RFR 247632 Substance Addiction Service Treatment for Civilly Committed Clients~2.docx

The Commonwealth of Massachusetts Department of Public Health Bureau of Substance Addiction Services

Address: 250 Washington Street, 3rd Floor, Boston, MA 02108

Contact Name: Ryan H. Naismith

Email: (781) 719-2154

Request for Response (RFR)

Document Title: Substance Addiction Service Treatment for Civilly Committed Clients

DPH RFR Document Number: 247632

COMMBUYS BID Number: BD-24-1031-BSAS0-BSA01-96180

December 12, 2023

Key RFR Information All Potential Bidder’s must read

COMMBUYS REGISTRATION

It is the responsibility of the prospective Bidder and awarded Contractor to maintain an active registration in COMMBUYS and to keep current the email address of the Bidder’s contact person and prospective contract manager, if awarded a contract, and to monitor that email inbox for communications from the Purchasing Department, including requests for clarification. The Purchasing Department and the Commonwealth assume no responsibility if a prospective Bidder’s/awarded Contractor’s designated email address is not current, or if technical problems, including those with the prospective Bidder’s/awarded Contractor’s computer, network or internet service provider (ISP) cause email communications sent to/from the prospective Bidder/Awarded contractor and the Purchasing Department to be lost or rejected by any means including email or spam filtering. To register review the COMMBUYS Job Aide COMMBUYS Vendor Registration and/or go to www.COMMBUYS.com.

QUOTE SUBMISSION

This BID requires the submission of electronic quotes. All Bidders are advised to allow adequate time for submission of their quotes by considering potential online impediments like Internet traffic, Internet connection speed, file size, and file volume. DPH is not responsible for delays encountered by Bidders or their agents, or for a Bidder’s local hardware failures, such as computers or related networks, associated with bid compilation or submission. Bids submitted via COMMBUYS are time stamped by the COMMBUYS system clock which is considered the official time of record.

If you plan to submit a quote to this RFR “No Bid” should not be checked anywhere in your quote in COMMBUYS. This includes on the General Screen and the Items tab. Checking No Bid sends your quote to a different location in COMMBUYS than the rest of the quotes for that Bid and you run the risk of the Department not receiving your response. The department will not guarantee that a bid received with a “No Bid” checked will be reviewed.

Section A: Procurement Overview

A1: Procurement Description or purpose

Massachusetts Department of Public Health (DPH), Bureau of Substance Addiction Services (BSAS), seeks proposals for the operation of secure treatment for adult civilly-committed persons pursuant to MGL 123, Section 35. The vendors for this service will provide assessment, admission, treatment, and discharge planning in an environment that is conducive to treatment in an involuntary setting. Vendors will provide affirmative referral and connection to community-based treatment and supports.

Treatment beds will be procured throughout the state, based on system needs. Vendors may propose to operate discrete treatment units or may propose capacity to serve civilly committed persons within an existing service setting.

Vendors currently contracted with DPH under procurement 211129 or 242425 to provide treatment to civilly committed persons must respond to this RFR a minimum of 120 days before the end of their current contracts in order to continue with no break in service. Contracts will be awarded on a rolling basis.

This is a rolling procurement with an estimated total value of $10,500,000. Eligible applicants should include the total anticipated number of individuals to be served by their agency in year one as well as subsequent years in their proposal.

A2: Program Background Information

Massachusetts General Law Chapter 123, Section 35 permits the courts to involuntarily commit an individual who has an alcohol or substance use disorder and demonstrates a likelihood of serious harm as a result of their alcohol or substance use. Such a commitment shall be for inpatient treatment of the individual’s alcohol or substance use disorder.

The Commonwealth is actively seeking vendors that have a demonstrated capacity to effectively, compassionately, and purposefully treat individuals with a substance use disorder (SUD) and co-occurring conditions. Vendors who have a history of treating individuals with a substance use disorder or mental health condition in a secure treatment facility operating twenty-four hours per day, seven days per week, three hundred sixty-five days a year, are preferred. Vendors must also have experience in overdose prevention and response.

Section B: Procurement Information B1: Applicable Procurement Law

Executive Branch Goods and Services

B2: Whether Single or Multiple Contractors Are Required For Contract(s)

Check One (“X”):

B3: Calendar Rule Type

B4: Acquisition Method: Fee for Service:

B5: Use of a Procurement by a Single or Multiple Departments

· Identify additional Eligible Entities by name or type.

The Purchasing Department reserves the right to add or remove additional authorized users during the contract term.

