SOW A1 - 988 MiCAL Crisis Line.docx

Michigan.gov/MiProcurement Schedule A1 – Statement of Work Request for Proposal No.260000000897 988 Suicide & Crisis Lifeline /MiCAL Crisis Line This schedule identifies the anticipated requirements of any Contract resulting from this RFP. The term “Contractor” in this document refers to a bidder responding to this RFP, as well as the Contractor who is awarded the contract. The term “Bidder” is used to identify where specific responses to the RFP are required.

The Contractor must respond to each requirement or question and explain how it will fulfill each requirement. Attach any supplemental information and appropriate reference within your response.

IMPORTANT NOTE TO CONTRACTORS/BIDDERS: There are specific requirements for which acceptance must be simply acknowledged through a checkbox(es), and others that require further explanation. Click the appropriate checkbox and complete the entries as appropriate.

BACKGROUND

The Michigan Integrated Crisis and Access Line (MiCAL) is a statewide initiative, intended to provide omnichannel communication methods to provide information, referral, and access to all Michiganders as outlined in the Michigan Mental Health Code at MCL 330.1165. Since the origination of the 988 Suicide and Crisis Lifeline in 2022, MiCAL is responsible for answering 988 calls in Michigan, except where a regional center provides primary service. MiCAL is responsible for answering all Michigan 988 texts and chats. While MDHHS no longer promotes the original MiCAL phone number, the line still receives calls and therefore will be answered as part of this contract. The Contractor(s) must use the State-owned and managed phone system and behavioral health customer relationship management system (BH CRM) for the intake of calls, text messages, and /or chats.

SCOPE

MiCAL will provide comprehensive support for Michiganders in crisis or distress through phone, text, and/or chat. All services will be integrated into broader crisis services systems in Michigan. Prospective vendors must hire and/or employ staff that reside in the state of Michigan to answer calls and supervise call specialist teams. Contractors must have a strong understanding of the state of Michigan, and Michigan’s behavioral health system and resources. The scope of services for the 988 Suicide & Crisis Lifeline and the Michigan Crisis and Access Line (MiCAL) includes the following:

The Contractors must operate the 988 Suicide & Crisis Lifeline 24/7 as a crisis line and act as a 988 Affiliate to answer 988 contacts that originate in Michigan and MiCAL calls. More than one Contractor can receive a contract for these services.

1. Requirements

1.1 General Requirements 988 Suicide & Crisis Lifeline and the Michigan Crisis and Access Line:

Operate the 988 Suicide and Crisis Lifeline call, text, and chat line modalities and the Michigan Crisis and Access Line phone number 24/7 to provide Michiganders with referrals and behavioral health and crisis supports. Must implement a service model of 988 Suicide and Crisis Lifeline as a crisis access point for Michigan’s behavioral health system.

Contractor must adhere to the following definition for crisis and standards for providing access to services via 988 and MiCAL:

“Crisis is defined by the individual/family experiencing it anywhere and anytime”. Vendor must implement this crisis definition throughout services contained within this contract.

Access for All People in the State of Michigan Contractor will not turn away people contacting the crisis line.

The Contractor must provide person-centered, trauma-informed crisis intervention services consistent with 988 Suicide & Crisis Lifeline clinical standards.

Services provided to contactors must include engagement, active listening, validation, collaborative risk assessment, de-escalation, safety planning, and connection to appropriate supports. Based on the individual’s level of distress and need, services must include, as appropriate:

1.1.2.5.1 Crisis intervention and supportive listening

1.1.2.5.2 Resource referral and linkage

1.1.2.5.3 Follow-up contact when appropriate

1.1.2.5.4 Coordination with crisis services and community services contained within the BH CRM.

1.1.2.5.5 Emergency intervention for imminent risk

Contractor must possess and maintain accreditation through the American Association of Suicidology for Crisis lines for each modality of communication provided or obtain accreditation within 6 months of contract start date.

Contractor must be a 988/Vibrant Emotional Health Affiliate able to receive Michigan calls upon service start date and through entirety of Contract term.

Any work product developed for this Contract, including but not limited to processes, procedures, and training will be owned by the State. All processes, procedures, and training created for this Contract are subject to continuous improvement and are contingent upon approval by the Michigan Department of Health and Human Services (MDHHS) and potentially the Department of Technology, Management and Budget (DTMB) Agency Services, in cases where the work products impact functionality of the CRM.

