SSQUAL-23 Final BID reposted 10_13_22 F~1.docx

For Internal Discussion Purposes Only

The Commonwealth of Massachusetts Department of Developmental Services (DDS) Central Office

Address: 1000 Washington Street Suite 410 Boston, MA 02108

Contact Name: Elizabeth Sandblom

Email: DDSPOSProcurement@mass.gov

Request for Response (RFR)

Document Title: Support Services Qualification 2023

COMMBUYS BID Number: BD-22-1023-1023C-1023L-71806

DDS RFR Document Number: SSQUAL-23

Reposted: October 13, 2022

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 go to www.COMMBUYS.com.

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. DDS 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.

Table of Contents

1.0 PROCUREMENT SCOPE AND DESCRIPTION

The Department of Developmental Services (DDS) is releasing this BID/RFR to create a qualifying list of providers of Support Services. The SSQUAL-23 BID/RFR will replace the SSQUAL-10 RFR, and any updates to this RFR, that have been posted on COMMBUYS. Contracts awarded as a result of SSQUAL-10 terminated effective June 30, 2022. Providers currently qualified under the SSQUAL-10 RFR and any updates to this RFR, must become qualified under SSQUAL-23 in order to continue service delivery.

DDS is reposting SSQUAL-23 to add two Children’s Respite Support Services as outlined below. Support Services include an array of discrete support services that are intended to provide assistance, skill development, and support in a variety of life areas to DDS eligible individuals. The intent is to offer individualized and flexible ways for individuals and their families, along with their support team, to identify and choose the services that will be most responsive and helpful to them in achieving their goals and support them to live safely and successfully in their home. Most services are designed to be provided on an individual, 1:1 basis, although some services may be provided to small groups of individuals. Refer to service definitions in Section 3.0 for more information.

Support Services included in this RFR/BID available for Adults only:

· Adult Companion

· Behavioral Supports and Consultation

· Individualized Home Supports

· Peer Supports

· Adult Respite Services

· Recipient’s/Family Home

· Caregiver’s Home

· Site Based

Supports Services included in the RFR/BID available for Children only:

· Children’s Respite Services

· Recipient’s/Family Home

· Caregiver’s Home

· Site Based Respite

Services for Adults and Children:

· Family Navigation

This rolling enrollment procurement is designed to qualify agency providers to deliver these discrete Support Services over the life of the BID. Children’s Respite in the Caregiver’s Home and Site Based Respite have been added to the list of Support Services the Department is Bidding through this procurement. Providers can seek initial qualification to deliver one, or any number of these services, based on their interest, capacity, and expertise. Providers that have been Qualified can submit proposals to add other Support Services to their contract up to June 30, 2031.

1.1 Procurement and Contract Structure

This Request for Response incorporates all relevant provisions of 801 CMR 21.00 Procurement of Commodities and Services, the Standard Contract Form and Instructions, the Commonwealth Terms and Conditions for Human and Social Services, the Operational Services Division’s REQUIRED SPECIFICATIONS for POS from September 1, 2019, Attachment C and any amendments and/or additions to these documents during the life of this BID.

This procurement will result in a Master List of providers (also known as bidders) who have been deemed Qualified to provide one or more of the services described below. Proposals will be reviewed and scored by regional Procurement Management Teams (PMT). Bidders whose response meets the scoring thresholds set forth in Section 9 will be awarded a Master Agreement contract. Bidders whose scores are below the scoring thresholds will be deemed not qualified and will need to submit a new response to the RFR in order to be considered again. Bidders may not seek qualification for the same Support Services more than three times during the lifetime of this procurement.

The Master Agreement contract will specify Support Services the bidder is qualified to provide. The Master Agreement contract does not guarantee that the bidder will be engaged by DDS to provide any services. Providers must receive written authorization from DDS prior to delivering services under this RFR. Funding will be managed by the DDS Regional Offices either through a Service Summary Form or other mechanism determined by the Department to track authorized units of service.

1.2 Applicable Procurement Law

Executive Branch Goods and Services

1.3 Whether Single or Multiple Contractors are Required for Contract(s)

Check One (“X”):

1.4 Calendar Rule Type

Open May be reopened at a time and for a duration deemed necessary by the Department.