B6: Expected Duration of Contract

B7: Anticipated Expenditures, Funding Or Compensation For Expected Duration

Dollar Amount

Estimated annualized procurement amount $6,000,000

Check One (“X”):

Notice concerning rates of payment – implementation of Chapter 257 of the Acts of 2008: An Act Relative to Rates for Human and Social Service programs, provides that the Secretary of Health and Human Services has the sole responsibility for established rates of payment for social service programs purchased by governmental units of the Executive Office. Contracted vendors will be reimbursed based on rates established by EOHHS regulation, 101 CMR 444, 101 CMR 346, or other applicable rate regulations as may be amended from time to time during the duration of the Contract. As a result of Chapter 257, during the life of the Contract, rates of payment and reimbursement structures may change.

Start Up and Capital Budget Any start-up costs deemed necessary will be negotiated between the purchasing Agency and the provider. Payment rates for start-up costs will be governed by 114.5 CMR 4.00 Rates for Certain Social, Rehabilitation, and Health Care Services or any successor regulation, and 808 CMR 1.00 Compliance, Reporting and Auditing for Human and Social Services. Any capital requests deemed necessary will be negotiated between the purchasing Agency and the provider and will be governed by 114.5 CMR 4.00 and any successor regulation, 808 CMR 1.00 and the Operational Services Division Purchase of Service (POS) Capital Items Procurement Policy.

Will Federal Funds be used to fund any part of Contract(s)?

*Additional information for contracts with Federal Dollars:

Sub-Recipient: Providers receiving federal grant funds will be considered sub-recipients for federal grant purposes and will be required to comply with applicable federal requirements, including but not limited to sub-recipient audit requirements under OMB Circular A-133.

Unique Entity Identifier: On April 4, 2022, the unique entity identifier used across the federal government changed from the DUNS Number to the Unique Entity ID also known as UEI or SAMS number. Any entity that wants to apply for federal contracts or wants to receive federal funds must register with SAM. Entities that use SAM include for profit businesses, nonprofits, government contractors or subcontractors, as well as state and local governments.

Registering with SAM.gov is free and is required for your organization to receive federal funds. Your organization can submit an application to this RFR without being registered on SAM, however if awarded your organization will need to have an active SAM account prior to contract execution.

Unspent Funds: Any funds from Capital, Trust and/or Federal Accounts designated in the budget that are unspent in any fiscal year will not be available for expenditure in the subsequent fiscal year.

Section C: Performance and Contract Specifications

C1: Eligibility

This RFR is for direct services under Office of the Comptroller’s object code classification MM3 or M03. To be considered eligible to apply for this RFR a bidder must be considered an organization. Individuals are not eligible to apply.

Providers of substance use disorder treatment for civilly committed clients will be required to have:

1. A 24-Hour Diversionary Withdrawal Management Service (WMS) license or approval;

2. Clinical Stabilization Services (CSS) license or approval; and

3. Ability to directly provide or provide access to all forms of Medications for Addiction Treatment (MAT).

Providers may be licensed by BSAS or may be licensed by another Massachusetts state licensor and approved by BSAS. All programs must maintain their license or approval and be licensed or approved in good standing with the Bureau of Substance Addiction Services and any other state licensor. In addition to being licensed to provide these services, programs must also be able to provide co-occurring enhanced treatment capacity, recovery coach services, recovery support navigation services, and all forms of Medications for Addiction Treatment.

To receive and maintain the licensure or approval listed in the previous paragraph, programs must be in compliance with the DPH Regulations found in 105 CMR 164.000 (Licensure of Substance Use Disorder Treatment Programs). Further information about the licensure process may be obtained from the licensing inspector in the appropriate region.

C1a: Provider Qualification Requirements

To be considered eligible and prior to entering into a contract with DPH a bidder must demonstrate that it meets minimum administrative and fiscal standards established through the Executive Office of Health and Human Services (EOHHS) provider qualification policy. Your provider qualification status will be considered in making award decisions.

Provider qualification is the process used to evaluate a provider’s administrative and financial condition. The main objectives of the provider qualification process are to determine whether the provider has (a) the capabilities to comply with the numerous federal and state administrative requirements that surround the expenditures of public funds and (b) sufficient fiscal and administrative capacity to fulfill its contractual obligations.

· New Providers of Purchased Human and Social Services to Clients Bidders who do not have current contracts with the Commonwealth of Massachusetts to provide human and social services for clients must submit completed provider qualification application materials as part of the response to this RFR. The Contracting Qualification Forms and instructions can be found in the Provider Qualification Folder (QUALIFICATION) in the attachments section of COMMBUYS for this RFR.

· Current Providers of Purchased Human and Social Services to Clients Bidders with current human and social services contracts (MM3/M03 contracts) must have filed their Uniform Financial Statements and Independent Auditor's Report (UFR) with the Operational Services Division via the internet using the UFR eFiling application for the most recently completed fiscal year before a contract can be executed and services may begin unless considered exempt from filing. Other contractor qualification/risk management reporting requirements and non-filing consequences promulgated by Secretariats or Departments pursuant to 808 CMR 1.04(3) may also apply. If you have questions about your UFR contact the UFR Help Desk at ufrefilehelp@mass.gov.