Contractor must notify MDHHS within the first hour by email or phone for any line outages or system interruptions.

List all exception(s):

Bidder must describe how they comply with the above requirement(s):

Please share your implementation strategy for ensuring that 988 is a key access point for behavioral health services and cite past experience that will support your ability to implement this strategy.

Please describe your change management approaching, sharing experience that will demonstrate your ability to implement a project of this size successfully and quickly.

Program Requirements Contractor must develop and follow policies and procedures that meet all national 988 Suicide & Crisis Lifeline Network Agreement requirements and all Michigan 988 best practices and requirements, including but not limited to imminent risk, active rescue, follow up, and chat and text training.

Contractor must develop and, subject to MDHHS approval, roll out a 988 chat and text implementation plan. At this time, 988 Suicide & Crisis Lifeline chats and texts are not being answered in-state. MDHHS is anticipating comparable staffing levels for 988 chats and texts to 988 calls.

Contractor must collaborate with other Michigan 988 centers, actively participate in required Michigan workgroups including but not limited to the Michigan 988 Workgroup and the Michigan 911/988 Workgroup, and follow the policies, procedures, and trainings determined within workgroup meetings.

Must work with MDHHS to develop and leverage a process for managing encounters by multiple contact methods from initial contact to resolution and/or warm hand off to another entity.

Must develop and implement a plan for collaboration and coordination of care for referral to local community-based services, including but not limited to Prepaid Inpatient Health Plans (PIHPs), Community Mental Health Services Programs (CMHSPs), Medicaid Health Plan (MHP) Behavioral Health Providers, and law enforcement.

Contractor’s staff will direct the contactor to the appropriate services, including referral to providers of mental health and/or substance use or any other community program commensurate with the support and services needed by the person contacting the lines.

Referral information should be located within the BH CRM or other MDHHS approved resource data bases and be documented appropriately in the contact encounter.

At least one Clinical Supervisor is to be on shift 24/7/365 to provide supervision and support to staff.

List all exception(s):

Bidder must describe how they comply with the above requirement(s):

Please share your experience demonstrating your success in providing 988 crisis line services. Please cite best practices you implemented.

Please provide a chat and text implementation plan, highlighting any experience you have providing chat and text services.

Describe your experience partnering with crisis services and other behavioral health services, especially services outside of your organization, including any data related to rate of referrals and evidence you will be successful.

Describe follow-up procedures and how connection to care will be supported after the initial contact, when appropriate.

Describe the availability and role of real-time clinical supervision during operations.

Quality Monitoring and Improvement The Contractor must maintain a written quality monitoring and improvement process consistent with 988 Suicide & Crisis Lifeline Quality Improvement standards across all call center service level activities. This plan will be reviewed and approved by MDHHS.

The monitoring program must include ongoing randomized review of interactions across all modalities and cannot be limited to the Lifeline minimum quarterly monitoring requirement. The Contractor must utilize the 988 Lifeline Quality Improvement Monitoring Form within the Vibrant Exchange and respond to all flagged interactions with appropriate corrective action.

All monitoring data submitted to the Lifeline Administrator must also be made available to MDHHS with the same level of detail. The Contractor must provide monthly summaries of quality monitoring activity, trends, and corrective actions to MDHHS.

Confidentiality The Contractor must maintain the confidentiality, security and integrity of client information that is used in connection with the performance of this Contract to the extent and under the conditions specified in HIPAA, the Michigan Mental Health Code (PA 258 of 1974, as amended), the Michigan Public Health Code (PA 368 of 1978 as amended), and 42 CFR Part 2.

All beneficiary information, medical records, data and data elements collected, maintained, or used in the administration of this Contract must be protected by the Contractor from unauthorized disclosure.

Contractor must provide safeguards that restrict the use or disclosure of information concerning beneficiaries to purposes directly connected with its administration of the Contract.

Contractor must have written policies and procedures for maintaining the confidentiality of data, including medical records and client information.

Written policies and procedures related to all applicable privacy and confidentiality laws are to be reviewed and updated annually by Contractor’s designated Privacy Officer.

Contractor will identify the Privacy Officer.

Contractor’s Privacy Officer must attend conferences and training to remain up to date on changes to laws and keep current best practices.

Contractor must ensure that all staff are trained in all applicable laws respecting individual and consumer privacy.

List all exception(s):

Bidder must describe how they comply with the above requirement(s):

Describe the process that will be used to review critical incidents and implement improvements.

