more intensive supervision is needed, please see observation protocol. Example: if someone is placed on 1:1 staff observation, the staff person covering that client shall not be included in the 1:5 ratio.

STATE will assess all clients who enter the unit. Working within scope, the provider will complete a risk assessment and assign any safety procedures and precautions necessary for the client.

i. Observation Protocol will be assigned by STATE in the following manner:

a. One on one – client is high risk for harm to self or others and is in imminent danger without 1:1 staff observation. The successful offeror’s staff shall remain two arms-length away, which means more staff will need to be brought into the unit to monitor the severity level of the one client only. The client must be always accompanied by a staff member, including to the bathroom, until a risk assessment can be conducted by emergency service staff in person or via telehealth to determine level of care needed.

b. Line of sight – client is moderately high risk for harm to self or others and must be within the sight of staff at all times. The bathroom door could be partially closed, as long as staff can still maintain sight of the client. The minimum staffing ratio, per shift, shall be provided.

c. To be seen – client is at moderately low risk for harm to self or others but can have distance from staff, as long as the client can be observed easily. Clients are required to be in an area where staff can easily observe them, as needed. The successful offeror’s staff shall be able to go see the client and provide routine check ins.

d. Proximity awareness – client is at low risk for harm to self or others, successful offeror’s staff are aware of client’s location, client may sign in and out of the unit, and the client can attend appointments without the assistance of staff.

ii. The successful offeror shall conduct criminal (including fingerprinting), child protective services, and driver’s license background checks on individuals applying to work at the successful offeror’s residential unit to avoid hiring individuals inappropriate to provide care to vulnerable clients.

iii. The successful offeror shall demonstrate that skilled paraprofessionals and professionals are available on site 24/7/365. The unit shall be staffed, at a minimum, by individuals with a high school diploma or equivalent, up to bachelor level crisis staff, and skilled professionals.

iv. A credentialed staff member shall be designated as “lead worker” during each shift, with added responsibilities to assure adherence to establish policies and procedures. All credentialed staff may be required to attend mandatory training provided by STATE. The staff in attendance at the trainings shall train the staff unable to attend.

v. Staff need to be awake and on-duty to provide supervision of clients 24 hours a day, in a manner that provides a safe and healthy recovery environment.

vi. The successful offeror must provide 40 hours of weekday registered nurse (RN) coverage and must participate in telehealth RN coverage, provided by STATE, when operational to ensure availability of 24-hour nursing assessment and support to meet client’s needs. Nursing staff shall include vital signs, provide diabetic care, and monitor self-administration of medications as clinically appropriate. Nursing staff shall assist and educate clients regarding self-administration and adherence to medications. Nursing staff shall provide reconciliation of medications on admission and upon adjustments throughout the stay. Nursing staff shall either have experience with or be trained to manage individuals in active withdrawal from substances including alcohol and opiates.

a. All clients admitted into the crisis residential unit shall receive a consult and nursing assessment provided by the RN on shift to ensure medical and medication needs are addressed and can be safely managed in a sub-acute level of care.

b. Nursing staff shall reconcile medications and coordinate with prescribers in the community to assist clients in making sure they have medications, as well as refills.

c. The successful offeror shall enter all nursing assessments and required documentation into Provider Connect.

d. Nursing staff shall complete med counts as required by licensure standard and best practices.

e. Nursing staff shall maintain all Medication Administration Records and reconcile medication that clients are prescribed.

f. Monitor and train staff in the use of Clinical Institute Withdrawal Assessment for Alcohol (CIWA) and Clinical Opiate Withdrawal (COW) and other withdrawal protocols as guided by STATE.

vii. Staffing ratios shall expand upon assessment of the needs of the clients and the milieu of the unit. Given the walk-in access, additional staff shall be accessible to provide service to the unit if need is indicated.

viii. Needs of the walk in (sit or stand individuals) may require additional staffing for higher risk needs. This may also occur at busier times of the day. The successful offeror is responsible to ensure the staffing ratio is adequate to meet the needs of the requested services and must report immediately to STATE if the needed staffing ratio is not available.

ix. All staff working within the facility shall have the capacity and training to do the following:

a. Assist individuals, within the rehab model, in performing routine daily living activities, such as personal care and hygiene, health and wellness, housework, laundry, meal preparation, and/or money management.

b. Assist individuals in skills coaching and integration for: verbal and nonverbal communication, self-help skills, behavior management, and/or vocational skills.

c. Assist individuals with transportation arrangements or coordination of appointments.

d. Support individuals in accomplishing their personal goals.

e. Maintain safety, including infection control protocols.

f. Clean, setup, and/or maintain equipment used for individual evaluation or treatments.

g. Serve as an advocate for individuals receiving services.

h. Follow individual support plans.