C2: Scope of Services

The vendors are required to offer clients WMS and Level 3.5 CSS step-down services in accordance with DPH regulations. Treatment facilities must provide structured programming 7 days per week, 24 hours a day.

In addition to existing WMS/Level 3.5 CSS Step-down service elements, the primary service components of the overall program(s) include:

A. Admission/Orientation B. Development of Individual Treatment/Service Plans C. Medical and Psychiatric Services D. Counseling and Education Services E. Behavior Management F. Harm Reduction and Overdose Prevention Education Services G. Use of Restraint H. Discharge, Continuing Care, and Active Referrals I. Transportation J. Other Program Requirements

A. Admission/Orientation

Program must have staff available Monday through Friday to receive calls for admission during the hours of court operation. Selected vendors shall have developed admission criteria for civilly committed patients that reflect the program’s capacity to manage or treat comorbid/coexisting conditions.

Admission to the secure units, and staffing for such, must be available 24 hours a day, including weekends, to accommodate client transport and transfers, which may happen outside of court hours.

A standardized assessment, including an initial medical and psychiatric assessment, must be used at Section 35 treatment programs to evaluate the appropriateness of each client for admission. The program shall meet requirements of 105 CMR 164.133 and 164.152 , providing a psychiatric evaluation for all clients within 72 hours of admissions directly or through QSOA, a medical evaluation within 24 hours of admission by a qualified healthcare professional, and medical follow up as indicated by the evaluation.

· The program will reassess the commitment criteria and levels of risk for each client daily, to be reflected in the Individualized Treatment Plan. All selected vendors will be required to adhere to any standards of care issued by the Department pertaining to civilly committed patients.

· Upon admission, each client must receive an orientation that will describe to the client their status as an involuntary client, including an explanation of their individual rights. All releases of information are to be obtained and in compliance with Federal Law 42 CFR Part 2.

· Client rights must be consistent with the standards set forth in 105 CMR 164.079 and 105 CMR 164.579.

· Clear and consistent behavioral contracting (i.e., agreement of rules and expectations) should be initiated at the time of admission. The client’s orientation includes a description of the rules, activities, and policies of the unit, including an expectation of client participation.

· Behavioral contracting and clear outlining of program expectations and parameters serve as proactive measures for establishing limits for challenging clients. Revisiting and reviewing these documents (consent forms, program guidelines, and behavioral contracts) with the client, at an appropriate time after admission, may prove beneficial in engaging them in the treatment process.

B. Development of Individual Treatment/Service Plans Each client will have a comprehensive individualized service plan that is developed based on information gathered during the admission and evaluation process described above, and that is consistent with Individual Treatment Plan standards set forth for WMS and Level 3.5 CSS in 105 CMR 164.073 or 164.573.

· Development of client service plans include collaborative participation of the client and include the following components: an assessment of the client’s Section 35 commitment in relation to their substance use or alcohol use and other drugs, ongoing assessment of risk of harm levels, identification of any mental health conditions noted in the initial screening, clear and specific service objectives and goals, including crisis prevention planning, and continuing care objectives and goals.

· A comprehensive treatment plan must be developed within a week of admission, updated at least weekly, and as needed through the course of treatment.

· Additional service needs of the client population may include overall compliance/ participation with treatment, compliance with probation/criminal justice, caring for co-morbid mental health conditions, compliance with medication, housing issues, domestic violence/ sexual assault victim and offender counseling, harm reduction, overdose prevention education, and on-site HIV and other infectious disease counseling, testing and risk reduction education.

C. Medical and Psychiatric Services Within WMS and Level 3.5 CSS Step-down services programs, the vendor shall provide:

· On-site psychiatric services that provide comprehensive medical and psychological screening within 24 hours

· Medical and psychiatric assessment and consultation

· Medication reconciliation

· Evaluation of medications

D. Counseling and Education Services Counseling and education services must be sensitive and appropriate to the Section 35 population, in conjunction with regulatory requirements of 105 CMR 164.074, 164.574, and 130 CMR 418.409 (5). The program must provide:

· Trauma-informed services including both individual and group counseling and educational meetings. Counseling and educational meetings should, at a minimum, cover general substance use disorder education, relapse prevention, overdose prevention, and other psychosocial issues such as co-occurring disorders, HIV and infectious disease risk reduction and education;

· Across WMS and CSS, there must be a minimum of 10 hours of group therapy available each day, with each group lasting 45 minutes. Group treatment must include a combination of clinical treatment, nursing education, including physical health and wellness, spirituality, medication education, physical activity, and social skills;

· Daily self-help meetings must be held on-site at the program and “Introduction to Self-Help” must be incorporated into educational meetings during program hours; and

· The program must include family support services such as psycho-educational groups for multiple families and family counseling/meetings with clients, as clinically indicated within a client’s individual treatment plan.