Please provide an example of when you made a change to improve quality and how it was determined change was needed.

How do you plan to institute quality improvement or change for a system that operates 24/7?

Please describe the quality monitoring process you would implement for the MiCAL and 988 lines, referencing past experience as applicable.

Staff Qualifications, Training and Support The Contractor must provide the following training:

Contractor must ensure all staff have appropriate training, education, experience, appropriate licensure, and liability insurance coverage to fulfill the requirements of the positions.

For each staffing level, the Contractor must maintain the required education levels, years of experience performing similar work, certification, and licensing for each of the following staffing levels:

0. General: all staff are required to successfully complete crisis intervention training.

0. Crisis Specialist: high school diploma or GED, prefer minimum of 1 year experience in crisis services.

At least one Clinical Supervisor (master’s degree and licensed in the State of Michigan as TLLP, LLP, LLPC, LPC, LLMSW, or LMSW) is to be on shift 24/7/365 to provide supervision of staff.

Manager of Crisis Line/Chat and Text Line: Master’s degree, licensed in the State of Michigan as LLP, LPC, LMSW, LP and 3 years’ experience in crisis field preferred.

Contractor must ensure that all employees receive annual training in recipient rights protection.

All employees are required to take at the time of hire and annually thereafter HIPAA training.

Must utilize ASIST training Training on providing referrals should be provided by the Contractor to staff on a yearly basis.

Must develop and implement a training plan for all staff based on needs identified through Quality Improvement, changes in best practices, and cultural sensitivity to foster continued growth of staff skills and abilities.

Must ensure staff receive behavioral health disaster trainings, such as Psychological First Aid, and partner collaboratively with communities and agencies for disaster behavioral health events.

Must leverage crisis debriefing and supervision model.

Any other training required by MDHHS. All trainings utilized will be approved by MDHHS.

The Contractor must provide documentation and training materials to MDHHS upon request.

List all exception(s):

Bidder must explain its training capabilities and any training that is included in its proposal:

Describe how staff competency will be evaluated prior to independently handling contacts.

Describe how you provide ongoing training to staff to maintain competency.

Describe how staff will be trained to conduct risk assessments, de-escalation, and safety planning.

Describe the decision-making process staff will use to determine the appropriate intervention, including de-escalation, safety planning, referral, mobile crisis activation, and emergency rescue.

Describe how your training plan prepares staff to meet the needs of various populations in Michigan.

Describe your crisis debriefing and supervision model.

Describe the process for providing feedback and corrective actions.

Describe strategies used to retain staff and prevent burnout.

Describe staff wellness and post-critical incident supports.

Funding Source Requirements Must have experience with Substance Abuse and Mental Health Services Administration (SAMHSA) grants and be able to provide detailed accounting to comply with SAMHSA requirements.

List all exception(s):

Bidder must describe how they comply with the above requirement(s):

Please describe any past experience you have complying with SAMHSA grant requirements.

Staffing Work Hours The Contractor must provide Contract Activities 24 hours a day, 7 days a week.

3.2. Staffing Levels

3.2.1 Staffing levels are determined by MDHHS based on service level need and available funding and are subject to change at the State’s discretion. If staffing expectations change, the Program Manager or designee will provide written notice. MDHHS is aware administrative staffing structure may vary based on organizational structure. Final staffing levels will be determined before the actual contract is finalized.

* Staffing for 988 chat and text is excluded from the 90-day transition period as this service is not currently active in-state.

List all exception(s):

Bidder must describe how they comply with the above requirement(s):

Please describe any experience you have operating a 24/7/365 call line.

With these anticipated staffing levels in mind, please submit your hiring plan as part of the project plan referenced in Schedule A, Statement of Work, 3.1, including details on how you will achieve full staffing levels within the 90-day transition period. Given that this contract may be awarded to more than one vendor, if full staffing levels are not feasible, please describe the staffing levels that would be achievable for your organization.

Data Reporting Requirements Leverage methods for measuring success.

Contractor will work with MDHHS to enable it to collect the following data as recommended by Vibrant Emotional Health/988 Suicide and Crisis Lifeline and SAMHSA, including but not limited to call volume, average speed of answer, average length of call, call abandonment rate, percentage of calls resolved by phone (including text or chat), number of mobile teams dispatched, number of referrals provided, and number of first responder-initiated calls connected to care. Call data must be collected in conjunction with the State’s system.