No responses will be received after the bid open date unless the Department choses to reopen the RFR at a later date.

|X|

Rolling Bidders may submit unsolicited proposals during the entire contract period. Providers can continue to submit proposal up to June 30, 2031. Proposals submitted after the initial due date will be reviewed and scored on a quarterly basis unless otherwise noted in the RFR/BID

1.5 Acquisition Method

1.6 Use of Procurement by a Single or Multiple Departments

· Massachusetts Rehabilitation Commission

· Massachusetts Commission for the Blind

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

1.7 Expected Duration of Contract

Anticipated Duration up to: 10 year(s)

Final End Date of this Contract: June 30, 2032

1.8 Anticipated Expenditure, Funding or Compensation for Expected Duration

Estimated Value of Procurement: $120 Million

All services in this RFR are subject to appropriation. Should funding levels be adjusted significantly, the Department may seek provider re-affirmation of willingness to continue under modified program requirements.

At any time during the duration of the contract, the Department may conduct reviews of services and may consider taking corrective action, up to and including cessation or termination of all or part of the services covered under the Contract. Reasons for taking corrective action include: the provider has not satisfactorily achieved performance goals; the needs of the individuals change to the extent that they can no longer be appropriately served under the original terms of this procurement; a provider is unable to meet licensing or certification standards, or other issues or circumstances arise that support the conclusion that a significant change in services is in the best interests of the individuals served or the Department. Generally, unless a termination notice has been given pursuant to the Commonwealth Terms and Conditions for Human and Social Services, the contract will remain in force for the duration of the procurement. The Department reserves the right to make contract awards for a shorter duration when it is in the best interests of individuals, the Department, or the Commonwealth.

Check One (“X”):

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

Capital, Trust and Federal Accounts Only:

Any funds designated in the budget that are unspent in any fiscal year will not be available for expenditure in the subsequent fiscal year.

Notice concerning rates of payment: M.G.L. c 118E 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. Contractors will be reimbursed based on rates established by the Executive Office Health and Human Services in 101 CMR 414.00: Family Stabilization Services, 101 CMR 420.00: Rates for Adult Long Term Residential Services, 101 CMR 423.00: Rates for Certain In-Home Basic Living Supports, and other applicable rate regulations as may be amended from time to time during the duration of the Contract. Rates of payment and reimbursement structures may change during the life of the Contract.

In limited cases, the Department may approve cost reimbursement contracts to cover expenses related to respite projects supported with the America Rescue Plan Act (ARPA) Act funding.

Commercial Earnings Fees (for profit entities): Refer to 808 CMR 1.00. Compliance, Reporting and Auditing for Human and Social Services, 1.03 (6). The commercial earning fee shall be equal to the current surplus revenue retention limit stated in 808 CMR 1.03 (7).

2.0 OVERVIEW

The mission of the Department of Developmental Services (DDS) is to create, in partnership with others, innovative and genuine opportunities for individuals with Intellectual and Developmental Disability, including Autism Spectrum Disorder, to participate fully and meaningfully in, and contribute to their communities as valued members.

The Support Services BID/RFR includes an array of discrete support services that are intended to provide assistance, skill development, and support in a variety of life areas to DDS eligible individuals. The intent is to offer individualized and flexible ways for individuals and their families, along with their support team, to identify and choose the services that will be most responsive and helpful to them in achieving their goals, support them to live safely and successfully in their home, foster self-advocacy, and meaningfully participate in their local communities. Most services are designed to be provided on an individual, 1:1 basis, although some services may be provided to small groups of individuals. Refer to service definitions in Section 3 for more information.

Many of these services will only be available to adults; however, this procurement also contains specific services that can be available to children less than 18 years of age. The services available to adults are inclusive of individuals who are eligible for DDS adult services based on meeting the criteria of Intellectual Disability; Autism Spectrum Disorder; Prader-Willi Syndrome; and/or Smith-Magenis Syndrome. Therefore, it is important for providers to consider how they will tailor the services they are interested in providing to be responsive to the diverse abilities, strengths, interests, challenges, and support needs of the individuals seeking services. Services need to be delivered in ways that are consistent with the Department’s commitment to diversity, equity, and inclusion.

The Department has several overarching principles and strategic initiatives that serve as a framework guiding the delivery and intended outcomes of these Support Services. All services need to be planned and delivered using person-centered planning approaches and practices, based on the principles of individual choice and self-determination. This involves choice in the selection of services that individuals and their family/guardians think best meets their assessed needs, as well as choice of service providers, and satisfaction with their supports.