E. Behavior Management It is anticipated that clients who are admitted to the program will respond to firm limit setting and behavioral contracting strategies that emphasize crisis de-escalation, earned privileges, and positive role modeling of staff and other clients as set forth in 105 CMR 164.078.

Selected vendor shall establish and maintain written policies and procedures for managing disruptive behavior including, but not limited to, aggression, harm or threats of harm to self or others, destruction of property, and refusal to comply with program policies. The policies and procedures shall be posted and shall:

· Describe the safeguards for the emotional, physical and psychological well-being of the population served;

· Describe the measures used to promote appropriate behavior;

· Define and explain the behavior management procedures used in the facility including, where applicable:

· level/point systems of privileges, including procedures for the patient's or resident's progress in the program;

· the type and range of clinical interventions a staff member can authorize for misbehavior of residents; and

· behavioral interventions to be used in response to angry or aggressive patients or residents, including de-escalation techniques.

Program staffing, which includes psychiatric consultation, and the requirement for ongoing staff training in behavioral management /violence prevention should ensure a safe and secure environment in the program.

· Explicit behavioral contracting with each client is conducted to reinforce expectations for participation in treatment, diminish treatment resistance, and engage clients in treatment and continuing care.

· Vendors must establish clear protocols for behavior management and provide a plan for crisis intervention and management, including psychiatric assessment, support and referral.

F. Harm Reduction and Overdose Prevention Education Services

Harm reduction is defined as a set of practical strategies and beliefs that is aimed at reducing risks associated with drug use, while utilizing a person-centered approach and non-judgmental way of service provision. It is vital to connect clients to harm reduction agencies and provide overdose prevention resources upon discharge.

Vendors are required to support Massachusetts’ efforts to prevent and reduce overdose, as evidenced by:

· A stated commitment to prevent and reduce overdose;

· Up-to-date knowledge of harm reduction programs, overdose prevention and response resources in their communities, including distributing naloxone rescue kits, fentanyl test strips and information on local harm reduction program upon discharge;

· Partnering with local community-based harm reduction organizations to access educational material about safer use practices, up-to-date drug supply alerts, and naloxone training, among other initiatives.

· Establishing an on-site overdose emergency response plan and ensuring all staff are trained in preventing, recognizing and responding to overdose; For more information please review “Guide to Developing and managing Overdose Prevention and Take-Home Naloxone Projects”

· Including review of overdose history (including witnessing overdose), in treatment assessments;

· Training clients and staff about naloxone administration, overdose prevention, recognition and response;

· Allowing clients to retain possession of naloxone rescue kits while in the treatment program;

· Including opioid overdose risk reduction in treatment and discharge plans.

Vendors can apply to order no-cost naloxone and order fentanyl test strips funded by MDPH-BSAS. In addition, vendors should utilize harm reduction educational materials and free trainings for overdose prevention and response.

G. Use of Restraint

If a vendor intends to implement restraint as a last resort patient safety measure, such restraint may only be used in the limited, emergency circumstances described in 104 CMR 27.12(5)(b). Such restraint shall be limited to the use of physical restraint only, as defined in 104 CMR 127.12(5)(3)(c). Selected vendors must also comply with any written guidance issued by the Department concerning the use of physical restraint.

H. Discharge, Continuing Care, and Active Referrals Discharge from the level of care occurs when:

· The Program Director or a designated Clinical Director has determined and documented that the client’s level of risk regarding danger of harm to self or others, resulting from their substance addiction, has diminished to such a degree that allows for safe transfer to a less-restrictive level of care or discharge;

· The client has indicated willingness to engage in appropriate aftercare and is transferred to an aftercare program;

· The client’s commitment period has expired/reached 90 days; or

· The client is transferred to a more intensive level of medical or psychiatric care and the court has been notified.

Programs must present a plan for the safe and secure transfer of medically or psychiatrically acute civilly committed individuals when such transfer is indicated. The plan should include evidence of a detailed agreement or understanding with the local mental health emergency service program (ESP) provider when ESP intervention is appropriate, to assess and facilitate transfer while including an explicit understanding of the specific nature and needs of civilly committed persons. This plan also must be applied to other transporting entities.

The committing court must be notified within 24 hours after a discharge, elopement, or transfer from the secure unit. Communications should be in compliance with state and federal confidentiality laws.

Programs must meet all aftercare requirements set forth in 105 CMR 164.076 and facilitate access to recovery support navigator services and peer recovery coach services either directly or through referral. Vendors must implement overdose prevention strategies upon discharge by providing clients with harm reduction kits that include naloxone rescue kits, fentanyl test strips and information on local harm reduction services.

