Technical Quotation Information Sheet.pdf

IMPORTANT INFORMATION TO KNOW:

Technical Quotation forms posted with this solicitation must be completed in their entirety and submitted with attachments required; no other format utilized will be accepted for review.

It is imperative that the Technical Quotation information is legible, detailed oriented and limited to the requested information (e.g., do not provide the history of Cognitive Behavioral Therapy, or the benefits of such; do not provide an explanation of what a Clinical Assessment is, or why it is beneficial).

The Technical Quotation forms must reference only the specific location for the quote submitted (e.g., provide specific information such as the hospital that will be utilized during a crisis; if the quotation is for a city in Scranton, AZ.

All information must be answered on the Technical Quotation form provided, unless otherwise specified.

Limit the number of attachments submitted to those specifically requested. Information submitted beyond what is required or sections written in as will not be considered for review or evaluation.

The Technical Quotation form provides directions on labeling attachments. Please ensure that attachments are sequential, labeled correctly, and correspond to the appropriate question.

The Decision Rule Criteria (DRC) is located on second page of this document and also located on the solicitation posted on beta.Sam.gov. Please refer to this when completing the packet for submission. Failure to provide the requested documentation will delay the ability to review the quotation in its entirety.

Technical Quotation information responses with use of subcontractor(s) and/or multiple site locations (within the geographical restrictions) must adhere to the following:

Submission of one, comprehensive Technical Quotation (from only the Primary Contractor), that addresses all factors on the form, including providing required attachments. Quoters who fail to furnish any of the below submission requirements shall be excluded from consideration.

The Technical Personnel form must be organized per site. The Authorized Negotiator must be identified on the prime contractor’s form, and sign all of the Technical Personnel form(s) submitted.

1. Facility Requirement – Proposed Location(s): The Quoter must provide treatment at performance sites that meet the specified restrictions, space requirements, ADA compliance guidelines, and that do not present safety risks to the community. [SOW 7.1 & 7.2.1]

a. List addresses for all proposed performance sites, including subcontractors, who will provide the following services, Substance Use Disorder and Mental Health Services, and that are within: a 5-mile distance from Scranton City Hall, 340 N Washington Ave, Scranton PA 18503 and located within a half mile from a County of Lackawanna Transit (COLTS) bus or subway stop.

b. Submit a deed, lease, bill of sale, option or intent to lease, or option to buy in the name of the Quoter, or subcontractor, if applicable, for all addresses listed in 1a.

Federal Bureau of Prisons Community Treatment Services Contract

COMMUNITY TREATMENT SERVICES 2020

DECISIONAL RULE CRITERIA – LPTA

c. Provide the methods and means that will be used to ensure individual and group rooms will be private and confidential during treatment sessions. [SOW 7.1.1]

d. Submit an office diagram (see attached example) for each proposed performance site listed in 1a. The diagram must identify all rooms that will be used as counseling space, i.e., individual, group, or psychiatric treatment rooms, as well as any areas used for a waiting, lobby or reception area. The location of the restroom facilities should also be identified. [SOW 7.1.1]

Specify on the office diagram the number of people each group room can comfortably accommodate.

Therapeutic group rooms must be primarily dedicated to treatment or reserved for outpatient community treatment services.

e. Complete and submit the attached Americans with Disabilities Act (ADA) Checklist for each proposed performance site listed in 1a. [SOW 7.1.1]

f. Complete and submit the attached Local Areas of Concern document for each proposed performance site listed in 1a. This document must identify the following areas of concern that are within: 500 feet. This must include the same space and/or same building, of each proposed performance site, and include a plan to mitigate risk to children and other vulnerable populations:

Schools, day-care centers, playgrounds, developed or improved parks, athletic fields, churches, school bus stops, and any facilities/businesses that primarily care for/educate/entertain minors or other vulnerable populations. [SOW 7.2.1]

2. Staffing Requirement: The Quoter must have key personnel to meet the solicitation requirements. The Quoter must ensure all personnel providing clinical services to Bureau inmates meet the experiential, educational, and appropriate licensure/certification as required by the state authority where the services will be rendered. [SOW 5.1]

a. Submit the Technical Personnel document that identifies the position and responsibility of all personnel proposed to meet or exceed the minimum staffing requirements of key personnel in table 3a below. All key personnel must be identified on this document. [SOW 5.2]

b. Submit copies of current and valid professional licenses for clinical staff. Clinical licenses submitted must be listed in table 3b below and must correspond to the respective clinical duties performed. [SOW 5.4]

• If unable to produce an original license, provide a license verification sheet with a copy of a government-issued photo identification card for the staff member.