The adoption and integration of Positive Behavioral Supports (PBS), that includes a broad range of strategies for helping individuals improve their social and functional skills while preventing problematic behaviors, is intended to transform how services are provided to individuals. PBS incorporates person-centered practices, gentle teaching approaches and is pro-active by focusing on changing the physical and/or social environment that triggers difficult behaviors in order to prevent them from occurring.

Increased access to and utilization of Supportive Technology is another strategic area of focus to promote skill development, independence, and enhanced quality of life. It will be important to consider how supportive technology may be a helpful resource and tool that can be integrated into how these services are delivered.

The services being BID through SSQUAL-23 for adults are Home and Community Based Waiver Program services, with the exception of Family Navigation. This enables the Department to maximize Federal Financial Participation (FFP) for adults enrolled in one of the Waiver Programs. These services are designed to maximize individual choice, a requirement of the Center for Medicare and Medicaid for Waiver Program services, in addition to supporting the Department’s overall commitment to self-determination. Waiver services have specific service limits, which consist of limits on frequency and duration.

In order for individuals to be considered for a particular service, they must have an identified need for the service as determined by the DDS Area Office and support team. Many of these services are specifically designed to support adults who live with their family, while some also support individuals who live more independently in their own home. For adults living with their family these services provide options to create ‘wrap-around’ supports that can meet both the needs of the individual as well as support the family in their caregiving role. The respite services available to both children and adults provide an important break and support for family caregivers.

Specific support services can be delivered virtually to supplement in person services. Virtual service delivery refers to services both through interactive video conferencing technology and phone calls. These visits are delivered directly with the service recipients using a device or phone and a secure video conferencing platform. Support services included in this RFR that can be provided virtually with prior approval include Behavioral Supports and Consultation, Individualized Home Supports and Peer Supports. Further guidance on delivery and billing for virtual services will be issued by the Department in FY23.

Providers who are qualified for specific services will be expected to recruit, train, and supervise potential agency employees. They will also be responsible for matching the prospective personnel to individual and families expressed needs. Development of approaches to assess satisfaction and quality of services will be important to consider as an integral aspect of service delivery.

All services contained in this procurement will be offered statewide and successful qualification enables providers to deliver services on a statewide basis. However, providers will be asked to select the initial geographical areas for which they intend to deliver services. These designations are meant for informational purposes and do not limit the regions where providers may offer services. Over time, providers may expand services qualified to provide to other areas based on staffing, regional need for services, etc. but will not need to re-apply to expand geographic areas for service delivery.

Over the life of the RFR/BID, DDS may determine that it is in the best interest of the Department to add other support services to the list of qualifying Support Services included under SSQUAL-23. Announcement of additional service models will be made via COMMBUYS, and current qualified providers will be given the opportunity to qualify for these additional Support Services.

DDS Licensure and Certification Qualified Providers of SSQUAL services, must be re-qualified by the Office of Quality Enhancement (Licensure and Certification) every two years if they wish to continue to be a SSQUAL qualified provider.

· Providers of SSQUAL services that only require re-qualification, will need to return a Renewal Form and complete all sections stating:

· Interest in renewing status as a qualified SSQUAL provider,

· Whether the provider has a current and valid DDS license or a current and valid license from another Massachusetts state agency, and

· Attestation that specific policies and procedures are in place for SSQUAL services qualified to provide.

· If the provider does not have a current and valid state agency license, they will be subject to an abbreviated renewal process that consists of a review of documentation (desk review) to ensure that qualification criteria are met.

Licensure: The following services require licensure

· Adult Site Based Respite

· Adult Respite Provided in a Caregiver’s Home

· Individualized Home Supports (IHS) if provider is serving individual(s) 15 hours a week or more

Providers of site based respite and/or respite provided in a caregiver’s home as well as providers of IHS services that exceed 15 hours a week, must have and maintain a license in good standing in order to provide these services. Providers in deferred status or on a track for de-licensure will be maintained on the qualified provider list until all applicable processes (e.g., follow-up, corrective action plans) have been completed and a decision regarding licensure status is finalized. Providers in either deferred status or on a track for de-licensure shall not be referred any new business unless and until they move out of that licensure status.