· Referrals must be available for a broad range of resources with which the program maintains active linkage agreements. These resources may include but are not limited to community-based substance use disorder treatment, medical, mental health and psychiatric care, domestic violence/ sexual assault victim and offender services, legal support, safe housing, transportation, self-help meetings, vocational training, and other social services.

· The referral may involve accompanying the client to the program itself, according to the needs of the client.

· Referrals must be made to community-based services which promote engagement and provide case management services, including those offered through state agencies such as DMH, DPH, and DDS.

I. Transportation:

· The client will be transported from the committing court by the Sheriff's Department to the treatment facility for admission.

· The treatment facility must provide trauma-informed and appropriate transportation as needed to medical appointments, criminal justice court dates, aftercare programs, or other discharge locations.

· The treatment facility must have plans and agreements in place to ensure safe transportation.

J. Other Program Requirements:

In addition to the service components detailed above, vendors providing Section 35 services must include the following requirements:

1. Client Eligibility

2. Building Site

3. Facility Requirements

4. Staffing

5. Staff Training

6. CORI Checks

7. Payment Requirements/Payor of Last Resort

8. Patient Access to Legal Representatives

1. Client Profile Civilly committed, court-referred individuals may participate in this treatment program if they are assessed by a Forensic Mental Health Clinician (FMHC) at the court who completes an evaluation, and the court has issued a section 35-commitment order. The commitment may be for a period of up to ninety (90) days. The length of stay is determined by the severity of the substance use disorder and by the clinical need as assessed by WMS and CSS facility staff. It is expected that the majority of clients will be stepped down to a less restrictive level of care while still meeting their clinical need.

Should an individual’s status decompensate while admitted at the Section 35 facility, the facility will be responsible for coordinating referrals to providers for higher level of medical or psychiatric care. The facility must have agreements in place to facilitate these referrals to a higher level of care. The facility must also have plans and agreements in place to ensure safe transportation.

2. Building Site:

The program site must contain adequate space to provide the required services. At a minimum, the program should have separate space available for the following:

· Individual bedding to accommodate clients (dorm style housing or bunk style bedding is not acceptable)

· Secure outdoor space accessible to individuals that are civilly committed.

· A community room / common space for utilization when clients aren’t involved in clinical programming (that is of sufficient space to accommodate the clients housed)

· Adequate group meeting/ group therapy space

· Sufficient number of individual therapy offices/ rooms

· Adequate dining room

· Bathing and toileting facilities in accordance with state law

· Nurses station with secure medication storage and adequate viewing of client areas

· Intake area with exam rooms that can accommodate multiple admissions simultaneously while ensuring confidentiality and dignified care.

3. Facility Requirements:

The program must be housed in a facility suitably designed to address any and all security concerns. The goal of creating a secure environment should be used to ensure the safety of the clients and to minimize the risk of elopement.

Minimum requirements include:

· Adequate space in order to provide the required services.

· Interior doors which are appropriately secured to minimize unwarranted movement within the building and that are designed to separate the facility into distinct units, restricting access from one unit to the other.

· Exterior windows must have security features that prohibit any form of unwarranted exit.

· Recreational area(s) must be fully safeguarded utilizing, at minimum, security-grade fencing as required and appropriate to minimize any risk of elopement.

· Security cameras at each point of egress, as well as within each common living area. Video monitoring is also required in any area used for seclusion and/or restraint. As appropriate, any high-risk areas which are not easily and/or readily observed or supervised by staff should be monitored by video surveillance.

· An alarm system designed to safeguard against the threat of fire and detect any unwarranted movement within the facility or warning of any unauthorized exit/entry from/into the building.

4. Staffing:

Section 35 treatment programs shall be staffed to meet the individualized care needs of the Section 35 population.

The facility will be required to demonstrate enhanced staffing patterns to meet the demand of its client’s caseload. The facility must be able to monitor and maintain clients on-site with multiple co-morbidities. In addition, the facility will be required to demonstrate increased and enhanced staffing patterns to accommodate clients presenting with mental health (DSM 5) diagnoses. This will include a dedicated team of mental health professionals with specific knowledge in addictions medicine and with the capacity to prescribe psychotropic medications. Staffing must include:

At a minimum, the staffing pattern for the Withdrawal Management Services (WMS) and Clinical Stabilization Services programs must comply with the BSAS licensing requirements in 105 CMR 164.207 (D) for the WMS and CSS levels of care, requirements for Individualized Treatment and Stabilization (ITS) Tier 1 in and the ability to provide MAT. Staff should also be prepared for the process of bringing MAT patients into the community and ensuring that a seamless transition occurs.

Section 35 treatment programs must maintain a staffing pattern that meets the minimum requirements for patient-safety and care as outlined below. Proposals for large programs should address any extra staffing necessitated by their size.