i. Assist individuals and other team members with more complex duties.

j. Take and record vital signs, complete and check medical charts/records, make observations, and record information in an individual’s file.

k. Trained team members must follow CIWA and COW procedures for alcohol and opioid withdrawal, respectively.

l. Assist individuals to perform a variety of exercises and/or treatment routines as part of an established regimen and document an individual’s progress.

m. Assess individual skill levels to assist individuals in developing a daily routine or weekly meal plan.

n. Participate in assigned groups that provide education and/or treatment to individuals.

o. Organize and facilitate social and recreational activities.

p. Attend meetings or groups, as assigned.

q. Provide program orientation to new individuals.

r. Monitor self-administration of an individual’s medications.

s. Provide personalized care to individuals in special populations that have additional program emphasis, such as: crisis intervention, sex offenders, severe behavioral problems marked by aggression or high-risk behavior, multiple disabilities, or are physically, mentally, or medically fragile.

x. All staff are required to complete training courses in person and/or online at the direction and discretion of STATE. This includes direct service, supervisory, and management staff attend all required STATE trainings.

3. Client Service Expectations and Program model:

i. The successful offeror shall comply with all applicable federal and state laws and regulations.

ii. The successful offeror shall provide on-site sub-acute crisis residential support services.

iii. The successful offeror shall monitor clients receiving sub-acute crisis residential support services.

iv. The successful offeror shall demonstrate consistent compliance in following STATE’s specified, individualized plan of care for each individual receiving services.

v. The successful offeror shall orient individuals to the unit and service program. This will include, but is not limited to:

a. Patient Rights and Responsibilities

b. Privacy and Confidentiality Practices

c. Civil Rights and Grievance Procedures

d. Informed Consent for Services

e. Service Description

f. Fees Associated with Services

g. Cell Phones and Electronic Devices

vi. The successful offeror shall provide client and guest check-in and orientation to the program and the unit. The patients’ rights and the program services available to them shall be reviewed at this time.

vii. The successful offeror shall provide withdrawal management level of care under STATE’s license and shall follow withdrawal management protocols, as required.

viii. The successful offeror shall aid in meal preparation for clients and maintain kitchen and common areas in a clean and orderly fashion. The successful offeror shall provide functional assessment (e.g., Excels, DLA-20 etc.) related to completion of activities for daily living to assist in identifying areas of programming needs.

ix. The successful offeror shall provide rehabilitation services to clients as the situation requires or as directed by STATE’s staff indicated in the Integrated Service Plan.

x. The successful offeror shall identify opportunities for recreational or supportive activities on evenings and weekends to help structure client time in a positive manner.

xi. The successful offeror shall document client activities and communicate promptly and effectively with treatment providers.

xii. The successful offeror shall initiate crisis intervention protocols and therapeutic response techniques when situations arise.

xiii. The successful offeror shall provide or assist with the arrangement of client transportation needs. This must include, but is not limited to:

a. Transportation as directed by STATE, in order to attend programming, community support groups, and practical supports.

b. Medical appointments or non-emergent transport to receive care or support.

xiv. When arrangements are made by STATE for an admission, the successful offeror shall coordinate with STATE and the client to be transported to the unit for admission.

a. If the client needs to go to other locations to get their essential belongings to stay at the crisis unit, the successful offeror shall accommodate that to ensure the client’s basic needs are met. This includes, but is not limited to:

i. Pharmacy

ii. Client’s home

iii. Homeless Shelter

iv. Hospital

v. Jail

xv. Crisis walk-in services:

a. Shall be available 24/7/365 and located at the sub-acute crisis residential unit.

i. The successful offeror shall provide mental health technician staffing to provide support and stabilization for clients that may not need to be admitted to the unit but would require further service on location to resolve crisis and return to the community, along with RN service for any identified emergent situations, as needed.

ii. The successful offeror shall notify STATE of all individuals who arrive for crisis services so STATE can provide screening, suicide and general risk assessment, and triage in a timely manner. If indicated through the screening process, STATE will provide integrated assessment services, crisis psychotherapy crisis intervention/stabilization, and/or admission to sub-acute residential care. If limited support is needed and the individual is not admitted for ongoing services, triage team members will provide a disposition plan and linkage to community resources.

iii. A secure area, preferably individual units, that can be locked for clients to store their property while at the facility is required. Clients should have access to these items while on site, with the exception of any weapons or non-prescribed substances.