Providers and/or sites that are not currently licensed for site based respite services, IHS services (15 hours or more), or respite in a caregiver’s home must submit a request for licensure prior to initiation of service(s) under this RFR and are subject to an initial review of the health, safety, and human rights protections, within 60 days.

Licensure of Providers New to DDS Qualified providers who are not previously licensed and have received referrals to begin a service subject to DDS licensure, must notify the DDS Office of Quality Enhancement (OQE) of their intent to provide services and must begin the application for licensure. Site-based services will undergo a review prior to operation. Additionally, OQE will conduct an Initial Review within 60 days of initiating services that focuses on essential safeguards related to health, environmental and personal safety and protection of rights. OQE will conduct a full licensure/certification survey within six months of the Initial Review.

If a provider is unable to maintain its certification or licensing status for a Support Service qualified to provide, the Department will take steps to amend the Master Agreement contract. This can include informing a provider that the organization is no longer qualified to provide a specific Support Service, amending the Master Agreement contract, and/or terminating the Master Agreement contract. Should any of these actions be taken, a provider may submit a new proposal to provide the Support Service through COMMBUYS once any licensing or certification concerns have been addressed.

3.0 SERVICE DEFINITIONS

This section includes information relating to Support Services for which the Department is seeking to qualify providers to include operational specifications of each service, program and staff requirements, pricing information, etc. Bidders seeking to deliver a specific support service/s must submit a response demonstrating that they meet the qualification standards set forth under each service

Minimum Staffing Requirements for All Programs:

The following requirements must be met for all staff, including any staff engaged as an independent contractor, who are employed to deliver services stated in this RFR. Certain services have established additional minimum requirements. Please refer to requirements stated under specific service definitions. Requirements stated in service definitions are in addition to those stated below.

· Be 18 years of age or older

· Criminal Offense Records Inquiry (CORI)

· Pursuant to Chapter 234 of the Acts of 2014, all individuals who qualify to provide these services who have the potential for unsupervised contact with persons with an intellectual or developmental disability are subject to fingerprint-based background checks (NBC)

· Pursuant to Chapter 19 of the Acts of 2020, employers that provide services to individuals between the ages of 18 to 59 with ID or DD are required to consult the Disabled Persons Protection Commission (DPPC) Registry of Abuse Care Providers prior to hiring prospective employees

Staff with titles that require credentials or professional licensure must maintain and continue to meet all licensing/certification requirements. Staff may not represent themselves with titles associated with credentialed/licensed titles unless they maintain an active credential/license in that discipline.

3.1 Adult Companion

DDS Activity Code: 3707

Description:

This service consists of non-medical care, supervision, and socialization provided to an adult living in their own home or in their family home. The service is provided to carry out personal outcomes identified in the individual’s plan that help the individual to successfully reside in their home or family home; offer companionship; and support the individual to engage in social activities and community life. Services may include assistance with meals, basic activities of daily living, and light housekeeping tasks that are incidental to the care and supervision of the individual. This service does not entail hands-on nursing care. Services may be delivered in the person’s own home, family home, or in the community.

This service may be provided as a one-to-one support for the individual or in small groups (1:2 or 1:3).

Services Available To:

· Individuals who are eligible for DDS adult services with an Intellectual Disability, Autism Spectrum Disorder, Prader-Willi Syndrome, or Smith-Magenis Syndrome

· Individuals who reside in the community and live with their family, or in their personal home. This service is not available for individuals who live in 24-hour licensed group home settings

· Referrals for services are made from the DDS Area Office and subject to DDS approval

Program and Staff Requirements:

Agencies seeking qualification are responsible for the recruitment, training, and supervision of staff who must meet the minimum qualifications set forth below as well as the Minimum Staffing Requirements stated in Section 3.0. Agencies will also be responsible to ensure that staff have the specific competencies needed to meet the unique support needs of the individual receiving services, as defined by the Area Office and support team.