· A program director who is responsible for the administrative and programmatic day-to-day operations of a program of substance use disorder treatment services and may provide supervision of all non-clinical staff.

· One senior clinician per service type offered who is responsible for the clinical/educational operation for each substance use disorder service offered.

· A Recovery Specialist Support Supervisor who is responsible for supervising Recovery Specialists.

· A Medical Director who is the designated authority responsible for ensuring adequate and quality medical and treatment services for all service types offered.

· A Nurse Director who is responsible for assisting the medical director in ensuring adequate and quality medical and treatment services.

· Dedicated Drivers, available Monday-Friday for 12 hours/day and weekends for 8 hours per day, minimum 1.9 FTE.

· At least one Recovery Specialist per 10 patients per shift, all shifts.

· At least one Clinician per six patients per shift, over 16 hours, 1st and 2nd shift.

· At least one Case Manager/Aftercare Coordinator per six patients per shift, all shifts.

· Two nurses per shift, up to 32 beds then increased in accordance with the ATS staffing grid.

· At least 2 FTE Intake Coordinators available Monday-Friday for sixteen hours per day, 1 per shift; must be RN/LPN.

5. Staff Training:

Training should include, at minimum, trainings covered in 105 CMR 164.044 B2. In-service education, case conferencing, and group and individual clinical supervision are all required to support the professional development and well-being of staff, which aids in reducing staff stress, prevents turnover, and creates a supportive therapeutic environment.

Vendors must present a detailed plan for training staff in evidence-based best practices for substance use disorder treatment, trauma-informed treatment, client behavior management, violence prevention and crisis de-escalation techniques, risk management, and interventions.

In addition, staff must be appropriately trained, educated, and credentialed in their respective disciplines. All staff will be expected to act in accordance with the professional ethics, standards, and guidelines of their dedicated vocation. In addition, all staff will be expected to adhere to the continuing education standards and requirements of their licensing/credentialing board and/or agency. Staff should also be prepared for the process of bringing MAT patients into the community and ensuring that a seamless transition occurs.

Each staff member, regardless of discipline, will be trained in appropriate de-escalation techniques. Each staff member will be expected to participate in re-fresher training in accordance with the standards and protocols set by the training institution.

Each staff member, regardless of discipline, will be educated in preventing, recognizing and responding to overdose, including the use of life-saving measures such as the administration of naloxone. For more information, please review “Guide to Developing and managing Overdose Prevention and Take-Home Naloxone Projects”. In addition, each staff member, regardless of discipline will be trained in basic first aid, cardiopulmonary resuscitation (CPR) for the professional rescuer, and in the use of an automated external defibrillator (AED). Overdose prevention training including the administration of naloxone and CPR for the Professional Rescuer (American Red Cross), Basic Life Support for Healthcare Providers (American Heart Association) or an equivalent level of CPR training must be renewed on an annual basis. Basic first aid must be renewed every two years.

6. CORI Checks The program will need to submit an application with the Criminal History Information Board to conduct background information reviews on employees, in compliance with the Executive Office of Health and Human Services (EOHHS) regulation 105 CMR 15.00.

Section 35 programs shall conduct a Criminal Offender Record Information (CORI) check prior to hiring an individual for any position within a Section 35 program, in accordance with 101 CMR 15.00, including providing qualified rehabilitated offenders with a fair opportunity to be employed and successfully reintegrated into the workforce. In addition, as provided in 101 CMR 15.09(5), the hiring authority must comply with the requirements of the Division of Criminal Justice Information Services (formerly the CHSB) governing CORI at 803 CMR 2.00 et seq.

7. Payment Requirements/Payor of Last Resort:

Programs are required to invoice MassHealth, MassHealth managed care entities, and other commercial coverage. Only where other insurance is not available, programs will be eligible to be reimbursed by BSAS for Section 35 clients at the Individualized Treatment and Stabilization (ITS). Rates for these services can be found at 101 CMR 444.00.

8. Patient Access to Legal Representative:

Programs shall meet patient and resident rights requirements as set forth in 105 CMR 164.079. Patients shall have the right to receive, or refuse, visits and telephone calls from their attorney at any reasonable time, regardless of whether the patient initiated or requested the visit or telephone call.

C2a: DPH Racial and Health Equity Commitment

DPH is committed to improving health outcomes for all Commonwealth residents while eliminating the marginalization and health inequities that disproportionately threaten of the ability for communities of color to reach their full potential of health. Applicants will be expected to design activities through a racial equity lens incorporating the principles for Racial Equity developed by DPH. (See Principles for Promoting Racial Equity in Attachments for this RFR on COMMBUYS). Applicants will also we expected to describe how the current or planned operations of their organization support racial equity. Each prospective applicant should demonstrate how they will incorporate racial equity into their service design. The social marginalization and inequities that racism cultivates in housing, education, employment, the built and social environments, and health care are felt across generations, most acutely in communities of color. DPH reviewers will be required to consider an applicant’s ability to reflect on racial equity and how it is incorporated into the agency operations and program design as they score proposals.