Service level for the 988 Suicide & Crisis Lifeline will be reported on a weekly and monthly basis in a report that is shared with MDHHS monthly. Service level measures the speed of answer and is defined as percentage of calls answered within the specified time period.

Service level is set at 95% answer rate within 20 seconds and a 90% answer rate within 15 seconds.

Service level should never drop below 85% in 20 seconds.

f the rate drops below 85%, Contractor will complete a review protocol preapproved by MDHHS which includes a written explanation on why this metric wasn’t met and steps to improve.

The answer rate for the 988 Suicide & Crisis Lifeline will be reported on a weekly and monthly basis in a report that is shared with MDHHS monthly. Answer rate is defined as the percentage of calls routed to the center that are answered by the center.

Answer rate is set at 90% of all Michigan 988 Suicide & Crisis Lifeline calls routed to the vendor should be answered.

If the rate drops below 85%, Contractor will complete a review protocol preapproved by MDHHS which includes a written explanation on why this metric wasn’t met and steps to improve.

The following items should be reported to MDHHS on a monthly basis Distress scores collected from the BH CRM Number of referrals Number of follow-up calls Abandoned calls Interaction monitoring and encounter reviews Average handle time of interactions Staff occupancy rates Employee vacancies and turnover Report on service quality incorporating a summary review of high-risk callers and all active rescues.

If reporting timelines are not met, Contractor will complete a review protocol preapproved by MDHHS which includes a written explanation on why this wasn’t met and steps to improve.

List all exception(s):

Bidder must describe how they comply with the above requirement(s):

Please share your experience which will allow you to be successful meeting the requirements in this section.

Please describe your process for gathering data and compiling reports, citing specific examples from your experience.

Please provide your answer rate for 988 calls in the past year, if applicable.

Please Note: Should bidders require clarification or have any questions with regard to the SLAs, they should submit them during the Question and Answer Period of this solicitation; please see the Proposal Instructions for the timeline.

(Service Level Agreements (SLA) for this Contract will be as follows:

The Contractor will be held accountable to meet the requirements and the service level requirements established in this Contract.

The State reserves the right to reconsider or amend SLA amounts for split awards should they occur, if a Contract supports more than one SOW.

SLA Metric 1. Call Center Service Level

Service level should never drop below 85% in 20 seconds.

1. $100 credit applied to the next invoice or a check to the State of Michigan will be assessed for each of the first five occurrences of non-compliance in a given calendar year.

2. $500 credit will be applied to the next invoice or a check to the State of Michigan will be assessed beginning with the sixth occurrence of non-compliance and on each occurrence thereafter in a given calendar year.

Extenuating circumstances will be reviewed by the Program Manager before any Service Credits are assessed.

At the discretion of the State, these credits will be applied toward any payable due to the Contractor or be payable directly to the State. Payments made directly to the State will be completed within 10 days of notice of assessment.

SLA Metric 2. Answer Rate

Contractor must notify MDHHS within the first hour by email or phone for any line outages or system interruptions.

1. $100 credit applied to the next invoice or a check to the State of Michigan will be assessed for each of the first five occurrences of non-compliance in a given calendar year.

2. $500 credit will be applied to the next invoice or a check to the State of Michigan will be assessed beginning with the sixth occurrence of non-compliance and on each occurrence thereafter in a given calendar year.

Extenuating circumstances will be reviewed by the Program Manager before any Service Credits are assessed.

3. At the discretion of the State, these credits will be applied toward any payable due to the Contractor or be payable directly to the State. Payments made directly to the State will be completed within 10 days of notice of assessment.

SLA Metric 3. Reporting

1. Distress Scores

2. Number of Referrals

3. Number of Follow-up calls

4. Abandoned Calls

5. Interaction Monitoring and Encounter Reviews

6. Average Handle Time of interactions

7. Staff Occupancy Rates

8. Employee Vacancy

1. 1. $100 credit applied to the next invoice or a check to the State of Michigan will be assessed for each of the first five occurrences of non-compliance in a given calendar year.

2. $500 credit will be applied to the next invoice or a check to the State of Michigan will be assessed beginning with the sixth occurrence of non-compliance and on each occurrence thereafter in a given calendar year.

Extenuating circumstances will be reviewed by the Program Manager before any Service Credits are assessed.

At the discretion of the State, these credits will be applied toward any payable due to the Contractor or be payable directly to the State. Payments made directly to the State will be completed within 10 days of notice of assessment.

List all exception(s):

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