Agencies are required to have qualified staff members who:

· Possess a High School diploma, GED, or equivalencies or relevant competencies

· Possess appropriate qualifications as evidenced by interview(s) and two personal or professional references

Agencies are responsible to ensure that staff:

· Be knowledgeable about what to do in an emergency

· Be knowledgeable about how to report abuse and neglect

· Have the ability to communicate effectively in the language and communication style of the participant;

· Maintain confidentiality and privacy of the individual

· Respect and accept different values, nationalities, races, religions, cultures, gender and sexual orientations, and standards of living (or socioeconomic status)

· Have the specific competencies needed to meet the unique support needs of the individual receiving services as defined by the Area Office and support team

Pricing / Rates:

Rates of payment will be established under 101 CMR 414.00: Rates for Family Stabilization Services. In FY2023, DDS intends to align reimbursement rates for Adult Companion services with those for Respite in Recipient’s Home (Hourly). Over the life of this procurement, DDS may issue guidance modifying rate levels.

3.2 Behavioral Supports and Consultation

DDS Activity Code: 3710 Description:

This service is designed to support individuals to remediate identified challenging behaviors or to acquire socially appropriate behaviors. These services are necessary to improve the individuals’ independence and integration in their community. Behavioral supports and consultation are provided by professionals in the fields of psychology, social work, mental health, or special education.

Service Elements:

The service may include:

· Functional assessment by a trained qualified clinician

· Development of a positive behavior support plan which includes the teaching of new skills for increasing new adaptive replacement behaviors, and decreasing challenging behavior(s) in the participant’s natural environments

· Intervention strategies

· Implementation of the positive behavior support plan and associated documentation and data analysis

· Monitoring of the effectiveness of the plan. Monitoring of the plan will occur at least monthly or more frequently as needed

The functional assessment and development of the behavioral support plan must be completed by a Qualified Clinician as defined below. Staff that hold a bachelor’s degree may implement the plan under the direction and supervision of the Qualified Clinician.

In order to carry out these behavioral supports, training, consultation and technical assistance to paid and unpaid caregivers may be provided to enable them to understand and implement the positive behavioral support plan at home. This service will include any changes to the positive behavior support plan when necessary. The professional(s) shall be available to provide recommendations to the ISP team and the Service Coordinator including making referral recommendations to community physicians and other clinical professionals that support the assessment findings.

The behavioral supports and consultation must be consistent with the DDS regulations as stated in 115 CMR 5.14 Standards to Promote Dignity. Access to this service is only permissible by prior authorization through the Area Office Psychologist or the Area Director. This service is available in the participants home or in the community. This service is expected to be primarily delivered in person. In limited circumstances, Behavioral Supports and Consultation may also be delivered virtually to supplement scheduled in-person services.

Behavioral Supports and Consultation does not include any service covered by the Medicaid State Plan including individual, group, or family counseling, or under private insurance including benefits under ARICA. If the participant has a co-occurring mental health diagnosis, those services must be accessed through the Medicaid State Plan. As the payer of last resort, all other sources of payment must be exhausted before the Department can be invoiced for this service.

Services Available To:

· Individuals who are eligible for DDS services with an Intellectual Disability, Autism Spectrum Disorder, Prader-Willi Syndrome, or Smith-Magenis Syndrome

· Individuals who reside in the community and live with their family/caregiver

· This service is not available to individuals who live in 24-hour licensed group home settings or shared living

· Referrals for services are made from the DDS Area Office and subject to DDS approval

Staffing Requirements In addition to Minimum Staffing Requirements stated in Section 3.0, staff or independent contractors providing this service for a provider agency must meet all relevant state and federal licensure requirements in their discipline. Doctoral degrees in psychology, education, medicine, or related discipline, and any related state licensure are preferred.

Qualified Clinicians shall at a minimum be currently licensed in Massachusetts in accordance with applicable law as one of the following:

· Psychologist

· An independent clinical social worker (LICSW)

· An applied behavior analyst

· A master’s or doctorate level speech pathologist

· A physician

· A master’s or doctorate level teacher with certification in special education

· A licensed mental health counselor (LMHC), or be a doctorate level special education teacher actively teaching the topics of positive behavior support or applied behavior analysis at the college or university level

In addition, the Qualified Clinician must:

· Have at least 3 years of training including post graduate class work or formal training and/or experience in function based behavioral assessment and treatment, and

· At least 3 years of clinical experience in the treatment of individuals with developmental disabilities

A PBS Qualified Clinician’s duties include providing supervision of:

· Clinicians who meet criteria noted above but do not have a minimum of three years of experience, and

· Personnel who have a bachelor’s degree in:

· Psychology

· Social Work

· Applied Behavior Analysis

· Speech or Language Pathology

· Education with one year of post graduate experience working with individuals with developmental disabilities

Providers of Behavioral Supports and Consultation will be subject to biannual review by the Department’s OQE unit. As part of this re-qualification process, providers may be subject to review of licensure and experience of Qualified Clinicians to ensure compliance with DDS regulations.