• If submitting a non-medical license that is not listed on the table below, complete the Mental Health/Behavioral Health Professionals Scope of Practice Summary. Any licenses other than those listed below will be reviewed on a case-by-case basis.

c. Psychiatric/Medication Monitoring: Submit a Drug Enforcement Agency Controlled Substance

Registration Certificate for a qualified practitioner with prescriptive authority who meets the standards of practice established by the state’s professional regulatory board to provide psychiatric evaluations and medication monitoring. [SOW 5.4.5]

3. Operational Requirement – Cognitive Behavioral Therapy (CBT): The Quoter must demonstrate adherence to the CBT model of treatment or other evidence-based programming compatible with CBT. [SOW 2.2]

a. Submit two cognitive behavioral methods or techniques that will be used with Bureau inmates in the delivery of Community Treatment Services (CTS). Limit response to listing the methods or techniques that will be used; do not provide explanations or descriptions of the methods or techniques, unless not a widely known form of treatment. [SOW 2.2.1]

4. Operational Requirement – Crisis Interventions: The Quoter must provide emergency crisis intervention assessments, when necessary. The Quoter must have the ability to complete a Crisis Intervention Evaluation and Report, contract line item number (CLIN) 6000, within 24 hours of the request made by CTS staff. [SOW 4.3.9]

a. Identify on the Technical Personnel document key personnel able to conduct a comprehensive diagnostic interview and submit a written report within 24 hours of referral for emergency crisis interventions.

3a. Minimum Staffing Requirements of Key Personnel Identify the following on the Technical Personnel Document:

Authorized Negotiator Key Personnel for Substance Use Disorder Services Key Personnel for Mental Health Services Key Personnel for Psychiatric Services

3b. Professional Licensing Requirements for Clinical Staff All clinicians must be licensed or certified in the state of Pennsylvania and must be able to practice independently, without supervision, in the state of Pennsylvania.

Mental Health/ Substance Use Substance Use Psychologist Licensed Professional Counselor (LPC) Licensed Social Worker (LSW) Psychiatrist

Certified Drug and Alcohol Counselor (CASAC)

Masters Addictions Counselor (MAC)

Certified Clinical Mental Health Counselor (CCMHC)

[Statement of Work (SOW) reference] [October 1, 2020]

FEDERAL BUREAU OF PRISONS

COMMUNITY TREATMENT SERVICES

TECHNICAL QUOTATION INFORMATION

Name of Company:

Authorized Negotiator:

Solicitation Number:

Directions: Provide detailed and concise written responses to all of the areas below and submit all supplementary documentation as a complete technical quotation packet. Please limit your responses to what is requested in this document.

1. Facility Requirement – Proposed Location(s): The Quoter must provide treatment at performance sites that meet the specified restrictions, space requirements, ADA compliance guidelines, and that do not present safety risks to the community. [SOW 7.1 & 7.2.1]

a. List addresses for all proposed performance sites, including subcontractors, who will provide the required services within the solicitation’s restrictions in the Decisional Rule Criteria (2.1 of SF

1449).

RESPONSE:

b. Submit a deed, lease, bill of sale, option or intent to lease, or option to buy in the name of the

Quoter, or subcontractor, if applicable, for all addresses listed in 1a.

RESPONSE: Attach documents for all addresses listed in 1a. ☐

c. Provide the methods and means that will be used to ensure individual and group rooms will be private and confidential during treatment sessions. [SOW 7.1.1]

RESPONSE:

d. Submit an office diagram (see attached example) for each proposed performance site listed in 1a.

The diagram must identify all rooms that will be used as counseling space, i.e., individual, group, or psychiatric treatment rooms, as well as any areas used for a waiting, lobby, or reception area.