Culturally and Linguistically Appropriate Services (CLAS) can be used as an additional tool to help achieve Health and Racial Equity. The National CLAS standards[footnoteRef:2] incorporate several principles, including but not limited to (1) collecting and analyzing data to better understand structural root causes of racial inequities; (2) building community partnerships to engage those who are most impacted in planning, implementing and evaluating programs; (3) fostering cultural competence to ensure staff understand and reflect the community served; and (4) ensuring language access services to increase quality of services to all communities. Applicants are expected to demonstrate the ability to provide culturally and linguistically competent services, including the ability to provide services to individuals whose primary language is not English, to individuals with disabilities especially the deaf and hard of hearing, to veterans, and to individuals who identify as GLBTQ. For further guidance visit www.mass.gov/dph/healthequity including The Making CLAS Happen Manual, a user’s guide to providing culturally and linguistically appropriate services in a variety of public health settings and the CLAS standards at https://www.mass.gov/lists/making-clas-happen-six-areas-for-action. [2: Adapted from National CLAS Standards and racial equity data roadmap

C2b: Supplier Diversity Program (SDP)

Pursuant to Executive Order 599, the Commonwealth’s Supplier Diversity Program (SDP) promotes business-to-business relationships between awarded Vendors, including health and human service providers, and diverse businesses and non-profit organizations (“SDP Partners”) certified or recognized by the Supplier Diversity Office (SDO).

All Bidders responding to this solicitation are required to make a significant annual financial commitment (“SDP Commitment”) to partnering with one or more SDO-certified or recognized diverse business enterprise(s) or non-profit organization(s). Providers that are issued a contract from this procurement (Bid) will be required to submit an annual “Supplier Diversity Program (SDP) Plan Form for Purchase of Service (POS)” with their Uniform Financial Report (UFR) through the Operational Services Division’s (OSD) eFiling site.

No contract shall be awarded to a Provider without an SDP Commitment that meets the requirements. This requirement extends to all Providers regardless of their own supplier diversity certification.

SDP Program Resources and Assistance: Additional information about the SDP policy can be found in the Attachments section of this RFR on COMMBUYS. Bidders seeking assistance in the development of their SDP Plans or identification of potential SDP Partners may visit the SDP webpage, www.mass.gov/sdp, or contact the SDP Help Desk at sdp@mass.gov.

C3: Performance Requirements and Contract Monitoring

The development of program evaluation and client outcome measures is a high priority for BSAS and its collaborating agencies. BSAS will work with the vendor to adopt standards and measures that reflect the specialized nature of this program and the emerging National Outcome Measures (NOMS). The vendor is expected to submit discrete ESM data for each client admitted to the secure unit. Additional outcome measures may be added over the contract period as they are developed.

3.1 Contract Monitoring, Evaluation and Reporting

The vendor will comply with all requirements of the Department of Public Health, Bureau of Substance Addiction Services. Requirements include:

· Site visits by DPH to the program

· In-person meeting attendance

· Compliance with the Terms and Conditions and Standards of Care, the Executive Office of Health and Human Services (EOHHS) Enterprise Invoice/Enterprise Service Management (EIM / ESM) data submission

· Other section 35 data collection as needed; and

· Collaboration with the BSAS statewide section 35 coordinator The vendor will conduct a consumer satisfaction survey for every client who participates in the program. Data obtained from the surveys will be compiled at a minimum of semi-annually to direct quality improvement actions and initiatives.

The vendor will collaborate with the Bureau of Substance Addiction Services to evaluate treatment effectiveness and outcomes at the program(s) for civilly committed clients. The vendor may be required to submit outcome measurement pre- and post- treatment assessments on all clients to BSAS. As funds allow, the Bureau may conduct an evaluation of the program.

C4: Contract Invoicing Select at least one of the following types of contracts:

· DPH billing procedures through the EIM/ESM system require that contracted providers submit an invoice, on a monthly basis, for all services provided in the previous month.

· DPH requires that this invoice be authorized in EIM-ESM no later than the 14th day of the month, following service delivery. This includes a zero invoice if no services were provided.

· The only exceptions will be when the Bureau has been previously notified of extenuating circumstances and the request has been approved by the bureau contract manager. If corrections need to be made to previously submitted invoices, supplemental invoices must be submitted for the month in which the billing was originally submitted.

· All offsets must be reported for each UFR on the Invoice.

· Refer to the Provider Billing Booklet Reimbursement Policies and Billing in EIM at for detailed invoicing requirements.

1. Providers using the EIM-ESM manual billing process are required to submit a Service Delivery Report (SDR), on a monthly basis, for all services provided in the previous month.

