W19128 - BHPL Amended NOO 10-2024~2.docx

THE COMMONWEALTH OF MASSACHUSETTS

EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH

BUREAU OF HEALTH PROFESSIONS LICENSURE

NOTICE OF OPPORTUNITY W19128

I. Summary The Massachusetts Department of Public Health (DPH) is reissuing this Notice of Opportunity (NOO) due to a change to Massachusetts General Law. Chapter 177 of the Acts of 2022, An Act Addressing Barriers to Care for Mental Health requires the DPH to establish a confidential, voluntary program for monitoring the recovery of the licensed health care professionals who seek support for their mental health or substance use disorder. This service will become available to over 500,000 licensed healthcare professionals in Massachusetts, across 21 separate licensing boards. Work to operationalize this program – the Unified Recovery and Monitoring Program (URAMP) – is at the final stages and DPH expects to launch the new service before the end of the year (2024).

This critical initiative establishes a recovery pathway for healthcare professionals in Massachusetts to return to practice while seeking treatment at the community level of care. Returning to the workforce is a critical element for competent and experienced professionals. Rather than losing these essential licensed professionals from the workforce, the URAMP program will monitor their substance use disorder and mental health recovery goals with the aim of returning to the workforce when they are safe to practice.

DPH currently has two voluntary programs for monitoring the recovery of licensed health care professionals for nursing and pharmacy boards and licensees. DPH currently has an agreement with a single Drug Testing Management Company (DTMC) to provide the toxicology and testing services outlined in this Notice of Opportunity for the existing pharmacy and nursing programs. That agreement was established following a Notice of Opportunity in November 2018. DPH intends to continue using this provider for the same services once it transitions its existing programs to URAMP. However, following analysis of existing caseloads and research from comparable services in other states it is projected that the expansion in scope and breadth of the URAMP service will lead to a 100% increase in overall service caseloads in the opening three years, with a potential influx in the opening year due to the high profile of this work.

DPH is therefore posting this amended NOO to invite any suitably qualified DTMCs to perform the services listed in the sections below if they believe they can provide these services at a better value to the Commonwealth. Otherwise, the DPH will utilize the existing vendor to provide these services for URAMP.

II. Nature and Scope of the Project

The Massachusetts Bureau of Health Professions Licensure (BHPL) offers toxicology monitoring for licensees whose ability to practice has been impaired because of substance misuse. Through monitoring, licensees are given the opportunity to contract for treatment and for monitoring of their recovery program as required by the individual Board. Licensees are permitted to re-enter their health professions practice with monitoring, provided they undergo random toxicology screening to ensure safe practice. The Bureau will require toxicology screening on a random basis for all participants requiring toxicology monitoring per their consent agreement.

This request for services describes the administrative and laboratory tasks and services required for the development, implementation and administration of a comprehensive forensic toxicology drug screening program for a population comprised of licensed health care professionals. The provider shall be responsible for: furnishing all labor, materials, supplies, facilities and trained personnel; collecting all participant fees; receiving, storing, shipping and handling all specimens; testing and analyzing specimens; data processing; reporting test results and statistics to BHPL Staff; assuring required confidentiality safeguards are in place; and providing expert testimony and litigation support materials when requested.

The licensee that participates in mandated monitoring programs may access to numerous controlled substances. This means that in addition to toxicology screening for alcohol, marijuana and other cannabinoids, and other common substances of addiction potential, participants must be screened for said substances commonly prescription drugs with misuse and/or addiction/cognitively impairing potential.

The Bureau of Health Professions Licensure is seeking quotes from DTMCs not only experienced with the administration and execution of a toxicology screening program, but also experienced with administration and execution of such a program for impaired healthcare professionals. The BHPL is aware that some of the drugs are very expensive to screen. Because program participants pay for the costs of the drug screenings, the BHPL is very conscious of the need to keep the costs of the drug screenings as low as possible. To that end, during the contract period, should the DTMC and/or BHPL Staff identify an alternative panel or panels that would allow for maximum public safety at a lower cost to the program participant, this agreement allows for such price adjustments.

The anticipated agreement resulting from this amended Notice of Opportunity will have a maximum duration of approximately five years.

III. Description of Needs

The Commonwealth of Massachusetts, Bureau of Health Professions Licensure, to satisfy a need of the, Unified Recovery and Monitoring Program and Individual Program requires a qualified, credentialed DTMC to administer all aspects of the BHPL toxicology drug screening monitoring. This toxicology drug screening is critical to the fulfillment to monitor licensee to ensure public protection from a licensee’s unsafe practice. Thus, this program must be designed and operated in a way that most effectively ensures protection of the public from unsafe practice and keeps costs for drug screens low. For FY23 and FY24, approximately 253 licensees were active with the Bureau’s current DTMC and required randomized toxicology screening with approximately 55 new enrollments yearly. The current DTMC conducted approximately 3,156 urine toxicology screens, with 93 dilute protocol tests, and 3 “tube B” reconfirmations, and approximately 291 alternative toxicology screens.