The location of the restroom facilities should also be identified. [SOW 7.1.1]

Specify on the office diagram the number of people each group room can comfortably accommodate. Therapeutic group rooms must be primarily dedicated to treatment or reserved for outpatient community treatment services.

RESPONSE: Attach an office diagram for all addresses listed in 1a. ☐

e. Complete and submit the attached Americans with Disabilities Act (ADA) Checklist for each proposed performance site listed in 1a. [SOW 7.1.1]

RESPONSE: Attach completed ADA Checklist for all addresses listed in 1a. ☐

f. Complete and submit the Local Area of Concerns document. This document must identify the following areas of concern that are within the solicitation restrictions listed in the Decisional Rule

Criteria (2.1 of SF 1449), to include the same space and/or same building, of each proposed performance site, and include a plan to mitigate risk to children and other vulnerable populations:

Schools, day‐care centers, playgrounds, developed or improved parks, athletic fields, churches, school bus stops, and any facilities/businesses that primarily care for/educate/entertain minors or other vulnerable populations. [SOW 7.2.1]

RESPONSE: Attach completed Local Area of Concern form for all addresses listed in 1a. ☐

2. Staffing Requirement: The Quoter must have key personnel to meet the solicitation requirements.

The Quoter must ensure all personnel providing clinical services to Bureau inmates meet the experiential, educational, and appropriate licensure/certification as required by the state authority where the services will be rendered. [SOW 5.1]

a. Submit the Technical Personnel document that identifies the position and responsibility of all personnel proposed to meet or exceed the minimum staffing requirements of key personnel identified in the Decisional Rule Criteria (2.1 of SF 1449). All key personnel must be identified on this document. [SOW 5.2]

RESPONSE: Attach completed Technical Personnel document. ☐

b. Submit copies of current and valid professional licenses for clinical staff. Clinical licenses submitted must be listed in the Decisional Rule Criteria (2.1 of SF 1449) and correspond to the respective clinical duties performed. [SOW 5.4]

If unable to produce an original license, provide a license verification sheet with a copy of a government‐issued photo identification card for the staff member.

If submitting a non‐medical license that is not listed on the table below, complete the Mental

Health/Behavioral Health Professionals Scope of Practice Summary. Any licenses other than those listed below will be reviewed on a case‐by‐case basis.

RESPONSE: Attach professional licenses for all clinical staff listed as key personnel on 3a. ☐

c. Psychiatric/Medication Monitoring: Submit a Drug Enforcement Agency Controlled Substance Registration Certificate for a qualified practitioner with prescriptive authority who meets the standards of practice established by the state’s professional regulatory board to provide psychiatric evaluations, medication monitoring, and MAT services, as applicable. [SOW 5.4.5]

RESPONSE: Attach DEA certificates for qualified practitioners listed on 3a. ☐

3. Operational Requirement – Cognitive Behavioral Therapy (CBT): The Quoter must demonstrate adherence to the CBT model of treatment or other evidence‐based programming compatible with

CBT. [SOW 2.2]

a. Submit two (2) cognitive behavioral methods or techniques that will be used with Bureau inmates in the delivery of Community Treatment Services (CTS). Limit response to listing the methods or techniques that will be used; do not provide explanations or descriptions of the methods or techniques, unless not a widely known form of treatment. [SOW 2.2.1]

RESPONSE 1:

RESPONSE 2:

4. Operational Requirement – Crisis Interventions: The Quoter must provide emergency crisis intervention assessments, when necessary. The Quoter must have the ability to complete a Crisis

Intervention Evaluation and Report, contract line item number (CLIN) 6000, within 24 hours of the request made by CTS staff. [SOW 4.3.9]

a. Identify on the Technical Personnel document key personnel able to conduct a comprehensive diagnostic interview and submit a written report within 24 hours of the referral for emergency crisis interventions.

RESPONSE: Attach completed Technical Personnel document listing key personnel for crisis intervention assessments. ☐

Example Office Diagram – 1D

For each proposed performance site listed in 1a, submit an office diagram:

Identify all rooms that will be used as counseling space.

Include any areas used for a waiting, lobby, or reception area.

Identify the location of the restroom facilities.

Specify the number of people each group room can comfortably accommodate.

ADA Compliance Checklist – Table 1E Submit the following checklist to assess each proposed performance site for accessibility.