1. Any prescribed medications shall also be stored securely for clients allowed to self-monitor their medications under staff observation.

b. Shall be structured in a manner that offers capacity to accept all referrals, with priority given to individuals accompanied by first responders, with the exception of individuals identified as having acute symptoms which would require emergency medical care.

c. Shall have the capacity to provide initial management and screen high acuity individuals, such as:

i. Individuals who are aggressive;

ii. Individuals with co-occurring substance use and/or behavioral health disorders;

iii. Individuals who are referred by law enforcement/first responders;

iv. Individuals on an alternative treatment order;

v. Individuals who present as altered by a substance (e.g. drug/alcohol); and;

vi. Individuals who are at imminent safety risk who may be suicidal, homicidal, or disabled.

xvi. STATE may require the successful offeror to provide secondary staff to be available occasionally for community-based assessment where safety concerns are moderate, but not to the level where law enforcement accompaniment is necessary. The purpose of the secondary staff would be to assist in incorporating a safety element to the client services. The expectation would be that this secondary staff could notify emergency personnel if the situation becomes escalated while STATE’s clinician attempts to work with the client.

xvii. Discharge Arrangements: When STATE determines level of care has changed, the successful offeror shall arrange to transport that client to the recommended level of care if law enforcement or emergency transport is not required. The successful offeror shall complete the required discharge documents and compete checkout procedures with the client. The successful offeror shall then transport client to the needed location based on the recommendation of STATE. This could include, but not limited to:

a. Walk-in clinic or hospital – non emergent

b. Home

c. Treatment center

d. Homeless shelter

e. Family/support person’s home

4. Other Requirements:

i. Sub-acute crisis services shall be confidential and only disclosed as required by law, or for other purposes permitted under the Health Insurance Portability and Accountability Act (HIPAA), HIPAA regulations, and Title 42 C.F.R. Part 2.

ii. The successful offeror must maintain North Dakota State Licensure Requirements and Council on Accreditation Standards as dictated by STATE.

iii. The successful offeror shall establish protocols to ensure that systems and processes follow HIPAA law and regulations and Title 42 C.F.R. Part 2, and use both physical and electronic access controls.

iv. The successful offeror shall partner with a 24/7/365-available interpreter service to assist with languages that are not spoken fluently by any crisis staff present within the unit. The successful offeror shall ensure that the identified language interpreter service is a HIPAA-compliant member of the National Coalition on Health Care Interpreter Certification. The interpreter service shall have languages available to meet demand.

v. The successful offeror shall utilize TTY environment (or TTY over Internet Protocol) to manage calls for individuals who are deaf or hard of hearing.

vi. The successful offeror shall ensure compliance with all applicable Americans with Disabilities Act (ADA) regulations on all modalities.

vii. The successful offeror shall have in place processes, policies, and procedures related to recovery and continuation of system operations after a natural or human-induced disaster. In the event there is an interruption in service lasting over two hours impeding the ability to meet the requirements of the contract, the successful offeror shall notify the DHHS Field Services Statewide Clinics Operations Director via email and/or phone within four hours of the time of onset with details of the disruption and planned resolution, including which services were impacted.

viii. The successful offeror shall establish written policies and procedures outlining recovery and continuation of the system operations in the event of a natural or human-induced disaster. Disaster criteria policies and procedures shall be subject to review.

ix. The successful offeror shall perform outreach and communication to establish working partnerships with local hospitals and emergency departments, law enforcement, programs for homeless individuals, and other community resources.

x. The successful offeror shall attend quarterly Community Coordinators Meetings to hear about community trends and report program updates and data reporting to the members.

5. Reporting Expectations:

i. The successful offeror shall communicate on a regular basis with STATE identified treatment team to make the appropriate treatment adjustments, in order to reduce risk factors and enhance the client’s skill development and stability of symptoms. To achieve the best outcomes, it is essential that the successful offeror works closely with STATE’s clinical staff.

ii. The successful offeror shall complete a monthly report on the number of individuals served by the fifth working day of the month following the month services were provided. At a minimum, the report must include the name and case number of the individuals, the specific bed days they were at the facility, and the total number of bed days requested for reimbursement. Copies of case notes for specific services provided to everyone in the program will need to be included in this monthly report.

a. The successful offeror shall comply with STATE’s recommendations regarding crisis walk-in data.

b. The successful offeror’s quality management program shall collaborate with STATE’s local quality manager and provide data, as requested.

iii. The successful offeror must have the ability to transmit electronic health records (EHR) to STATE. All EHR transmissions shall comply with Meaningful Use Standards.

a. There shall be an ability to scan documents related to the client (i.e., court, medical, consent, releases, etc.) and house them within the case or system.

b. Use an encrypted email system to communicate with STATE and have the ability to transmit documents and needed information under state and federal privacy standards previously stated in this Section 2.03.

c. All clinical documentation completed by the successful offeror must be entered into a designated electronic health record within 24 hours of the service being provided. The standard of care is within the same shift as the service was provided or concurrently, if possible.

iv. Without sufficient documentation of the service, the successful offeror will not receive payment for the declared service in the billing submission.