Pricing / Rates:

Rates of payment will be established under 101 CMR 414.00: Rates for Family Stabilization Services. Over the life of this procurement, DDS may issue guidance modifying rate levels

3.3 Family Navigation

DDS Activity Code: 3700

Family Navigation is a term used widely across DDS family support services. For the purposes of this RFR, the Family Navigation service only refers to Navigation services contracted as a stand-alone service. Agencies currently providing Family Navigation services as part of the DDS/DESE program, Agency with Choice, and through Family/Cultural/Autism Support Centers do not need to apply for this service in order to continue providing these supports.

Description:

Family Support Navigation provides unbiased expert information and referral services that are designed to assist families to identify their needs and strengths, explore resources, and facilitate access to local generic supports through coordination between the family and other service providers.

Service Elements:

· The Family Navigator acts as a guide and resource development expert to ensure families have knowledge of and access to a broad array of both community resources and state funded services, provides assistance in navigating the service system, and recognizes and promotes the value of natural supports.

· They assist families to identify their strengths and develop individualized family support plans, including emergency contingency plans.

· The Family Navigator serves as a resource developer for the family and facilitates opportunities for families to connect with other families to promote collaborative networks. Navigators also need to be responsive to the diversity of families seeking support based on culture, ethnicity, language, gender, sexual orientation, and religion.

Services Available to:

· Individuals who are eligible for DDS adult services with an Intellectual Disability, Autism Spectrum Disorder, Prader-Willi Syndrome, or Smith-Magenis Syndrome

· Individuals who reside with their family, or in their own home and are dependent on their family for daily supports

· Referrals for services are made from the DDS Area Office and subject to DDS approval

Program and Staffing Requirements:

Agencies providing Family Navigation need to be able to provide culturally responsive services to families with varied cultural and linguistic needs. This includes being able to provide on-demand telephonic interpretation, or access to interpretation services and translation of essential documents. This may include coordination and collaboration with other grass-roots and community organizations that provide services in different cultural and linguistic communities.

Services need to be available and provided on a flexible schedule that may include week-ends and evenings, in order to be responsive to the specific needs, work schedules, and time constraints of families. Staff need to be mobile and able to meet families in their homes or other preferred settings in their local communities.

Agencies are required to employ qualified staff members who meet the following requirements:

· Meet the Minimum Staffing Requirements stated in Section 3.0

· Program staff must have a Bachelor’s Degree and experience in the Human Services field, or, five years’ experience working in the Human Services field.

· Program staff should have experience working with families and children and adults with intellectual and developmental disabilities including Autism Spectrum Disorder, and co-occurring physical, behavioral and mental health challenges.

· Staff must be knowledgeable about different clinical interventions and resources, and have competency in assessing family needs, and utilizing a variety of planning and problem-solving approaches.

· Staff must be knowledgeable about public benefits, entitlements, and generic resources available in the geographic areas in which they provide services, and relevant to families at different life stages.

· Staff must be knowledgeable about trauma-informed service delivery and have experience working with families who face a variety of social and economic challenges, such as substance use disorder, housing instability, etc.

Pricing / Rates:

Rate of payment are established under 101 CMR 414.00 Rates for Family Stabilization Services.

In order to contract for this service, Agencies that currently operate DDS funded Family/Cultural/Autism Support Centers must be able to clearly delineate between the staff and navigation services that are funded through the support center contract, and any additional hours of service purchased through a Family Navigation contract. Staff that are already funded through the support center contract cannot be additionally contracted to provide hours through the Family Navigation service.

3.4 Individualized Home Supports

DDS Activity Code: 3703

Description:

Individualized Home Supports consists of services and supports in a variety of daily life activities that may be provided on a regular or intermittent basis. This service provides the support and supervision necessary for the individual to maintain a living arrangement in the family home. Individualized Home Supports are provided for less than 24 hours per day and are not available for individuals living in a 24/7 residential facility or group home. This service is expected to be primarily delivered in person. In limited circumstances, Individualized Home Supports may also be delivered virtually to supplement scheduled in-person services. The Department will be updating guidance to clarify when providers of Individualized Home Supports can provide services virtually.