Please note this is not a complete or detailed checklist for ADA compliance.

More information can be found at: www.ada.gov

Proposed Performance Site Address:

Solicitation Number:

Existing Buildings and Facilities Yes No NA

1 Are accessible entrances clearly marked? ☐ ☐

Is there an accessible route to an accessible entrance from parking, drop-off points, public transportation, and public sidewalks?

Is there at least one entrance that is accessible (e.g., with a level entrance or ramp)?

If there is more than one floor or level, is each connected by an elevator with accessible controls?

Do doors have a 32-inch clearance and usable hardware (e.g., lever handles)?

6 Are signs accessible to people who are blind or have low vision? ☐ ☐

Are accessible restrooms provided with accessible stalls and lavatories and directional signage?

If the site where services will be provided are not accessible, can the services be moved to accessible locations or can other modifications be made to ensure participation by those who have disabilities?

Provide a plan for ADA compliance and estimated completion date for any “NO” responses above:

Click or tap here to enter text.

Local Areas of Concern – Table 1F Identify any of the following areas of concern, including those in the same space and/or same building, that are within the restrictions of 2.1 of

SF1449 for each proposed performance site and submit a plan to mitigate risk to children and other vulnerable populations: schools, day-care centers, playgrounds, developed or improved parks, athletic fields, churches, school bus stops, and any facilities/businesses that primarily care for/educate/entertain minors or other vulnerable populations.

The plan to mitigate risk to children and other vulnerable populations must include details to limit or eliminate contact with the local areas of concern identified.

The following table must be completed fully with all appropriate information for each proposed performance site.

Name of Company:

Proposed Performance Site Address:

Solicitation Number:

Area of concern:

(name and location/address)

Distance from proposed perfor-mance site:

Days & hours of operation:

Potential risk or negative impact of proposed site to area of concern.

Plan to mitigate potential risk or negative impact.

Technical Personnel List – Table 3A

Proposed Performance Site Address:

Solicitation Number:

Last Name, First Name

Required Key Personnel Professional License and Numb.

or Admin Position

Title

License Expiration

Date

Employee or Subcontractor?

EVALUATION

USE ONLY AN SU MH

C R

IS

IS

IN

T E

R V

P S Y

SO

M A T

1 ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ L ☐ PA

2 ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ L ☐ PA

3 ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ L ☐ PA

4 ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ L ☐ PA

5 ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ L ☐ PA

6 ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ L ☐ PA

7 ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ L ☐ PA

8 ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ L ☐ PA

9 ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ L ☐ PA

10 ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ L ☐ PA

Professionals Scope of Practice Summary – Table 3B

State:

Profession Licensing Board and Website

Scope of Practice Scope of License

Professionals Scope of Practice Summary ***EXAMPLE*** State: Somewhere (SW), USA

Profession Licensing Board and Website

Scope of Practice Scope of License

Licensed Professional Clinical Counselors

(LPCC)

SW Board of Behavioral Health and Therapy www.bbht.state.sw.us/Home/tabid/10

The scope of practice of a licensed professional clinical counselor includes, but is not limited to:

1. implementation of professional counseling treatment interventions including evaluation, treatment planning, assessment, and referral;

2. direct counseling services to individuals, groups, and families;

3. counseling strategies that effectively respond to multicultural populations;

4. knowledge of relevant laws and ethics impacting practice;

5. crisis intervention;

6. consultation; and

7. program evaluation and applied research.

(S.W. 148B.50)

Practice Independently

Clinical Social Worker (LICSW)

SW Board of Social Work www.socialwork.state.sw.us

May engage in clinical practice. Clinical practice is the diagnosis and treatment of psychosocial function, disability, or impairment, including addictions and emotional, mental, and behavioral disorders, including plans based on a differential diagnosis. Treatment may include psychotherapy.

(S.W. 148D.050)

Practice Independently

Licensed Social Worker (LSW)

SW Board of Social Work http://www.socialwork.state.sw.us/

Practices under supervision. May not engage in clinical practice.

Practice includes:

1. assessment

2. case management ‘

3. client-centered advocacy

4. client education and counseling

5. crisis intervention

6. referral

(S.W. 148D.050)

Requires Supervision