The DTMC will be required to perform the tasks and deliver the services listed in this section. The services required by the BHPL in toxicology drug screening programs fall into the following categories.

A. Administration tasks and services, which include but are not limited to:

1. Enrolling BHPL participants in the toxicology screening program.

2. Provide participants online timely access to their results and educate participants on how to access such.

3. Ensuring confidentiality of all participants.

4. Randomizing toxicology screening of participants.

5. Designating appropriate and multiple specimen collection sites throughout the continental U.S., as well as training and monitoring the staff at all sites utilized. Collection sites must provide observed specimen collection.

6. Ensuring collection of specimens (including but not limited to urine, blood, sweat, oral fluid, nail and/or hair), industry forensically accepted storage of specimens and transporting of the specimens to the laboratory in a timely manner.

7. Collecting applicable fees from all BHPL participants.

8. Reporting testing results to the appropriate BHPL Board within 4 to 6 days from collection

9. Reporting on participant noncompliance with program procedures.

10. Maintaining an online database with access afforded to BHPL including probation monitors, URAMP and Bureau staff, as appropriate.

11. Receiving specimen re-testing authorizations from BHPL staff and collecting re-testing fees from participant.

12. Reporting to BHPL staff on participant positive and/or invalid toxicology screen results daily.

13. Providing a certified Medical Review Officer (MRO) to provide a certificate of results.

14. Coordinating the provision of testimony regarding (1) administrative procedures (testimony from the DTMC); (2) collection (testimony from staff at the collection site); (3) laboratory results from the certifying scientist or other expert from the laboratory; and (4) analysis of results from the MRO.

15. Coordinating necessary logistics for testimony and hearing preparation for DTMC, collector and laboratory staff; and collecting re-testing fees from participant for testing with lower cut off parameters.

B. Laboratory Tasks and Services, which include but are not limited to:

1. Performing Quest Medpro Panel E drug screens (or equivalent) on specimens;

2. Performing screens on blood, sweat, oral fluids, nails and/or hair specimens and/or conducting breathalyzer testing when requested by BHPL staff;

3. Performing screens for specific drugs;

4. Confirming positive test results of urine screens by the gas chromatography/mass spectrometry method, or an equally or more forensically acceptable method;

5. Observe participants during collection of specimens;

6. Confirming positive blood, sweat, oral fluid, nail, hair and/or breathalyzer results by the method(s) generally regarded as most forensically accurate according to the National Institute on Drug Abuse (“NIDA”);

7. Automatically performing a second toxicology screen on urine samples that have a low creatinine (Urine Creatinine less than 20mg/dl) to test for drugs at lower cut off levels;

8. Performing all required laboratory procedures in accordance with generally accepted professional standards.

IV. Compensation The DTMC will be responsible for the collection of all fees directly from participants. All fees must be approved, in writing, by the Bureau prior to the collection of said fees. There shall be no compensation provided by the Bureau for services rendered. The Bureau reserves the right to review financial statements related to collection activities associated with Notice of Opportunity and any subsequent agreement(s) related thereto.

V. Application Requirements Please provide a response to each of the following topics.

A. Provide a narrative of your agency’s experience providing services similar to those outlined here.

B. Describe in detail collection/testing process including number of proposed sites and location.

C. Provide listing of key staff, including the primary point of contact, with brief description of their background/experience.

D. Describe your data handling processes to ensure confidentiality of all information.

E. Provide a list of all fees to be charged to individuals with a detailed methodology of how those fees were determined.

F. Provide a detailed description of the fee collection process.

G. Provide a description of the system(s) you will utilize for collecting fees from individuals.

H. Provide a list of all certifications or accreditations.

There will be an opportunity to submit written questions. All questions must be submitted by October 23, 2024. Questions with answers will be posted on COMMBUYS with this Notice.

All application to this Notice of Opportunity from bidders must be mailed or sent via email and received by the Department no later than November 7, 2024. Applications from bidders should be addressed to the Bureau of Health Professions Licensure’s Policy Unit at BHPL-Policy@mass.gov.

BUREAU OF HEALTH PROFESSIONS LICENSURE NOTICE OF OPPORTUNITY – DRUG TESTING MANAGEMENT SERVICES 1

BUREAU OF HEALTH PROFESSIONS LICENSURE NOTICE OF OPPORTUNITY – DRUG TESTING MANAGEMENT SERVICES 1

BUREAU OF HEALTH PROFESSIONS LICENSURE NOTICE OF OPPORTUNITY – URAMP DRUG TESTING MANAGEMENT COMPANY 1