· DPH requires that this SDR be authorized in EIM-ESM no later than the 14th day of the month, following service delivery. This includes a zero invoice if no services were provided.

· DPH requires that all services delivered to clients and paid by a third party be reported on the SDR as fully offset.

· Providers using the HIPAA electronic billing process are required to submit an all claims for the services provided in the previous month no later than the 14th day of the month, following service delivery.

· DPH requires that all delivered services paid by a third party be reported on an 837 HIPAA “encounter”.

· Program service delivery is paid through accommodation rates that are monthly rates developed to cover core services.

· Reports may be required for generation of payment.

Payment through Electronic Funds Transfer (EFT) is required for any contract awarded through this solicitation. If awarded a contract bidders not already enrolled will be required to sign up for EFT as a contract requirement by completing the Authorization for Electronic Funds Transfer Form. Additional information will be sent at the time of contract.

Section D: RFR Evaluation

D1: Evaluation Criteria

Applicants must meet the initial criteria below:

· Identification of an appropriate site on the award date and if needed, a detailed renovation and capital budget plan and timeline.

· Experience providing withdrawal management services in a DMH, DPH HCQ or DPH BSAS-licensed facility.

· Vendors are required to have current status as a MassHealth Provider or demonstrate that an application for provider status has been submitted. Vendors must also have the ability to bill other third-party payers and Managed Care Organizations for medically necessary services.

· Vendors are required to have the capacity to prescribe all forms of Medication for Addiction Treatment.

· Vendors shall have written agreements governing admission priority with both medical and psychiatric facilities, when clinically indicated, at the time of proposal submission.

Applicants that meet the initial criteria will be evaluated against the following additional evaluation criteria:

· Experience providing treatment within a secure, involuntary setting.

· Ability to provide enhanced medical and psychiatric services in a licensed, secure, acute setting.

· Demonstrated experience in the provision of a culturally competent, age and gender-responsive, trauma-informed continuum of substance use disorder treatment services.

· Demonstrated strong working linkages with providers of Residential Rehabilitation Services (RRS), ambulatory services (physical and behavioral health including narcotic treatment and other behavioral health prescribing), community case management programs, harm reduction providers, primary care, mental health services, and other relevant health and human services.

· Experience working with individuals who are civilly committed or with individuals who may be treatment resistant.

D2: Review Process

Proposals will undergo multiple levels of review described below based on the evaluation criteria:

· Technical Review: The quality of the response to each question in the narrative is evaluated by a team of objective reviewers who score each question according to criteria related to that question. Reviewers are instructed to evaluate each question for content, comprehensiveness, and clarity of each answer.

· SDP form: A key component of the technical level review will be the evaluation of the Supplier Diversity Program form. To encourage substantial Bidder supplier diversity initiatives and commitments as measures valuable to the Commonwealth, at least 25% of the total available evaluation points shall be allocated to the evaluation of the SDP Plan submissions. A portion of the score will be allocated to the evaluation of additional equity and inclusion criteria relevant to health and human services.

· Second Level Review: During the second level of review, factors such as an applicant’s past performance, billing, license status, agency demographics, need, resources available, and other criteria are considered and scored. These criteria may vary depending upon the service being procured.

Based on all review scores, recommendations will be made to the Commissioner, who makes the final funding determination.

Section E: Estimated Procurement Calendar

RFR Release Date

December 12, 2023

Deadline for Submission of RFR Q&A.1

Deadline for Submission of Responses Also known as the BID Opening Date in COMMBUYS

Anticipated Contract Start Date

February 1, 2024

1All Questions must be received in writing. Questions can be sent by email no later than the date and time indicated in the Procurement Calendar. All questions should be sent to the email listed in the calendar and should include the RFR title and number in the subject of the email. All Questions with answers will be posted on the COMMBUYS Attachment section for this procurement.

Section F: Instructions for Submission of Responses

F1: Bidder Response Requirements

Potential bidder’s should refer to the Application Response Form found in the Attachments to this RFR on COMMBUYS for required questions to be completed as part of this RFR.

F2: Multiple Quotes

DPH will allow a bidder to upload more than one quote in response to this RFR

Multiple Quotes will be accepted:

F3: COMMBUYS Submission Instructions

All responses are to be submitted electronically using the online submission tools available to bidders registered in COMMBUYS. There is no charge to register in COMMBUYS To Register go to www.COMMBUYS.com and click on the “Register” link on the front page. The COMMBUYS Vendor Registration Job Aide is also available.

All Quotes must be received by the Department of Public Health before the specified date, month, year and time of the Bid Opening Date displayed on COMMBUYS. Times are Eastern Standard/Daylight Savings (US), as applicable.

All Bidders are advised to allow adequate time for submission by considering potential online submission impediments like Internet traffic, Internet connection speed, file size, and file volume.