Service Elements:

Individualized Home Supports includes the assessment, development, and implementation of Individual Service Plans. This process emphasizes a person-centered planning approach that includes the family to the extent possible. An Individual Service Plan is developed based on participant assessment and services are limited to the amount specified in the ISP. Services must also include ongoing engagement and communication with the individual’s family to assist in the planning and coordination of activities and supports that will be provided, especially related to skill development offered in the home.

Services identified in the ISP may include, but are not limited to, assistance and support in the following areas:

· Teaching and fostering the acquisition, retention, or improvement of skills related to personal finance, health, shopping, meal preparation, use of community resources, community safety, and other social and adaptive skills to live in the community

· Training and education in self-determination and self-advocacy to enable the individual to acquire skills to exercise control and responsibility over the services and supports they receive and to become more independent, integrated, and productive in their communities

Providers may also assist in coordinating other services and supports on behalf of the individual.

Providers of Individualized Home Supports must have systems in place whereby individuals and/or their family may reach program staff outside of normal business hours. Providers must also have plans in place to ensure adequate back-up staffing in cases where normal program staff are not available.

Services Available to:

· Individuals who are eligible for DDS adult services with an Intellectual Disability, Autism Spectrum Disorder, Prader-Willi Syndrome, or Smith-Magenis Syndrome

· Individuals who reside in the community and live with their family/caregiver

· This service is not available to individuals who live in 24-hour licensed group home settings

· Virtual delivery of these services is not available to individuals enrolled in a DDS Remote Supports and Monitoring program

· Referrals for services are made from the DDS Area Office and subject to DDS approval

Program and Staff Requirements:

Agencies seeking qualification as Individualized Home Support Providers are responsible for the recruitment, training, and supervision of staff who must meet the minimum qualifications set forth below as well as the Minimum Staffing Requirements stated in Section 3.0. Agencies will also be responsible to ensure that staff have the specific competencies needed to meet the unique support needs of the individual receiving services, as defined by the Area Office and Support Team.

Agencies are required to have qualified staff members who:

· Possess a High School diploma, GED, or equivalencies or relevant competencies

· Possess appropriate qualifications as evidenced by interview(s) and two personal or professional references

Agencies are responsible to ensure that staff:

· Be knowledgeable about what to do in an emergency

· Be knowledgeable about how to report abuse and neglect

· Have the ability to communicate effectively in the language and communication style of the participant;

· Maintain confidentiality and privacy of the individual

· Respect and accept different values, nationalities, races, religions, cultures, gender and sexual orientations, and standards of living (or socioeconomic status)

· Have the specific competencies needed to meet the unique support needs of the individual receiving services as defined in the Individual Support Plan

Pricing/Rates:

Rates of payment are established under 101 CMR 423.00: Rates for Certain In-Home Basic Living Supports.

In FY2023, the Department intends to continue purchasing Individualized Home Supports predominantly at Level C, as stated in 101 CMR 423. In addition, DDS may authorize services at Level F for individuals with significant clinical, behavioral health, and/or medical needs who require staff with higher levels of education and/or experience. Determinations will be considered by the DDS Area Office on a case by case basis. Staff providing services at Level F must hold a Bachelor’s degree or have equivalent education and experience. Over the life of this procurement, DDS may issue guidance modifying allowable rate levels and assessment processes.

3.5 Peer Supports

DDS Activity Code: 3716

Description:

Peer support services are designed to provide training, instruction, and mentoring to individuals in the areas of self-advocacy, leadership development, civic participation, public benefits, participant direction of services, and to foster fuller engagement in community life. The service enhances the skills and capabilities of the individual to function more independently in the community and/or family home. Activities may include helping individuals develop their public speaking skills, ability to make presentations, to move into leadership roles within self-advocacy organizations, and to effectively participate and contribute as members of advisory groups and other civic organizations.

This service may also include mentoring and guidance by similar age peers without disabilities to facilitate access and exposure to different activities and settings and foster welcoming environments for individuals supported by DDS, as well as promote socialization and meaningful involvement in inclusive opportunities, such as on college campuses, in clubs or on sports teams.