a. The successful offeror shall produce an audit report of this to detail any missing documentation at the submission of billing.

b. All submissions are subject to review by STATE.

v. The successful offeror shall participate in the weekly on-site resident meeting and attend weekly meetings with STATE’s staff.

vi. The successful offeror shall maintain a quality management team with a designated lead. This team will be expected to meet quarterly and will be composed of staff members from both STATE and the successful offeror.

a. The successful offeror shall report to STATE any grievances and/or complaints made to the agency and document follow-up and resolution on a quarterly basis.

vii. The successful offeror shall maintain an internal quality management group.

a. Quality management functions shall include management of incident reports, collection of satisfaction/outcome surveys, and identify and complete ongoing performance improvement initiatives. A yearly summary report from the internal quality management group shall be provided to STATE.

i. The successful offeror shall collect client surveys and provide the results of these surveys to the internal quality management group on 75% of all planned discharges.

b. The successful offeror shall collect data and produce evidence of the internal quality management group’s plan and provide regular reviews and progress towards the plan.

c. The successful offeror shall identify outcome measures relating to services provided by the successful offeror. The successful offeror shall produce monthly, quarterly, and annual reports to STATE to include, but not limited to:

i. Bed day

ii. Client surveys and results

iii. Incident reporting

iv. Client outcome

v. Program outcome

vi. Process outcome

vii. Community engagement

d. The successful offeror shall comply with any STATE quality management audits.

viii. The successful offeror shall develop its own incident report forms and internal process for reviewing and managing these. The successful offeror shall provide the written documentation of the incident to STATE within 24 hours of the incident. Reportable incidents shall include incidents involving accidents and injuries, including those resulting in serious physical or psychological trauma; medication errors; and inappropriate client or staff conduct, including inappropriate sexual contact. Incidents involving death must be reported immediately.

a. The successful offeror shall produce minutes from quarterly (or more frequent) incident review with a process improvement plan.

ix. STATE will designate a primary contact and the successful offeror shall communicate any program issues or concerns directly with the primary contact.

x. STATE will provide consultation 24 hours a day, seven days a week, to address critical, atypical, or other urgent client care concerns that may arise, particularly for those situations that fall outside of the policy and procedure manual or are not specified in the care requirements for individual clients.

2.04 Location of Work

STATE will not provide workspace for the successful offeror. The successful offeror shall be responsible for site and location selection, subject to the approval of STATE.

The successful offeror shall be responsible for the coordination of all building construction, renovation, or changes necessary to operate the sub-acute crisis residential unit in conformity with the provisions of the Purchase of Service Agreement, subject to the approval of STATE.

The successful offeror shall comply with all applicable federal, state, and local ordinances, including applicable zoning, building code, and health code ordinances. The successful offeror shall be responsible for securing any necessary zoning ordinance changes or amendments necessary to develop a site for the operations of the facilities and programs.

2.05 Required Licenses

By the Deadline for Receipt of Proposals, an offeror must have and keep current any professional licenses and permits required by federal, state, and local laws for performance of a contract entered as a result of this RFP. An offeror who does not possess required licenses at the time proposals are due will be determined non-responsive.

2.06 Federal and State Requirements

An offeror shall identify all known federal and state requirements that apply to the proposal, the evaluation, or the contract to be entered as a result of this RFP.

SECTION THREE

GENERAL CONTRACT INFORMATION

3.01 Contract Term, Extension, and Renewal Options

STATE intends to enter a contract effective June 1, 2024, through June 30, 2025.

STATE may extend the contract period for an additional period of time, not to exceed 12 months, beyond the normal expiration date of the contract, upon mutual written agreement by both parties.

The contract resulting from this RFP may be renewed upon satisfactory completion of the initial contract term. STATE reserves the right to renew the contract for up to three additional periods, each period of renewal being for 24 months, upon written agreement by both parties. The contract will not automatically renew. STATE will provide written notice to the successful offeror of its intent to renew this contract at least 30 days before the contract’s expiration date. The estimated dollar amount for renewal options is dependent upon legislative appropriation. STATE and successful offeror may revise the firm fixed price for each renewal option.

3.02 Contract Type

A contract resulting from this RFP is a Firm Fixed Price. Successful offeror will be required to hold the price firm for the contract period, except as otherwise provided in the contract.

3.03 Standard Contract Provisions

The successful offeror will be sent a contract to sign and return to STATE. The successful offeror shall comply with the contract provisions set out in the “Sample Purchase of Service Agreement” document, attached as Attachment A, and made a part of this RFP. An offeror may state any objections or propose changes or additions to the Sample Purchase of Service Agreement. Describe the changes to the contract being proposed or provide a red-line of STATE’s Sample Purchase of Service Agreement. Offerors are not to submit their own contract or standard terms and conditions with their proposals.