This service may be provided in small groups or as a one-to-one support to the individual. Supports may also be provided as one peer providing support to another peer (the service participant/recipient) to promote the individual’s ability to be involved in self-advocacy. The one-to-one peer support is instructional; it is not counseling. While Peer Supports are often provided in person, they can be provided virtually with prior approval of the Area Office. Further guidance will be issued by the Department in FY23.

Services Available to:

· Individuals who are eligible for DDS adult services with an Intellectual Disability, Autism Spectrum Disorder, Prader-Willi Syndrome, or Smith-Magenis Syndrome

· This service is available to individuals residing in the community who live with family or in their own home, and licensed residential group homes

· Referrals for services are made from the DDS Area Office and subject to DDS approval

Program and Staff Requirements:

Agencies seeking qualification to provide Peer Support Services are responsible for the recruitment, training, and supervision of staff. Providers must have experience in supporting self-advocacy and providing skills training to promote independence. Agencies need to employ individuals with disabilities who are self-advocates, supporters of self-advocates, or other similar-age peers who must be able to communicate effectively in the language and communication style of the individual to whom they are providing support. The applicant must have experience in providing peer support, self-advocacy, skill development and training to promote independence.

Staff in this program may be engaged as either employees of the provider or as independent contractors. However, the manner of employment arrangement shall not preclude compliance with requirements for background checks set forth in Section 3.0, Minimum Staffing Requirements for All Programs.

Pricing/Rates:

Rates of payment are established under 101 CMR 414.00: Rates for Family Stabilization Services. Over the life of this procurement, DDS may issue guidance modifying rate levels

Respite Services: Overview

Respite services available to individuals and families supported by DDS are available through several different approaches including Family Support flexible funding allocations administered by contracted Family Support Centers and Programs, self-direction, and from qualified provider agencies. The respite services in this procurement described below are for the qualification and delivery of this service from a provider agency who is responsible for the hiring, training and supervision of staff who will be providing respite to an individual and their family.

3.6 Respite for Adults

Service Description:

Respite services provide support and supervision to individuals on a short-term basis, including on a short-term overnight basis, who are unable to care for themselves when the primary caregiver is absent or there is a need for relief for those persons who normally provide care for the individual. These services are also inclusive of enrichment and socialization experiences for the individual while providing a break for the caregiver. Assistance with basic activities of daily living may be provided incidental to the support and supervision of the individual, but this is not a primary focus of the service. Providers must track provision of respite services and any personal care supports.

Respite services are available to adults who live with their families and can be provided in the recipient’s/family home, in the home of a caregiver, or in a site-based respite setting. Respite may be provided for varying lengths of time depending on the needs of the family, funding availability and within Waiver service limits. This service often reduces family/caregiver stress and thereby helps preserve the family unit, support family stability, and prevent lengthy and costly out-of-home residential placements.

While the primary focus of respite is to provide a short break for caregivers, these services can include accompanying and supervising individuals to participate in social, recreational, and enrichment activities in a variety of community activities and settings. There can be many secondary benefits for individuals engaged in respite which can include the development of skills, interests, and greater independence, while also providing opportunities for enjoyment and socialization with peers. Ultimately, the benefits to individuals receiving this service can also have a positive impact on the family unit and may contribute to minimizing stress and creating greater stability.

There are three different settings where respite services for adults may occur. More detailed information about the specific requirements and standards for each of these types of respite is provided below. Providers can seek qualification to deliver respite services in one or more of these settings but will need to meet the specific standards for each of these settings and service models. Respite services can be provided on an hourly basis, or overnight/daily basis depending on the needs of the individual and their caregiver.

· Recipient’s/Family Home

· Caregiver’s Home

· Site Based

3.6 (1) Respite for Adults in the Recipient/Family Home DDS Activity Code: 3731 (hourly)

Respite in the recipient/family home is typically a planned service that can occur in the home of the family/caregiver, in the community, or be based at community settings. This service is provided in-person typically on a 1:1 basis, but it may also be provided in small group settings that include 1:2 or 1:3 ratios of staff to participants.

Service Elements:

· Communication with the individual and family to understand their expectations for the respite service and identify the specific interests and support needs of the person, including approaches to be responsive to unique communication styles and to address specific health, safety, behavioral challenges, etc.

· When respite is provided in the home, the respite worker will review any safety concerns and considerations with the caregiver to ensure a safe environment.